Infectious endocarditis caused by Bartonella henselae associated with infected pets: two case reports.

BACKGROUND: Blood culture-negative infective endocarditis is a potentially severe disease that can be associated with infectious agents such as Bartonella spp., Coxiella burnetti, Tropheryma whipplei, and some fungi. CASE PRESENTATION: Reported here are two cases of blood culture-negative infective endocarditis in patients with severe aortic and mitral regurgitation in Brazil; the first case is a 47-year-old white man and the second is a 62-year-old white woman. Bartonella henselae deoxyribonucleic acid was detectable in the blood samples and cardiac valve with vegetation paraffin-fixed tissue samples. Additionally, an investigation was carried out on patients' pets, within the context of One Health, and serum samples collected from cats and dogs were reactive by indirect immunofluorescence assay. CONCLUSIONS: Even though the frequency of bartonellosis in Brazil is unknown, physicians should be aware of the possibility of blood culture-negative infective endocarditis caused by Bartonella, particularly in patients with weight loss, kidney changes, and epidemiological history for domestic animals.

Changes in AIDS risk behaviors among homosexual male physicians and university students.

Two samples of homosexual men, 64 physicians and 58 university students, reported profound decreases in several sexual practices linked to transmission of acquired immune deficiency syndrome (AIDS). The physicians showed the greater reduction. When sociodemographic variables, health beliefs, feeling of control over outcome, mood, sexual interest before the AIDS epidemic, and medical care utilization were correlated with decrease and/or increase in AIDS risk behaviors, the clusters of variables most strongly correlated with change in risk behaviors differed between the physicians and students. Interventions designed to change behaviors in AIDS high-risk groups should be tailored for specific subgroups.

Illness concerns, attitudes towards homosexuality, and social support in gay men with AIDS.

High levels of illness-related psychologic distress, marked social stigmatization and loss of social support, and negative internalized feelings towards homosexuality have previously been reported in homosexual men with the diagnosis of acquired immune deficiency syndrome (AIDS). We assessed 50 homosexual or bisexual men who were within 3 months of their AIDS diagnosis with respect to medical status, illness concerns, attitudes towards homosexuality, and social support. Subjects reported levels of illness-related concerns comparable to previously studied cancer patients. Their attitudes towards homosexuality were similar to previously studied healthy homosexual males. Their social support needs were variable, as was their satisfaction with specific types of social support. Their social networks were moderately small. In this AIDS subject group, illness concerns, attitudes toward homosexuality, and social support satisfaction were significantly correlated with each other, and with previously reported levels of psychologic distress and subjective (but not objective) measures of health status.

[Cutaneous leishmaniasis: incidental outbreak in a new endemic area?].

In the autumn of '94 we saw 32 patients with cutaneous leishmaniasis from a newly populated areas south of Yerucham. Yerucham had never previously been reported as a focus of leishmaniasis. Ongoing construction in the town and the health hazards that resulted may play a part in this new situation. There are a number of ways of controlling and preventing outbreaks leishmaniasis. They include elimination of the vector, Phlebotomus and its host, the gerbils as well as their food supply, "maloach" bushes, other health hazards and vaccination of the population. Patients were treated according to the severity of disease. It is still too early to determine whether our efforts to limit the spread of the outbreak have been successful.

Electrophoretic Deposition of Chitosan/h-BN and Chitosan/h-BN/TiO2 Composite Coatings on Stainless Steel (316L) Substrates.

This article presents the results of an experimental investigation designed to deposit chitosan/hexagonal boron nitride (h-BN) and chitosan/h-BN/titania (TiO2) composites on SS316L substrates using electrophoretic deposition (EPD) for potential antibacterial applications. The influence of EPD parameters (voltage and deposition time) and relative concentrations of chitosan, h-BN and TiO2 in suspension on deposition yield was studied. The composition and structure of deposited coatings were investigated by FTIR, XRD and SEM. It was observed that h-BN and TiO2 particles were dispersed in the chitosan matrix through simultaneous deposition. The adhesion between the electrophoretic coatings and the stainless steel substrates was tested by using tape test technique, and the results showed that the adhesion strength corresponded to 3B and 4B classes. Corrosion resistance was evaluated by electrochemical polarization curves, indicating enhanced corrosion resistance of the chitosan/h-BN/TiO2 and chitosan/h-BN coatings compared to the bare stainless steel substrate. In order to investigate the in-vitro inorganic bioactivity, coatings were immersed in simulated body fluid (SBF) for 28 days. FTIR and XRD results showed no formation of hydroxyapatite on the surface of chitosan/h-BN/TiO2 and chitosan/h-BN coatings, which are therefore non bioactive but potentially useful as antibacterial coatings.

Structured group intervention model for AIDS patients.

We have gathered and analyzed data on 50 gay men with AIDS before and after a ten-week structured group intervention aimed at reducing psychological distress and improving coping skills. Among the major findings have been information relating coping strategies to depression and anxiety, information about the support networks of people with AIDS, and the relationships between coping strategies, support networks and psychological mood states. We have also found that structured group interventions comprised of problem solving techniques, health education, relaxation training and emotional support are helpful in reducing anxiety and depression and in teaching people more positive ways of coping with their illness.

Pilot study of the efficacy of spent grain dietary fiber in the treatment of constipation.

Spent grain is the crude fiber obtained by decanting the fermented distillate of barley. The spent grain was processed to yield dietary fiber composed of: cellulose and hemicellulose 65.6% (by weight), lignin 5.2%, pectin 2.2%, protein 10.9% and lipid 8.0%. Biscuits and scones were prepared by 25% substitution of wheat flour by fiber, yielding 7 to 8 g fiber per biscuit/scone. Nineteen ambulatory patients with chronic, laxative-dependent constipation were treated in a pilot study for 4 weeks with 20 to 25 g fiber daily. Fifteen patients (79%) showed improvement in some or all of five factors, while four patients were largely unresponsive to fiber. Specific symptoms improved as follows: bowel movement frequency in 15 patients (79%), flatulence in 12 (63%), abdominal pain in 10 (53%), stool consistency in 8 (42%) and laxative dependence in 14 (74%). A 4-week post-treatment follow-up showed a return to prefiber status in 11 of 13 improved subjects. This preliminary study suggests a role for spent grain fiber in the treatment of constipated patients, and a comparative study with placebo and wheat fiber is now warranted.

The relationship between medical and psychological status in newly diagnosed gay men with AIDS.

We assessed current medical and psychological status in 50 homosexual/bisexual males who were within 3 months of the diagnosis of AIDS. Subjects had typically impaired cellular immunity, relatively well-maintained physical performance capacity, and reported surprisingly good current health status, in spite of significant numbers of medical symptoms. While as a group they reported moderate levels of psychological distress, intact self-esteem, and a high quality of life, a significant minority reported high psychological distress, low self-esteem, and low quality of life. Psychological distress was correlated with subjective, but not objective, measures of current health status.

História familiar e escolar em crianças com otite média secretora / Familiar and school history in children with otitis media with effusion

Os autores fazem uma revisäo de 54 casos de crianças, atendidas em clínica privada, que tiveram firmado o diagnóstico de otite média crônica secretora. Foram levantados os dados de história fornecidos pelos pacientes, seus pais, professores e analisados em termos de freqüência em que ocorreram. Após revisäo de literatura sobre possível seqüelas e, com isto, da necessidade de diagnóstico e tratamento precoces. Tentamos chamar a atençäo para dados de história que, embora muito pouco valorizados, consideramos de suma importância para que seja feita esta hipótese diagnóstica