Knowledge of genotypic resistance mutations among providers of care to patients with human immunodeficiency virus.

A questionnaire assessed clinician knowledge of genotypic resistance mutations in human immunodeficiency virus. Only 24% of respondents were able to identify at least 1 mutation for each of > or =4 drug groups listed, and 36% were unable to match any mutations with any of the drug groups. Knowledge was most deficient among providers caring for < or =50 patients (P=.001) but also was poor among the 38 physicians caring for > or =100 patients (mean patient load, 211 patients).

Auditory evoked potential abnormalities in cluster headache.

Mid-latency and long-latency auditory evoked responses were investigated in 27 patients with cluster headache who had a mean age of 38.7+/-9.7 years and who were free of pain at the time of testing. Twenty-five age-matched healthy persons served as controls. Latencies and amplitudes of corresponding responses (N100, P200, and P300) were measured. The parameters were calculated at Pz for the P300 and Cz electrodes for the N100 and P200. Multiple analysis of variance revealed a significant overall effect of group (P=0.011). P200 amplitude was significantly smaller in cluster headache patients (P=0.0002). No differences were found for N100 or P300. These data suggest a hitherto unrecognized defect in the information processing pathways, in the early attentive phase represented by the P200 component.

Clinical effect of imiquimod 5% cream in the treatment of actinic keratosis.

BACKGROUND: Actinic keratosis (AK) is the earliest clinical manifestation of squamous cell carcinoma. Metastatic SCC causes the majority of the 1300 to 2300 deaths attributed to nonmelanoma skin cancer in the United States each year. Recent studies have shown that intralesional administration of interferon can be used successfully in the treatment of AK. OBJECTIVE: Imiquimod is an immune response modifier, currently approved for the treatment of genital warts. The topically applied immune response modifier acts by up-regulating interferon and other cytokines involved in the cell-mediated immune response at the site of application. The aim of this was to determine the efficacy and safety of imiquimod 5% cream for the treatment of AK. METHODS: Twenty-two patients with AK lesions were treated with imiquimod 5% cream, initially at 3 times per week for 8 weeks, or until total clearance of lesions. Patients applied imiquimod to lesions on one side of the body and vehicle cream to the other side. A total of 17 patients who completed treatment were evaluated for number of lesions and adverse reactions before treatment and at weeks 2, 4, 6, and 8 after initiation of treatment. AK lesions were also assessed 4 and 8 weeks after treatment. RESULTS: A significant reduction in the average number of lesions per patient was observed for patients treated with imiquimod. The most frequent reactions to treatment were erythema, itching, and scabbing; however, all adverse events were mild to moderate. CONCLUSION: Imiquimod 5% cream may be a promising treatment for AK.