AIDS Awareness among Clinical Dental Students of Karnataka, India.

Objective: HIV-infected patients, with or without knowledge of their own serologic status are seeking dental care in increasing numbers. Dental students are at the risk of exposure to the HIV infections during their clinical training if adequate and stringent infection control measures. The objective of the present study was to assess the level of understanding and awareness of this disease among the third year clinical dental students at a private dental institution in Mangalore, Karnataka, India. Materials and methods: A cross sectional survey of 100 third year clinical dental students of Karnataka was carried out using a self-administered questionnaire. The questionnaire comprised of sociodemographic details, apart from 8 questions on knowledge and 2 questions on attitude towards HIV/AIDS patient. Descriptive analysis was carried out. Results: The response rate was 100%. Majority of students’ knew that AIDS is a disease of immunity. About 78% of the students knew that HIV/ AIDS is transmitted by contaminated blood products. Eighty six percent of the subjects knew which test was done to detect AIDS while others were not quite sure of it. Only 15% answered correctly regarding the percentage risk of transmission of HIV to a health care worker following contaminated needle stick injury. Most of the students were either not aware or not sure about the universal precaution measures to be taken while treating an AIDS patient. Conclusion: The results showed that the third year dental students of Karnataka, India had fair knowledge and good attitude regarding HIV/AIDS. However it did reveal some of the inadequacies and misconceptions regarding the disease among the dental students.

Polymyositis: rare complication of hepatitis B vaccination. An unusual cause of toxic shock syndrome

Transient weakness of the legs developed in a 17 year-old male high school student three weeks after the initial injection of a hepatitis B vaccine. Seventeen days after the second injection of the vaccine, low-grade fever, a pruritic maculopapular rash appeared and weakness of the legs recurred. This was associated with elevation of the creatinine kinase to 2,406 U/L. The day after admission he became afebrile and in the subsequent four days the rash improved but leg weakness persisted. One-month later, muscle strength had returned; and the creatinine kinase had returned to normal levels. The only case of dermatomyositis associated with hepatitis B vaccination and the findings in the six reported cases of surface antigen-positive hepatitis associated with polyomyositis or dermatomyositis are briefly reviewed. Hepatitis B vaccination should be encouraged, but it is important to be aware that, rarely, dermatomyositis, polymyositis or neurovascular complications may occur. Polymyositis associated with the administration of the hepatitis B vaccine or with hepatitis B virus infection is a rare occurrence. A Medline Search performed from 1960 to January 2002 associating hepatitis B vaccine or hepatitis B virus with myopathy, myositis, polymyositis and dermatomyositis, showed only one case of dermatomyositis related to the hepatitis B vaccine, and six case reports relating polymyositis to hepatitis B virus infection. We present a case where a causal relationship between polymyositis and hepatitis B vaccination appears quite likely

Detection of early apoptosis and cell death in T CD4+ and CD8+ cells from lesions of patients with localized cutaneous leishmaniasis

Human localized cutaneous leishmaniasis (LCL), induced by Leishmania braziliensis, ranges from a clinically mild, self-healing disease with localized cutaneous lesions to severe forms which can present secondary metastatic lesions. The T cell-mediated immune response is extremely important to define the outcome of the disease; however, the underlying mechanisms involved are not fully understood. A flow cytometric analysis of incorporation of 7-amino actinomycin D and CD4+ or CD8+ T cell surface phenotyping was used to determine whether different frequencies of early apoptosis or accidental cell death occur at different stages of LCL lesions. When all cells obtained from a biopsy sample were analyzed, larger numbers of early apoptotic and dead cells were observed in lesions from patients with active disease (mean = 39.5 + or - 2.7 per cent) as compared with lesions undergoing spontaneous healing (mean = 17.8 + or - 2.2 per cent). Cells displaying normal viability patterns obtained from active LCL lesions showed higher numbers of early apoptotic events among CD8+ than among CD4+ T cells (mean = 28.5 + or - 3.8 and 15.3 + or - 3.0 per cent, respectively). The higher frequency of cell death events in CD8+ T cells from patients with LCL may be associated with an active form of the disease. In addition, low frequencies of early apoptotic events among the CD8+ T cells were observed in two patients with self-healing lesions. Although the number of patients in the latter group was small, it is possible to speculate that, during the immune response, differences in apoptotic events in CD4+ and CD8+ T cell subsets could be responsible for controlling the CD4/CD8 ratio, thus leading to healing or maintenance of disease.

Immunologic patterns associated with cure in human American cutaneous leishmaniasis

Patients with American cutaneous leishmaniasis were studied before therapy (active lesion) and at the end of therapy (cured patients). Assays of lymphocyte proliferative responses of peripheral blood mononuclear cells induced in vitro by Leishmania braziliensis promastigote antigens (Lb) were performed. Antigen-stimulated cells were harvested for CD4 and CD8 phenotype analysis and the levels of gamma interferon (IFN-gamma) and interleukin 4 (IL-4) produced were also determined in the culture supernatants. Two different patterns of Lb-induced T cell responses were observed: a) predominance of responding CD4+ cells and mixed type 1 and type 2 cytokine production (IFN-gamma and IL-4) during the active disease, and b) similar proportions of responding CD4+ and CD8+ cells, and type 1 cytokine production (presence of INF-gamma and very low IL-4) at the end of therapy (healed lesions). This last pattern is probably associated with a beneficial T cell response.

Meningite neonatal causada pelo Flavobacterium meningosepticum: relato de caso tratado com ceftriaxona / Neonatal meningitis caused by Flavobacterium meningosepticum: report treated with ceftriayone

O artigo descreve um caso de meningite neonatal causada pelo Flavobacterium meningosepticum. O recém-nascido desenvolveu uma ventriculite e hidrocefalia como complicaçöes. O tratamento inicial com antibióticos usualmente utilizados em casos de meningite nessa faixa etária foi ineficaz, tendo sido introduzida a ceftriaxona. A dose utilizada foi de 70mg/Kg/dia, via endovenosa, com esterilizaçäo liquórica após 10 dias. A criança evolui com hidrocefalia descompensada e anormalidades neurológicas por ocasiäo da alta hospitalar

Importancia de fatores psicossomaticos na demanda de tratamento ambulatorial por trabalhadores de uma empresa. / Importance of psychosomatic factors in demand of ambulatory treatment by workers in a company

Os autores analisaram 22 empregados da Cia. Suzano de Papel e Celulose que se utilizavam constantemente do Depto. Medico da empresa, porem, nao apresentavam queixas de doenca fisica e sim, problemas psicologicos e psicossomaticos. Esses empregados, na maioria das vezes, procuravam o Depto. Medico sem motivo plausivel quanto a saude; outros tinham desajustes emocionais sendo conhecidos como pessoas nervosas. Apenas um pequeno numero apresentava problemas somaticos ou psicosomaticos