Differences in testing, stigma, and perceived consequences of stigmatization among heterosexual men and women living with HIV in Bengaluru, India.

Approximately 2.4 million people in India are living with HIV. Gender inequality affects HIV prevention, detection, and management. The purpose of this paper was to describe gender differences in the experience of living with HIV in Bengaluru, India. A subsample of n = 313 (159 men and 154 women) from a larger cohort was used for these analyses. Participants were recruited through AIDS service organizations. They completed an interviewer-administered survey assessing HIV testing experience, types of stigma, and perceived consequences of stigmatization. The majority of men (67%) reported getting HIV tested because of illness, while women were more likely to be tested after learning their spouse's HIV-positive status (42%). More men (59%) than women (45%, p<0.05) were tested in private care settings. Men reported significantly higher mean levels of internalized stigma (men: M=0.71, SD = 0.63; women: M=0.46, SD = 0.55; p<0.001), whereas the women reported significantly higher scores for enacted stigma (men: M=1.30, SD = 1.69; women: M=2.10, SD = 2.17; p<0.001). These differences remained significant after controlling for potential socio-demographic covariates. Following their diagnosis, more women reported moving out of their homes (men: 16%; women: 26%; p<0.05). More men (89%) than women (66%; p<0.001) reported to have modified their sexual behavior after being diagnosed. These findings suggest that the experience of living with HIV and HIV stigma varies by gender in this population. Suggestions for a gender-based approach to HIV prevention and stigma reduction are provided.

Thoracic aortic imaging without angiography.

Imaging of the thoracic aorta without recourse to angiography has great theoretic appeal. We have used computerized tomography (CT) in the initial evaluation of 297 patients with suspected mediastinal disease. Nineteen of this group had important findings related to the thoracic aorta: aortic dissection (six), descending thoracic aortic aneurysm (nine), suspected aortic trauma (three), and suspected false aneurysm at a coarctation repair (one). In all cases, the aorta and related pathology were readily demonstrated by CT, aided by the intravenous infusion of contrast material. In 13 of 15 cases, aortic dissection and aortic aneurysm could be accurately diagnosed. In two instances of ascending aortic dissection, it was not possible to distinguish the false lumen from mural thrombus in an atherosclerotic aneurysm.

Increased digitalis-like activity in human cerebrospinal fluid after expansion of the extracellular fluid volume.

The present study was designed to determine whether acute expansion of the extracellular fluid volume influenced the digitalis-like activity of human cerebrospinal fluid (CSF), previously described by our laboratory. Human CSF samples, drawn before and 30 minutes after the intravenous infusion of 1 liter of either saline or glucose solutions, were assayed for digitalis-like activity by inhibition of either the 86Rb+ uptake into human erythrocytes or by the activity of a purified Na+ - K+ ATPase. The CSF inhibitory activity on both systems significantly increased after the infusion of sodium solutions but did not change after the infusion of glucose. These results indicate that the digitalis-like factor of human CSF might be involved in the regulation of the extracellular fluid volume and electrolyte content and thereby in some of the physiological responses to sodium loading.

Diagnosis of retroperitoneal hemorrhage by serial computed tomography.

A case of retroperitoneal hematoma is presented in which the characteristic density changes of the hematoma as seen on serial computed tomography permitted an accurate preoperative diagnosis.

Congenital renal arteriovenous malformation: ultrasonic appearance.

We report a case in which a congenital renal arteriovenous fistula was detected using gray scale ultrasonography and arteriographically confirmed. This abnormality should be considered when renal ultrasonography reveals anechoic structures located centrally or peripherally within the kidney in association with an enlarged renal vein.

Ouabain-like activity in human cerebrospinal fluid.

Human cerebrospinal fluid has been found to mimic the effect of ouabain on net Na+ efflux and 86Rb+ influx across erythrocyte membranes and on the in vitro activity of a purified Na+/K+-ATPase (ATP phosphohydrolase, EC 3.6.1.3) derived from canine kidney. These results indicate the possible existence in human cerebrospinal fluid of an endogenous factor with ouabain-like activity, which might be linked to sodium metabolism.

Plastic bowing, torus and greenstick supracondylar fractures of the humerus: radiographic clues to obscure fractures of the elbow in children.

The anterior humeral line is a valuable aid in the search for supracondylar fractures in children. When it is abnormal other signs of fracture should be carefully sought. The AHL was normal in only 5.8% of the cases reviewed (4 of 68 cases). There was other evidence of fracture in each case. Comparison of the AHLs on both sides is helpful when the AHL is normal since it may disclose subtle displacement of the line on the affected side. In children younger than 2 1/2 years the AHL may pass through the anterior third of the capitellum due to the small size of the ossification center; in these patients comparison with the opposite side may also be helpful.

Diagnosis of hydronephrosis: comparison of radionuclide scanning and sonography.

Diagnostic sonographic and radioisotope scanning techniques have been shown to be useful in the diagnosis of obstructive uropathy. The accuracy of both methods was compared and sonography was found to provide the more accurate data (sensitivity, 90%; specificity, 98%; accuracy, 97%). Sonography provides excellent anatomic information and enables one to grade the degree of dilatation. Renal radionuclide studies were less sensitive in detecting obstruction, particularly in the presence of chronic renal disease, but offered additional information regarding relative renal blood flow, total effective renal plasma flow, and interval change in renal parenchymal function.

Descending venography: a method of evaluating lower extremity venous valvular function.

Recently developed surgical techniques for the correction of lower extremity venous insufficiency have renewed interest in venous valvular functions. To assess the value of descending venography in the evaluation of venous valvular incompetence, this technique was compared with bidirectional Doppler ultrasound and ascending venography in the examination of 32 patients with clinical signs of chronic venous insufficiency. Twelve of these patients underwent surgery to valvular incompetence, and all underwent descending venography and Doppler ultrasound examinations postoperatively. Descending venography proved to be an effective, accurate method of diagnosing venous valvular incompetence of the saphenofemoral system.

Computed vs. conventional tomography in evaluation of primary and secondary pulmonary neoplasms.

One hundred patients, ultimately proved to have chest malignancies, were evaluated prospectively with conventional chest tomography and computed tomography. In 58 patients with primary malignancies, conventional tomograms were more useful in evaluation of the hilus than CT scans. The mediastinum was better assessed by CT. Thus, evaluation of the presence of neoplasia is better accomplished by conventional examination, while extent of disease is best assessed by CT. Thoracotomy for curative resection was not attempted (in the latter cases of this series) based on CT findings of mediastinal involvement. In 42 patients with metastases to the chest, CT scans of the lung parenchyma were more sensitive than whole lung tomography but had little additional impact on patient treatment. Nevertheless, in 18 patients the results of CT or whole lung tomography directly affected patient therapy.

Computed tomography in the diagnosis of aortic aneurysm dissection or traumatic injury.

Thirty patients thought to have an atherosclerotic thoracic aneurysm or chronic aortic dissection were evaluated by computed tomography (CT) and the findings compared with those from conventional radiography, thoracic aortography, and surgery. In all cases, CT defined the lesion and correlated well with angiography. Staging of atherosclerotic aneurysms was possible, and CT also demonstrated the relationship between true and false lumina in aortic dissections; however, aortography was often necessary to differentiate a dissection from an aneurysm or for staging. The relative value of CT and aortography is discussed.

Evaluacion del metodo de Aburel. / Evaluation the Aburel method

Se presenta un estudio sobre 72 casos de interrupcion de la gestacion a partir del segundo trimestre, mediante el uso de inyeccion intraamniotica de solucion salina hipertonica. Las indicaciones principales fueron rubeola (6l,l%), obito fetal (19,4%) y malformacion fetal congenita (8,3%). Se fracaso en l caso (l,4%) En el (69,4%) de los casos la edad gestacional estuvo comprendida entre las 10 y 21 semanas Se uso sistematicamente la infusion intravenosa de l00 Uds. de ocitocina, desde la finalizacion de la inyeccion intraaamniotica hasta la expulsion del producto en 70 (97,2%) de los casos. Todos los procedimientos se realizaron en pacientes hospitalizadas y se procedio sistematicamente a la revision instrumental o manual de la cavidad uterina, inmediatamente despues de la expulsion del producto. Las complicaciones observadas fueron: sangramiento en 4,l%, fiebre en 2,7% y un abruptio placentae (l,3%). Se revisa la literatura y se recomienda el procedimiento, siempre que se realice en pacientes hospitalizadas, bien evaluadas y bajo estricta vigilancia hospitalaria

Estudio de localización de la fuente de hipersección de andrógenos mediante el muestreo venoso selectivo ovarico y adrenal. Uyilidad en el diagnóstico y tratamiento / Localization study of the hypersection source of androgens by meanthe selective venous sampling studies ovarice and adrenal utility in the diagnostic and treatment

Reportamos nuestra experiencia con la técnica de caracterización venosa selectiva adrenal y ovárica en dos pacientes con patología virilizantes no tumoral (hipertecosis). Las mediciones de los valores periféricos y centrales nos permitieron localizar los órganos hipersecretores cuales eran los ovarios además de obtener información de lateralización de la secreción predominante cuyas características ayudan en el diagnóstico y manejo tanto quirúrgico como médico de este tipo de patología