Postpartum care and breast-feeding.

Scientific studies investigating the postpartum period are scarce, and observational studies greatly outnumber controlled trials. Many studies are biased in their assumptions about the social roles of women and men and in the interpretation of observations and treatment strategies. The published literature is fragmentary; few researchers have attempted a comprehensive, biopsychosocial system-oriented view of postpartum health.

The safety and pharmacokinetics of a reverse transcriptase inhibitor, 3TC, in patients with HIV infection: a phase I study.

Objective: To determine the safety and pharmacokinetics of the nucleoside analogue, 3TC.

Design: A Phase I, open-label, single-centre study.

Methods: Twenty asymptomatic, HIV-infected male patients with CD4 lymphocyte counts < 500 x 10(6)/l who had not received previous antiretroviral therapy completed the study.

Breastfeeding the neurologically impaired infant.

Care of neurologically impaired infants usually is complex and challenging. Mothers of these infants who want to breastfeed should be supported, given sound information, and assisted to set realistic expectations. The health care team can provide guidance while continuously assessing the infant's status.

Breastfeeding the infant with a cleft defect.

Infants with cleft defects should be assisted to feed at the breast whenever a mother chooses this as the method of feeding. This is an ideal choice for such infants because it encourages normal, physiologic muscular involvement of the mouth and face, it benefits speech development, and it provides protection against upper respiratory infections, particularly otitis media. Successful breastfeeding helps normalize the infant to the family.

Effects of recombinant human granulocyte colony-stimulating factor on leucopenia in zidovudine-treated patients with AIDS and AIDS related complex, a phase I/II study.

Twelve male patients, eight with the acquired immunodeficiency syndrome (AIDS) and four with AIDS related complex (ARC), who had zidovudine associated neutropenia (less than 1 x 10(9) neutrophils/l) were treated with recombinant human granulocyte colony-stimulating factor (G-CSF) in a phase I/II study. Treatment consisted of daily subcutaneous injections with G-CSF in a weekly increasing dose of 0.4, 2, 5 or 10 micrograms/kg body weight until a neutrophil count of more than 3 x 10(9) neutrophils/l was observed.

Attitudes of health-care workers towards AIDS at three Dutch hospitals.

A questionnaire survey was held among 938 doctors and 2304 nurses to assess their attitudes toward AIDS and the influence of their concern about the occupational risks involved. The response was 65 and 72%, respectively. The results suggest that in treating patients with actual or possible HIV infection, in non-invasive procedures many doctors and nurses often take too many precautions, whereas in invasive procedures doctors often take too few.

Combined zidovudine and interferon-alpha treatment in patients with AIDS-associated Kaposi's sarcoma.

The effectiveness of addition of interferon-alpha (IFN-alpha) to zidovudine in patients with AIDS-associated Kaposi's sarcoma was assessed in a non-randomized, phase II clinical trial. Twenty-one patients were treated with oral zidovudine (600 mg daily) and IFN-alpha was increased to 18 MU daily for another 4 weeks. Only one of the 20 evaluable patients achieved a partial response at 8 weeks, that lasted for 3 months.

Failure to maintain high-dose treatment regimens during long-term use of zidovudine in patients with symptomatic human immunodeficiency virus type 1 infection.

Long-term tolerance of zidovudine treatment was retrospectively analysed in 97 patients with AIDS or AIDS-related complex. After one year of treatment 68% and after two years 87% of the patients had had at least one dose adjustment during their course of therapy. Myelotoxicity was the most common cause (58% of all cases) of dose reductions and therapy interruptions (dose adjustments).

[Generalized histoplasmosis in 3 patients with an HIV infection].

Three patients with generalized histoplasmosis and the acquired immunodeficiency syndrome (AIDS) are described. Symptoms of generalized histoplasmosis in patients with AIDS are not specific and concomitant opportunistic infections frequently occur. Two patients suffered from an infection by Mycobacterium tuberculosis, one patient had Pneumocystis carinii pneumonia, and one had cerebral toxoplasmosis.

Low incidence of anti-interferon-alpha antibodies in patients treated with interferon-alpha-2a for AIDS-associated Kaposi's sarcoma.

Anti-interferon (IFN)-alpha antibodies were determined in the serum of 28 patients treated with high-dose human recombinant IFN-alpha-2a for AIDS-associated Kaposi's sarcoma. After a median treatment duration of 3 months, 3 patients developed anti-IFN-alpha antibodies, of whom 2 showed a long lasting tumour response despite the development of these antibodies. None of 3 patients with tumour progression after an initial treatment response had developed IFN-alpha neutralizing antibodies.

Can the course of high dose cotrimoxazole for Pneumocystis carinii pneumonia in AIDS be shorter? A possible solution to the problem of cotrimoxazole toxicity.

Fifty consecutive patients with confirmed PCP received a high dose of cotrimoxazole for 14 d, or until development of intolerance, directly followed by reduced dose maintenance therapy. Seven individuals died during the high dose course. Twenty (47%) of the 43 survivors showed toxicity reactions that necessitated dose reduction to maintenance level on average after 9.

Therapy for cytomegalovirus polyradiculomyelitis in patients with AIDS: treatment with ganciclovir.

Six AIDS patients with progressive cytomegalovirus (CMV) polyradiculomyelitis were treated with ganciclovir in an open study. The diagnosis was based on the presence of a distinct clinical syndrome with progressive flaccid paraparesis, preserved proprioception and urinary retention with specific cerebrospinal fluid (CSF) findings. Ganciclovir therapy, 5-10 mg/kg per day, instituted 3-6.

Molecular Characterization of the Brittle-2 Gene Effect on Maize Endosperm ADPglucose Pyrophosphorylase Subunits.

Activity of the enzyme ADPglucose pyrophosphorylase is known to be reduced in maize (Zea mays L.) endosperm mutants at two independent loci, Shrunken-2 (Sh(2)) and Brittle-2 (Bt(2)). Spinach leaf ADPglucose pyrophosphorylase has previously been shown to comprise two subunits of 51 and 54 kilodaltons.

HIV seropositivity and tuberculosis in a large general hospital in Malawi.

The incidence of the acquired immunodeficiency syndrome (AIDS) in Malawi is one of the highest in Central Africa. Since tuberculosis is an important initial manifestations of the disease, consecutive patients admitted to the tuberculosis (TB) wards of Zomba General Hospital, Malawi, were asked for permission to undergo a human immunodeficiency virus (HIV)-antibodies test. In addition, two other studies were done: from September 1986 all medical in-patients, clinically suspected for immune deficiency and from April 1988 all blood donors were tested for HIV seropositivity.