High levels of HPV-16 DNA are associated with high-grade cervical lesions in women at risk or infected with HIV.

Objective: To examine associations between levels of episomal and integrated human papillomavirus (HPV) 16 DNA and the grade of cervical disease.

Design: Cross-sectional data were obtained from a cohort of women with and without HIV infection and with high-risk sexual behaviour.

Methods: Episomal and integrated HPV-16 DNA loads were measured in cervicovaginal lavages collected from 75 women (58 HIV seropositive, 17 HIV seronegative) using real-time polymerase chain reaction assays, controlling for cell content and the presence of inhibitors.

Drug use and risk of bloodborne infections: a survey of female prisoners in British Columbia.

Background: Clinicians working in a women's prison in British Columbia observed hepatitis C sero-conversion among inmates, prompting this study to determine: the characteristics of women who do and do not report illicit drug use in prison; patterns of drug use inside prison; factors associated with illicit drug use that might contribute to bloodborne transmission inside prison.

Methods: A cross-sectional observational data set was created using an anonymous 61-item self-administered survey.

Results: Eighty-three percent (104/126) of eligible inmates participated.

RETIRED: The prevention of early-onset neonatal group B streptococcal disease.

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Human papillomavirus type 16 viral load is higher in human immunodeficiency virus-seropositive women with high-grade squamous intraepithelial lesions than in those with normal cytology smears.

Human papillomavirus type 16 (HPV-16) viral load in cervicovaginal lavage samples collected from 66 human immunodeficiency virus-seropositive women was inversely correlated with blood CD4 count (P = 0.002). HPV-16 viral load was 81-fold higher in women with cervical smears suggestive of high-grade lesions (median, 4,425,883 copies/ micro g of DNA) than in women with normal smears (median, 54,576), controlling for age (P = 0.

Antiviral and antiretroviral use in pregnancy.

The history of antiviral and antiretroviral therapy is recent compared with many other medical therapies, including traditional antibiotics in pregnancy. There are few long-term data on which to base decisions of management in pregnancy. Accessing up-to-date information is critical to optimizing the safety of care for mothers and their infants.

Lactic acidemia in human immunodeficiency virus-uninfected infants exposed to perinatal antiretroviral therapy.

Objective: To investigate potential mitochondrial toxicity in HIV-uninfected infants exposed to highly active antiretroviral therapy (HAART) in utero and/or neonatal zidovudine.

Design: A prospective observational study performed in a tertiary referral center for HIV-infected women and their infants and children.

Methods: Plasma lactate was measured repeatedly during the first 6 months of life in a consecutive cohort of infants exposed to HAART in utero and/or neonatal zidovudine.

Levels of antibodies against cytomegalovirus and Chlamydophila pneumoniae are increased in early onset pre-eclampsia.

Objective: The origins of pre-eclampsia/eclampsia lie in a mismatch between feto-placental demands and utero-placental supply, a situation that also arises in normotensive intrauterine growth restriction (IUGR). Could reactivated chronic infection be both a trigger for these differential maternal responses to the same underlying pathology and a link between pre-eclampsia and its attendant lifelong risks of atherosclerosis?

Design: Nested case-control study.

Setting: Tertiary obstetric centre.

A double-blind, randomized, placebo-controlled trial of acyclovir in late pregnancy for the reduction of herpes simplex virus shedding and cesarean delivery.

Objective: The purpose of this study was to assess the efficacy of acyclovir in the reduction of herpes simplex virus culture and polymerase chain reaction positivity and cesarean delivery.

Study Design: Women with recurrent genital herpes simplex virus were randomized to acyclovir 400 mg three times daily or placebo from 36 weeks of gestation until delivery. A subset of daily specimens for herpes simplex virus culture and DNA polymerase chain reaction was self-collected.

The association of placental abnormalities with maternal and neonatal clinical findings: a retrospective cohort study.

Objectives: (1) To determine the nature and extent of placental pathologic findings; (2) to associate placental pathologic findings with clinical indicators of infection; (3) to evaluate placental pathology in the context of the guidelines outlined by the College of American Pathologists (CAP).

Methods: A retrospective cohort study, through review of maternal and neonatal charts and placental pathology, of 100 sequential pregnancies in which placentas were submitted to pathology. Data were examined using descriptive statistics, and proportional differences were compared using the chi-square test and Fisher's exact test.

Genital tract and plasma human immunodeficiency virus viral load throughout the menstrual cycle in women who are infected with ovulatory human immunodeficiency virus.

Objective: The purpose of this study was to determine the vaginal, cervical, and plasma viral load through the menstrual cycle in women who are positive for human immunodeficiency virus.

Study Design: A prospective cohort study was performed on 14 women with ovulatory menstrual cycles who have human immunodeficiency virus. Duplicate cervical and vaginal viral load samples (n = 301) were taken at four stages (menstrual, follicular, periovulatory, and luteal) of two consecutive cycles.

Debate: the argument for. Should every STD clinic patient be considered for type-specific serological screening for HSV?

The arguments against screening for all individuals attending sexually transmitted disease and genitourinary medicine clinics for herpes simplex virus may seem compelling, but an examination of the facts indicate that the case in favour is strong. While no screening test is perfect, testing can confirm the diagnosis, improve management, help to reduce the risk of transmission - including to the newborn - and assist in the development of public health strategies. Not least, patients want to know whether or not they are infected.

Pelvic inflammatory disease associated with Enterobius vermicularis.

A case of pelvic inflammatory disease in a sexually non-active 13 year old girl is described, with evidence of pinworms as the cause. Albendazole treatment cleared the infestation but the patient suffered subsequent bouts of lower abdominal pain. The literature is reviewed regarding abdominal pathology associated with ectopic migration of pinworms.

Serum concentrations, efficacy, and safety of a new, intravenously administered varicella zoster immune globulin in pregnant women.

Chickenpox is teratogenic in humans, and varicella zoster immune globulin (VZIG) is given to pregnant women believed to be susceptible to the virus after contact with chickenpox. Available VZIG is given as intramuscular injections. The objective of this study was to evaluate the efficacy, safety, and serum concentrations of a new VZIG that can be given intravenously.

Central nervous system complications of von Hippel-Lindau disease and pregnancy; perinatal considerations: case report and literature review.

A 30-year-old woman with von Hippel-Lindau disease presented at 30 weeks' gestation with a symptomatic cerebellar hemangioblastoma. She underwent a craniotomy for complete removal of the tumor. The postoperative period and the remaining of the pregnancy were uneventful.

Initial multicenter experience with double nucleoside therapy for human immunodeficiency virus infection during pregnancy.

Objective: To study maternal and neonatal effects of combination nucleoside analog therapy administered to human immunodeficiency virus (HIV)-infected pregnant women for maternal indications.

Methods: A multicenter, prospective observational study was undertaken at six perinatal centers in the United States and Canada that supported regional referral programs for the treatment of HIV-infected pregnant women. Demographic, laboratory, and pregnancy outcome data were collected for 39 women whose antiretroviral treatment regimens were expanded to include more than one nucleoside analog for maternal indications.

Routine prenatal screening for HIV in a low-prevalence setting.

Background: The objectives of this study were to assess the effect of British Columbia's June 1994 guidelines for prenatal HIV screening on the rate of maternal-fetal HIV transmission and to estimate the cost-effectiveness of such screening.

Methods: The authors conducted a retrospective review of pregnancy and delivery statistics, HIV screening practices, laboratory testing volume, prenatal and labour management decisions of HIV-positive women, maternal-fetal transmission rates and associated costs.

Results: Over 1995 and 1996, 135,681 women were pregnant and 92,645 carried to term.

Prevalence and correlates of antibody to chlamydial heat shock protein in women attending sexually transmitted disease clinics and women with confirmed pelvic inflammatory disease.

A cross-sectional study of 306 women was done to correlate antibody to the chlamydial hsp60 (Chsp60) with epidemiologic, serologic, and laparoscopic findings of women with and without pelvic inflammatory disease (PID). Of the 306 women, 150 had confirmed PID by laparoscopic (n = 69) or histologic (n = 81) criteria, and 156 sexually transmitted disease clinic attendees without clinical PID did (n = 94) or did not (n = 62) have chlamydia. In multivariate analyses, Chsp60 antibody was independently associated with confirmed PID, age > 20 years, nonwhite race, > 10 lifetime sex partners, current oral contraceptive use, and IgG antibody titers; it was not associated with a positive Chlamydia trachomatis culture.

Antibodies to the chlamydial 60 kd heat-shock protein are associated with laparoscopically confirmed perihepatitis.

Objective: Our purpose was to examine clinical, microbiologic, serologic, and laparoscopic findings associated with perihepatitis.

Study Design: In a prospective study of 157 women with a clinical diagnosis of pelvic inflammatory disease, 27 women with laparoscopically confirmed perihepatitis and salpingitis were compared with 46 patients with salpingitis alone.

Results: Both current use or a history of ever using oral contraceptives was negatively associated with perihepatitis (p = 0.

A comparison of three approaches to delivering a speech and language therapy service to people with learning disabilities.

This research aimed to compare three different approaches to delivering a speech and language therapy service to people with learning disabilities, in order to make recommendations for future service delivery. The three approaches all involved working with key communication partners in the environment. They were: (i) working directly on a one-to-one basis with the person and partner; (ii) working indirectly by providing teaching for partners; and (iii) a combination of these two approaches.

Bridging the Gender Gap in HIV Diagnosis and Care.

Since its emergence in 1981, the human immunodeficiency virus (HIV) has been viewed by the Western world as a disease that primarily affected men. Yet in mid 1996, the World Health Organization (WHO) estimated that globally 42% of the 21 million adults living with HIV infection were women. They also reported that the proportion of infected women continues to grow in developed and underdeveloped countries.

Symmetric bilateral brachymetacarpalia of a dog.

Malformations of the canine manus are infrequently cited in the literature but include polydactylia and syndactylia. Here, a case of brachymetacarpalia affecting the second and fifth metacarpal bones of both forelimbs of a mixed-breed dog is described. The initial impression of shortened digits was disproved by statistical comparison with normal skeletons, but the presence of shortened metacarpal bones was demonstrated.