HIV-1 disease progression and AIDS-defining disorders in rural Uganda

BACKGROUND: The majority of people infected with HIV-1 live in Africa, yet little is known about the natural history of the disease in that continent. We studied survival times, disease progression, and AIDS-defining disorders, according to the proposed WHO staging system, in a population-based, rural cohort in Uganda. METHODS: In 1990 we recruited a random sample of people already infected with HIV-1 (as prevalent cases) detected during the initial survey round of a general-population study to form a natural-history cohort. Individuals from the general-population cohort who seroconverted between 1990 and 1995 (incident cases) were also invited to enroll. Participants were seen routinely every 3 months and when they were III. FINDINGS: By the end of 1995, 93 prevalent cases and 86 incident cases had been enrolled. Four patients in the prevalent group were in stage 4 (AIDS) at the initial visit. During the next 5 years, 37 prevalent cases progressed to AIDS. Seven incident cases progressed to AIDS and the cumulative progression to AIDS at 1, 3, and 5 years after seroconversion was 2%, 6%, and 22%, respectively. The cumulative probability of AIDS at 4 years from entering stages 1, 2, and 3 was 11%, 33%, and 58%, respectively. There were 47 deaths among prevalent cases and seven among incident cases during follow-up. The cumulative mortality 4 years after patients entered stages 1, 2, 3, and 4 was 9%, 33%, 56%, and 86%, respectively. The median survival after the onset of AIDS was 9.3 months. INTERPRETATION: Our results are important for the setting of priorities and rationalisation of treatment availability in countries with poor resources. We found that progression rates to AIDS are similar to those in developed countries for homosexual cohorts and greater than for cohorts infected by other modes of transmission. However, we have found that the rates of all-cause mortality are much higher and the progression times to death are shorter than in developed countries.     

Extended transsternal thymectomy

We recorded auditory event-related potential (ERP) by using the standard oddball paradigm in seven amnestic patients. Patients were divided into three groups according to brain CT or MRI findings. (1) Three patients with no detectable lesion, including two patients studied during the episode of transient global amnesia, showed a well-defined P300. (2) Three patients with detectable lesions in the mesial temporal lobes did not show any wave form corresponding to P300. In two of these three patients, the ERP wave form showed a significant change in accordance with the improvement of MRI findings. (3) One patient who had a hypothalamic lesion due to total resection of craniopharyngioma showed a low-amplitude P300. Although neuropsychological examinations showed selective and severe impairment of recent memory function in all of these patients, no significant relationship was found between the degree of memory disturbance and P300 abnormality. These results suggest that P300 is more affected by existence and extension of brain lesions, especially in the mesial temporal lobes, rather than degree of memory disturbance. However, these results do not necessarily suggest that the potential generated in the mesial temporal lobes is directly recorded as a component of the scalp-recorded P300.     

Thyroid disease in women

Thyroid diseases occur more commonly in women than men, in part because of the autoimmune nature of many thyroid disorders. Hypothyroidism, and thyroid nodules occur frequently in both pre- and postmenopausal women. Pregnancy is also associated with changes in thyroid function. The goal of this article is to review the current information on the pathophysiology and treatment of thyroid disorders which are common in women.     

Knowledge systems and the law: The JURICAS project

There has been worldwide interest in looking at using artificial intelligence technology for legal applications. At Erasmus University in Rotterdam, The Netherlands, a JURICAS “Advice System Shell” has been created to allow lawyers to develop their own advisory systems. This paper describes the JURICAS project, and describes a Social Security Legal advisory system that has been created as a derivative of this project.     

Computer Science and Engineering Education Introduction and Overview

A question often asked of those closely associated with the affairs of the Computer Society is, "What can the society do for me?" Occasionally I have asked the same question. In these introductory comments, I would like to present one way in which our society, using part of the dues we each pay each year along with a great amount of volunteer effort, has been addressing the current and future needs of society members. The effort has to do with education in computer science and engineering; the results are partly evidenced by the ten solicited articles of this special supplement, which present the results of the Computer Society's Model Curriculum Subcommittee Report, A Curriculum in Computer Science and Engineering (EHOI 19-8).     

Pituitary adenylate cyclase-activating peptide is upregulated in sensory neurons by inflammation

The neuropeptide pituitary adenylate cyclase-activating peptide (PACAP) is expressed in sensory neurons. Expression of several neuropeptides is up-regulated in sensory neurons following inflammation. To examine whether also PACAP expression is regulated by inflammation, PACAP expression in L5 dorsal root ganglion (DRG) was determined, using in situ hybridization, after unilateral adjuvant-induced inflammation in the rat paw. At 12 h and day 3, but not day 21, the percentage of neurons expressing PACAP mRNA was greater in the innervating L5 DRG. Similarly, PACAP mRNA expression in individual neurons was higher in the innervating L5 DRG at 12 h and day 3, but not day 21. Up-regulated PACAP expression following adjuvant injection suggests a role for PACAP in inflammation.     

Transpleural vascularization of pulmonary arteries in fibrous mediastinitis. Report of a case

Idiopathic granulomatous and fibrous mediastinitis is an uncommon disease, the manifestation of which depends upon the organs involved. In a case of a Moroccan the rather unique complication of pulmonary artery obstruction on one side resulted in the development of functional important anastomoses between the bronchial and pulmonary arteries and also between the intercostal and pulmonary arteries by way of transpleural vascularization as is clearly demonstrated by bronchial and intercostal arteriography.