Prevention of vertical HIV transmission with zidovudine: projected impact of HIV testing and prenatal care

We sought to estimate the impact of maternal HIV testing and prenatal care on the potential to reduce vertical transmission through zidovudine (AZT) use by HIV-infected mothers. We evaluated the prepartum maternal HIV diagnosis rate, prenatal care, disease stage, and vertical transmission rate (from a two-part mixture model) using New York State Medicaid and vital statistics data for HIV-infected mothers and their singletons in 1985-90. We used published data to estimate the effect of AZT on vertical transmission and expert input to define other parameters for the model. Our HIV-infected (N = 1514) had a vertical transmission rate of 27.0%. HIV was diagnosed prepartum for 39.5% of women in 1990. Transmission would have been 22.2% if AZT had been taken only by the subset of women diagnosed prepartum with HIV and receiving prenatal care by 34 weeks gestation (86.7%). Transmission would have dropped to 11.2% if all women had been diagnosed prepartum with HIV and received adequate prenatal care. The observed deficiencies in prenatal care and maternal HIV diagnosis rates in this Medicaid population-based cohort must be addressed to realize the promise of AZT to reduce vertical transmission.     

Readability analysis of health, physical education, recreation and dance journal articles

The readability levels of 10 articles each from the Journal of Health Education, Journal of Physical Education, Recreation and Dance, Research Quarterly for Exercise and Sport, and Strategies: A Journal for Physical and Sport Educators were estimated. On average, the 40 articles were written at the college junior level (M = 14.9, SD = 1.6); however, significant between-journal differences were found, with between-journal effect sizes ranging from 0.36 to 3.64.     

Instrumentation in hysteroscopy

Good instruments and proper training enable one to make an accurate diagnosis and to operate successfully to correct an intrauterine abnormality. There are a limited number of instruments for diagnostic and operative hysteroscopy so that the gynecologist can quickly become acquainted with the most appropriate instruments for each clinical situation.