Prevalence of HIV infection in childbearing women in the United States

Citations from the Literature

HIV INFECTION CD4 T-lymphocyte counts and Pneumocystis in pediatric HIV infection

carinii pneumonia

Kovacs A; Frederick T: Church J; Eller A; Oxtoby M; Mascola L University of Southern California Medical Cenier, 1129 N State St, Los Angeles. CA 90033, USA J AM MED ASSOC 1991 265113 (1698-1703) The relationship between CD4 T-lymphocyte counts and infection with the human immunodeficiency virus (HIV) is retrospectively investigated for 266 HIV-infected and uninfected children who were cluding 39 with Pneumocystis population-based surveillance infected children with PCP

born to infected women, incarinii pneumonia (PCP), in a study. Of 21 perinatally HIVonly 10 (48”/u) had CD4 T-

lymphocyte counts that were less than 500 x IO6 cells/L (500 cells/mm3), compared with all 18 who were infected via blood transfusions or clotting factors. Among 88 children who were 1 year or younger, 18 (90%) of 20 PCP cases had CD4 Tlymphocyte counts that were less than 1500 x IO6 cells/L (1500 cells/mm3) compared with only five (IO%) of 48 children who did not have the acquired immunodeficiency syndrome (odds ratio, 77.4; 95% confidence interval, 19.7 to 313.4). The mean CD4 T-lymphocyte count was lower for the 39 PCP cases when compared with the 188 children who were at different stages of HIV infection and did not have the acquired immunodeficiency syndrome (AIDS) independent of age. The majority of perinatally HIV-infected children with PCP were 8 months or younger and 5O”/uwere previously unknown to be infected. Thus, HIV-positive children should be identified early and followed closely. CD4 T-lymphocyte counts may be useful in monitoring HIV-positive begin PCP prophylaxis.

children

and determining

when to

Prevalence of HIV infection in childbearing women in the United States Gwinn M; Pappaioanou M; George JR; Hannon WH; Wasser SC: Redus MA; Hoff R; Grady GF; Willoughby A; Novello AC; Petersen LR; Dondero TJ Jr; Curran JW Division of HIV/AIDS. Centers for Disease Control, Atlanta, GA 30333, USA J AM MED ASSOC 1991 265113 (1704-1708) A national, population-based survey was initiated in 1988 to measure the prevalence of human immunodeficiency virus (HIV) infection in women giving birth to infants in the United States. Following standardized procedures, residual driedblood specimens collected on filter paper for newborn metabolic screening were tested anonymously in state public health laboratories for maternal antibody to HIV. As of September 1990, annual survey data were available from 38 states and the District of Columbia. The highest HIV seroprevalence rates were observed in New York (5.8 per 1000). the District of Columbia (5.5 per IOOO), New Jersey (4.9 per lOOO), and Florida (4.5 per 1000). Nationwide, an estimated 1.5 per 1000 women giving birth to infants in 1989 were infected with HIV. Assuming

a perinatal

transmission

rate of 30%. we

321

estimate that approximately 1800 newborns acquired HIV infection during one 12-month period. Preventing transmission of HIV infection to women and infants is an urgent public health priority

GYNECOLOGICAL

OPERATIONS

A multi-centre collaborative study into the treatment of menorrhagia by Nd-YAG laser ablation of the endometrium Garry R; Erian J; Grochmal SA South Cleveland Hospital. Marron Road, Cleveland TS4 3BW. GBR BR J OBSTET GYNAECOL 1991 9814 (357-362) Objective - To determine the safety and clinical tiveness of Nd-YAG laser ablation of the endometrium

effecin the

treatment of menorrhagia. Design - A prospective 3-year observational multi-centre study. Setting - Gynaecological units in the UK and USA with special interest in endoscopic laser surgery. Subjects - 859 women with menorrhagia resistant to medical therapy. Main outcome measure - Duration of laser ablation, intraand post-operative complications, amenorrhoea rate, oligomenorrhoea rate. and woman’s subjective assessment of treatment. Results - No major complications occurred in 859 treatments. Four (0.4%) cases of transient fluid overload, 4 (0.4%) of infection, and 3 (0.3%) of uterine perforation occurred. Each of the perforations occurred during insertion of the rigid instruments and none was produced by the laser. There were no major haemorrhages, no blood transfusions were needed, and no woman required a laparotomy. The mean duration of the laser,ablation was 24 mitt, and the average stay in hospital was <24 h. Of the 479 women followed up for at least 6 months after treatment 288 (60’%) developed complete amenorrhoea and 152 (32%) reported continuing but satisfactorily reduced menstruation; 39 (8%) failed to improve with the first treatment, but 26 of them responded to a second laser ablation. Overall 466 (97%) had a satisfactory response to laser ablation and only 13 (3”%) required subsequent hysterectomy. Conclusion - Endometrial laser ablation would appear to be a popular. safe, effective and economical menorrhagia

alternative

to hysterectomy

for the treatment

of

Laser laparoscopic management of large endometriomas Daniel1 JF; Kurtz BR; Gurley LD 2222 State Street, Nashville, TN 37203, USA FERTIL STERIL 1991 5514 (692-695) Forty-seven patients underwent laser laparoscopic

manage-

ment of endometriomas from 3 to 12 cm in diameter. Eighteen patients had infertility, 15 had pelvic pain, and 14 had both. The types of laser used were the carbon dioxide, argon, and potassium-titanyl-phosphate. There were no surgical complications Twelve of 32 patients with infertility achieved pregnancy after the initial procedure. Subsequently, 2 patients conceived after a second-look procedure. Twenty-three of 30 patients with pelvic pain reported improvement or resolution. We confirm the efficacy management

of operative laparoscopy using of large ovarian endometriomas.

lasers

in the

Int J Gynecol Obsrer 37