Diarrhoea is the most common manifestation of acquired immunodeficiency syndrome (AIDS) in Africa. Numerous parasitic or bacterial agents have been implicated, but a pathogen-specific aetiology has not been found. Enteric viruses (i.e., rotavirus, small round structured viruses, coronavirus, and adenovirus) were detected by enzyme-linked immunosorbent assay or electron microscopy in faecal specimens of 17% of 198 consecutive adult admissions to a general medical ward of an urban hospital in Kinshasa, Zaire. Overall, 57% of patients were seropositive for infection with human immunodeficiency virus (HIV) 1; of these, 50% were classified as World Health Organization AIDS stage IV. The prevalence of enteric viruses in stool specimens did not differ significantly between patients with and without HIV infection, and was not associated with acute or chronic diarrhoea, or constitutional symptoms. However, a trend (P = 0.14) towards greater frequency of virus in stools from patients in the lower 3 quintiles of the CD4/CD8 T cell ratio was seen. This trend approached statistical significance (P = 0.07) with stratification by HIV infection. Although we found no evidence in this population to support a major pathogenic role for these viruses alone in the enteropathy of AIDS, increased viral shedding was weakly associated with immunodeficiency.

Acquired Immunodeficiency Syndrome↗

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Panic disorder, agoraphobia, and anxiety-relevant cognitive style.

We attempted to identify factors differentiating Agoraphobia with Panic Attacks (AG) from Panic Disorder (PD) patients. Twenty-three AG and 27 PD patients were compared. No significant difference in severity of illness was found. As predicted, the groups differed on a measure of anxiety-relevant cognitions developed for this study, the Anxious Thoughts and Tendencies scale (AT&T) (P less than 0.02). We suggest that differences in interpretation of panic attacks account for the development of of phobic avoidance behavior in some but not all PD patients. The intercorrelations among measures suggest that Panic Disorder may be conceptualized as having several independent although related components (panic attacks, general anxiety, phobic anxiety, and cognitive distortions).

Adolescent↗

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Acute arsine posioning in two workers cleaning a clogged drain.

On February 6, 1978, two maintenance workers employed by a chemical company in Atlanta, Georgia, became ill after cleaning a clogged drain. Both were hospitalized with acute fulminant hemolytic anemia and renal failure. While the clinical picture suggested arsine or stibine poisoning, preliminary investigation of the plant revealed no obvious source of arsenic, antimony, or hydrogen gas. During the cleaning operation, the men drained a mixing tank that 5 yr before had been used to store arsenical herbicides. To unclog the drain, they added a standard drain cleaner containing sodium hydroxide and aluminum chips, a combination that reacted to release hydrogen gas. This gas combined with the arsenic residue to form toxic quantities of arsine gas (arsenic trihydride). Arsenic was found in the liquid and gas from the drain and in blood and urine of both patients, and of two other workers who worked in the vicinity of the drain. This investigation suggests that drain cleaners which react to release hydrogen should not be used in situations where arsenic or antimony may be present. Furthermore, maintenance men, who may be exposed to the chemicals used in a plant, should be educated, supervised, and screened so that their risk for occupational hazards may be reduced.

Acute Disease↗

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The role of rotaviruses in pediatric diarrhea.

Explore the source record for details and available documents.

Animals↗

PubMedDate not supplied

Education and training of occupational therapists for neonatal intensive care units.

OBJECTIVE: The neonatal intensive care unit (NICU) is an area in which occupational therapists require specialized advanced training and skills. The purpose of this study was to evaluate the nature of current practice among occupational therapists in NICU settings, their training, and their opinions regarding educational experiences necessary for NICU work. METHOD: One hundred seventy-four NICU occupational therapists completed a survey questionnaire designed to elicit information about these issues. RESULTS: The majority of respondents were engaged in similar practice duties in NICUs, most of which had been using therapy services for less than 10 years. Most of the respondents (83%) reported that their primary source of training was on the job rather than through formal course work or training programs. Many of the respondents (40%) lacked training in the use of any infant assessments, and 50% had 2 years or less of pediatric work experience before entering practice in the NICU. The respondents indicated that mentored experience, on-the-job training, pediatric work experience, extended continuing education courses, and formal internships could prove helpful to future occupational therapists who wish to acquire the knowledge and skills to become competent in the NICU. CONCLUSION: Results of the survey indicate that current training and education to work in an NICU is inadequate and needs to be addressed. Occupational therapists working in NICUs desire and express the need for specialized training to work in this practice area. A more aggressive effort toward standard NICU education and training is necessary to ensure that occupational therapists are competent members of the NICU team.

Adult↗

PubMedDate not supplied