HIV infection and associated sexually transmitted diseases in women

We determined the prevalence of other sexually transmitted diseases (STDs) in 56 women infected with the human immunodeficiency virus (HIV) and compared the usefulness of this prevalence to that of standard risk assessment alone in identifying HIV-infected women. Of the 56 women studied, 54 were infected with HIV. These women received instruction as to the modes of transmission and were then placed in standard risk groups based on their own assessments. A history of previous or current STD was obtained and followed by appropriate testing. We found that combining standard risk assessment with a current or previous STD enabled us to identify a greater percentage of women who are infected with HIV.

Thoracic disc disease: experience with the transpedicular approach in twenty consecutive patients

TWENTY CONSECUTIVE PATIENTS were treated for symptomatic thoracic disc herniation with the transpedicular approach. Most patients had severe, incapacitating local or radicular pain. Myelopathy was uncommon as magnetic resonance imaging allowed an early diagnosis. Computed tomography, after myelography, provided further information necessary for surgical planning. Three patients had disc disease at two levels. Nine central and 14 lateral disc herniations were found. Disc calcification or an associated osteophyte was identified in six instances. Although the size of the disc herniation correlated with the amount of cord compression, no radiological features were found to be correlated with neurological function. The transpedicular approach was used in all patients. New curettes, specifically designed for the procedure, allowed the removal of all discs, including central and calcified fragments. A modified arthroscope was used to confirm neural decompression in some instances. One year after surgery, all 20 patients were significantly improved and 8 patients were asymptomatic. Apart from the duration of the symptoms, no other factors were found to affect outcome. The findings suggest that the prognosis of thoracic disc herniation is excellent if the disease is recognized early. The transpedicular approach, using curettes specifically designed for the procedure, can be an effective and safe method of surgical decompression in carefully selected patients.

Carotid sinus syndrome and embolization procedures

Two patients developed carotid sinus syndrome following embolization procedures. One patient had undergone balloon occlusion of the internal carotid artery; in the other patient, embolization of a carotid body tumor had been performed. The method of diagnosis as well as the etiology and treatment are discussed.