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Purpose: There are limited and conflicting data regarding the impact of comorbid hepatitis C virus (HCV) infection on diabetic retinopathy (DR). This study sought to compare the prevalence and severity of DR among patients with diabetes mellitus (DM) with and without HCV. Patients and methods: This was a retrospective, case–control study of patients with DM comparing 120 patients with comorbid HCV and 120 age-matched controls. DR prevalence and several measures of severity were compared between groups. Subgroup analyses were performed among HCV patients with cirrhosis, comorbid HIV, or history of treatment with interferon. Statistical analysis for between-group comparisons utilized both univariate and multivariate analyses. Results: Cases and controls exhibited similar baseline characteristics: average hemoglobin A1c, DM duration, and age (p>0.05). Among cases and controls, there was no difference in DR prevalence (35.8% versus 42.5%, respectively, p=0.29) or severity (p>0.05). Within the HCV subgroup, DR severity was reduced in patients with HIV or cirrhosis. However, multivariate analysis identified reduced DM duration in these subgroups as the primary contributor to lesser DR severity, rather than HIV or cirrhosis. Conclusion: In this study, comorbid HCV did not modulate the prevalence or severity of DR among patients with DM. These findings may inform clinical monitoring among HCV-positive diabetics undergoing ophthalmic evaluation. [ABSTRACT FROM AUTHOR]

The goal of this work was to evaluate tissue-device interactions due to implantation of a mechanically operated drug delivery system onto the posterior sclera. Two test devices were designed and fabricated to model elements of the drug delivery device--one containing a free-spinning ball bearing and the other encasing two articulating gears. Openings in the base of test devices modeled ports for drug passage from device to sclera. Porous poly(tetrafluoroethylene) (PTFE) membranes were attached to half of the gear devices to minimize tissue ingrowth through these ports. Test devices were sutured onto rabbit eyes for 10 weeks. Tissue-device interactions were evaluated histologically and mechanically after removal to determine effects on device function and changes in surrounding tissue. Test devices were generally well-tolerated during residence in the animal. All devices encouraged fibrous tissue formation between the sclera and the device, fibrous tissue encapsulation and invasion around the device, and inflammation of the conjunctiva. Gear devices encouraged significantly greater inflammation in all cases and a larger rate of tissue ingrowth. PTFE membranes prevented tissue invasion through the covered drug ports, though tissue migrated in through other smaller openings. The torque required to turn the mechanical elements increased over 1000 times for gear devices, but only on the order of 100 times for membrane-covered gear devices and less than 100 times for ball bearing devices. Maintaining a lower device profile, minimizing microscale motion on the eye surface and covering drug ports with a porous membrane may minimize inflammation, decreasing the risk of damage to surrounding tissues and minimizing disruption of device operation. [ABSTRACT FROM AUTHOR]

The article reports on tuberculosis (TB) patients with HIV in the U.S. from 1993 to 2005. According to data from the U.S. Centers for Disease Control & Prevention, patients with HIV and TB are more likely to die when being treated for TB. According to the author, it is important to know if a TB patient has HIV in order to provide optimal patient management.

Looks at the trends in tuberculosis (TB) in the U.S. since 1993. Rate of decline of TB cases in the country; Number of multidrug-resistant TB cases in 2004; Health report being submitted by the health department of each state to the Centers for Disease Control and Prevention; States that reported additional TB cases in 2005.

To assess prevalence and variations in the oral manifestations of HIV in HIV-infected subjects in southern Thailand (a new HIV epidemic) and northern Thailand (a mature epidemic), and the association with age, sex, risk behaviours, CD4 count and medication used. A total of 102 and 135 HIV-infected individuals were enrolled in northern and southern hospitals, respectively. Oral and haematological examination was performed after sociodemographic interview of the patients. Clinical history was retrieved from patients’ medical records. Oral candidiasis (OC, 55%), oral hairy leucoplakia (OHL, 21%) and HIV-associated-periodontal disease (14%) were among the most common oral lesions in southern Thailand. OHL (38%), OC (25%), HIV-associated-periodontal disease (15%) were the three most common lesions in the north. A significant association was found between any oral lesion, OC, particularly the pseudomembranous type (PC), and CD4 < 200 cells mm−3 at both sites. A negative relationship was found between systemic antifungal treatment and OC including PC and erythematous candidiasis (EC) in the southern data. OHL showed a positive relationship with male sex and a negative relationship with antiretroviral treatment in the northern site. Younger age and being a current smoker were positively associated with oral lesions in the southern group. OC, particularly PC, could be useful as a marker for immunosuppression, particularly where CD4 count cannot be determined routinely. Antifungal treatment is of benefit in the subjects who cannot afford highly active antiretroviral therapy (HAART). [ABSTRACT FROM AUTHOR]

This study investigated the association between caries status and sealant need at a prior survey and subsequent sealant use in a Medicaid program. Clinical data from a 1986-87 statewide epidemiological survey (N = 8026) representative of North Carolina (NC) schoolchildren (grades K-12) were linked with all NC Medicaid dental claims submitted during 1987-92, yielding 570 children in the survey who had at least one dental visit during 1987-1992. From the 570, 390 children were included: 71 who received sealants (S) and 319 who received non-sealant care (NS). Children were excluded based on age, having pre-existing sealants, or having no sealant-eligible molars or premolars. S and NS were compared on baseline dfs, DMFS, and sealant need, controlling for the patient's age, number of visits, and the provider's propensity to seal. At all ages, NS was twice as likely to have had prior dfs or DMFS (OR = 2.04, 95% CI = 1.15, 3.70). The association between sealant receipt and prior sealant need varied by age. At 6 to 11 years, S and NS had equal likelihood of sealant need (OR = 1.41, 95% CI = 0.62, 3.18). At 12 to 15 years, NS had a greater likelihood of sealant need (OR = 6.82, 95% CI = 1.60, 29.08). Caries-free status was associated with subsequent sealant receipt. Prior sealant need caused variability in dentists' decisions, depending on the child's age and past caries experience. Sealants were used infrequently by most providers and for a minority of patients. These findings are important for the Medicaid program and for future non- randomized studies of sealant effectiveness. [ABSTRACT FROM AUTHOR]

This article presents news from U.S. Centers for Disease Control and Prevention. The group updates a report on the number of drug resistant tuberculosis (TB) cases in the in the United States from 1993 to 2006. Drug-resistant TB is known as XDR TB. In the United States there were 49 cases of XDR TB and of these, 17 cases were reported during 2000-2006. The later cases were more likely to be in people who were foreign born and less likely to be in persons with HIV infection. The reported cases came from nine states and one city. New York City and California led in the numbers of reported cases. A TB epidemic occurred in the U. S. During 1985-1992when the number of cases increased to 10.4 cases per 100,000 population.

The article presents a report from the U.S. Centers for Disease Control and Prevention that examines trends in the incidence of tuberculosis in the United States. It is stated that racial and ethnic minority populations and foreign-born persons in the United States are affected disproportionately by tuberculosis. More cases of tuberculosis were reported in Hispanic Americans than any other ethnic or racial population. The affect of HIV on the tuberculosis pandemic is discussed. Cases of multidrug-resistant tuberculosis are discussed.

This report describes recent efforts by the Centers for Disease Control and Prevention (CDC), Division of Oral Health, to understand more fully women's knowledge and attitudes regarding oral health and dental visits during pregnancy. Using data from the CDC Pregnancy Risk Assessment Monitoring System (PRAMS), investigators are conducting both quantitative and qualitative research on these issues. PRAMS is an ongoing state-based and population-based surveillance survey of women's attitudes, experiences, and behaviors before, during, and after pregnancy. Findings have shown that most mothers did not make a dental visit during pregnancy, and of those who reported having oral problems, one-half did not seek care. Preliminary analysis of qualitative results shows that some women may believe that poor oral health status during pregnancy is normal; also, they may fear certain aspects of dental care during pregnancy. For example, some women may believe that they or their fetus could be harmed by treatment. If pregnancy modifies perceptions of oral health and dental care in women, it may contribute to women's avoidance of dental treatment while pregnant. Therefore, researchers and health program planners should give increased attention to the oral health needs and behaviors of pregnant women. [ABSTRACT FROM AUTHOR]

This article presents news from the U.S. Centers for Disease Control and Prevention (CDC). Because the HIV status of tuberculosis (TB) patients is vital for treatment, the CDC sought to see how many TB patients had been checked for HIV. It is a recommendation of the CDC that all TB patients be tested for HIV due to the increased risk of death of patients with both conditions. The agency checked on the number of reported HIV tested TB patients in the U.S from 1993-2005. The study found that the reports of HIV status among TB patients increased to 68 percent of patients by 2005 but says that number needs to be higher. The agency calls for improvements in HIV testing and reporting especially in high risk patients.

Background: Prevention of transfusion transmissible HIV and other infections relies on selection of low risk donors and screening donors with sensitive assays. Selection of donors at low risk in developing countries with major heterosexual epidemics of HIV has been difficult. However, the prevalence of HIV among blood donors reflects the control of infection in the community and the self exclusion in part of donors who have previously tested positive. Methods: We evaluated the trends in HIV prevalence among 175,251 blood donors in Chiang Mai, Thailand, between 1990 and 1998. This area has had an explosive HIV epidemic beginning in 1988-1998. These data were useful to monitor the safety of the blood supply and the evolution of the epidemic. Results: The overall HIV prevalence was 3.0% in men and 0.96% in women; prevalence was higher in first time than repeat donors. The HIV prevalence peaked at 4.04% in 1991, leveled off at about 3.5% between 1992 and 1994, then declined to 0.68% in 1998. In 1998 HIV prevalence was similar in men and women and volunteer and repeat donors. Conclusions: There has been a substantial decline in the HIV prevalence among blood donors in N. Thailand in the past few years. This decline probably reflects widespread testing for HIV and a decreased HIV incidence due to an effective public health program to prevent incident infections from exposure during commercial sex the, "100% condom program. More effective exclusion of high risk donors may have contributed to the decline. This is an example of improvement in the safety of blood in a developing country experiencing a major AIDS epidemic. [ABSTRACT FROM AUTHOR]