With reference to clinical practice, the authors recommend the undertaking of further research to explore the effects of music therapy on the behaviour and wellbeing of older people with dementia.

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Background: Treatment of older patients with myelodysplastic syndrome (MDS) is based on disease biology and performance status. Performance status, however, does not reflect increasing co-morbidities, functional dependence or psychosocial issues in older patients. Patients and Methods: This prospective study evaluated the burden of geriatric related health issues, assessed feasibility of "tailored" Comprehensive Geriatric Assessment (CGA), and compared treatment duration and survival in older patients with MDS and oligoblastic acute myeloid leukemia with and without deficits in CGA domains (n = 98). Results: Although only 27 (28%) patients had an Eastern Cooperative Oncology Group score ≥2, 78% (n = 77) patients had deficits in at least one CGA domain. Deficits were spread across all CGA domains, including dependence for instrumental activity of daily living (iADL; n = 33, 34%). Importantly, patients who were dependent for iADL (3.7 ± 2.6 vs 12.1 ± 7.9; p = .009), had cognitive impairment (3.5 ± 2.1 vs. 10.9 ± 7.9; p = .034) or impaired mobility (3.8 ± 2.5 vs. 13.2 ± 7.6; p = .001) completed significantly less azacitidine cycles as compared to those without these deficits. Cox-proportional regression showed that iADL dependency (hazard ratio 3.37; p = .008) and higher comorbidities (hazard ratio 4.7; p b .001) were associated with poor prognosis independent of disease related factors. Poor survival of iADL dependent patients was seen in both azacitidine (6 vs 19 months; p b .001) and supportive care cohorts (26 vs 48 months; p = .01). Conclusion: CGA detected geriatric related health issues, predicted poor survival and identified patients less likely to continue and benefit from azacitidine. Hence, CGA should be included in the treatment decision algorithm of older patients with MDS.

Women form an increasing proportion of HIV-infected individuals in the developed world. Early data suggest that women with HIV are at particular risk of developing sexual problems. The aim of this study was to describe our anecdotal experience of HIV-infected women and to ascertain their sexual dysfunction, and also to conduct a national survey to evaluate what sexual dysfunction services are provided for women in other UK HIV centres. Retrospective analysis of clinic notes of women attending our HIV clinic and letter surveys of HIV centres in the UK were carried out. About half our cohort reported that they had sexual problems or were not satisfied with sex over the preceding 12 months. Contextual issues seemed to be the commonest cause of these problems. Sixty percent of HIV physicians in the UK rarely/never ask their female HIV patients about sexual functioning. Sexual dysfunction is probably common in HIV-infected women. Most physicians seeing women with HIV in the UK do not ask about sexual functioning. 'Physician coaching' could help to redress this situation, so that at the least the sexual problems could be brought up in discussion.

Results suggest that a high percentage of Doberman Pinschers with equivocal echocardiographic evidence of dilated cardiomyopathy will be found to have VPC during 24-hour ambulatory electrocardiography and that most will develop echocardiographic abnormalities indicative of cardiomyopathy.