Cardiovascular disease (CVD) is an increasing concern for human immunodeficiency virus (HIV)-infected patients, and risk assessment is recommended in routine HIV care. The absolute cardiovascular risk in an individual is determined by several factors, and various algorithms may be applied. To date, few comparisons of HIV patients with persons of the same age from the general population have been conducted. We hypothesized that the calculated risk of CVD may be increased in HIV patients. The probability for acute coronary events within 10 y (Framingham Risk Score) and the probability for fatal cardiovascular disease (SCORE algorithm) were assessed in 403 consecutive HIV-positive subjects free from overt cardiovascular disease, as well as in 96 age- and gender-matched control subjects drawn from the general population living in the same geographical area. The average 10-y risk for acute coronary events (Framingham Risk Score) was 7.0%+/-5% in HIV subjects and 6.3%+/-5% in the control group (p =0.32). The 10-y estimated risk for cardiovascular mortality (SCORE algorithm) was 1.23%+/-2.3% and 0.83%+/-0.9%, respectively (p =0.01). The main contributor to the increased CVD risk was the high proportion of smokers, but not an increase in cholesterol level. In conclusion, a limited increase in estimated risk of CVD was found in HIV-infected patients compared to the general population. In HIV-infected individuals other factors of less value in the general population and not included in any cardiovascular algorithm might be important. In our patients intervention to modify traditional risk factors should be addressed primarily towards modifying smoking habits.

To evaluate, for the first time, circulation and clinical expression of Toscana virus (ToSv) in Umbria region we studied: (1) 93 cases of aseptic meningitis and meningoencephalitis admitted to our Department from 1989 to 2001 with negative results for common neurotropic virus; (2) 50 healthy subjects. Specific antibodies (IgM and IgG) anti-TOSv were found in 36.6% of aseptic meningitis, in 6.06% of meningoencephalitis and (IgG) in 16% of healthy subjects.

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This paper reports on a prospective observational study that evaluated the frequency of prosthetic infections after total knee arthroplasty. During a six-year observational period, 171 patients underwent knee arthroplasty. Single shot prophylaxis with teicoplanin was administered to all patients. Nine patients (5.3%) had a followup of less than four weeks; the remaining 162 had a follow-up of at least 12 weeks. Of these, 155 completed the 24-month observational period. In the end, three patients developed early prosthetic joint infection which produced infection rates of 1.85% and 1.93% when the follow-up was ≥12 weeks and ≥24 months, respectively. The mean time from surgery to infection was 54 days (range, 14-87). All three infections were caused by Staphylococcus aureus susceptible to methicillin. Fever, pain, effusion and secretion were present in all cases. In this cohort of patients, no cases of delayed infection were observed. Thorough reporting is the first step in reducing the incidence of post-surgical infective complications and can contribute to more productive prophylactic protocols.