The effects of human immunodeficiency virus (HIV) type 1 on the placenta and the role of the placenta in mother-to-child HIV-1 transmission are not well understood. Placentas from 78 HIV-infected and 158 HIV-uninfected women were examined as part of a prospective perinatal HIV transmission study in Bangkok. HIV-infected women were more likely than HIV-uninfected women to have chorioamnionitis (odds ratio [OR], 2.1; P=.03), placental membrane inflammation (PMI; OR, 2. 7; P=.02), and deciduitis (OR, 2.3; P=.03) and less likely to have villitis (OR, 0.3; P=.02). However, among HIV-infected women, fewer women who transmitted infection to their child had chorioamnionitis (relative risk [RR], 0.2; P=.03), funisitis (RR, 0.4; P=.1), or PMI (RR undefined; P=.03). These findings suggest that, in this population, HIV-infected women are at increased risk for placental membrane inflammatory lesions, but that placental inflammatory lesions are not associated with increased perinatal HIV transmission.

ABSTRACT. Objective. To describe survival and signs of human immunodeficiency virus (HIV) infection in perinatally infected children in Thailand.Methods. At 2 large Bangkok hospitals, 295 infants born to HIV-infected mothers were enrolled at birth from November 1992 through September 1994 and followed up with clinical and laboratory evaluations every 1 to 3 months for 18 months. Infected children remained in follow-up thereafter. For the infected children, we used data collected through October 2000 to estimate survival times and compare characteristics among those whose disease progressed at rapid (died within 1 year), intermediate (died at 1-5 years), and slow (survived at least 5 years) rates.Results .

Objective: Elderly patients often present to the emergency department (ED) with non-specific complaints. Previous studies indicate that such patients are at greater risk for lifethreatening illnesses than similarly aged patients with specific complaints. We evaluated the diagnoses and outcomes of elderly patients presenting with non-specific complaints. Methods: Two trained data abstractors independently reviewed all records of patients over 70 years old presenting (to two academic EDs) with non-specific complaints, as defined by the Canadian Emergency Department Information System (CEDIS). Outcomes of interest were ED discharge diagnosis, hospital admission, length of stay, and ED revisit within 30 days. Results: Of the 743 patients screened for the study, 265 were excluded because they had dizziness, vertigo, or a specific complaint recorded in the triage notes. 419 patients (87.7%) presented with weakness and 59 patients (12.3%) presented with general fatigue or unwellness. The most common diagnoses were urinary tract infection (UTI) (11.3%), transient ischemic attack (TIA) (10.0%), and dehydration (5.6%). There were 11 hospital admissions with median length of stay of five days. Eighty-one (16.9%) patients revisited the ED within 30 days of discharge. Regression analysis indicated that arrival to the ED by ambulance was independently associated with hospital admission. Conclusions: Our results suggest that elderly patients presenting to the ED with non-specific complaints are not at high risk for life-threatening illnesses. The most common diagnoses are UTI, TIA, and dehydration. Most patients can be discharged safely, although a relatively high proportion revisit the ED within 30 days. RÉSUMÉObjectif: Il est fréquent que des personnes âgées consultent au service des urgences (SU) pour des symptômes généraux. D'après des études antérieures, ces patients connaissent un risque plus grand de maladies potentiellement mortelles que les patients de même âge ayant des symptômes précis. Aussi les auteurs ont-ils évalué les diagnostics posés chez des personnes âgées examinées pour des symptômes généraux, de même que l'issue. Méthode: Deux personnes formées à l'abstraction de données ont examiné, chacune de leur côté, tous les dossiers de patients âgés de plus de 70 ans, qui ont consulté dans deux SU d'hôpitaux universitaires pour des symptômes généraux tels qu'ils sont définis dans le Canadian Emergency Department Information System (CEDIS). Les principaux critères d'évaluation comprenaient le diagnostic au moment du congé du SU, l'hospitalisation, la durée de séjour et les nouvelles consultations au SU dans les 30 jours suivants. Résultats: Sur 743 patients présélectionnés pour l'étude, 265 ont été écartés parce qu'on faisait déjà mention d'« étourdis-sements » ou de « vertiges » ou encore de symptômes précis dans les notes relatives au triage. Sur le nombre restant de patients, 419 (87,7 %) présentaient de la faiblesse, et 59 (12,3 %), de la fatigue générale ou un état de malaise. Les diagnostics les plus f...

Reduced MTCT of HIV was significantly associated with infant acquisition of GBV-C but not with maternal GBV-C infection. The mechanism for this association remains unknown.