Prevalence of intestinal microsporidiosis in Human Immunodeficiency Virus-infected patients with diarrhea in major United States cities

To determine the prevalence of intestinal microsporidiosis in HIV-infected patients, we performed a prospective study of HIV-infected patients with diarrheal illnesses in three US hospitals and examined an observational database of HIV-infected patients in 10 US cities. Among 737 specimens from the three hospitals, results were positive for 11 (prevalence 1.5%); seven (64%) acquired HIV through male-to-male sexual contact, two (18%) through male-to-male sexual contact and injection drug use, and one (9%) through heterosexual contact; one (9%) had an undetermined mode of transmission. Median CD4 count within six months of diagnosis of microsporidiosis was 33 cells/µL (range 3 to 319 cells/µL). For the national observational database (n = 24,098), the overall prevalence of microsporidiosis was 0.16%. Prevalence of microsporidiosis among HIV-infected patients with diarrheal disease is low, and microsporidiosis is most often diagnosed in patients with very low CD4+ cell counts. Testing for microsporidia appears to be indicated, especially for patients with very low CD4+ cell counts.Para determinar a prevalência de microsporidiose intestinal em pacientes infectados pelo HIV foi realizado um estudo prospectivo em três hospitais dos Estados Unidos da América do Norte (EUA) e analizada uma base de dados nacional composta de dados coletados de pacientes infectados pelo HIV em 10 cidades dos EUA. De um total de 737 amostras de fezes de pacientes infectados pelo HIV que apresentavam diarréia, amostras de 11 pacientes (prevalência de 1,5%) foram positivas para microsporídios. Todos os positivos eram do sexo masculino e, entre eles, sete (64%) pacientes adquiriram a infecção pelo HIV através de relação homossexual, dois (18%) através de relação sexual e drogas injetáveis e um (9%) através de contato heterosexual, enquanto que em um paciente o modo de transmissão do HIV não foi determinado. A contagem média de linfócitos CD4 realizada até seis meses do diagnóstico de microsporidiose foi de 33 células/microlitro (3 a 319 células/microlitro). A análise da base de dados nacional (n = 24.098) mostrou uma prevalência de microsporidiose de 0,16%. A prevalência de microsporidiose em pacientes HIV-positivos com diarréia é baixa. Entretando, como a microsporidiose é mais frequentemente diagnosticada em pacientes com contagens de CD4 muito baixas, a indicação de pesquisa de microsporídios é justificada, especialmente para estes pacientes

Mycobacterium tuberculosis Transmission from Human to Canine

A 71-year-old woman from Tennessee, USA with a 3-week history of a productive, nonbloody cough was evaluated. Chest radiograph showed infiltrates and atelectasis in the upper lobe of the right lung. A tuberculosis (TB) skin test resulted in a 14-mm area of induration. Sputum stained positive for acid-fast bacilli (AFB) and was positive for Mycobacterium tuberculosis by DNA probe and culture. Treatment was initiated with isoniazid, rifampicin, and pyrazinamide. After 14 days of daily, directly observed therapy, the patient complained of nausea, vomiting and diarrhoea. Treatment adjustments were made, and therapy was completed 11 months later with complete recovery. Six months after the patient\u27s TB diagnosis, she took her three and a half-year-old male Yorkshire Terrier to a veterinary clinic with cough, weight loss, and vomiting of several months\u27 duration. Initial sputum sample was negative on AFB staining. Eight days after discharge from a referral veterinary teaching hospital with a presumptive diagnosis of TB, the dog was euthanized due to urethral obstruction. Liver and tracheobronchial lymph node specimens collected at necropsy were positive for M. tuberculosis complex by polymerase chain reaction. The M. tuberculosis isolates from the dog and its owner had an indistinguishable 10-band pattern by IS6110-based restriction fragment length polymorphism genotyping

Cultural agenda setting and the role of critics: an empirical examination in the market for art-house films

In this study we investigate and expand agenda setting theory in the context of the market for art-house films. First, we test first and second-level agenda setting hypotheses, according to which higher media visibility and favorable media valence of a particular film are expected to have positive effects on public salience. Second, we expand agenda setting theory by adding critical valence as an important influence of public salience within cultural contexts. Our findings suggest that while higher media visibility, favorable media valence, and critical valence have positive effects on public salience, they are also independent of one another in carrying salience over to the public

Imprensa, cobertura eleitoral e objetividade: a eleição de 2000 na capital paulista

O texto discute a objetividade jornalística nas coberturas eleitorais da imprensa paulista, tendo como ponto de partida o reconhecimento prévio de que numa "democracia de público" o poder de agenda da mídia demanda a exigência normativa de uma imprensa independente capaz de informar com a maior objetividade o leitor. O artigo tem como referência empírica a cobertura eleitoral do pleito municipal de 2000 na Capital paulista realizada por três dos grandes jornais locais.<br>The text discusses objectivity in the 2000 election press coverage in São Paulo, Brazil. The idea that underlines the paper is that, in reference to Bernard Manin's 'democracy of the public', the strength of the media agenda requires objectivity from an independent press to inform people. The empirical data come from the election press coverage of the three major local newspapers