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A determination of the incidence of squamous intraepithelial lesions (SILs) in HIV-seropositive women with normal cytology results, by baseline human papillomavirus (HPV) DNA results is done. The results suggest that similar cervical cancer screening practices would be applicable to both HIV-seronegative and HIV-seropositive women.

HIV-infected women may have a greater risk of death than HIV-infected men, although the overall risk of disease progression may not differ significantly according to gender. Researchers studied the medical, demographic, and HIV risk factor data of 768 HIV-infected women and 3,779 HIV-infected men to determine gender-based differences in disease progression and death. After a median follow-up period of 14.5 to 15.5 months, the women were 1.33 times more likely to die than the men, independent of the patients' CD4 counts and other variables associated with the disease. The risk of disease progression measured in terms of AIDS-related infections was similar among patients of both genders. Women were more likely to develop bacterial pneumonia or other mycobacterial infections as men. But they were less likely to develop nonvisceral Kaposi's sarcoma or oral hairy leukoplakia ., Objective.--To compare disease progression and mortality between women and men infected with human immunodeficiency virus (HIV). Design.--Multicenter cohort. Setting.--Seventeen community-based centers participating in the Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA). Patients.--A total of 768 women and 3779 men enrolled in one or more of 11 protocols between September 7, 1990, and September 30, 1993. Main Outcome Measures.--Survival and opportunistic events. Results.--The median CD[4.sup.+] cell count at enrollment into the cohort was 0.240 x[10.sup.9]/L (240/[micro]L) for women and 0.137 x [10.sup.9]/L for men (P Conclusions.--Compared with men, HIV-injected women in the CPCRA were at increased risk of death but not disease progression. Risks of most incident opportunistic diseases were similar for women and men; however, women were at an increased risk of bacterial pneumonia. These findings may reflect differential access to health care and standard treatments or different socioeconomic status and social support for women compared with men. (JAMA. 1994;272:1915-1921)

Frequent consumption of the n-3 polyunsaturated fatty acids found in fish may help protect smokers against chronic obstructive lung disease. The Atherosclerosis Risk in Communities (ARIC) study provided a database of 8,960 former or current smokers whose respiratory symptoms and dietary habits were known. After controlling for confounding factors such as race, age and weight, subjects in the upper 25% for fish consumption were two-thirds as likely to have chronic bronchitis, one-third as likely to have emphysema, and half as likely to have lung function in the lower 5% of the group. One explanation for the protective effect is that these diseases result from inflammatory processes triggered by tobacco smoke, and these fatty acids inhibit inflammatory processes. Chronic obstructive lung disease is so rare among nonsmokers that the effect of fish consumption could not be evaluated.

Determines the association of Chlamydia pneumoniae strain TWAR with asymptomatic carotid atherosclerosis in cross-sectional case-control study among participants in the Atherosclerosis Risk in Communities (ARIC) Study. Background aon ARIC; Ultarsound measurements; Antibody determinations; Potential causal role for TWAR in atherosclerosis.

The purpose of this study was to evaluate the association of periodontal health and human immunodeficiency virus infection among individuals in the early stages of disease who were participating in randomized placebo-controlled clinical trials of zidovudine. Previous reports have described a rapidly progressive periodontitis and atypical gingivitis associated with late stages of infection by the human immunodeficiency virus. A health history was completed by each subject. Baseline oral examinations were completed on 97 asymptomatic patients and nine with AIDS-related complex (ARC) during their regular clinic visit. Follow-up examinations were conducted at 3-month intervals throughout the 48 weeks of the oral study. Evaluations of plaque, calculus, gingival abnormalities, caries, and periodontal disease were conducted. Periodontal measurements included plaque index (PI), gingival index (GI), bleeding index (BI), probing depth (PD), and observation for cratering, necrosis, and tooth mobility on six teeth in each patient. More than half of the subjects had visited their dentist during the previous year and had an oral prophylaxis; less than 25% of them had either restorative work or extractions. The mean scores for periodontal indices averaged over the course of the study in asymptomatic and ARC respectively were: PI: 0.9 (SE 0.04) and 0.9 (SE 0.08), P = 0.818; GI: 1.0 (SE 0.04) and 0.9 (SE 0.07), P = 0.412; BI: 0.6 (SE. 0.04) and 0.4 (SE 0.07), P = 0.278; PD: 2.9 (SE 0.05) and 2.6 (SE 0.10), P = 0.140. There was no evidence of cratering, necrosis, or tooth mobility in either group. Few had calculus or dental caries. There were no clinically significant differences detected between ARC versus asymptomatic patients. Dental histories and oral examinations showed that two groups of patients in early stages of HIV-disease were in good periodontal health. [ABSTRACT FROM AUTHOR]

The etiology of Kaposi's sarcoma remains somewhat obscure. While lesions of classic Kaposi's sarcoma, African Kaposi's sarcoma, and immunosuppressed Kaposi's sarcoma have been found to be indistinguishable from one another, the reasons for the variations in type and severity have not been established. The origin of the spindle cell is yet to be agreed on. Geographic variation does not seem as important as ethnic variation. The very young and the very old, perhaps two ages of weakened immunity, tend to have a higher incidence of Kaposi's sarcoma. Children and AIDS patients tend to develop more virulent disease. Males tend to get Kaposi's sarcoma at higher rates than do females. Jewish and Mediterranean males have the highest incidence of classic Kaposi's sarcoma, and African Bantu have the highest incidence of African Kaposi's sarcoma, classifications which do not apply to the Kaposi's sarcoma population in the United States. Male homosexuals have much higher incidence of Kaposi's sarcoma than do male heterosexuals, but since the early 1980s, its incidence as the presenting manifestation of AIDS has decreased dramatically. There is no unequivocal association with HLA haplotype (though DR5 carriers may be at especially high risk) or evidence of family clustering. There is an impressive but not always consistent association between Kaposi's sarcoma development and immunodeficiency. Environmental factors, such as nitrite use, immunosuppression, and repeated cytomegalovirus infection, are associated with Kaposi's sarcoma, but the exact mechanism is unclear and the associations remain inconsistent. Finally, it is still unclear if there is a causative infectious agent for Kaposi's sarcoma. While cytomegalovirus has been linked to Kaposi's sarcoma, there are weaknesses in its hypothetical role as an etiologic agent as is the case for HIV itself.(ABSTRACT TRUNCATED AT 400 WORDS) [ABSTRACT FROM AUTHOR]

Background: Fish contain n-3 polyunsaturated fatty acids, principally eicosapentaenoic acid and docosahexaenoic acid, which are known to interfere with the body's inflammatory response and may be of benefit in chronic inflammatory conditions., Methods: We studied the relation between the dietary intake of n-3 fatty acids and chronic obstructive pulmonary disease (COPD) in 8960 current or former smokers participating in a population-based study of artheroscierosis. Intake of fatty acids was estimated with a dietary questionnaire. The presence of COPD was assessed by a questionnaire on respiratory symptoms and by spirometry. Three case definitions of COPD were used: symptoms of chronic bronchitis (667 subjects), physician-diagnosed emphysema reported by the subject (185 subjects), and spirometrically detected COPD (197 subjects)., Results: After control for pack-years of smoking, age, sex, race, height, weight, energy intake, and educational level docosahexaenoic acid was inversely related to the ris of COPD in a quantity-dependent fashion. The adjusted odds ratio for the highest quartile was 0.66 for chronic bronchitis (95 percent confidence interval, 0.52 to 0.85; P<0.001 for linear trend across the range of intake value), 0.31 for physician-diagnosed emphysema (95 percent confidence interval, 0.18 to 0.52; P for liner trend, 0.003), and 0.50 for spirometrically detected COPD (95 percent confidence interval, 0.32 to 0.79; P for linear trend, 0.007)., Conclusion: A high dietary intake of n-3 fatty acids may protect cigarette smokers against COPD.