Storytelling: Armenian Family Albums in the Diaspora

Armenians were scattered across the world after experiencing the collective pain of massacres and deportation from Turkey in 1915. They are an example of a people who have lived through loss and the brutalities of history. In this article, I trace one response to enduring loss: the role of photograph albums in capturing such historical ruptures. For scholars concerned with life stories, family photos and records serve both as goads to recollection and as aids to their certification. “Seeing” other pasts obviates somehow our requirement for complete recollection from our interviewees. Yet our sense of other people's pasts involves more than this. At times photos portray only frozen, static moments cut off from their lived experiences. At other times these albums are a verification of presence in history.

All the sorrows of life can be borne if only we can make them into stories. Isak Dinesen (Karen Blixen)     

Three newly published albums of seventeenth-century mycological drawings

In the Bibliothèque de l'Institut de France are three albums containing almost 600 drawings of fungi, compiled in Italy the 1620s. Many of these drawings were made using the newly-invented microscope. These albums constitute the finest and most extensive set of mycological illustrations made before the eighteenth century. The three albums have recently been published in their entirety, with all the drawings reproduced in colour.     

Use and commercialization of Podocnemis expansa (Schweiger 1812) (Testudines: Podocnemididae) for medicinal purposes in two communities in North of Brazil

The emergence of alternative medicines for AIDS in Asia and Africa was discussed at a satellite symposium and the parallel session on alternative and traditional treatments of the AIDSImpact meeting, held in Marseille, in July 2007. These medicines are heterogeneous, both in their presentation and in their geographic and cultural origin. The sessions focused on the role of these medications in selected resource poor settings in Africa and Asia now that access to anti-retroviral therapy is increasing. The aims of the sessions were to (1) identify the actors involved in the diffusion of these alternative medicines for HIV/AIDS, (2) explore uses and forms, and the way these medicines are given legitimacy, (3) reflect on underlying processes of globalisation and cultural differentiation, and (4) define priority questions for future research in this area. This article presents the insights generated at the meeting, illustrated with some findings from the case studies (Uganda, Senegal, Benin, Burkina Faso, China and Indonesia) that were presented. These case studies reveal the wide range of actors who are involved in the marketing and supply of alternative medicines. Regulatory mechanisms are weak. The efficacy claims of alternative medicines often reinforce a biomedical paradigm for HIV/AIDS, and fit with a healthy living ideology promoted by AIDS care programs and support groups. The AIDSImpact session concluded that more interdisciplinary research is needed on the experience of people living with HIV/AIDS with these alternative medicines, and on the ways in which these products interact (or not) with anti-retroviral therapy at pharmacological as well as psychosocial levels.     

Spontaneous cytotoxicity and tumor necrosis factor production by peripheral blood monocytes from AIDS patients

Peripheral blood monocytes (PBM) from AIDS patients have exhibited defects in some but not all of the immune functions yet tested. This study has examined the capacity of AIDS PBM to lyse tumor target cells as well as their ability to secrete TNF. Untreated PBM from AIDS patients were significantly cytotoxic to U937 target cells and responded to IFN-gamma pretreatment with augmented cytotoxicity. Both the spontaneous and IFN-gamma-stimulated cytotoxic activity was significantly (p less than 0.01) higher than that observed with normal PBM. The cytotoxic activity depended on the E:T ratio used and was higher in AIDS PBM at all ratios tested (10:1 to 40:1). Because TNF has been implicated in macrophage cell-mediated cytotoxicity, we examined whether the elevated cytotoxic activity of AIDS PBM was associated with an increase in TNF production. Supernatants from PBM cultured overnight with or without IFN-gamma were tested in a bioassay measuring cytotoxicity against U937 target cells as well as in an RIA specific for TNF. Supernatants derived from either unstimulated or IFN-gamma-treated AIDS PBM exhibited significantly higher levels of cytotoxicity than supernatants from normal macrophages. Both normal and AIDS PBM produced higher levels of cytotoxic factors in response to IFN-gamma. As determined by the RIA, AIDS PBM spontaneously released high levels of TNF whereas little TNF was produced by normal PBM. Treatment with IFN-gamma augmented the level of TNF production in both AIDS and normal PBM. These results demonstrate that PBM from AIDS patients have undergone in vivo activation as manifested by both cytotoxicity against tumor target cells and production of TNF. Target cell lysis by both AIDS PBM and their supernatants was inhibited by monoclonal anti-rTNF, suggesting that the increase in PBM cell-mediated cytotoxicity was caused by an increase in TNF production. The significance of these findings in the pathogenesis of the disease is discussed.     

Women and AIDS: the ethics of exaggerated harm

This article examines the way in which some biomedical ethicists have constructed sexually transmitted AIDS as a significant threat to women's health. We demonstrate that the familiar claim that'women are the fastest growing group'— whether of HIV-infected or of AIDS patients — is misleading because it obscures the distinction between proportional rate of growth and absolute increase. Feminist ethicists have suggested that misogyny of a male dominated health care system has led to underreporting of women AIDS cases in order to support these feminists'claim of AIDS being a real threat to women's health. Given the apparent rarity of tertiary transmissions of AIDS, the assertion that most or even many women are at significant risk for AIDS seem wrong. Particularly disturbing in this campaign is the fact that the theme of'risky sex'has been extended all the way to lesbians, even though their risk to acquire AIDS sexually is non-existent to minuscule. We argue that actual harm is done to women by this exaggeration of their risk of contracting AIDS sexually. The scare has led to misappropriations of scarce health care funds. AIDS disproportionately affects women who inject drugs, and who suffer other diseases, poverty and malnutrition. It would have been better to concentrate health care efforts in this area instead of'educating'women not at risk for AIDS how to prevent the acquisition of this disease. Unjustifiable AIDS anxiety has been created in women and has resulted in millions of unnecessary HIV-tests, and many broken relationships. This anxiety has inevitably reduced the pleasure of having sex for many women. We reject the kind of'victim ideology'that lies at the heart of this strategy which has, unfortunately, been supported by a number of influential feminist ethicists.     

Transnational Medicine in Public Arenas: Aids Treatments in the South

This article looks at the AIDS-related controversy surrounding the experiments on and the availability of medicines in southern countries. It situates these debates in a longer-term history of transnational medicine. It highlights the rise of international therapeutic modernity at the beginning of the 1990s, based on the strict regulation of clinical trials and on the formalization of the international ethical rules governing experiments. This rise helped to change radically the reception of experiments conducted in southern countries around AIDS. With regard to this new ethics applied to clinical trials in southern countries, this article goes on to demonstrate the confrontation at the end of the 1990s between two different approaches to the universalization of healthcare. Finally, it shows how new laws on international trade have reinitiated this confrontation. Through this story, the article suggests in what sense the study of the political transformations of transnational medicine could offer a new field of investigation for the social sciences.     

Homeopathic Medicine in the City of Oaxaca, Mexico: Patients'' Perspectives and Observations

This article looks at the growth and use of homeopathic medicine in the city of Oaxaca, Mexico. Based on interviews with 174 male and female patients from half of the homeopathic clinics in the city, this research examined attitudes toward disease causation and how one stays healthy. Findings suggest that women are better at monitoring and trying to improve their health than are their male counterparts. Although homeopathy enjoys a strong and almost devoted following, women seem to be more convinced of the overall efficacy of homeopathic medicine than do men.     

Targeting the HIV-protease in AIDS therapy: a current clinical perspective

This review deals with clinical applications of compounds that inhibit the action of the protease encoded within the genome of human immunodeficiency virus (HIV). The HIV-protease is essential for viral maturation and represents an important therapeutic target in the fight against AIDS. Following a brief overview of the enzyme structure and function, the article focuses on a number of peptide and non-peptide based HIV-protease inhibitors that are in current clinical use. These drugs are discussed both with respect to their efficacy in treatment of AIDS, and to problems related to insurgence of viral resistance and side effects seen to date in patient populations.     

Kunyenga, "real sex," and survival: assessing the risk of HIV infection among urban street boys in Tanzania

This article examines possible avenues of HIV infection among urban street boys in Tanzania. In doing so, it questions the ways that AIDS researchers have defined and approached the phenomenon of "survival sex" in East and Central Africa. The article specifically examines the boys' sexual networks, sexual practices, and attitudes regarding their own sexual behavior, including their perceived risk of HIV/AIDS infection. Seventy-five street boys aged eight to 20 from the city of Mwanza were interviewed. Results suggest that almost all street boys are involved in a sexual network in which homosexual and heterosexual behavior occurs. Homosexual practices are rooted in a complex set of behaviors and ideologies known as kunyenga, which is a situated aspect of life on the streets and helps maintain the boys' strong dependence on one another. A key aspect of the boys' sexual careers involves a decrease in kunyenga activity as they approach the age of 18 and an increase in heterosexual encounters after the age of 11. There appears to be a critical period between these ages in which heterosexual and kunyenga activities overlap. It is suggested that boys between these ages represent a potential bridge for HIV/AIDS infection between the general population and the relatively enclosed sexual network of street boys.     

STEM CELL TREATMENTS IN CHINA: RETHINKING THE PATIENT ROLE IN THE GLOBAL BIO‐ECONOMY

The paper looks in detail at patients that were treated at one of the most discussed companies operating in the field of untried stem cell treatments, Beike Biotech of Shenzhen, China. Our data show that patients who had been treated at Beike Biotech view themselves as proactively pursuing treatment choices that are not available in their home countries. These patients typically come from a broad variety of countries: China, the United Kingdom, the United States, South Africa and Australia. Among the patients we interviewed there seemed to be both an awareness of the general risks involved in such experimental treatments and a readiness to accept those risks weighed against the possible benefits. We interpret this evidence as possibly reflecting the emergence of risk‐taking patients as ‘consumers’ of medical options as well as the drive of patients to seek treatment options in the global arena, rather than being hindered by the ethical and regulatory constraints of their home countries. Further, we found that these patients tend to operate in more or less stable networks and groups in which they interact and cooperate closely and develop opinions and assessments of available treatment options for their ailments. These patients also perform a multiple role as patients, research subjects, and research funders because they are required to pay their way into treatment and research activities. This new social dynamics of patienthood has important implications for the ethical governance of stem cell treatments.     

And One Day There Was a Coup d’état: Notes and Insights from a Photographic Experience at the Paine Memorial

This article reflects upon the expectation, the encounter and redefinition of strategies, based on a concrete field experience: the photographic workshop named “Fotografías Vitales, Memorias Biográficas y Álbumes Familiares” (Life photographs, biographic memories and family albums), developed at the end of 2014 at the Memorial of the locality of Paine, Chile, with participation of members of that Memorial who are relatives of “disappeared” people. This work aims to think ethnographically about the particular ways photographic images can become relevant in life history and memories, as well as how sociopolitical events form part of an individual narration with varying strategies, divergences and convergences, with tensions or omissions.     

Some Opportunistic Parasitic Infections in AIDS: Candidiasis, Pneumocystosis, Cryptosporidiosis, Toxoplasmosis

Almost 80% of patients with AIDS die from infections other than human immunodeficiency virus (HIV). These infections usually occur late in the course of disease when CD4(+) T-cell count has fallen below 200 permm(3) cells per milliliter. Most of these infections are caused by organisms that do not normally afflict healthy individuals and are thus considered to be opportunistic. In this article, Lloyd Kasper and Dominique Buzoni-Gatel review the host-parasite interaction for four important pathogens: Candida albicans and Pneumocystis carinii (usually non-invasive pathogens), Cryptosporidium parvum (invades the cells but remains localized in the gut) and Toxoplasma gondii (penetrates through the gut to cause systemic infection). These organisms, which generally cause limited or even insignificant clinical evidence of infection in the normal host, were chosen because of their high prevalence in AIDS patients and because they exhibit different invasive abilities. The reason why individuals with AIDS are susceptible to this particular group of pathogens is uncertain.     

Analysis of DNA distribution in Kaposi's sarcoma in patients with and without the acquired immune deficiency syndrome

While Kaposi's sarcoma in patients with the acquired immune deficiency syndrome (AIDS) may present as a multicentric disease with progressive organ involvement, the classic form of Kaposi's sarcoma is an indolent tumor seldom affecting extracutaneous areas and almost never responsible for the patient's demise. An attempt was made to correlate these clinical differences with the nuclear DNA content of tumor cells in histologic sections from 15 patients (9 with AIDS and 6 without AIDS). All tumors showed a similar DNA distribution pattern, with most cells appearing diploid, indicative of a low malignant potential. These findings indicate that Kaposi's sarcoma of both AIDS and non-AIDS patients is a tumor of intrinsically low malignancy and that lack of immune surveillance is most probably responsible for its aggressive biologic behavior in many AIDS patients.     

Chinese NGOs in action against HIV/AIDS

Chinese non-governmental organizations (NGOs) have played a significant role in the battle against AIDS in the People's Republic of China. This article provides a brief overview of the structure of these organizations, as well as an analysis of their principle accomplishments. Of great significance in this analysis is the fact that Chinese NGOs have effectively dealt with many sensitive health education areas that government authorities have felt reluctant to handle directly. As such, they have provided an indispensable component in the HIV/AIDS prevention and control calculus on the mainland.     

Patterns of primary care of patients infected with human immunodeficiency virus.

To determine the patterns of care of patients infected with the human immunodeficiency virus (HIV), data from 2 sources were analyzed. Initial data obtained from the Washington State HIV/Acquired Immunodeficiency Syndrome (AIDS) Epidemiology Unit indicate that 46% of patients with class IV AIDS were seen by physicians who reported fewer than 5 patients with AIDS, and 68% of all Washington physicians who reported treating patients with AIDS have reported only 1 patient. Subsequent data obtained from a questionnaire distributed in 4 Northwest states suggest that 74% of primary care internists and 73% of family practitioners have some experience in caring for patients with HIV infection, but most of these physicians report fewer than 6 patients in the past 2 years. Although most providers seeing large numbers of HIV-infected patients in their practices were based in the region''s major metropolitan area, 59% of the internists and 55% of the family practitioners surveyed outside of the metropolitan area had seen at least 1 HIV-infected patient in their practices. These results suggest that primary care physicians with relatively little experience treating HIV infection are providing care for a large number of HIV-infected persons. Further study is needed to determine the extent and quality of care provided.     

Verbal Intercourse and Sexual Communication: Impediments to STD Prevention

This article explores the problems of risky sexual behavior by examining the ways people verbally negotiate sexual interaction regarding sexually transmitted diseases. Based on in-depth interviews with 124 adults (ages 21–63) who are infected with genital herpes, the article shows that knowledge about sexually transmitted diseases is not necessarily related to the action needed for their prevention. People are more afraid of being rejected by a partner than they are of contracting an STD (except, of course, AIDS). By examining difficulties people have with sexual health discourse and showing how these difficulties are related to both the problem of communicating politeness and the problem of representing the self and the sexual other, this article demonstrates that STD prevention programs overlook a very important emotional and communicative issue: the lack of a culturally sanctioned language with which to discuss sexual health with partners, [genital herpes, STD prevention, STD communication, sexually transmitted diseases, STD risk]     

T cell response and persistence of the microsporidia

The microsporidia are a diverse phylum of obligate intracellular parasites related to the fungi that cause significant and sometimes life-threatening disease in immune-compromised hosts, such as AIDS and organ transplant patients. More recently, their role in causing pathology in immune-competent populations has also been appreciated. Interestingly, in several instances, the microsporidia have been shown to persist in their hosts long term, causing at opposite ends of the spectrum either an intractable chronic diarrhea and wasting in patients with advanced-stage AIDS or asymptomatic shedding of spores in healthy populations. Much remains to be studied regarding the immune response to these pathogens, but it seems clear that CD8+ T cells are essential in clearing infection. However, in the infection models examined thus far, the role for CD4+ T cells is unclear at best. Here, we discuss the possible reasons and ramifications of what may be a weak primary CD4+ T cell response against Encephalitozoon cuniculi. Given the central role of the CD4+ T cell in other models of adaptive immunity, a better appreciation of its role in responding to microsporidia may provide insight into the survival strategies of these pathogens, which allow them to persist in hosts of varied immune status.     

Epidemiology of HIV infection and AIDS in Croatia--an overview

This article presents an overview of HIV/AIDS epidemiology and surveillance in Croatia 20 years after the first documented case of AIDS in the country. Here we describe strategies employed for HIV/AIDS surveillance in Croatia as well as preliminary results of HIV seroprevalence among most-at-risk populations (MARPs) research conducted by the Infectious Diseases Epidemiology Service at the Croatian National Institute of Public Health (CNIPH). Croatia has a low incidence and prevalence of HIV and AIDS. At the end of 2005, there were 553 documented cases of HIV infection, 239 of which progressed to AIDS. In Croatia, AIDS is being registered within MARPs only and dominantly among men who have sex with men (MSM). AIDS patients and HIV infected persons are found in all parts of the country. Crude prevalence of HIV among MARPs was found to be 0.9%. It is necessary to continue with current prevention and control measures in the country, and to create a culture of awareness and precaution, a strategy that has proven effective in reducing risk of HIV infection.     

Wake up call for Dutch cardiologists

Drug-eluting stents have been available in the Netherlands since April 2002. Despite the revolutionary randomised data demonstrating their low rate of restenosis compared with conventional bare stents, their market penetration rate is estimated at only between 15 and 25%. The reasons are twofold — a perception that only high-risk groups benefit and that these new stents are more expensive. This article seeks to show that both high- and low-risk subgroups of patients requiring intervention benefit, and that these stents are cost-effective, both on an individual and on a societal level. It also puts forward a strong case for the immediate recognition of this new device by the insurance companies to allow Dutch patients to benefit from this remarkable technology.     

Sequence analysis of human cytomegalovirus US28 gene in low-passage clinical isolates from children and AIDS patients

Human cytomegalovirus (HCMV) is often a dangerous opportunistic pathogen that causes significant morbidity and mortality in newborn children and immunocompromised patients. The different symptoms and tissue tropisms of HCMV infection may result from genetic polymorphism. This study investigated the sequence variability of the HCMV US28 ORF, which shows sequence homology to the G protein-coupled receptor. HCMV isolated from suspected pediatric cases and isolates from AIDS patients were compared in order to examine the possible associations between polymorphisms and pathogenesis. Seventy children with suspected congenital HCMV infection, who suffered from jaundice (47), megacolon (10), and microcephaly (13), and 17 AIDS patients, were studied. Mutation was prevalent among the sequences of US28, with a focus on the two ends of US28. The important functional groups of US28 are highly conserved. An unrooted tree showed that all sequences from suspected congenitally infected infants and AIDS patients were divided into three groups. Comparison showed that most of the sequences (12/17) from pediatric patients were included in the first group (G1), whereas most of the sequences (11/17) from AIDS patients were included in the third group (G3). The specific high mutation sites in US28 from children were located at the C terminus of the protein, whereas those from AIDS patients were located at the N terminus. We demonstrated the existence of polymorphisms among the US28 genes of clinical isolates of HCMV from infants with suspected congenital infection. Comparison of US28 sequences from AIDS patients with those from children showed that both sequences have their own specific high mutation points.