Minerva

Minerva

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7008.820 (Published 23 September 1995) Cite this as: BMJ 1995;311:820

Research groups carrying out trials of treatment for HIV infection in Africa face a serious ethical dilemma (Science 1995;269:1332-5). International guidelines state that if a treatment proves effective “there should be some assurance that it will be made reasonably available to the inhabitants of the host community or country.” In reality, virtually every treatment under trial would be too expensive in all developing countries. Trials in Africa are likely to benefit people in Western countries, not the people on whom the treatments are tested.

As many as 10% of patients with AIDS develop symptoms of toxoplasmosis, which usually presents as encephalitis. Toxoplasma colitis, which is rare, causes watery diarrhoea and loss of weight--features of many other, more common intestinal infections. The “Southern Medical Journal” (1995;88:860-1) warns that toxoplasmosis should be included in the differential diagnosis; if left untreated toxoplasma colitis is “invariably fatal.”

Congenital malformations are two to three times more frequent in the infants born to women with epilepsy than to the general population, and part of the explanation is the teratogenic effect of anticonvulsants such as phenytoin. A fetal valproate syndrome has also been described (Journal of Medical Genetics 1995;32:724-7). A …

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