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The purine nucleoside adenosine is clinically employed in the treatment of supraventricular tachycardia. In addition, it has direct coronary vasodilatory effects, and may influence platelet aggregation. Experimental observations mechanistically link extracellular adenosine to cellular adaptation to hypoxia. Adenosine generation has been implicated in several pathophysiologic processes including angiogenesis, tumor defenses and neurodegeneration. In solid organ transplantation, prolonged tissue ischemia and subsequent reperfusion injury may lead to profound graft dysfunction. Importantly, conditions of limited oxygen availability are associated with increased production of extracellular adenosine and subsequent tissue protection. Within the rapidly expanding field of adenosine biology, several enzymatic steps in adenosine production have been characterized and multiple receptor subtypes have been identified. In this review, we briefly examine the biologic steps involved in adenosine generation and chronicle the current state of adenosine signaling in hepatic ischemia and reperfusion injury.

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PURPOSE: The purpose of this study was to identify the factors that contributed to intervention effectiveness in acquired immunodeficiency syndrome (AIDS) prevention projects targeting youth. METHODS: Eleven AIDS prevention projects funded by the Robert Wood Johnson Foundation whose target populations consisted of at least 60% youth were studied. A blended methodology resulted in quantitative data (i.e., survey responses) from all 11 projects supplemented with qualitative data (i.e., open-ended interviews) drawn from in-depth site visits to six projects. RESULTS: Projects reported using a mean of 16.6 intervention activities (selected from a list of 30). Six activities were used by all 11 projects. Small group discussions were rated as one of three most effective activities by 72.7% of the projects that used them. Project staff identified three elements of effective interventions: involvement of peer educators, recognition of the role of adults (e.g., parents, teachers), and use of structured settings to gain access to the target population (e.g., schools, clubs). CONCLUSIONS: The most powerful strategies described by project staff for reaching adolescents at risk for human immunodeficiency virus (HIV) transmission also bring considerable challenges. Opportunity costs associated with using peer educators, gatekeeper support, and structured settings may include limited control of the message, impaired credibility, and failure to reach those youth at greatest risk of HIV infection, respectively. Health educators will do well to consider the advantages and disadvantages of these factors when developing, implementing, and evaluating AIDS prevention programs for youth.

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In this intervention, participants design and implement an HIV/AIDS prevention project for Mexican homosexual men. The intervention is consistent with, and contributes to, empowerment theory because it enhances collective action, provides opportunities to develop knowledge and skills, creates needed resources, and includes shared control with professional and among participants. The intervention described provides an illustration of an empowering process and distinguishes itself from empowerment outcomes. An evaluation of the project is also described, but the outcomes were HIV/AIDS-related behaviors rather than psychological empowerment of the participants. The results suggest that the participants' HIV/AIDS knowledge and preventive behavior improved when compared to individuals who did not participate in the intervention. In addition, the intervention generated community change initiated by participants. Implications for designing interventions using an empowerment approach are discussed.

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Little knowledge exists about AIDS and Human Immunodeficiency Virus (HIV) infection among Latin American gay males. In Latin America, sexual transmission from man to man is the leading cause of HIV infection. In Mexico, which ranks third in number of AIDS cases in the Americas, more than three-quarters of the cases are due to sexual transmission; among these cases, 35% and 23.7% are due to homosexual and bisexual male practices, respectively. A sample of 200 individuals from Juarez, Mexico, a city on the U.S. border, was interviewed. Information about their AIDS knowledge, sexual behavior, and condom use was obtained. Factory workers and individuals who meet sexual partners in the streets reported more sexual partners than workers in service or professional occupations and those who meet their partners in bars and discos. Number of sexual partners and respondents' age were inversely associated with condom use. Implications for HIV prevention are discussed.

PIP: Two hundred gay and bisexual men of mean age 26.4 years from Juarez, Mexico, were interviewed by the Mexican Federation of PRivate Associations for Community Development (FEMAP) about their AIDS knowledge, sexual behavior, and condom use. 88% were single and never married. 66% self-identified as being gay, 29% as bisexual, and 2% as transvestites; 10% reported having sex for money. 14% had had at least one sexually transmitted disease and 57% were negative about condom use. Having an average 4.46 sex partner/month, most respondents were knowledgeable about HIV transmission routes, AIDS symptoms, and HIV antibody tests. 75% and 77.5%, respectively, reported practicing receptive anal intercourse and insertive anal intercourse. They used condoms an average of 6.47 times in their most recent ten sexual encounters. By profession and social behavior, factory workers and individuals who recruit sex partners from the street reported having more sex partners than service and professional workers and those who meet their partners in bars and discos. Further, the number of sex partners and respondents' age were inversely associated with condom use. These findings clearly highlight the failure of knowledge about HIV to bring about change in sexual behavior among certain subpopulations in the study area. Since homosexuality remains unaccepted in Mexican society, the author suggests targeted peer education and small-group session prevention efforts which do not confront mainstream social structure and values.

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Os autores apresentam um caso da doenca de Wolman, tambem conhecida como xantomatose familiar ou lipidose familiar de Wolman, caracterizada pela deposicao de esteres de colesterol no SRE e calcificacao bilateral das adrenais. A doenca apresenta-se precocemente na vida e evolui com progressiva hepatoesplenomegalia e ma absorcao intestinal. O prognostico e fatal

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