------------- cut here -----------------           ONCE A YEAR...FOR A LIFETIME VIDEO KIT.  This kit         includes a 25-minute VHS videotape that presents common         misconceptions about mammography.  It tells of the         benefits gains by the early detection of breast cancer.         Jane Pauley and Phylicia Rashad are the narrators.  Kit         includes a guide, poster, flyer, and pamphlets on         mammography.  This kit is available directly by writing         to:  Modern, 5000 Park Street North, St. Petersburg, FL         33709-9989.       ADDITIONAL RESOURCES          COMBINED HEALTH INFORMATION DATABASE (CHID).  A computerized      bibliographic database developed and managed by agencies of      the U.S. Public Health Service.  It contains references to      health information and health education resources.  The      database provides bibliographic citations and abstracts for      journal articles, books, reports, pamphlets, audiovisuals,      product descriptions, hard-to-find information sources, and      health promotion and education programs under way in state      and local health departments and other locations.  In      addition, CHID provides source and availability information      for these materials, so that users may obtain them directly.        At present, there are twenty-one subfiles on CHID. The      National Cancer Institute created the Cancer Patient      Education subfile in 1990. It serves as a resource for the      CHID user who is interested in identifying patient education      programs for specific cancer patient populations, as well as      for the user who is trying to locate educational resources      available for patient or family cancer education.  Citations      include the contact person at cancer centers, so the user      can follow up directly with the appropriate person.        To access CHID, check with your local library.  Most medical      school, university, hospital, and public libraries subscribe      to commercial database vendors.  HICNet Medical Newsletter                                              Page 28 Volume  6, Number 11                                           April 25, 1993         FINAL REPORT:  AN INTEGRATED ONCOLOGY WORKSTATION (revised      5/92).  This book provides a conceptual overview of what a      clinical information system for practicing oncologists might      include:  a database of electronic patient chart records      combined with access to a knowledge base of information      resources such as PDQ, CANCERLIT, and MEDLINE--an      integration of data and knowledge combined to create a      clinical "oncology workstation."  The concept was developed      as a means to assist the oncologist and his or her office      staff in the daily management of patient care and clinical      trials.  This book can be obtained by contacting:  Dr.      Robert Esterhay, Project Officer, Computer Communications      Branch, Building 82, Room 201, Bethesda, MD 20892.        SCIENTIFIC INFORMATION SERVICES OF THE NATIONAL CANCER      INSTITUTE. (91-2683). This booklet from the International      Cancer Information Center (ICIC) describes each ICIC product      or service, including scientific journals (Journal of the      National Cancer Institute and NCI Monographs), specialized      current awareness publications (CANCERGRAMS, and ONCOLOGY      OVERVIEWS), and online databases (PDQ and CANCERLIT). To      obtain copies of the booklet, write to: International Cancer      Information Center, Dept. JJJ, National Cancer Institute,      Bldg. 82, Rm. 123, Bethesda, Maryland 20892 or fax your      request to 301-480-8105.                    HICNet Medical Newsletter                                              Page 29 Volume  6, Number 11                                           April 25, 1993              Publications for Patients Available from the NCI (1/93)   Free copies of the following patient education materials are available (in  single copy or bulk) by calling the NCI's Publication Ordering Service, 1-800- 4-CANCER.      CANCER PREVENTION        CHEW OR SNUFF IS REAL BAD STUFF.  This brochure, designed for seventh and eighth graders, describes the health and social effects of using smokeless tobacco products.  When fully opened, the brochure can be used as a poster.        CLEARING THE AIR:  A GUIDE TO QUITTING SMOKING.  This pamphlet, designed to help the smoker who wants to quit, offers a variety of approaches to cessation. [24 pages]        DIET, NUTRITION & CANCER PREVENTION:  THE GOOD NEWS.  This booklet provides an overview of dietary guidelines that may assist individuals in reducing their risks for some cancers.  It identifies certain foods to choose more often and others to choose less often in the context of a total health-promoting diet. [16 pages]        WHY DO YOU SMOKE?  This pamphlet contains a self-test to determine why people smoke and suggests alternatives and substitutes that can help them stop.     EARLY DETECTION          BREAST EXAMS:  WHAT YOU SHOULD KNOW.  This pamphlet provides answers to questions about breast cancer screening methods, including mammography, the medical checkup, breast self- examination, and future technologies.  Includes instructions for breast self-examination. [10 pages]        CANCER TESTS YOU SHOULD KNOW ABOUT:  A GUIDE FOR PEOPLE 65 AND OVER.  This pamphlet describes the cancer tests important for people age 65 and older.  It informs men and women of the exams they should be requesting when they schedule checkups with their doctors.  It provides a checklist for men and women to record when the cancer tests occur, and it describes the steps to follow  HICNet Medical Newsletter                                              Page 30 Volume  6, Number 11                                           April 25, 1993  should cancer be found. [14 pages]        DO THE RIGHT THING:  GET A MAMMOGRAM.  This brochure targets black women age 40 or older.  It describes the importance of regular mammograms in the early detection of breast cancer.  It states the NCI guidelines for mammography.        ONCE A YEAR FOR A LIFETIME.  This brochure targets all women age 40 or older.  It describes the importance of regular mammograms in the early detection of breast cancer.  It states the NCI guidelines for mammography.        QUESTIONS AND ANSWERS ABOUT BREAST LUMPS.  This pamphlet describes some of the most common noncancerous breast lumps and what can be done about them.  Includes instructions for breast self-examination. [22 pages]        QUESTIONS AND ANSWERS ABOUT CHOOSING A MAMMOGRAPHY FACILITY. This brochure lists questions to ask in selecting a quality mammography facility.  Also discusses typical costs and coverage.        TESTICULAR SELF-EXAMINATION.  This pamphlet contains information about risks and symptoms of testicular cancer and provides instructions on how to perform testicular self- examination.        THE PAP TEST:  IT CAN SAVE YOUR LIFE!  This easy-to-read pamphlet tells women the importance of getting a Pap test.  It explains who should request one, how often it should be done, and where to go to get a Pap test.     GENERAL          RESEARCH REPORTS.  In-depth reports covering current knowledge of the causes and prevention, symptoms, detection and diagnosis, and treatment of various types of cancer.  Individual reports are available on the following topics:        Bone Marrow Transplantation      Cancer of the Colon and Rectum      Cancer of the Lung      Cancer of the Pancreas      Melanoma  HICNet Medical Newsletter                                              Page 31 Volume  6, Number 11                                           April 25, 1993       Oral Cancers        THE IMMUNE SYSTEM - HOW IT WORKS.  This booklet, written at a high school level, explains the human immune system for the general public.  It describes the sophistication of the body's immune responses, the impact of immune disorders, and the relation of the immune system to cancer therapies present and future. [28 pages]          WHAT YOU NEED TO KNOW ABOUT CANCER.  This series of pamphlets discusses symptoms, diagnosis, treatment, emotional issues, and questions to ask the doctor.  Includes glossary of terms and other resources.  Individual pamphlets are available on the following topics:        Bladder      Bone      Brain      Breast      Cervix      Colon and Rectum      Dysplastic Nevi      Esophagus      Hodgkin's Disease      Kidney      Larynx      Lung      Melanoma      Multiple Myeloma      Non-Hodgkin's Lymphoma      Oral Cancers      Ovary      Pancreas      Prostate      Skin      Testis      Uterus     PATIENT EDUCATION        ANTICANCER DRUG INFORMATION SHEETS IN SPANISH/ENGLISH.  Two- sided fact sheets (in English and Spanish) provide information about side effects of common drugs used to treat cancer, their  HICNet Medical Newsletter                                              Page 32 Volume  6, Number 11                                           April 25, 1993  proper usage, and precautions for patients.  The fact sheets were prepared by the United States Pharmacopeial Convention, Inc., for distribution by the National Cancer Institute.  Single sets only may be ordered.        ADVANCED CANCER:  LIVING EACH DAY.  This booklet addresses coping with a terminal illness by discussing practical considerations for the patient, the family, and friends. [30 pages]        CHEMOTHERAPY AND YOU:  A GUIDE TO SELF-HELP DURING TREATMENT. This booklet, in question-and-answer format, addresses problems and concerns of patients receiving chemotherapy. Emphasis is on explanation and self-help. [64 pages]        EATING HINTS:  RECIPES AND TIPS FOR BETTER NUTRITION DURING CANCER TREATMENT.  This cookbook-style booklet includes recipes and suggestions for maintaining optimum nutrition during treatment.  All recipes have been tested. [92 pages]        FACING FORWARD: A GUIDE FOR CANCER SURVIVORS.  This booklet presents a concise overview of important survivor issues, including ongoing health needs, psychosocial concerns, insurance, and employment.  Easy-to-use format includes cancer survivors' experiences, practical tips, recordkeeping forms, and resources. It is recommended for cancer survivors, their family, and friends. [43 pages]        PATIENT TO PATIENT:  CANCER CLINICAL TRIALS AND YOU.  This 15-minute videocassette provides simple information for patients and families about the clinical trials process (produced in collaboration with the American College of Surgeons Commission on Cancer).        QUESTIONS AND ANSWERS ABOUT PAIN CONTROL:  A GUIDE FOR PEOPLE WITH CANCER AND THEIR FAMILIES.  This booklet discusses pain control using both medical and nonmedical methods.  The emphasis is on explanation, self-help, and patient participation. This booklet is also available from the American Cancer Society. [44 pages]        RADIATION THERAPY AND YOU:  A GUIDE TO SELF-HELP DURING TREATMENT. This booklet addresses concerns of patients receiving forms of radiation therapy.  Emphasis is on explanation and self-help. [52 pages]  HICNet Medical Newsletter                                              Page 33 Volume  6, Number 11                                           April 25, 1993         TAKING TIME:  SUPPORT FOR PEOPLE WITH CANCER AND THE PEOPLE WHO CARE ABOUT THEM.  This sensitively written booklet for persons with cancer and their families addresses the feelings and concerns of others in similar situations and how they have coped. [68 pages]        WHAT ARE CLINICAL TRIALS ALL ABOUT?  This booklet is designed for patients who are considering taking part in research for new cancer treatments.  It explains clinical trials to patients in easy-to-understand terms and gives them information that will help them decide about participating. [24 pages]        WHEN CANCER RECURS:  MEETING THE CHALLENGE AGAIN.  This booklet details the different types of recurrence, types of treatment, and coping with cancer's return. [28 pages]     BREAST CANCER EDUCATION SERIES        BREAST BIOPSY:  WHAT YOU SHOULD KNOW.  This booklet      discusses biopsy procedures.  It describes what to expect in      the hospital and while awaiting a diagnosis. [16 pages]        BREAST CANCER:  UNDERSTANDING TREATMENT OPTIONS. This      booklet summarizes the biopsy procedure and examines the      pros and cons of various types of breast surgery.  It      discusses lumpectomy and radiation therapy as primary      treatment, adjuvant therapy, and the process of making      treatment decisions. [19 pages]        MASTECTOMY:  A TREATMENT FOR BREAST CANCER.  This booklet      presents information about the different types of breast      surgery.  It explains what to expect in the hospital and      during the recovery period following breast cancer surgery.      Breast self-examination for mastectomy patients is also      described. [25 pages]        AFTER BREAST CANCER:  A GUIDE TO FOLLOWUP CARE.  This      booklet is for the woman who has completed treatment.  It      explains the importance of checking for possible signs of      recurring cancer by receiving regular mammograms, getting      breast exams from a doctor, and continuing monthly breast      self-exams.  It offers advice for managing the physical and      emotional side effects that may accompany surviving breast  HICNet Medical Newsletter                                              Page 34 Volume  6, Number 11                                           April 25, 1993       cancer. [15 pages]        PEDIATRIC CANCER EDUCATION SERIES        HELP YOURSELF:  TIPS FOR TEENAGERS WITH CANCER. This      magazine-style booklet is designed to provide information      and support to adolescents with cancer.  Issues addressed      include reactions to diagnosis, relationships with family      and friends, school attendance, and body image. [37 pages]        HOSPITAL DAYS, TREATMENT WAYS. This hematology-oncology      coloring book helps orient the child with cancer to hospital      and treatment procedures. [26 pages]        MANAGING YOUR CHILD'S EATING PROBLEMS DURING CANCER      TREATMENT.  This booklet contains information about the      importance of nutrition, the side effects of cancer and its      treatment, ways to encourage a child to eat, and special      diets. [32 pages]        TALKING WITH YOUR CHILD ABOUT CANCER.  This booklet is      designed for the parent whose child has been diagnosed with      cancer.  It addresses the health-related concerns of young      people of different ages; it suggests ways to discuss      disease-related issues with the child. [16 pages]        WHEN SOMEONE IN YOUR FAMILY HAS CANCER.  This booklet is      written for young people whose parent or sibling has cancer.      It includes sections on the disease, its treatment, and      emotional concerns. [28 pages]        YOUNG PEOPLE WITH CANCER:  A HANDBOOK FOR PARENTS.      This booklet discusses the most common types of childhood      cancer, treatments and side effects, and issues that may      arise when a child is diagnosed with cancer.  Offers medical      information and practical tips gathered from the experience      of others. [86 pages]     SPANISH LANGUAGE PUBLICATIONS   Si desea hablar con un especialista en informacion sobre el cancer, por favor llame al 1-800-422-6237 (1-800-4-CANCER).   CANCER PREVENTION  HICNet Medical Newsletter                                              Page 35 Volume  6, Number 11                                           April 25, 1993         A TIME OF CHANGE/DE NINA A MUJER.  This bilingual fotonovela      was developed specifically for young women.  It discusses      various health promotion issues such as nutrition, no      smoking, exercise, and pelvic, Pap, and breast examinations.      [34 pages]        DATOS SOBRE EL HABITO DE FUMAR Y RECOMENDACIONES PARA DEJAR      DE FUMAR.  This bilingual pamphlet describes the health      risks of smoking and tips on how to quit and how to stay      quit. [8 pages]        GUIA PARA DEJAR DE FUMAR.  This booklet is a full-color,      self-help smoking cessation booklet prepared specifically      for Spanish-speaking Americans.  It was developed by the      University of California, San Francisco, under an NCI      research grant. [36 pages]     EARLY DETECTION        HAGASE LA PRUEBA PAP: HAGALO HOY...POR SU SALUD Y SU      FAMILIA.  This bilingual brochure tells women why it is      important to get a Pap test.  It gives brief, clear      information about who needs a Pap test, where to go to get      one, and how often the Pap test should be done.        HAGASE UN MAMOGRAMA: UNA VEZ AL ANO...PARA TODA UNA VIDA.      This bilingual brochure describes the importance of      mammograms in the early detection of breast cancer.  It      gives brief information about who is at risk for breast      cancer, how a mammogram is done, and how to get one.        LA PRUEBA PAP: UN METODO PARA DIAGNOSTICAR CANCER DEL CUELLO      DEL UTERO.  This booklet in Spanish answers questions about      the Pap test, including how often it should be done,      significance of results, and other diagnostic tests and      treatments. [16 pages]        LO QUE USTED DEBE SABER SOBRE LOS EXAMENES DE LOS SENOS.      This booklet in Spanish explains the importance of the three      actions recommended by the NCI to detect breast cancer as      early as possible:  requesting regular mammography, getting      an annual breast exam from the doctor, and performing a      monthly breast self-exam. [6 pages]  HICNet Medical Newsletter                                              Page 36 Volume  6, Number 11                                           April 25, 1993         PREGUNTAS Y RESPUESTAS SOBRE LA SELECCION DE UN CENTRO DE      MAMOGRAFIA.  This brochure lists questions and answers to      ask in selecting a quality mammography facility.   PATIENT EDUCATION        ANTICANCER DRUG INFORMATION SHEETS IN SPANISH/ENGLISH.  Two-      sided fact sheets (in English and Spanish) provide      information about side effects of common drugs used to treat      cancer, their proper usage, and precautions for patients.      The fact sheets were prepared by the United States      Pharmacopeial Convention, Inc., for distribution by the      National Cancer Institute.  Single sets only may be ordered.        DATOS SOBRE EL TRATAMIENTO DE QUIMIOTERAPIA CONTRA EL      CANCER.  This flyer in Spanish provides a brief introduction      to cancer chemotherapy. [12 pages]        EL TRATAMIENTO DE RADIOTERAPIA:  GUIA PARA EL PACIENTE      DURANTE EL TRATAMIENTO.  This booklet in Spanish addresses      the concerns of patients receiving radiation therapy for      cancer.  Emphasis is on explanation and self-help. [48      pages]                      HICNet Medical Newsletter                                              Page 37 Volume  6, Number 11                                           April 25, 1993    ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::                               AIDS News Summaries ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::                 AIDS Daily Summary for April 19 to April 23, 1993              The Centers for Disease Control and Prevention (CDC) National AIDS   Clearinghouse makes available the following information as a public  service  only. Providing this information does not constitute endorsement  by the CDC,  the CDC Clearinghouse, or any other organization. Reproduction  of this text  is encouraged; however, copies may not be sold.  Copyright 1993, Information,  Inc., Bethesda, MD          =================================================================                                      April 19, 1993         =================================================================       "Absence of HIV Transmission From an Infected Orthopedic Surgeon" Journal of  the American Medical Association (04/14/93) Vol. 269,  No. 14, P. 1807  (von  Reyn, C. Fordham)        The risk of HIV transmission from an HIV-positive surgeon to  patient is  extremely low, provided that the surgeon strictly  adheres to universal  infection control procedures, write C.  Fordham von Reyn et al. of the  Dartmouth-Hitchcock Medical Center in Lebanon, N.H.  The researchers contacted  2,317 former patients on whom an HIV-positive orthopedic surgeon performed  invasive  procedures between January 1, 1978 and June 30, 1992.  The   orthopedic surgeon voluntarily withdrew from practice after  testing positive  for HIV.  A total of 1,174 former patients  underwent HIV testing,  representing 50.7 percent of patients on  whom the orthopedic surgeon  performed invasive procedures during  the 13.5-year period.  Patients were  tested from each year and  from each category of invasive procedure.  All  patients were  found to be negative for HIV by enzyme-linked-immunosorbent   assay.  Two former patients reported known HIV infection prior to surgery.   The examination of AIDS case registries and vital  records neglected to detect  cases of HIV infection among former  surgical patients.  The estimated cost of  the initial patient  notification and testing was $158,000, with the single  most  expensive activity being counseling and testing.  This accounted  for 37  percent of the total expense.  The patient notification  and testing were  conducted while maintaining the confidentiality  of the orthopedic surgeon who  was an active participant in the  planning and execution of the study.   Notifying patients of the  infected surgeon's HIV-status is both disruptive  and expensive  and is not routinely recommended, the researchers conclude. \         =================================================================      "Investigation of Potential HIV Transmission to the Patients of  an HIV- Infected Surgeon" Journal of the American Medical Association (04/14/93) Vol.   HICNet Medical Newsletter                                              Page 38 Volume  6, Number 11                                           April 25, 1993  269,  No. 14, P. 1795  (Smith Rogers, Audrey et al.)        The risk of HIV transmission during surgery is so remote that it  will be  quantified only by gathering data from multiple,  methodologically similar  investigations, writes Audrey Smith  Rogers et al. of the Johns Hopkins  University School of Medicine  in Baltimore, Md.  The researchers identified a  total of 1,131  persons in hospital databases who underwent invasive surgical   procedures between 1984 and 1990 and for whom the HIV-positive  surgeon was  listed as the operating surgeon.  The AIDS case  registries were reviewed for  all patients having undergone  invasive procedures and death certificates were  obtained.  Among  the 1,131 patients, 101 were dead, 119 had no address, 413  had  test results known, and 498 did not respond to the questionnaire. No  study patient name was found in reported AIDS case registries. One newly  detected, HIV-positive patient was determined to have  been most probably  infected in 1985 during a transfusion.  There  was no HIV transmission in 369  person-hours of surgical exposure, suggesting that HIV transmission to  patients is unlikely to occur more frequently than once per 1000 person-hours  of surgical  exposure.  The researchers determined there is no evidence to   suggest that the surgeon failed to adhere to standard  infection-control  guidelines; over 50 percent of the patients  with invasive procedures chose to  be tested, and of those whose  results were revealed, only one person was  found to be infected  with HIV.  The study patient's infection was probably  the result  of a tainted blood transfusion received in 1985.  As a result,   there is no evidence that the transmission of HIV from the  HIV-positive  surgeon to any patient transpired, the researchers  conclude.        ==================================================================                                 April 20, 1993        ==================================================================  "Drug Concerns to Share AIDS Data" New York Times (04/20/93), P. C10   (Kolata, Gina)        A total of 15 major pharmaceutical companies have decided, in a  highly  unusual move, to share AIDS drugs and information while  the drugs are  undergoing early clinical testing.  Dr. Edward  Scolnick, president of the  Merck Research Laboratory in Rahway,  N.J., arranged the collaboration.  He  said that cooperation  between companies seemed increasingly significant as it  had  become clear that combinations of drugs were likely to be more  effective  in fighting HIV than any drug used alone.  The  researchers are hopeful that  HIV, when faced with a combination  of several drugs requiring mutation at  different sites for  resistance to develop, will be unable to evolve all the  mutations at the same time.  Therefore, several drugs taken together or one  after the other could halt the spread of HIV.  Currently, the  drug companies  do not know what other drugs their competitors are developing.  The new  agreement allows companies to routinely  exchange animal data and safety data  on new AIDS drugs.  "An  agreement like this will greatly facilitate   HICNet Medical Newsletter                                              Page 39 Volume  6, Number 11                                           April 25, 1993  companies' ability to choose the best drug combinations much faster and in a  much more  efficient way," said Scolnick.  He also said that the   collaboration would not violate antitrust laws.  In creating the  agreement,  Merck spoke frequently to members of AIDS advocacy  groups, including ACT-UP.   Dr. Daniel Hoth, director of the  division on AIDS at the National Institute  of Allergy and  Infectious Disease said, "We're delighted to see the   pharmaceutical industry take this step because we think that  increasing the  information flow will likely accelerate the  discovery of better compounds for  AIDS."  Related Stories: Wall Street Journal (04/20) P. B1; Philadelphia   Inquirer (04/20) P. A3; USA Today (04/20) P. 1B  ==================================================================  "The Next Step in AIDS Treatment" Nature (04/08/93) Vol. 362, No. 6420, P. 493   (Maddox, John)        Although AZT was found to be ineffective in prolonging the lives  of  people infected with HIV, the findings do not indicate that  AZT should not be  administered in people with full-blown AIDS,  writes columnist John Maddox.   AZT has been used in the United  States in asymptomatic HIV-positive people on  the basis that  administration of the drug appeared to abate the decline of   T-cell counts.  However, a report in the Lancet demonstrated that AZT should  not be used early in the course of disease.  While the CD4 counts of the 877  people given AZT were consistently greater  than those of patients receiving  only placebo, the first three  years of follow-up have shown that the  proportions of people in  the two groups progressing to overt AIDS or even to  death were  not significantly different at roughly 18 percent.  The   conclusions are that AZT is not an effective AIDS drug in  HIV-infected  individuals, and that CD4 cell count may not be a  reliable proxy for the  progression to AIDS in infected people.   But nothing is implied by the study  of the utility of AZT in the  treatment of those in whom symptoms have already  appeared--there  is no case for abandoning that treatment, at least on the   evidence now available.  It is much more alarming that the CD4  count has  proven to be an unreliable mark of the efficacy of drug treatment in HIV  infection.  AIDS researchers should acknowledge  HIV is alive from the  beginning of infection and turn it into a  workable assay of the progress of  disease.  The general  application of such an assay will probably in itself  provide a  better understanding of the pathogenesis of AIDS, concludes   Maddox.        ==================================================================  "Infective and Anti-Infective Properties of Breastmilk From  HIV-1-Infected  Women" Lancet (04/10/93) Vol. 341, No. 8850, P. 914   (Van de Perre, Philippe  et al.)        A vaccine preparation inducing a persistent immune response of  the IgM  type in the mother's body fluids could be valuable to  prevent transmission of  HIV-1 from mother to child, write  Philippe Van de Perre et al. of the   HICNet Medical Newsletter                                              Page 40 Volume  6, Number 11                                           April 25, 1993  National AIDS Control Program in Kigali, Rwanda.  The researchers hypothesized  that  transmission of HIV-1 through breastmilk could be favored by the   presence of infected cells, by deficiency of anti-infective  substances in  breastmilk, or both factors.  A total of 215  HIV-1-infected women were  enrolled at delivery in Kigali, Rwanda; milk samples were collected 15 days, 6  months, and 18 months post partum.  HIV-1 IgG, secretory IgA, and IgM were  assayed by  western blot, for the latter two after removal of IgG with   protein G.  In the 15-day and 6-month samples, the researchers  sought viral  genome in milk cells by double polymerase chain  reaction with three sets of  primers (gag, pol, and env).  At 15  days, 6 months, and 18 months post  partum, HIV-1 specific IgG was detected in 95 percent, 98 percent, and 97  percent of breastmilk  samples; IgA in 23 percent, 28 percent, and 41 percent;  and IgM  in 66 percent, 78 percent, and 41 percent.  In children who  survived  longer than 18 months the risk of infection was  associated with lack of  persistence of IgM and IgA in their  mothers' milk.  The presence of HIV-1- infected cells in the milk  15 days post partum was strongly predictive of  HIV-1 infection in the child by both univariate and multivariate analysis.   The  combination of HIV-1 infected cells in breastmilk and a defective IgM  response was the strongest predictor of infection.  IgM and  IgA anti-HIV-1 in  breastmilk may protect against postnatal  transmission of HIV, the researchers  conclude.        ==================================================================                                     April 21, 1993        ==================================================================     "Firms to Share AIDS Research in Global Venture" Journal of Commerce  (04/21/93), P. 7A        A total of fifteen U.S. and European pharmaceutical companies  announced  Tuesday they will swap drug supplies and information on early-stage AIDS  research to hasten the search for combination  therapies to fight HIV  infection and AIDS.  The companies said  the unusual move resulted primarily  from the increasing  concentration of AIDS research on combination therapies  since  realizing that HIV is likely to develop resistance to every  individual  AIDS drug.  Edward Scolnick, president of Merck & Co.  Research Laboratories,  led the collaborative effort that took a  year of negotiations to come  together, said participants.  In  addition to Merck, the other companies  involved in the  Inter-Company Collaboration for AIDS Drug Development are   Bristol-Myers Squibb Co., Burroughs Wellcome, Glaxo Inc.,  Hoffman-La Roche,  Eli Lilly & Co., Pfizer Inc., Smithkline  Beecham, AB Astra, Du Pont Merck,  Syntex Inc., Boehringer  Ingelheim, Miles Inc., and Sigma-Tau.  The  participants said that all companies involved in AIDS drug development they  were aware  of had joined the collaboration, and that any company actively   involved in HIV anti-viral development may participate.  Scolnick said the  collaborators would most likely meet every couple of  months for a daylong  scientific meeting where they will review  for one another their preclinical   HICNet Medical Newsletter                                              Page 41 Volume  6, Number 11                                           April 25, 1993  and early clinical data.  The  American Foundation for AIDS Research (AmFAR)  was pleased with  the news of the collaboration, which it hopes will lead to  the  development of drug combinations that will reduce viral  resistance.    Related Story: Financial Times (04/21) P. 1  ==================================================================     "Guidance Over HIV-Infected Health-Care Workers" Lancet (04/10/93) Vol. 341,  No. 8850, P. 952  (Horton, Richard)        The United Kingdom's Department of Health recently followed the  advice  of AIDS experts that there is no scientific reason for  routine HIV testing  among health-care workers.  Following recent  highly publicized reports of  health professionals who contracted  HIV, the department issued revised  guidelines on the management  of such cases.  Dr. Kenneth Calman, Chief  Medical Officer, said  doctors, dentists, nurses, and other health-care  workers have an  ethical duty to seek advice if they have been exposed to HIV   infection, including, if appropriate, diagnostic HIV testing.  He said,  "Infected health care workers should not perform invasive  procedures that  carry even a remote risk of exposing patients to  the virus."  The guidelines  --------- end of part 3 ------------