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Sample records for aids patients exhibiting

  1. Epidemiology of cryptosporidiosis among European AIDS patients

    DEFF Research Database (Denmark)

    Pedersen, C; Danner, S; Lazzarin, A;

    1996-01-01

    OBJECTIVE: To study epidemiology and possible risk factors associated with the development of cryptosporidiosis among European patients with AIDS. METHODS: An inception cohort of 6548 patients with AIDS, consecutively diagnosed from 1979 to 1989, from 52 centres in 17 European countries was studi...

  2. Exhibition

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    China[Guangzheu] International Trade Fair for Home Textiles Date:March 18th- March 21st,2011 Venue:China Import and Export Fair Complex(Guangzhou,China) Organizers:China National Textile&Apparel Council China Foreign Trade Center(Group) China Home Textile Association China Foreign Trade Guangzhou Exhibition Corp.

  3. Epidemiology of cryptosporidiosis among European AIDS patients

    DEFF Research Database (Denmark)

    Pedersen, C; Danner, S; Lazzarin, A;

    1996-01-01

    OBJECTIVE: To study epidemiology and possible risk factors associated with the development of cryptosporidiosis among European patients with AIDS. METHODS: An inception cohort of 6548 patients with AIDS, consecutively diagnosed from 1979 to 1989, from 52 centres in 17 European countries was studied....... Data on all AIDS defining events were collected retrospectively from patients' clinical records. Kaplan-Meier estimates, log rank tests and Cox proportional hazard models were used to examine for possible risk factors associated with cryptosporidiosis. RESULTS: Cryptosporidiosis was diagnosed in 432 (6.......6%) patients, 216 at time of the AIDS diagnosis and 216 during follow-up. The probability of being diagnosed with cryptosporidiosis at AIDS diagnosis was significantly lower for intravenous drug users (1.3%) than for homosexual men (4.1%) and for patients belonging to other transmission categories (4.0%) (p...

  4. Exhibition

    CERN Multimedia

    Staff Association

    2016-01-01

    Encounters Hanne Blitz From February 1st to 12th 2016 CERN Meyrin, Main Building What is our reaction to a first encounter with a tourist attraction? Contemporary Dutch painter Hanne Blitz captures visitors' responses to art and architecture, sweeping vistas and symbolic memorials. Encounters, a series of oil paintings curated specially for this CERN exhibition, depicts tourists visiting cultural highlights around the world. A thought-provoking journey not to be missed, and a tip of the hat to CERN's large Hadron Collider.

  5. Exhibition

    CERN Document Server

    Staff Association

    2017-01-01

    Sintropie Flavio Pellegrini From 13 to 24 March 2017 CERN Meyrin, Main Building Energia imprigionata - Flavio Pellegrini. The exhibition is composed by eleven wood artworks with the expression of movement as theme. The artworks are the result of harmonics math applied to sculpture. The powerful black colour is dominated by the light source, generating reflexes and modulations. The result is a continuous variation of perspective visions. The works generate, at a first approach, an emotion of mystery and incomprehension, only a deeper contemplation lets one discover entangling and mutative details, evidencing the elegance of the lines and letting the meaning emerge. For more information : staff.association@cern.ch | Tél: 022 766 37 38

  6. Cerebral toxoplasmosis in Danish AIDS patients

    DEFF Research Database (Denmark)

    Smith, E; Pers, C; Aschow, C;

    1991-01-01

    We estimate the frequency of central nervous system (CNS) toxoplasmosis in Danish AIDS patients and evaluate the diagnostic accuracy using the following criteria for acceptance of the diagnosis: either (1) the demonstration of Toxoplasma gondii in brain tissue or (2) one or more hypodense or ring......-enhancing lesions on computerized axial tomography (CAT) scan and a neurologic and CAT scan improvement in response to 2 weeks of treatment. From 1981 until July 1990 266 patients were diagnosed with AIDS at Hvidovre Hospital, Copenhagen and 29 (11%) were treated, suspected for CNS toxoplasmosis. 17 patients had...... the diagnosis confirmed but since 5 patients, who were never treated, were diagnosed at autopsy, the overall cumulated incidence was 8% (22/266 patients). The overall diagnostic accuracy was 59% (17/29 patients) showing some changes over time. Among patients diagnosed with AIDS in 1988 or later, the accuracy...

  7. Epidemiology of cryptosporidiosis among European AIDS patients.

    Science.gov (United States)

    Pedersen, C; Danner, S; Lazzarin, A; Glauser, M P; Weber, R; Katlama, C; Barton, S E; Lundgren, J D

    1996-01-01

    OBJECTIVE: To study epidemiology and possible risk factors associated with the development of cryptosporidiosis among European patients with AIDS. METHODS: An inception cohort of 6548 patients with AIDS, consecutively diagnosed from 1979 to 1989, from 52 centres in 17 European countries was studied. Data on all AIDS defining events were collected retrospectively from patients' clinical records. Kaplan-Meier estimates, log rank tests and Cox proportional hazard models were used to examine for possible risk factors associated with cryptosporidiosis. RESULTS: Cryptosporidiosis was diagnosed in 432 (6.6%) patients, 216 at time of the AIDS diagnosis and 216 during follow-up. The probability of being diagnosed with cryptosporidiosis at AIDS diagnosis was significantly lower for intravenous drug users (1.3%) than for homosexual men (4.1%) and for patients belonging to other transmission categories (4.0%) (p < 0.001). The probability was also higher for patients from Central Europe compared with patients from South Europe (4.1% versus 2.5%, p = 0.005). The rate of developing cryptosporidiosis after the diagnosis of AIDS was 3 per 100 patient years of follow-up. The rate was significantly lower for intravenous drug users than for homosexual men (relative risk 0.34, 95% confidence limits 0.22-0.54) and for women compared with men (RR 0.43 (0.21-0.87)). The risk was higher in North Europe than in South and Central Europe. In a multivariate analysis only transmission category remained a significant predictor for the development of cryptosporidiosis. CONCLUSION: The development of cryptosporidiosis in AIDS patients may be associated with sexual risk behaviour. PMID:8698361

  8. Socio-economic status of AIDS patients

    DEFF Research Database (Denmark)

    Laursen, E; Larsen, L

    1995-01-01

    The charts of 187 patients diagnosed at Hvidovre University Hospital, Copenhagen from 1981 through 1989 as having AIDS were reviewed retrospectively in order to examine the extent of their employment and alternative sources of income during the first 2 years after diagnosis. At the time of diagno......The charts of 187 patients diagnosed at Hvidovre University Hospital, Copenhagen from 1981 through 1989 as having AIDS were reviewed retrospectively in order to examine the extent of their employment and alternative sources of income during the first 2 years after diagnosis. At the time...... amounted to US$16,150. As shown here, the work capacity of AIDS patients is quite low, and alternative sources of income must be provided....

  9. Functional assesment of patients with AIDS disease

    Directory of Open Access Journals (Sweden)

    Marise Bueno Zonta

    2003-10-01

    Full Text Available We documented the types and degree of functional disability in 74 patients with AIDS at the Hospital de Clínicas of the Federal University of Paraná, Brazil. Few of these patients are referred for rehabilitation services and there is only a limited team approach in their care. We found that 91% of the patients had some degree of functional impairment; in 81% the complaint was weakness and in 47% it was neurological involvement. According to the Barthel Index, 79% were considered functionally independent, 14% partially dependent and 7% dependent. For most of them, independence requires effort and their quality of life is reduced. Severe disability was rather unusual, while mild or moderate disability levels were not. The functional physical disability found in 21% of the patients required management by a rehabilitation team. We conclude that it is important to focus attention on the quality of life of patients with AIDS.

  10. Spouse-aided therapy with depressed patients

    NARCIS (Netherlands)

    EmanuelsZuurveen, L; Emmelkamp, PMG

    1997-01-01

    Twenty-three non-maritally distressed depressed patients who were married or cohabitating were randomly assigned to either individual behavioral-cognitive therapy or spouse-aided treatment. Both treatment conditions focused on depressed mood, behavioral activity, and dysfunctional cognitions, the di

  11. Nosocomial outbreak of cryptosporidiosis in AIDS patients

    DEFF Research Database (Denmark)

    Ravn, Pernille; Lundgren, Jens Dilling; Kjaeldgaard, P;

    1991-01-01

    OBJECTIVE--To describe a nosocomial outbreak of cryptosporidiosis during four months after June 1989. SETTING--A department of infectious diseases in Copenhagen, seeing about half the patients with AIDS in Denmark. SUBJECTS--73 HIV antibody negative subjects and 60 antibody positive subjects...

  12. Pulmonary cryptococcosis in non-AIDS patients

    Directory of Open Access Journals (Sweden)

    Jin-Quan

    2012-12-01

    Full Text Available OBJECTIVE: To investigate the clinical features, management, and prognosis of pulmonary cryptococcosis in non-acquired immunodeficiency syndrome (AIDS patients. METHOD: 24 cases of pulmonary cryptococcosis with accurate pathological diagnosis were retrospectively studied. RESULTS: 15 male patients and nine female patients were diagnosed at the first affiliated hospital of Sun Yat-sen University from November 1999 to November 2011. The mean age at the time of diagnosis was 44.2 ± 11.3 years (range: 24 to 65 years. Among these patients, 13 had other comorbidities. 15 were symptomatic and the other nine were asymptomatic. The most common presenting symptoms were cough, chest tightness, expectoration, and fever. None had concurrent cryptococcal meningitis. The most frequent radiologic abnormalities on chest computed tomography (CT scans were solitary or multiple pulmonary nodules, and masses or consolidations, and most lesions were located in the lower lobes. All patients had biopsies for the accurate diagnosis. Among the 24 patients, nine patients underwent surgical resections (eight had pneumonectomy via thoracotomy and one had a pneumonectomy via thoracoscopy. Five of the patients who underwent surgery also received antifungal drug therapy (fluconazole for one to three months after the surgery. The other 15 only received antifungal drug therapy (fluconazole or voriconazole for three to six months (five patients are still on therapy. The follow-up observation of 19 patients who had already finished their treatments lasted from two to 11 years, and there was no relapse, dissemination, or death in any of these patients. CONCLUSION: Non-AIDS patients with pulmonary cryptococcosis have a good prognosis with appropriate management.

  13. CT of disseminated plasmacytoma - in an AIDS patient

    Energy Technology Data Exchange (ETDEWEB)

    Leder, D.S.; Nazarian, L.N.; Burke, M. [Thomas Jefferson Univ., Philadelphia, PA (United States)

    1996-05-01

    It is well known that acquired immunodeficiency syndrome (AIDS) is associated with increased risk of neoplasms, particularly Kaposi sarcoma and non-Hodgkin lymphoma. There have been several recent reports in the literature describing plasma cell tumors in AIDS patients. We report the imaging findings in a case of widely disseminated plasmacytoma in a patient with known AIDS. 7 refs., 3 figs.

  14. Clinical characteristics of 297 newly diagnosed Chinese HIV / AIDS patients

    Institute of Scientific and Technical Information of China (English)

    曹玮

    2014-01-01

    Objective To determine the clinical characteristics of HIV infected patients in China in order to improve early recognition and diagnosis of AIDS.Methods A total of297 newly diagnosed HIV/AIDS patients were enrolled in Peking Union Medical College Hospital(PUMCH)from January 2001 to December 2012,including 19 patients of primary phase,115 of asymptomatic phase and 163 of AIDS phase.Clinical characteristics of these patients were retrospectively analyzed.Results Two hundred and

  15. HEARING AID USE IN PATIENTS WITH PRESBYACUSIS: A QUESTIONNAIRE SURVEY

    Directory of Open Access Journals (Sweden)

    A. Karimaneh A. Eftekharian

    2004-11-01

    Full Text Available The acceptability of hearing aids in people with presbyacusis has been improved but assessment of whether there is a need for more counseling to increase the number of regular hearing-aid users seems to be important. The aim of this study was to determine if the hearing aid was worn regularly and over a long period of time in people with presbyacusis. A questionnaire survey of patients with presbyacusis who had been fitted with a monaural behind the ear hearing aid for the first time was undertaken. The patients were divided into four groups ranging from 6 months to 3 years after fitting. Overall regular long-term use of the hearing aid was found in the majority of patients with presbyacusis. The main dropout point was within the first year after fitting the hearing aid. The study furthermore revealed a relatively high demand for further help and advice with the hearing aid in all groups.

  16. Opportunistic infections and malignancies in 231 Danish AIDS patients

    DEFF Research Database (Denmark)

    Pedersen, C; Gerstoft, J; Tauris, P;

    1990-01-01

    We analysed cumulative disease frequencies in the first 231 adult Danish AIDS patients with life tables. There was a certain hierarchical pattern in the occurrence of complicating diseases. Herpes zoster, Kaposi's sarcoma and Pneumocystis carinii pneumonia were early manifestations, whereas...... diseases caused by cytomegalovirus and atypical mycobacteria tended to occur later in the course of AIDS. Compared with all other AIDS patients, homosexual men were more likely to develop Kaposi's sarcoma, cytomegalovirus chorioretinitis and mucocutaneous herpes simplex virus infection. The proportion...

  17. Opportunistic infections and malignancies in 231 Danish AIDS patients

    DEFF Research Database (Denmark)

    Pedersen, C; Gerstoft, J; Tauris, P;

    1990-01-01

    We analysed cumulative disease frequencies in the first 231 adult Danish AIDS patients with life tables. There was a certain hierarchical pattern in the occurrence of complicating diseases. Herpes zoster, Kaposi's sarcoma and Pneumocystis carinii pneumonia were early manifestations, whereas...... diseases caused by cytomegalovirus and atypical mycobacteria tended to occur later in the course of AIDS. Compared with all other AIDS patients, homosexual men were more likely to develop Kaposi's sarcoma, cytomegalovirus chorioretinitis and mucocutaneous herpes simplex virus infection. The proportion...... of patients who developed particular diseases changed with calendar time. Most striking was a three to fourfold decrease in diseases caused by cytomegalovirus. In conclusion, the study showed that disease frequencies in patients with AIDS may vary with the patients risk behaviour and duration of AIDS...

  18. Patients with carcinoid syndrome exhibit symptoms of aggressive impulse dysregulation

    NARCIS (Netherlands)

    Russo, S; Boon, JC; Kema, IP; Willemse, PHB; den Boer, JA; Korf, J; de Vries, EGE

    2004-01-01

    Objective: Carcinoid tumors can produce excessive amounts of biogenic amines, notably serotonin. We assessed psychiatric symptoms in carcinoid patients and peripheral metabolism of tryptophan, the precursor of serotonin. Methods: Twenty consecutive patients with carcinoid syndrome underwent a struct

  19. SPECTRUM OF OPPORTUNISTIC INFECTIONS IN HIV-AIDS PATIENTS

    OpenAIRE

    S S Madkar; Ashok Jaykumar Vankudre; SL Nilekar

    2012-01-01

    Aim: AIDS is characterized by a number of opportunistic infections which are responsible for high morbidity and mortality. The spectrum and distribution of opportunistic infections (OIs) in AIDS patients is ever-expanding. This spectrum varies from continent to continent. The aim of the present study was to document the spectrum of OIs in HIV-infected patients in Ambajogai. Material and Method: 178 HIV positive symptomatic patients, either hospitalized or coming to ART (Antiretroviral Therapy...

  20. A Multimodal Communication Aid for Global Aphasia Patients

    DEFF Research Database (Denmark)

    Pedersen, Jakob Schou; Dalsgaard, Paul; Lindberg, Børge

    2004-01-01

    This paper presents the basic rationale behind the development and testing of a multimodal communication aid especially designed for people suffering from global aphasia, and thus having severe expressive difficulties. The principle of the aid is to trigger patient associations by presenting...... various multimodal representations of communicative expressions. The aid can in this way be seen as a conceptual continuation of previous research within the field of communication aids based on uni-modal (pictorial) representations of communicative expressions. As patients suffering from global aphasia...... expressions can be used to support patients with global aphasia in communicating by means of short sentences with their surroundings. Only a limited evaluation is carried out, and as such no statistically significant results are obtained. The tests however indicate that the aid is capable of supporting...

  1. Burnout in Hospital Social Workers Who Work with AIDS Patients.

    Science.gov (United States)

    Oktay, Julianne S.

    1992-01-01

    Surveyed 128 hospital social workers who worked with Acquired Immune Deficiency Syndrome (AIDS) patients. Found that hospital AIDS social workers had slightly higher rates of emotional exhaustion and depersonalization on Maslach Burnout Inventory but also felt substantially higher level of personal accomplishment. Age, autonomy, and belonging to…

  2. EEG and dementia indicators in AIDS patients' Rorschach test

    Directory of Open Access Journals (Sweden)

    G. Fernandes do Prado

    1994-09-01

    Full Text Available We studied the EEG and Rorschach test (RT of nineteen AIDS patients and eight normal people in the same age group. Eight patients presented slow alpha rhythms (8 to 9 Hz; three, not-slow alpha rhythms (>9 to 13Hz; and eight, beta rhythms in background activity. Paroxystic activity, characterized by diffuse theta or delta waves, was present in eleven patients. We observed Oberholzer syndrome (organic dementia diagnosed by RT in ten patients and Piotrowski syndrome (organic dementia diagnosed by RT in eleven patients; six presented both. When considering only the group of AIDS patients, we did not observe a significant relation among slow alpha rhythm, not-slow alpha rhythm and the presence of paroxystic activity with the above-mentioned syndromes. AIDS patients with slow alpha rhythms showed a significantly greater number of Piotrowski syndrome dementia indicators when compared to normal individuals or those with slow alpha rhythms. We did not observe the same with Oberholzer syndrome.

  3. Effect of oral nutritional support on hospitalized patients with AIDS

    OpenAIRE

    Renata Pereira da Silva; Ìsis Lucilia Santos Borges de Araùjo; Poliana Coelho Cabrai; Maria Goretti Pessoa de Araùjo Burgos

    2013-01-01

    Introduction: The emergence of more effective therapies for the treatment of Acquired Immunodeficiency Syndrome (AIDS) has reduced the rates of illness, mortality and malnutrition among infected patients. However, reduced food intake, nutrient malabsorption and metabolic alterations induced by fever and infection are seen in cases of hospital malnutrition. Objectives: The aim of the present study was to assess the impact of oral nutritional support (ONS) on hospitalized patients with AIDS. Me...

  4. The changing face of HIV/AIDS in treated patients.

    Science.gov (United States)

    Llibre, Josep M; Falco, Vicenç; Tural, Cristina; Negredo, Eugenia; Pineda, Juan A; Muñoz, Jose; Ortega, Enrique; Videla, Sebastia; Sirera, Guillem; Martinez, Esteban; Miralles, Celia; Iribarren, Josean; Galindo, Maria J; Domingo, Pere; d'Arminio-Monforte, Antonella; Miro, Jose M; Clotet, Bonaventura

    2009-07-01

    The spectrum of complications emerging in successfully treated HIV-infected patients has dramatically changed since the advent of HAART. Typical AIDS-defining illnesses have been substituted by new comorbid conditions that threaten even those patients who maintain virologic suppression. Proper management of cardiovascular risk, and early diagnosis of AIDS-related and, particularly, non-AIDS-related malignancies (including papilomavirus-related neoplasms) must be introduced into the routine of care. Hot areas of investigation include HIV-associated neurocognitive disorders, hepatitis B and C coinfection, non-alcoholic fatty liver disease, progressive multifocal leukoencephalopathy and tuberculosis. Bone and kidney long-term toxicities and lipoatrophy remain as issues of paramount importance. The identification and early treatment of immune reconstitution disease is also of major interest, specially in those patients starting their antiretroviral treatment with severe CD4 cell depletion. The present review focuses on these twelve areas of increasing interest for physicians currently facing successfully treated HIV+ patients.

  5. Disseminated histoplasmosis in a Danish patient with AIDS

    DEFF Research Database (Denmark)

    Smith, E; Franzmann, M; Mathiesen, Lars Reinhardt

    1989-01-01

    We present the first case of disseminated histoplasmosis in an AIDS patient in Europe, a 33-year-old Danish homosexual man, and recommend a detailed travel history in HIV-positive patients presenting with fever, weight loss and organomegaly. In Scandinavia disseminated histoplasmosis is rare...

  6. Multicenter Brazilian Study of Oral Candida Species Isolated from Aids Patients

    Directory of Open Access Journals (Sweden)

    Priscilla de Laet Sant'Ana

    2002-03-01

    Full Text Available Oropharyngeal candidiasis continues to be considered the most common opportunistic disease in Aids patients. This study was designed to investigate species distribution, serotype and antifungal susceptibility profile among Candida spp. isolated from the oral cavity of Aids patients recruited from six Brazilian university centers. Oral swabs from 130 Aids patients were plated onto CHROMagar Candida medium and 142 isolates were recovered. Yeast isolates were identified by classical methods and serotyped using the Candida Check® system-Iatron. Antifungal susceptibility testing was performed according to the NCCLS microbroth assay. C. albicans was the most frequently isolated species (91%, and 70% of the isolates belonged to serotype A. We detected 12 episodes of co-infection (9%, including co-infection with both serotypes of C. albicans. Non-albicans species were isolated from 12 episodes, 50% of them exhibited DDS or resistance to azoles. Otherwise, only 8 out 130 isolates of C. albicans exhibited DDS or resistance to azoles. Brazilian Aids patients are infected mainly by C. albicans serotype A, most of them susceptible to all antifungal drugs.

  7. Enhanced mucosal reactions in AIDS patients receiving oropharyngeal irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Watkins, E.B.; Findlay, P.; Gelmann, E.; Lane, H.C.; Zabell, A.

    1987-09-01

    The oropharynx and hypopharynx are common sites of involvement in AIDS patients with mucocutaneous Kaposi's sarcoma. The radiotherapist is often asked to intervene with these patients due to problems with pain, difficulty in swallowing, or impending airway obstruction. We have noted an unexpected decrease in normal tissue tolerance of the oropharyngeal mucosa to irradiation in AIDS patients treated in our department. Data on 12 patients with AIDS and Kaposi's sarcoma receiving oropharyngeal irradiation are presented here. Doses ranged from 1000 cGy to 1800 cGy delivered in 150-300 cGy fractions. Seven of eight patients receiving doses of 1200 cGy or more developed some degree of mucositis, four of these developed mucositis severe enough to require termination of treatment. All patients in this study received some form of systemic therapy during the course of their disease, but no influence on mucosal response to irradiation was noted. Four patients received total body skin electron treatments, but no effect on degree of mucositis was seen. Presence or absence of oral candidiasis was not an obvious factor in the radiation response of the oral mucosa in these patients. T4 counts were done on 9 of the 12 patients. Although the timing of the T4 counts was quite variable, no correlation with immune status and degree of mucositis was found. The degree of mucositis seen in these patients occurred at doses much lower than expected based on normal tissue tolerances seen in other patient populations receiving head and neck irradiations. We believe that the ability of the oral mucosa to repair radiation damage is somehow altered in patients with AIDS.

  8. [Stereotaxic brain biopsy in AIDS patients with neurological manifestations].

    Science.gov (United States)

    Nasser, J A; Confort, C I; Ferraz, A; Esperança, J C; Duarte, F

    1998-06-01

    Prospective series showing the importance of computerized stereotactic brain biopsy in the management of AIDS patients neurologically symptomatic and confirmed by images. Patients undergone an algorithm step by step done by their own doctors and referred to us for stereotactic biopsy. Our protocol was opened in August 1995 and closed in December 1996. Twenty patients were biopsied. This protocol is similar to the Levy's one (Chicago IL, USA). We have got diagnosis in all cases. Lymphoma was predominant and followed by toxoplasmosis, progressive multifocal leukoencephalopathy and HIV encephalopathy. We included one patient with diploic giant cells lymphoma. Our mortality and morbidity was zero. By these results we conclude that stereotactic biopsy in AIDS patients is safe and effective.

  9. Estomatologic manifestations in HIV/AIDS patients

    OpenAIRE

    Garibay Rodríguez, Lorena Elvira; CD. Práctica privada.; Cisneros Zárate, Luis; Departamento Académico Médico Quirúrgico. Facultad de Odontología, UNMSM.

    2014-01-01

    The study was carried out at Hospital Nacional Guillermo Almenara Irigoyen, on 128 patients infected by the human inmunodefense virus. The aim of the investigation was to study the frecuency, and location of oral lesions, in relation with age and sex, also to establish the relationship between CD4 cells counts with oral lesions detected. The sample were selected in a probabilistic way; the data was recorded in a special designed format. 74 subjects of the sample were male and 57 female. Oral ...

  10. Attitudes and knowledge of nurses regarding HIV+/AIDS patients

    Directory of Open Access Journals (Sweden)

    Angeles Merino Godoy

    2004-06-01

    Full Text Available Objective: To know attitudes and knowledge of nursing personnel regarding HIV/AIDS patients in the Hospital General de Huelva. Methods: Descriptive cross-sectional study. Sample: Nursing staff of the Hospital General de Huelva (Registered nurses and Nursing auxiliar personnel randomised selected (N=980, n=88. Selected subjects were asked to answer a validated questionnaire including questions about personal and professional characteristics, attitudes about HIV+/AIDS patients and knowledge about HIV infection. Additionally, 8 interviews were performed to Nursing staff who suffered occupational accidents with HIV contaminated fluids. Another 8 interviews were performed to HIV+/AIDS patients about the nurses attitudes when working with them. Results: Participating subjects were worried about the risk of infection. A low rate of knowledge about HIV infection was observed. Conclusion: A modification of some attitudes of Nursing staff is mandatory as well as an improvement of specific knowledge about HIV infection and measures to avoid the infection in a professional setting. Strategies to improve nurses abilities when working with HIV+/AIDS patients should be provided.

  11. AIDS

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000594.htm HIV/AIDS To use the sharing features on this page, ... immunodeficiency virus (HIV) is the virus that causes AIDS. When a person becomes infected with HIV, the ...

  12. Nutritional status in patients with HIV infection and AIDS.

    Science.gov (United States)

    Stambullian, Marcela; Feliu, Susana; Slobodianik, Nora H

    2007-10-01

    The aim of this study was to evaluate the nutritional status of adults with HIV infection or with AIDS through the use of biochemical parameters. The study was performed on 43 patients (19 HIV+ and 24 AIDS patients), between 26 and 44 years of age, from low and medium socioeconomic status, with access to health care services; 35 patients were under highly active antiretroviral therapy (HAART) treatment. Body weight and height were determined, and the Body Mass Index calculated (kg/m2). Blood samples were collected from fasting patients. Plasma cholesterol (total, HDL and LDL), triacylglycerol, total protein, apolipoproteins A-I and B, albumin, transthyretin, retinol binding protein, and ceruloplasmin concentrations were determined. Plasma levels of zinc, copper, and selenium were determined in a haemolysis-free sample by flame atomic absorption spectrometry. Statistical analyses were performed with the Student's t-test. AIDS patients showed changes in biochemical parameters, particularly an increase in fibrinogen and a trend to decreased transthyretin levels. These findings stress the importance of the inclusion of functional biochemical parameters in the periodic evaluation of these patients. This would allow an early assessment of the need for appropriate nutritional support, implemented along with the specific retroviral treatment. This would aim at delaying the progression of the disease, and might improve the prospects of survival and quality of life.

  13. [Colorectal diseases in AIDS patients and endoscopic findings].

    Science.gov (United States)

    Averbach, M; Cutait, R; Corrêa, P; Duarte, M I; Leite, K; Borges, J L

    1998-01-01

    In order to establish which are the most frequent endoscopic detectable colorectal disorders in AIDS patients with intestinal complaints we analysed 236 colonoscopies in a series of 186 patients. The colonoscopic procedure was always followed by biopsies, even in the absence of macroscopic lesions. The most frequent diagnosis was colitis due to citomegalovirus infection observed in 64 exams (27.1%) and presented with an inflammatory pattern with ulcers, followed by Cryptosporidium sp., found in 31 exams (13.1%). This infection, conversely, presented as an inflammatory non-ulcerative lesion. Others pathogens found in lower frequency were: Mycobacterium sp., Histoplasma capsulatum, Herpes simplex, Isospora sp., Giardia sp., Candida sp. and Campilobacter sp.. Neoplastic lesions, mostly Kaposy's sarcoma, were detected in 10 of the colonoscopies (4.2%). The most frequent colorectal disorders in AIDS patients detected by endoscopic procedures are citomegalovirus and Cryptosporidium infection. Biopsies are always necessary to confirm the endoscopic diagnosis and to identify the presence of associated pathogens.

  14. SPECTRUM OF OPPORTUNISTIC INFECTIONS IN HIV-AIDS PATIENTS

    Directory of Open Access Journals (Sweden)

    S S Madkar

    2012-10-01

    Full Text Available Aim: AIDS is characterized by a number of opportunistic infections which are responsible for high morbidity and mortality. The spectrum and distribution of opportunistic infections (OIs in AIDS patients is ever-expanding. This spectrum varies from continent to continent. The aim of the present study was to document the spectrum of OIs in HIV-infected patients in Ambajogai. Material and Method: 178 HIV positive symptomatic patients, either hospitalized or coming to ART (Antiretroviral Therapy centre in S.R.T.R. Medical College, Ambajogai, were included in the study for finding the spectrum of opportunistic infections. Result: The commonest opportunistic infection seen was tuberculosis (59% of patients, followed by oral candidiasis (37.6% of patients and parasitic diarrhea due to Cryptosporidium parvum(18 % of patients. It was observed that out of 178 patients, maximum 53.3% were in the age group of 29-38 years followed by 21% in the age group of 39-48 years. It was found that 77% were males and 23% were females, with male to female ratio is 3.3:1. Conclusion: This study demonstrates that tuberculosis is the commonest opportunistic infection seen in HIV patients. Clinicians should consider HIV in the differential diagnosis and management of all persons with tuberculosis.

  15. A comparative study of bacterial isolates from the urine samples of AIDS and non-AIDS patients in Benue, Nigeria

    Institute of Scientific and Technical Information of China (English)

    Okwori EE; Nwadioha SI; Jombo GTA; Nwokedi EOP; Odimayo MS

    2010-01-01

    Objective:To determine the common bacterial causes of urinary tract infection and their antibiotic susceptibility pattern in AIDS patients versus non-AIDS patients. Methods: One thousand consecutive AIDS patients with signs and symptoms of AIDS and non-AIDS patients (served as control) each on admission were recruited into the study between January 2005 to January 2008, in Federal Medical Center, Makurdi. Urine samples were collected with sterile universal bottles and analysed with appropriate laboratory methods and antibiotic susceptibility test was carried out by disk diffusion technique in accordance with National Committee for Clinical Laboratory Standards (NCCLS, now CLSI) criteria. The results were analysed using SPSS 11.0 statistical software. Results:Urine samples of AIDS patients with urinary infection had a more spectrum of micro-organisms including Candida organisms, Pseudomonas aeruginosa and Staphylococcus aureus. Ceftriaxone, Ceftazidime or Ciprofloxacin had a remarkably high anti-bacterial activity across the two study groups. A general resistance was recorded in ampicillin, tetracycline and co-trimoxazole. There was no significant difference in antibiotic susceptibility patterns between AIDS and non-AIDS patients(P>0.05). Conclusions:A reduction in unnecessary use of antibiotics as well as infection control should be encouraged in our health facilities.

  16. Optimal management of cytomegalovirus retinitis in patients with AIDS

    Directory of Open Access Journals (Sweden)

    Michael W Stewart

    2010-04-01

    Full Text Available Michael W StewartDepartment of Ophthalmology, Mayo School of Medicine, Jacksonville, FL, USAAbstract: Cytomegalovirus (CMV retinitis is the most common cause of vision loss in patients with acquired immunodeficiency syndrome (AIDS. CMV retinitis afflicted 25% to 42% of AIDS patients in the pre-highly active antiretroviral therapy (HAART era, with most vision loss due to macula-involving retinitis or retinal detachment. The introduction of HAART significantly decreased the incidence and severity of CMV retinitis. Optimal treatment of CMV retinitis requires a thorough evaluation of the patient’s immune status and an accurate classification of the retinal lesions. When retinitis is diagnosed, HAART therapy should be started or improved, and anti-CMV therapy with oral valganciclovir, intravenous ganciclovir, foscarnet, or cidofovir should be administered. Selected patients, especially those with zone 1 retinitis, may receive intravitreal drug injections or surgical implantation of a sustained-release ganciclovir reservoir. Effective anti-CMV therapy coupled with HAART significantly decreases the incidence of vision loss and improves patient survival. Immune recovery uveitis and retinal detachments are important causes of moderate to severe loss of vision. Compared with the early years of the AIDS epidemic, the treatment emphasis in the post-HAART era has changed from short-term control of retinitis to long-term preservation of vision. Developing countries face shortages of health care professionals and inadequate supplies of anti-CMV and anti-HIV medications. Intravitreal ganciclovir injections may be the most cost effective strategy to treat CMV retinitis in these areas.Keywords: cytomegalovirus, AIDS, retinitis, immune recovery uveitis, retinal detachment, treatment

  17. Cognitive impairment in patients with AIDS – prevalence and severity

    OpenAIRE

    Watkins CC; Treisman GJ

    2015-01-01

    Crystal C Watkins,1,2 Glenn J Treisman2 1The Memory Center in Neuropsychiatry, Sheppard Pratt Health System, 2Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: The advent of highly active antiretroviral therapy has prolonged the life expectancy of HIV patients and decreased the number of adults who progress to AIDS and HIV-associated dementia. However, neurocognitive deficits remain a pronounced consequence of HIV/...

  18. Oral health of patients with HIV-AIDS: influence of local and systemic factors

    OpenAIRE

    Batista, Anne Margareth

    2013-01-01

    ABSTRACT The research entitled "Oral Health of HIV-AIDS patients: influence of local and systemic factors" was held during the year 2012 in Diamantina, Minas Gerais. The aim of this research was to evaluate the oral and systemic conditions of patients with HIV / AIDS attended by Municipal DST-AIDS of Diamantina, from 24 cities of Jequitinhonha Valley. To do this, 118 patients with HIV-AIDS were evaluated. The patients were observed about their conditions of oral and general health, socioecono...

  19. Líquido cefalorraqueano em 50 pacientes com AIDS Cerebrospinal fluid in 50 AIDS patients

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    S. L. Hinrichsen

    1996-06-01

    Full Text Available Foram estudados 50 pacientes com AIDS. Todos estes pacientes apresentavam anticorpos anti-HIV1 (ELISA e preenchiam os critérios de pontuação OPAS/Caracas de definição de casos de AIDS em adultos. A análise do liquido cefalorraqueano (LCR incluiu: pressão; citologia (número de células e aspectos citomorfológicos; proteína total e eletroforese; concentrações de glicose, cloretos e testes imunológicos para sífilis, toxoplasmose e infecções virais (citomegalovírus, varicela-zoster, Herpes simplex, e HI VI. Investigações bacteriológicas e micológicas (pesquisa direta e cultura, além de teste de aglutinação (látex para Cryptococcus foram também realizados. Os testes imunológicos usados foram fixação do complemento, imunofluorescência indireta, hemaglutinação passiva e/ou ELISA. Todos os LCR foram analisados no mesmo laboratório seguindo sempre a mesma metodologia. O LCR esteve alterado em 45 pacientes (90,0% dos 50 pacientes estudados. As principais alterações encontradas no LCR foram: aumento de gamaglobulina em 25 casos (55,5%; aumento da proteína total em 23 (51,1%; hipercitose em 22 (48,9% e diminuição dos cloretos em 18(40,0%. A detecção de anticorpos anti- HIV1 estiveram presentes em 42 pacientes (93,3%. Toxoplasmose isolada ou associada a outros agentes foi a infecção oportunista mais freqüente, detectada em 26 casos (57,7%. O LCR deverá ser sempre analisado em todos os pacientes com AIDS, com ou sem sintomas neurológicos.Fifty AIDS patients were studied. AH patients had anti-HIV antibodies (ELISA present and met OPAS/ Caracas punctuation criteria for AIDS cases in adults. Cerebrospinal fluid (CSF analysis included pressure, cytology (number and cytomorphological aspects, total protein and electrophoresis, glucose and chloride concentration. Bacteriological and mycological investigations were performed as well as agglutination tests for Cryptococcus. Complement fixation, indirect immunoflorescence

  20. Yeasts isolated from clinical samples of AIDS patients

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    Neves Rejane Pereira

    2002-01-01

    Full Text Available In order to investigate yeasts in oropharyngeal secretion, urine, sputum and inguinal scales from AIDS patients, clinical samples were collected from one hundred patients interned in the Infectious and Parasitic Diseases Sector of the Hospital das Clínicas of the Universidade Federal de Pernambuco and in Hospital Universitário Osvaldo Cruz of the Universidade de Pernambuco. Yeasts were isolated from seventy-two out of one hundred and eight clinical samples. The isolated yeasts were: Candida albicans (sixty-two isolates, Candida tropicalis (four isolates, Candida glabrata (two isolates, Candida parapsilosis (two isolates, Candida krusei (one isolate and Trichosporon pullulans (one isolate.

  1. ENTERIC PARASITES IN PATIENTS LIVING WITH HIV & AIDS

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    Ashwini

    2015-08-01

    Full Text Available CONTEXT: HIV is a major global public health issue. Most of the patients with HIV disease die of infections other than HIV. Gastrointestinal infections are very common in patients with HIV infection or AIDS . AIMS : To detect opportunistic intestinal parasi tes in patients living with HIV & AIDS and relate it with CD4 count. SETTINGS AND DESIGN: A single stool sample was obtained in sterile plastic containers from the patients attending pre ART. The stool samples were examined macroscopically and microscopica lly. Formalin ether concentration method was used. The modified Ziehl Neelsen staining method was used for the detection of the oocyst of coccidian parasites. CD4 count was measured on partec flow cytometry. RESULTS: Out of the 53 patient s, 33(62.26% were males and 20 (37.73% were femal es with age between 25 - 65 years . The study population consist of 4 patients with CD4 count > 500 cells/μl , 22 patients with CD4 count 200 - 499 cells/μl and 27 patients with CD4 count < 200 cells/μl. Enteric parasites we re detec ted by microscopy in 21 (39.62% stool samples . Number of samples showing parasites were Cryptospridium 11 (20.75%, Strongyloides stercoralis 3(5.6% , Cyclospora 1 (1.8%. Ascaris lumbricoides 3 (5.6%, Ancylostoma duodenale 1 (1.8% and Tenia eggs 2(3.7%. Ov erall, Cryptosporidium 11 (20.75% was the most frequently encountered pathogen in the study population. CONCLUSIONS: The results of our study highlight the importance of evaluation of HIV infected individuals with diarrhoea for intestinal parasitic infect ions which may help in better management of these patients.

  2. Clinical Profile Of HIV/AIDS Patients in Srinagar, Kashmir

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    Kaiser Ahmed Wani

    2011-03-01

    Full Text Available Background: Since the inception of the integrated counseling and testing centre (ICTC at governmentmedical college (GMC and associated hospitals, there was no previous study on the clinical experiencesin HIV/AIDS positive cases in this institution.Aims & objectives: The aim of this study was to delineate the epidemiological profile of HIV/AIDSseropositive cases and which included to study:• Number of HIV seropositive patients from April 2002 to December 2009.• Common signs and symptoms of HIV/AIDS seropositive patients.• Age and sex distribution of all seropositive cases.• Mode of transmission of HIV infection.• Residence and profession profile of seropositive cases.• Different types of opportunistic infections in these patients.Methods/study design: The present study is documental and analytical descriptive and it was conductedat the govt. medical college and associated hospitals through data collection of 128 records of individualwho tested positive for HIV by three rapid test methods using three different antigens at integratedcounseling and testing centre (ICTC. Demographic variables such as age, sex and occupation, data onmode of transmission and clinical manifestation were examined together.Results/Findings: A total of 128 patients had tested positive for HIV by at least three tests using threedifferent antigens, which included 112 (87.5% male and 16 (12.5% females. The mean age of thesepatients were 34.45±8.40 with male to female ratio of 7:1.The peak incidence was found in the age groupof 30-39 yrs (36.8%.Majority of HIV positive patients belonged to security personnel’s followed bymigrant labourers and housewives.Transmission of infection was through sexual contact in 90.7 % followed by homosexual transmission in4.7 %. Vertical transmission and blood transfusion accounted in 2.3% cases each. 78.9 % of patientspresented with fever of > 1mon-th duration, 35.1 % with weight loss and 33.5 % withdiarrhea.Tuberculosis and

  3. Effect of oral nutritional support on hospitalized patients with AIDS

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    Renata Pereira da Silva

    2013-04-01

    Full Text Available Introduction: The emergence of more effective therapies for the treatment of Acquired Immunodeficiency Syndrome (AIDS has reduced the rates of illness, mortality and malnutrition among infected patients. However, reduced food intake, nutrient malabsorption and metabolic alterations induced by fever and infection are seen in cases of hospital malnutrition. Objectives: The aim of the present study was to assess the impact of oral nutritional support (ONS on hospitalized patients with AIDS. Methods: The following variables were analyzed: weight, body mass index (BMI, triceps skinfold (TSF, arm circumference (AC, arm muscle circumference (AMC, albumin, hemoglobin, hematocrit and total serum lymphocytes. Results: Significant improvements were found in weight, BMI, TSF, AC, albumin and lymphocytes after 19.27 ± 7.45 days of ONS, whereas no significant improvements were found in AMC, hemoglobin or hematocrit. Conclusion: Dietary intervention with nutritional counseling and the use of supplements led to an improvement in the nutritional status of malnourished individuals with AIDS, but with an increase in adipose tissue and no impact on lean muscle mass or anemia.

  4. A rare case of Histoplasma fungemia in an AIDS patient

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    V P Baradkar

    2011-01-01

    Full Text Available Disseminated cases of histoplasmosis in acquired immune deficiency syndrome (AIDS are rarely reported from India. Most of these cases report isolation of this fungus from the bone marrow, lymph node aspirate, spleenic aspirate, and biopsies. We report isolation of Histoplasma capsulatum from the blood of an AIDS patient. A 30-year-old male from Utter Pradesh was admitted with fever, loss of appetite, and nausea since two months. Few intracellular and extracellular budding cells were observed on bone marrow examination on the fifth day of admission. Diagnosis was confirmed by blood cultures taken on the 11th day of admission. Amphotericin B was started, but the patient′s condition deteriorated and he died.

  5. Prevalence and factors associated with lipodystrophy in AIDS patients

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    Lunara Basqueroto Della Justina

    2014-01-01

    Full Text Available Introduction: The published literature shows an increased occurrence of adverse events, such as human immunodeficiency virus (HIV-associated lipodystrophy syndrome, that are associated with the continuous use of antiretroviral therapy. This study was performed to estimate the prevalence and factors associated with lipodystrophy in acquired immune deficiency syndrome (AIDS patients. Methods: We conducted a cross-sectional study between October 2012 and February 2013. The sample consisted of patients with AIDS who attended the Outpatient Treatment Center for Infectious Diseases at Nereu Ramos Hospital, Florianópolis, State of Santa Catarina, Brazil. We collected information on demographics, lifestyle, HIV infection, and clinical aspects of the disease. Self-reported signs of lipodystrophy and body measurements were used for lipodystrophy diagnosis. Results: We studied 74 patients (mean age 44.3±9.2 years; 60.8% men. Among the patients, 45.9% were smokers, 31.1% consumed alcoholic beverages, and 55.4% were sedentary. The prevalence of lipodystrophy was 32.4%, and sedentary subjects had a higher prevalence of lipodystrophy compared with physically active individuals. Conclusions: The prevalence of lipodystrophy was 32.4%. Physical activity was considered an independent protective factor against the onset of HIV-associated lipodystrophy.

  6. Role of Gallium and labeled leukocyte scintigraphy in AIDS patient

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    Palestro, C.J. [Division of nuclear medicine, Long Island Jewish Medical Center, New Hyde Park, New York (United States); Goldsmith, S.J. [Division of nuclear medicine, New York Hospital, Cornell Medical Center, New York (United States)

    1995-09-01

    Because AIDS patients frequently present with minimal symptomatology, radionuclide imaging with its ability to survey the entire body, is especially valuable. Gallium-67 citrate, the most commonly performed radionuclide study for localizing infection in these patients, is most useful for detecting opportunistic infections, especially in the thorax. A negative gallium scan, particularly when the chest X-ray is unremarkable, rules strongly against pulmonary disease. A negative gallium scan in a patient with an abnormal chest X-ray and Kaposi`s sarcoma, suggests that the patient`s respiratory distress is related to the neoplasm. Diffuse pulmonary parenchymal uptake of gallium in the HIV (+) patient is most often associated with PCP. While there are other causes of diffuse pulmonary uptake, the more intense or heterogeneous the uptake, the more likely the patient is to have PCP. Focal pulmonary uptake is usually associated with bacterial pneumonia although PCP may occasionally present in this fashion. Lymph node uptake of gallium is usually associated with Mycob acterium avium complex, tuberculosis, or Iymphoma. When corresponding abnormalities are present on thallium scintigraphy lymphoma is likely. Gallium positive, thallium negative, studies suggest mycobacterial disease. Labeled leukocyte imaging is not useful for detecting opportunistic infections probably because of the inflammatory response incited by these organisms. Leukocyte imaging is, however, more sensitive for detecting bacterial pneumonia. In the abdomen, gallium imaging is most useful for identifying lymphadenopathy, while labeled leukocyte imaging is superior for detecting AlDS-associated colitides. In summary, radionuclide studies are valuable diagnostic modalities in AIDS. Their success can be maximized by tailoring the study to the individual`s needs.

  7. Nutritional status and CD4 cell counts in patients with HIV/AIDS receiving antiretroviral therapy

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    Ana Celia Oliveira dos Santos

    2013-12-01

    Full Text Available Introduction Even with current highly active antiretroviral therapy, individuals with AIDS continue to exhibit important nutritional deficits and reduced levels of albumin and hemoglobin, which may be directly related to their cluster of differentiation 4 (CD4 cell counts. The aim of this study was to characterize the nutritional status of individuals with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS and relate the findings to the albumin level, hemoglobin level and CD4 cell count. Methods Patients over 20 years of age with AIDS who were hospitalized in a university hospital and were receiving antiretroviral therapy were studied with regard to clinical, anthropometric, biochemical and sociodemographic characteristics. Body mass index, percentage of weight loss, arm circumference, triceps skinfold and arm muscle circumference were analyzed. Data on albumin, hemoglobin, hematocrit and CD4 cell count were obtained from patient charts. Statistical analysis was performed using Fisher's exact test, Student's t-test for independent variables and the Mann-Whitney U-test. The level of significance was set to 0.05 (α = 5%. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS 17.0 software for Windows. Results Of the 50 patients evaluated, 70% were male. The prevalence of malnutrition was higher when the definition was based on arm circumference and triceps skinfold measurement. The concentrations of all biochemical variables were significantly lower among patients with a body mass index of less than 18.5kg/m2. The CD4 cell count, albumin, hemoglobin and hematocrit anthropometric measures were directly related to each other. Conclusions These findings underscore the importance of nutritional follow-up for underweight patients with AIDS, as nutritional status proved to be related to important biochemical alterations.

  8. Leptospirosis patient with AIDS the first case reported

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    Elizabeth de Souza Neves

    1994-03-01

    Full Text Available A case of renal icterohaemorrhagic leptospirosis involving a patient with acquired immunodeficiency syndrome (AIDS is reported. Despite the low levels of CD4+ Tlymphocytes, the clinical course of leptospirosis was similar to that observed in non-immunodepressed patients, and no worsening of AIDS occurred due to the infebtion by the spirochete. Serologic conversion was observed in the microscopic agglutination test, with maximum titer of1:3,200. The patient had positive urine cultures for Leptospira interrogans for two months, whereas blood cultures were negative.Os autores relatam um caso de forma íctero- hemorrágica de leptospirose ocorrida em paciente com síndrome de imunodeficiência adquirida (SIDA. A evolução clínica da leptospirose se deu de modo semelhante ao observado em pacientes sem imunodepressão, apesar dos níveis muito baixos de linfócitos TCD4+. Tampouco houve agravamento da SIDA em decorrência da infecção pelo espiroqueta. Observou-se conversão sorológica na prova de aglutinaçãomicroscópica com títulos máximos de 1:3.200. O paciente permaneceu por dois meses com urinocultura positiva para Leptospira interrogans, sendo as hemoculturas negativas.

  9. Study Discounts Myth of 'Patient Zero' in U.S. AIDS Crisis

    Science.gov (United States)

    ... Study Discounts Myth of 'Patient Zero' in U.S. AIDS Crisis Genetic analysis of 40-year-old blood ... in North America of the virus that causes AIDS. One myth already debunked by the research: That ...

  10. A holistic model for matching high-tech hearing aid features to elderly patients.

    Science.gov (United States)

    Johnson, C E; Danhauer, J L; Krishnamurti, S

    2000-12-01

    Successful hearing aid fittings using high-technology features for elderly patients require consideration of factors beyond results obtained from routine audiologic evaluations. A holistic hearing aid selection, fitting, and evaluation approach that considers patient characteristics from communication, physical, psychological, and social assessment domains is presented here along with a checklist and flowcharts for matching high-tech hearing aid features to older persons who are hearing aid candidates.

  11. Tuberculosis and histoplasmosis co-infection in AIDS patients.

    Science.gov (United States)

    Agudelo, Carlos A; Restrepo, Carlos A; Molina, Diego A; Tobón, Angela M; Kauffman, Carol A; Murillo, Carolina; Restrepo, Angela

    2012-12-01

    Abstract. Coinfection with tuberculosis in some countries occurs in 8-15% of human immunodeficiency virus (HIV) -infected patients who have histoplasmosis. This coinfection interferes with prompt diagnosis, and treatment is difficult because of drug interactions. We retrospectively reviewed the cases of 14 HIV-infected patients who had concomitant tuberculosis and histoplasmosis. The most frequent clinical manifestations were weight loss (85.7%), asthenia (78.5%), and fever (64.2%). The diagnosis of histoplasmosis was made primarily by histopathology (71.4%), and the diagnosis of tuberculosis was made by means of direct microscopic examination (71.4%). Death occurred in two patients, and relapse of both infections occurred in one patient. Moxifloxacin was substituted for rifampicin in six patients, with good outcomes noted for both infections. The clinical presentation does not readily identify acquired immunodeficiency syndrome (AIDS) patients who have tuberculosis and histoplasmosis. The use of a fluoroquinolone as an alternative agent in place of rifampicin for tuberculosis allows effective therapy with itraconazole for histoplasmosis.

  12. Survey of mycotic infection in patients with AIDS

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    Kazemi A

    1998-07-01

    Full Text Available In an attempt to investigate the fungous infections of AIDS stricken patients, a study which lasted 1.5 years was conducted, in which 21 patients were examined. The subjects were 20 males and a female. One of the male patients was from Uganda, another was an intravenous drug addict, and one had been abroad for sometimes and had received blood there. All other patients had also blood transfusion instances before 1984. To do the research, 414 laboratory specimens were gathered and examined regarding fungus involvement. The result showed 104 negative and 310 positive cases. Based on these findings and also clinical examination, all patients suffered from one or more fungous infections in the forms of oral candidiasis, perleche, candidal onychomycosis, perianal candidiasis, mucocutaneous candidiasis, tinea versicolor, pityrosporosis and rhodotrulosis. The latter caused skin lesion with scaling and is being reported for the first time. Candida parapsilosis and trichosporon pololans were also isolated specimens. However, concerning the diagnostic value of trichosporon pololans more investigation is needed.

  13. Sepsis in AIDS patients: clinical, etiological and inflammatory characteristics

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    João Manoel Silva

    2013-01-01

    Full Text Available Introduction: Intensive care mortality of HIV-positive patients has progressively decreased. However, critically ill HIV-positive patients with sepsis present a worse prognosis. To better understand this condition, we propose a study comparing clinical, etiological and inflammatory data, and the hospital course of HIV-positive and HIV-negative patients with severe sepsis or septic shock. Methods: A prospective observational study enrolling patients with severe sepsis or septic shock associated or not with HIV infection, and admitted to intensive care unit (ICU. Clinical, microbiological and inflammatory parameters were assessed, including C-reactive protein (CRP, procalcitonin (PCT, interleukin-6, interleukin-10 and TNF-α. Outcome measures were in-hospital and six-month mortality. Results: The study included 58 patients with severe sepsis/septic shock admitted to ICU, 36 HIV-positive and 22 HIV-negative. All HIV-positive patients met the criteria for AIDS (CDC/2008. The main foci of infection in HIV-positive patients were pulmonary and abdominal (p=0.001. Fungi and mycobacteria were identified in 44.4% and 16.7% of HIV-positive patients, respectively. In contrast, the main etiologies for sepsis in HIV-negative patients were Gram-negative bacilli (36.4% and Gram-positive cocci (36.4% (p=0.001. CRP and PCT admission concentrations were lower in HIV-positive patients (130 vs. 168 mg/dL p=0.005, and 1.19 vs. 4.06 ng/mL p=0.04, respectively, with a progressive decrease in surviving patients. Initial IL-10 concentrations were higher in HIV-positive patients (4.4 pg/mL vs. 1.0 pg/mL, p=0.005, with moderate accuracy for predicting death (area under receiver-operating characteristic curve =0.74. In-hospital and six-month mortality were higher in HIV-positive patients (55.6 vs. 27.3% p=0.03, and 58.3 vs. 27.3% p=0.02, respectively. Conclusions: The course of sepsis was more severe in HIV-positive patients, with distinct clinical, etiological and

  14. Evaluation of HIV/AIDS patients' knowledge on antiretroviral drugs

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    Regina Flávia de Castro Almeida

    2009-06-01

    Full Text Available Lack of information on antiretroviral drugs or the misunderstanding of available information can facilitate incorrect use of such drugs. This can result in non-adherence to the prescribed regimen, leading to a great possibility of a therapeutic failure. The aim of this study was to know which information HIV/AIDS patients, who receive their medicines at the pharmacy of a reference hospital in the northeast Brazil, have on the drugs they use, the source of this information and whether there is a need for additional information. A total of 195 HIV/AIDS patients, who were using either zidovudina + lamivudina 300+150mg (AZT+3TC, efavirenz 600mg (EFZ or lopinavir/ritonavir 133.33/33mg (LPV/r, were interviewed. The mean age was 41 years (SD = 9.55 and 70.8% were males. Of the total, 55.4% didn't know the effect of the drug in the organism; 35.9% were unaware of the necessity of taking antiretroviral drugs for the rest of their lives; only 14.4% knew how to proceed when a dosage was missed; 22.1% said they could die and the same number of individuals believed in aggravation of the disease in case of treatment interruption. The majority, 68.2%, considered it very necessary to receive drug information. The results show that there is an apparent lack of general information among users of antiretroviral drugs, and at the same time a need for it. It is necessary that all professionals involved in the health care of the patients agree that an efficient supply of information on prescribed drugs is an ethical component of the treatment that favors and fosters its adherence.

  15. Cognitive impairment in patients with AIDS – prevalence and severity

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    Watkins CC

    2015-01-01

    Full Text Available Crystal C Watkins,1,2 Glenn J Treisman2 1The Memory Center in Neuropsychiatry, Sheppard Pratt Health System, 2Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: The advent of highly active antiretroviral therapy has prolonged the life expectancy of HIV patients and decreased the number of adults who progress to AIDS and HIV-associated dementia. However, neurocognitive deficits remain a pronounced consequence of HIV/AIDS. HIV-1 infection targets the central nervous system in subcortical brain areas and leads to high rates of delirium, depression, opportunistic central nervous system infections, and dementia. Long-term HIV replication in the brain occurs in astrocytes and microglia, allowing the virus to hide from antiviral medication and later compromise neuronal function. The associated cognitive disturbance is linked to both viral activity and inflammatory and other mediators from these immune cells that lead to the damage associated with HIV-associated neurocognitive disorders, a general term given for these disturbances. We review the severity and prevalence of the neuropsychiatric complications of HIV including delirium, neurobehavioral impairments (depression, minor cognitive-motor dysfunction, and HIV-associated dementia. Keywords: HIV, delirium, depression, HAND, dementia; HIV-associated neurocognitive disorder

  16. [Quality of support by artificial nutrition: difficulties with AIDS patients].

    Science.gov (United States)

    Ayúcar Ruiz de Galarreta, A; Cordero Lorenzana, M L; García Filgueira, P; Martínez-Puga, E

    1998-01-01

    The use of Enteral Nutrition (EN) in patients with AIDS with a severe nutritional deterioration, is the most common route, not only because of the risk/benefit relation, bur also because this is a physiological route that is easily managed and is profitable in terms of renutrition. However, and given the characteristics of the affected population, whose origin in a large percentage is the addiction to parenteral drugs, implanting this route in these patients is a challenge, as these patients refuse in more than 50% of the cases. Moreover, the risk group is not only a factor in the difficulty for applying the ideal across route, but also the combination of other elements like sex or the disease itself, force the clinical to use more aggressive methods (Parenteral Nutrition) or those that are less profitable nutritionally (Supplements). The negative aspects with regard to tube feeding of these patients are shown, in relation to the factors, and these are compared with the negative aspects of other diagnosis groups (rest of the Hospital).

  17. A digital patient for computer-aided prosthesis design.

    Science.gov (United States)

    Colombo, Giorgio; Facoetti, Giancarlo; Rizzi, Caterina

    2013-04-06

    This article concerns the design of lower limb prosthesis, both below and above knee. It describes a new computer-based design framework and a digital model of the patient around which the prosthesis is designed and tested in a completely virtual environment. The virtual model of the patient is the backbone of the whole system, and it is based on a biomechanical general-purpose model customized with the patient's characteristics (e.g. anthropometric measures). The software platform adopts computer-aided and knowledge-guided approaches with the goal of replacing the current development process, mainly hand made, with a virtual one. It provides the prosthetics with a set of tools to design, configure and test the prosthesis and comprehends two main environments: the prosthesis modelling laboratory and the virtual testing laboratory. The first permits the three-dimensional model of the prosthesis to be configured and generated, while the second allows the prosthetics to virtually set up the artificial leg and simulate the patient's postures and movements, validating its functionality and configuration. General architecture and modelling/simulation tools for the platform are described as well as main aspects and results of the experimentation.

  18. General Characteristics of HIV/AIDS Patients in Ditan Hospital

    Institute of Scientific and Technical Information of China (English)

    刘彦春; 徐克沂; 张福杰; 赵红心; 李兴旺; 李秀兰; 闫会文

    2004-01-01

    Objective: To elucidate general characteristics of HIV/AIDS patients seeking care at Ditan Hospital in an attempt to guide early diagnosis in routine medical care. Materials and methods: A retrospective analysis of 185 HIV/AIDS cases from January 1990 to June 2002 was completed using SPSS statistical analysis. Results: Male to female ratio was 1.8:1. Subjects ranged in age from 1 year old to 64 years old. 16 cases were younger than 20 years old with the median age among the younger subset at 7.7 years. 169 cases were older than 20 years old with a median age of 36 years old. 29% of the subjects were peasants. The remaining 71%, were of other unspecifiedoccupations. 90.8% of individuals were of Han descent while 3.7% of individuals were of a minority heritage. 50.3% of subjects were married; 23.8% have never married; 8.1% were divorced; and the remaining 17.8% were of unknown marital status. Of those represented in this study, 36.8% came from the Henan province; 17.8% were from Beijing; 8.6% were from Shanxi; 31.4% from the other 20 provinces of China; and 5.4% from outside of China. Mode of transmission: 40.0% (74/185) contracted HIV through unprotected sexual contact; 29.2% (54/185) through receiving blood or plasma transfusions; 21.1%(39/185) through donating plasma; 7 cases were intravenous drug users; 7 cases were vertically transmitted. Mode of transmission was unknown in 4 cases. Clinical categories: An included 45 cases; B included 85 cases: C consisted of 76 cases. 12 cases were deceased. Initial presentation: 39 cases presented with_fever ,cough and diarrhea. 37 cases had fever and cough only-38 cases presented with chronic diarrhea. 16 cases were discovered incidentally at time of operation. 8 cases presented with fungal infection of the oral cavity or in esophagus. The common HIV associated symptoms and opportunistic infections were: weight loss and diarrhea, respiratory diseases, dermatologic diseases, anemia, neutropenia. Diseases of other organ

  19. Disseminated cryptococcosis in a patient with HIV/AIDS at a teaching hospital in Ghana

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    KP Akakpo

    2015-01-01

    Full Text Available Objective: To raise awareness of the existence of cryptococcal infections in HIV/AIDS patients in Ghana. Method: Detailed postmortem gross and histopathological analysis of an HIV/AIDS patient suspected to have cryptococcal meningitis was carried out and histopathological findings correlated with clinical findings. Results: showed disseminated Cryptococcosis in an HIV/AIDS patient which was confirmed with special stains. Conclusion: cryptococcal infection occurs in HIV /AIDS patients in Ghanaian and when clinically suspected the diagnosis should be pursued vigorously.

  20. Paracoccidioides brasilienses isolates obtained from patients with acute and chronic disease exhibit morphological differences after animal passage

    Directory of Open Access Journals (Sweden)

    SVIDZINSKI Terezinha Inez Estivalet

    1999-01-01

    Full Text Available The basis for virulence in Paracoccidioides brasiliensis is not completely understood. There is a consensus that the sequencial in vitro subcultivation of P. brasiliensis leads to loss of its pathogenicity, which can be reverted by reisolation from animal passage. Attention to morphological and biochemical properties that are regained or demonstrated after animal passage may provide new insights into factors related to the pathogenicity and virulence of P. brasiliensis. We evaluated morphological characters: the percentage of budding cells, number of buds by cell and the diameter of 100 mother cells of yeast-like cells of 30 P. brasiliensis isolates, before and after animal passage. The isolates were obtained from patients with different clinical forms of paracoccidioidomycosis (PCM: acute form (group A, n=15 and chronic form (group C, n=15. The measurement of the yeast cell sizes was carried out with the aid of an Olympus CBB microscope coupled with a micrometer disc. We measured the major transverse and longitudinal axes of 100 viable cells of each preparation. The percentage of budding cells as also the number of buds by cell was not influenced by animal passage, regardless of the source of the strain (acute or chronic groups. The size values of P. brasiliensis isolates from groups A and C, measured before the animal passage exhibited the same behavior. After animal passage, there was a statistically significant difference between the cell sizes of P. brasiliensis isolates recovered from testicles inoculated with strains from groups A and C. The maximum diameter of mother cells from group A isolates exhibited a size of 42.1mm in contrast with 32.9mm exhibited by mother cells from group C (p<0.05. The diameter of 1500 mother cells from group A isolates exhibited a medium size of 16.0mm (SD ± 4.0, a value significantly higher than the 14.1mm (SD = ± 3.3 exhibited by 1500 mother cells from group C isolates (p<0.05. Our results reinforce the

  1. Varicella-zoster virus encephalitis in an AIDS patient

    Directory of Open Access Journals (Sweden)

    P.V. Toledo

    2004-06-01

    Full Text Available A 37-year-old man with a three-year history of Acquired Immunodeficiency Syndrome was admitted with impaired consciousness, seizures and fever. He was on highly active antiretroviral therapy and on neurotoxoplasmosis secondary prophylaxis. Laboratory exams from two months before showed a CD4 cell count of 37/µL and a viral load of 230,000 copies/mL. Three months before admission he developed herpetic skin rash in the right trunk and acyclovir was added to his treatment regimen. On physical exam he was drowsy and had motor and sensory aphasia. The patient had elevated protein levels and normal pressure in the cerebrospinal fluid (CSF. Contrast enhanced computed tomography scan of the brain showed a hypodense lesion in the left parietal lobe, with poorly defined margins and no contrast enhancement. The magnetic resonance scan (MRI showed multiple hyperintensities in T2-weighted image in white and grey matters and hypointense products of hemorrhage in both hemispheres and in the cerebellum. He was empirically treated with intravenous acyclovir and prednisone. Viral DNA of Varicella-zoster virus (VZV was detected in the CSF by means of polymerase chain reaction (PCR analysis. Acyclovir was continued for 10 days and the patient became well, with improvement of aphasia.We present a case of VZV encephalitis, confirmed by nested PCR, in a patient with suggestive MRI findings, who succeeded with treatment. VZV encephalitis is a rare opportunistic infection, occurring in 0.1 to 4% of AIDS patients with neurological disease; it is related to severe immunodeficiency and has a high mortality.

  2. Comparison of long-term prognosis of patients with AIDS treated and not treated with zidovudine. AIDS in Europe Study Group

    DEFF Research Database (Denmark)

    Lundgren, Jens Dilling; Phillips, A N; Pedersen, C;

    1994-01-01

    OBJECTIVE--To determine the association between elapsed time since starting zidovudine and survival in patients with acquired immunodeficiency syndrome (AIDS). DESIGN--Inception cohort and observational study of patients treated and not treated with zidovudine. SETTING--Fifty-one centers in 17...... European countries. PATIENTS--A total of 4484 patients diagnosed as having AIDS from 1979 to 1989 who survived their initial AIDS-defining event and who had not started zidovudine before AIDS diagnosis. MAIN OUTCOME MEASURES--Use of zidovudine and mortality. RESULTS--Among patients who did not receive...... zidovudine, the death rate was approximately constant for the first 5 years after AIDS diagnosis. For patients treated with zidovudine, the death rate within the first year since starting zidovudine was markedly lower than for untreated patients who had developed AIDS at the same time (relative rate, 0...

  3. Abdominal Computed tomography of 25 patients with AIDS or lymphadenopathy Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Arrive, L.; Frija, J.; Couderc, L.J.; Clauvel, J.P.; Laval-Jeantet, M.

    1986-03-01

    An abdominal computed tomographic examination was performed to 20 patients with Acquired Immunodeficiency Syndrome (AIDS) and to 5 patients with Lymphadenopathy Syndrome (LAS). Intraabdominal lymph nodes were seen in 18 out of 20 cases of AIDS and in 5 cases of LAS. Lymph nodes have a normal size or are slightly enlarged but they are too numerous. Splenomegaly was found in 17 patients. Rectal modifications secondary to a proctitis were seen in the homosexual patients.

  4. Strongyloides stercoralis disseminated infection and schistosomiasis in an AIDS patient

    Directory of Open Access Journals (Sweden)

    Rodrigo Martins Brandão

    2012-12-01

    Full Text Available Strongyloides stercoralis hyperinfection syndrome is classically associated with impaired host response and implies in an overburden of larvae in its usual cycle. It has been recognized as a severe and potentially fatal condition in immunocompromised individuals, especially those using oral corticosteroids. Infection with Schistosoma mansoni not only increases the susceptibility to HIV infection, but also promotes progression to disease. The association of the most severe forms of strongyloidiasis and AIDS is scarcely described, even more when S. mansoni is also associated. The authors describe a case of a 34-year-old previously healthy male, admitted to the emergency department with a history of hematemesis associated with dyspnea, hemoptysis, and fever. He referred homosexual relations for 6 years. Physical examination showed an ill-looking patient, and was remarkable for tachycardia, tachypnea, diaphoresis, and pulse oximetry of 70% in room air. Lungs examination revealed the presence of rales in the left base. Chest radiography showed a diffuse and bilateral reticulo-nodular pattern. HIV serology was positive. Empirical antimicrobial therapy and corticosteroids were initiated. On the third day of hospitalization, petechiae appeared over the periumbilical area, but no further investigation was undertaken because the patient died soon after. The autopsy findings were compatible with S. stercoralis disseminated infection, a hepatic intestinal chronic form of schistosomiasis, and septic shock as the primary cause of death. The authors call attention to this infrequent association.

  5. Anti-HIV-1 integrase activity of medicinal plants used as self medication by AIDS patients

    Directory of Open Access Journals (Sweden)

    Sopa Kummee

    2006-07-01

    Full Text Available The extracts of selected medicinal plants used as self medication by AIDS patients were investigated for their inhibitory activities against HIV-1 integrase (HIV-1 IN using the multiplate integration assay (MIA. Of these, the water extract of Eclipta prostrata (whole plant exhibited the most potent inhibitory activity with an IC50 value of 4.8 μg/ml, followed by the methanol extract of Eclipta prostrata (whole plant, IC50 = 21.1 μg/ ml, the water extract of Barleria lupulina (stem, IC50 = 26.4 μg/ml, the chloroform extract of Barleria lupulina (stem, IC50 = 33.0 μg/ml, the methanol extract of Barleria lupulina (stem, IC50 = 38.2 μg/ml and the chloroform extract of Piper betle (leaf, IC50 = 39.3 μg/ml, respectively.

  6. Are physiotherapy graduates adequately prepared to to manage hiv/aids patients

    Directory of Open Access Journals (Sweden)

    T. Puckree

    2004-02-01

    Full Text Available Physiotherapy learners treat patients with Human Immuno-deficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS. There is no available published research on physiotherapy learners' opinions about how the South Afican physiotherapy undergraduate program is  helping them cope with HIV/AIDS patients. This study determines whether the physiotherapy degree offered at South African Universities, adequately prepares learners to cope with HIV/AIDS patients. Differences in knowledge and attitudes of physiotherapy learners regarding HIV/AIDS, amongst  universities is also explored. Two hundred and two senior physiotherapy learners from eight South African universities returned their  questionnaires and 55% of these were viable for analysis. A large portion (79% of learners indicated that the physiotherapy undergraduate degree did not adequately prepare them to cope with HIV/AIDS patients. Learners' knowledge and attitudes regarding HIV/AIDS differed significantly (41% to 73%  amongst universities. Formal lectures on HIV/AIDS significantly affected knowledge (0% -100% but not attitude towards patients. The role of the physiotherapist, precautions, transmission modes, syndrome stages, counseling and clinical skills were considered critical in the management of HIV/AIDS patients.

  7. Type 2 diabetic patients with non-alcoholic fatty liver disease exhibit significant haemorheological abnormalities

    Institute of Scientific and Technical Information of China (English)

    Hui Dong; Fu'er Lu; Nan Wang; Xin Zou; Jingjing Rao

    2011-01-01

    Haemorheological abnormalities have been described in diabetes mellitus,as well as in non-alcoholic fatty liver disease (NAFLD).However,the relationship between the changes in liver fat content and haemorheology is unknown.The current study aims to show the correlation between haemorheological parameters and intrahepatic lipid content (IHLC) in patients with type 2 diabetes.The serum biochemical markers,such as fasting plasma glucose (FPG),haemoglobin A1c (HbA1c),liver enzymes,lipid profiles,and haemorheological properties,were examined.IHLC was quantified using proton magnetic resonance spectroscopy (1H-MRS) scanning of the liver.A significant correlation was observed between IHLC and whole blood viscosity at high,middle,and low shear rates.IHLC also positively correlated with haematocrit,the reduced whole blood viscosity at low and middle shear rates,and the erythrocyte aggregation index.Diabetic patients with NAFLD exhibited significant haemorheological abnormalities compared with patients without NAFLD.In summary,haemorheological disorders are linked to non-alcoholic fatty liver in type 2 diabetes.

  8. Prevalence of depression and anxiety in patients requesting physicians’ aid in dying: cross sectional survey

    OpenAIRE

    Ganzini, Linda; Goy, Elizabeth R; Dobscha, Steven K.

    2008-01-01

    Objective To determine the prevalence of depression and anxiety in terminally ill patients pursuing aid in dying from physicians. Design Cross sectional survey. Setting State of Oregon, USA. Participants 58 Oregonians, most terminally ill with cancer or amyotrophic lateral sclerosis, who had either requested aid in dying from a physician or contacted an aid in dying advocacy organisation. Main outcome measures Diagnosis of depression or anxiety according to the hospital anxiety and depression...

  9. Oral candidiasis and oral yeast carriage among institutionalised South African paediatric HIV/AIDS patients.

    Science.gov (United States)

    Blignaut, Elaine

    2007-02-01

    South Africa currently has an estimated 500,000 AIDS orphans, many of whom are HIV-positive. Oral candidiasis commonly occurs in both adult and paediatric HIV/AIDS patients. Published information on HIV-positive children in Africa mainly concerns hospitalised patients. The objective of this study was to determine the prevalence of oral candidiasis and oral yeast carriage among paediatric HIV/AIDS patients residing in orphanages in Gauteng, South Africa, and to compare the prevalence of isolated yeast species with species obtained from adult HIV/AIDS patients. Eighty-seven paediatric HIV/AIDS patients residing in five homes were examined and a swab taken from the dorsal surface of the tongue, cultured on CHROMagar and yeast isolates identified with the ATB 32C commercial system. The species prevalence of 57 identified isolates was compared with that of 330 isolates from adult HIV/AIDS patients. Twelve (13.8%) children presented with clinically detectable candidiasis. Yeasts were isolated from 0% to 53% of children in the individual homes, with Candida albicans (40.4%) and C. dubliniensis (26.3%) constituting the most frequently isolated species. Gentian violet prophylaxis was administered in one particular home and a higher carriage rate (66.6%) of non-C. albicans and non-C. dubliniensis was observed among these children. The prevalence of C. albicans was lower while the prevalence of C. dubliniensis, C. glabrata and C. tropicalis was significantly higher (p candidiasis in institutionalized paediatric HIV/AIDS patients.

  10. Infectious dengue vesicles derived from CD61+ cells in acute patient plasma exhibited a diaphanous appearance.

    Science.gov (United States)

    Hsu, Alan Yi-Hui; Wu, Shang-Rung; Tsai, Jih-Jin; Chen, Po-Lin; Chen, Ya-Ping; Chen, Tsai-Yun; Lo, Yu-Chih; Ho, Tzu-Chuan; Lee, Meed; Chen, Min-Ting; Chiu, Yen-Chi; Perng, Guey Chuen

    2015-12-11

    The levels of neutralizing antibody to a pathogen are an effective indicator to predict efficacy of a vaccine in trial. And yet not all the trial vaccines are in line with the theory. Using dengue virus (DENV) to investigate the viral morphology affecting the predictive value, we evaluated the viral morphology in acute dengue plasma compared to that of Vero cells derived DENV. The virions in plasma were infectious and heterogeneous in shape with a "sunny-side up egg" appearance, viral RNA was enclosed with CD61+ cell-derived membrane interspersed by the viral envelope protein, defined as dengue vesicles. The unique viral features were also observed from ex vivo infected human bone marrow. Dengue vesicles were less efficiently neutralized by convalescent patient serum, compared to virions produced from Vero cells. Our results exhibit a reason why potencies of protective immunity fail in vivo and significantly impact dengue vaccine and drug development.

  11. Trichosporon pullulans (Lidner Diddens & Lodder isolated from the oral cavity of AIDS patient

    Directory of Open Access Journals (Sweden)

    Rejane Pereira Neves

    2002-09-01

    Full Text Available Trichosporon has been reported as a remarkable emerging pathogen and usually occurs in imunodrepressed patients. An oropharyngeal secretion sample was collected from a patient with AIDS, at the Sector of Infectious and Parasitic Diseases, Osvaldo Cruz University Hospital, Pernambuco State, Brazil. No yeast cells or arthroconidia were observed in the direct exam, but a culture was positive for Trichosporon pullulans, which is being reported in an AIDS patient for the first time.

  12. Hanseníase tuberculóide em paciente com Aids Tuberculoid leprosy in aids patient

    Directory of Open Access Journals (Sweden)

    Régio José Santiago Girão

    2005-12-01

    Full Text Available Relata-se o caso de uma criança de oito anos, portadora de Aids, que desenvolveu hanseníase tuberculóide antes do início da terapia anti-retroviral. Apresentava lesões ulceradas nos membros, Mitsuda de 8,5mm, hipoestesia em perna esquerda, e o diagnóstico de hanseníase foi definido pela imuno-histoquímica antiproteína S-100, que mostrou fragmentos de ramos nervosos no interior dos granulomas. A incidência da hanseníase não aumentou com o advento da Aids, e não há modificações na apresentação clínica ou na resposta terapêutica nos casos de hanseníase associados à Aids. Também não se observou neste caso o desenvolvimento da reação tipo 1 como resultado da reconstituição imunológica devido ao tratamento anti-retroviral.The authors present a 8 year-old child with AIDS who developed tuberculoid leprosy prior the beginning of the anti-retroviral treatment. The pacient presented ulcered lesions in arms and legs, the Mitsuda reaction was 8,5 mm, there was hypostesia of the left leg and the leprosy diagnosis was reached mainly supported by the anti-S100 protein immunohistochemistry staining that showed fragments of nerve branches inside granulomas. The incidence of leprosy has not increased because of AIDS. There haven’t been changes in the clinical presentation and in the response to therapy in cases of leprosy associated with AIDS. We haven’t also observed development of type 1 reaction in this patient resulting from restoring of the immune response after the anti-retroviral treatment.

  13. Rupioid histoplasmosis: first case reported in an AIDS patient in Argentina.

    Science.gov (United States)

    Corti, Marcelo; Villafañe, María F; Palmieri, Omar; Negroni, Ricardo

    2010-01-01

    Disseminated histoplasmosis is a relatively common AIDS-defining illness, occurring in almost 4% of patients living in endemic areas and it may be the first clinical expression of the HIV infection. A broad spectrum of clinical skin lesions associated with Histoplasma capsulatum infection have been described in AIDS patients, such as erythematous macules, papules, nodules, and pustules. Herpetic, acneiform, erythema multiforme-like, molluscum contagiosum-like, vasculitic, and exfoliative forms have also been reported. To our knowledge, this is the first case of disseminated histoplasmosis in an AIDS patient presented as a rupioid eruption.

  14. Trends in survival of Danish AIDS patients from 1981 to 1989

    DEFF Research Database (Denmark)

    Pedersen, C; Gerstoft, J; Tauris, P;

    1990-01-01

    Length of survival was analysed in relation to year of diagnosis, AIDS-indicative disease, age, risk behaviour, zidovudine therapy, and CD4 cell count and serum immunoglobulin (Ig) levels at the time of diagnosis in a group of 231 consecutive adult Danish AIDS patients reported before 1 January...

  15. Pulmonary involvement of Kaposi sarcoma in an AIDS patient: radiologic and pathologic findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Ho; Goo, Jin Mo; Lee, Jun Woo; Chung, Myung Jin; Lee, Yu Jin; Im, Jung Gi [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2002-01-01

    Kaposi sarcoma is the most common malignancy in aquired immunodeficiency syndrome (AIDS), and when disseminated may involve any organ system. Pulmonary involvement of Kaposi sarcoma in AIDS patients has not been previously reported in Korea and we report one such case, confirmed pathologically at autopsy.

  16. Correlates of participation in AIDS education and HIV antibody testing by methadone patients.

    Science.gov (United States)

    Magura, S; Grossman, J I; Lipton, D S; Amann, K R; Koger, J; Gehan, K

    1989-01-01

    The authors examined the factors associated with methadone patients' decisions about participating in a clinic-based AIDS prevention protocol. Despite the offer of incentives, only 27 percent attended AIDS education and only 12 percent obtained voluntary HIV antibody (ab) testing. However, AIDS education was attended by proportionately more of those who were at highest risk for AIDS because of current intravenous drug use. The availability of HIV-ab testing neither encouraged nor discouraged participation in AIDS education. Patients who were relatively more likely to choose HIV-ab testing were older, had been or were married, had plans to have children, believed the test to be useful, and believed that their counselors support their decision to be tested. Those who declined to be tested were reluctant to confront the emotional aspects of their risk status, were concerned about possible breaches of confidentiality, and doubted the value of testing. The implications of the findings for implementing AIDS prevention measures in methadone programs are discussed. Programs need either to require attendance at AIDS education or give patients an incentive to attend. HIV-ab testing should be available but should remain voluntary. A stronger medical rationale for testing is developing and may increase future participation. Methadone programs must continue to engage patients actively in AIDS risk reduction efforts.

  17. Cultural Competence in a Group Intervention Designed for Latino Patients Living with HIV/AIDS

    Science.gov (United States)

    Acevedo, Vanessa

    2008-01-01

    Although the trajectory of the HIV/AIDS epidemic has changed dramatically over the past 25 years, addressing the psychosocial needs of patients living with HIV/AIDS remains vital. Ensuring the effective delivery of services demands that interventions be rooted in cultural competence and aimed at vulnerable populations. This article describes a…

  18. Put a Face to a Name (Part A): The Effects of Photographic Aids on Patient Satisfaction, Clinician Communication, and Quality of Care

    Science.gov (United States)

    2014-04-04

    Effects of Photographic Aids (Photos of Faces) on Patient Recall of Their Clinical Care Team; Effects of Photographic Aids (Photos of Faces) on Clinician-patient Communication; Effects of Photographic Aids (Photos of Faces) on Overall Patient Satisfaction

  19. Factors associated with the development of Pneumocystis carinii pneumonia in 5,025 European patients with AIDS. AIDS in Europe Study Group

    DEFF Research Database (Denmark)

    Lundgren, Jens Dilling; Barton, S E; Lazzarin, A;

    1995-01-01

    This study examined the factors associated with the development of a first episode of Pneumocystis carinii pneumonia (PCP) in 5,025 patients with AIDS, including 1,976 patients with primary PCP at the time of AIDS diagnosis and 635 with primary PCP occurring subsequently. Compared with untreated ...

  20. [Hygiene practices for patients with HIV/AIDS].

    Science.gov (United States)

    da Cunha, Gilmara Holanda; de Araujo, Thelma Leite; Lima, Francisca Elisângela Teixeira; Cavalcante, Tahissa Frota; Galvão, Marli Teresinha Gimeniz

    2014-09-01

    The objective of this study was to analyze the scientific production on health interventions related to hygiene for adults with HIV/AIDS. An integrative literature review was performed using six databases in June 2013. The descriptors AIDS and Hygiene were used, in Portuguese, English or Spanish. A total of 682 articles were found and 16 were selected. Personal hygiene practices were identified, such as hand washing, showers, tooth brushing and quitting smoking. Food hygiene practices involved washing food and kitchen utensils, using treated water, conserving and cooking food. Environmental hygiene took into account raising domestic animals, control of disease vectors, household cleanliness, waste disposal and basic sanitation. In conclusion, these specific hygiene interventions can be applied to the general population and, especially, to people with HIV/AIDS, due to immunosuppression.

  1. Factors associated with the development of Pneumocystis carinii pneumonia in 5,025 European patients with AIDS. AIDS in Europe Study Group

    DEFF Research Database (Denmark)

    Lundgren, Jens Dilling; Barton, S E; Lazzarin, A;

    1995-01-01

    This study examined the factors associated with the development of a first episode of Pneumocystis carinii pneumonia (PCP) in 5,025 patients with AIDS, including 1,976 patients with primary PCP at the time of AIDS diagnosis and 635 with primary PCP occurring subsequently. Compared with untreated...... patients, patients treated with zidovudine were at similar risk of developing PCP during the first year of therapy but were at greater risk after longer intervals of treatment. The following factors were associated with an increased risk of PCP (either at the time of AIDS diagnosis or thereafter): lack...... of primary PCP prophylaxis, male homosexuality/bisexuality, diagnosis of AIDS in northern Europe, and CD4 cell count below 200 x 10(6)/L at the time of AIDS diagnosis. Patients with severe weight loss had a 60% higher risk of developing PCP during follow-up than those without such weight loss. Thus...

  2. The neglected topic: presentation of cost information in patient decision AIDS.

    Science.gov (United States)

    Blumenthal-Barby, J S; Robinson, Emily; Cantor, Scott B; Naik, Aanand D; Russell, Heidi Voelker; Volk, Robert J

    2015-05-01

    Costs are an important component of patients' decision making, but a comparatively underemphasized aspect of formal shared decision making. We hypothesized that decision aids also avoid discussion of costs, despite their being tools designed to facilitate shared decision making about patient-centered outcomes. We sought to define the frequency of cost-related information and identify the common modes of presenting cost and cost-related information in the 290 decision aids catalogued in the Ottawa Hospital Research Institute's Decision Aid Library Inventory (DALI) system. We found that 56% (n = 161) of the decision aids mentioned cost in some way, but only 13% (n = 37) gave a specific price or range of prices. We identified 9 different ways in which cost was mentioned. The most common approach was as a "pro" of one of the treatment options (e.g., "you avoid the cost of medication"). Of the 37 decision aids that gave specific prices or ranges of prices for treatment options, only 2 were about surgery decisions despite the fact that surgery decision aids were the most common. Our findings suggest that presentation of cost information in decision aids is highly variable. Evidence-based guidelines should be developed by the International Patient Decision Aid Standards (IPDAS) Collaboration.

  3. Gadolinium-enhanced MRI in a patient with AIDS and the Ramsay-Hunt syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Li, J. (Neuroradiology Section, Univ. of Texas Health Science Center, San Antonio, TX (United States)); Xiong, L. (Neuroradiology Section, Univ. of Texas Health Science Center, San Antonio, TX (United States)); Jinkins, J.R. (Neuroradiology Section, Univ. of Texas Health Science Center, San Antonio, TX (United States))

    1993-04-01

    Conrast-enhanced MRI is very sensitive to disease in the internal auditory meatus, but lacks specificity. This report illustrates the MRI findings in the Ramsay-Hunt syndrome caused by herpes zoster infection in a patient with AIDS. (orig.)

  4. Assessing the quality of decision support technologies using the International Patient Decision Aid Standards instrument (IPDASi).

    NARCIS (Netherlands)

    Elwyn, G.; O'Connor, A.M.; Bennett, C.; Newcombe, R.G.; Politi, M.; Durand, M.A.; Drake, E.; Joseph-Williams, N.; Khangura, S.; Saarimaki, A.; Sivell, S.; Stiel, M.; Bernstein, S.J.; Col, N.; Coulter, A.; Eden, K.; Harter, M.; Rovner, M.H.; Moumjid, N.; Stacey, D.; Thomson, R.; Whelan, T.; Weijden, G.D.E.M. van der; Edwards, A.

    2009-01-01

    OBJECTIVES: To describe the development, validation and inter-rater reliability of an instrument to measure the quality of patient decision support technologies (decision aids). DESIGN: Scale development study, involving construct, item and scale development, validation and reliability testing. SETT

  5. IgM, IgG and IgA rheumatoid factors and circulating immune complexes in patients with AIDS and AIDS-related complex with serological abnormalities.

    Science.gov (United States)

    Procaccia, S; Lazzarin, A; Colucci, A; Gasparini, A; Forcellini, P; Lanzanova, D; Foppa, C U; Novati, R; Zanussi, C

    1987-01-01

    To investigate some humoral aspects which may reflect the involvement of B lymphocytes in the acquired immunodeficiency syndrome (AIDS), we used an enzyme-linked immunoassay (ELISA) to determine the levels of IgM, IgG and IgA rheumatoid factors (RF) in 16 patients suffering from full-blown AIDS and 32 patients with AIDS-related complex (ARC), in the clinical form of lymphoadenopathy syndrome (LAS), compared with 40 healthy, young heterosexual subjects. Both AIDS and ARC patients showed a greater incidence of high IgM RF levels, with mean values significantly higher than controls, but with no differences between the two pathological groups. IgG RF behaviour was similar in the two patient populations and the healthy subjects. IgA RF were significantly raised in AIDS and ARC. Further information on RF was obtained by determination of the immunoglobulin levels of the respective isotypes in the same patients. Mean IgG levels were above normal in AIDS and ARC patients, but the latter group showed a higher incidence of increased values and higher mean levels. The IgA isotype was significantly increased mainly in AIDS patients. The behaviour of IgM was virtually the same in the three groups studied. A difference between AIDS and ARC patients was established by the detection of circulating immune-complexes (IC) by the C1q-binding and CIC-conglutinin assays. IC were significantly high, by both methods, only in the ARC group, but normal or very low in AIDS. These overall findings suggest once again the impairment of B cell function in AIDS, with prevalent hyperactivation in ARC and exhaustion in full-blown AIDS, and apparent preservation, in the latter group, of the antibody responses which are more closely related to the activity of subsets of T helper cells. PMID:3608224

  6. Vibrant Soundbridge and Bone Conduction Hearing Aid in Patients with Bilateral Malformation of External Ear

    OpenAIRE

    Mondelli, Maria Fernanda Capoani Garcia; Mariano, Thais Cristina Barbosa; Heitor Marques HONÓRIO; Brito, Rubens Vuono de

    2016-01-01

    Introduction Hearing loss is the most common clinical finding in patients with malformation of the external ear canal. Among the possibilities of treatment, there is the adaptation of hearing aids by bone conduction and the adaptation of implantable hearing aids. Objective To assess speech perception with the use of Vibrant Soundbridge (VBS - MED-EL, Innsbruck, Austria) associated with additional amplification in patients with bilateral craniofacial malformation. Method We evaluated 11 p...

  7. Aspidosperma subincanum II. Usefulness of uleine and ribonucleic fragments in the treatment of AIDS patients

    Directory of Open Access Journals (Sweden)

    Dominique Maes

    2015-02-01

    Full Text Available Aids patients were treated during a year with three different food supplements commercially available: para-pau-aspido (Aspidosperma subincanum Mart. ex A. DC., Apocynaceae; 2Leid (nucleic acids and cytokines; and Para Immuno (propolis, pollen and royal jelly. All foods, given either alone or in combination, proved useful to all AIDS patients who received the supplements, be these under tri-therapy (Triomine: stavudine, lamivudine, névirapine or left unattended.

  8. The experience of nursing students in caring for aids patients

    Directory of Open Access Journals (Sweden)

    Joyce Mokoena

    1997-03-01

    Full Text Available In South Africa the cumulative total of people suffering from AIDS between 1982 and 1991 was 969.

    Opsomming
    In Suid-Afrika het 969 persone reeds tussen 1982 en 1991 aan VIGS gely (Epidemilogiese aantekeninge vol. 18, (11, November 1991. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

  9. Computers in engineering 1983; Proceedings of the International Conference and Exhibit, Chicago, IL, August 7-11, 1983. Volume 1 - Computer-aided design, manufacturing, and simulation

    Science.gov (United States)

    Cokonis, T. J.

    The papers presented in this volume provide examples of the impact of computers on present engineering practice and indicate some future trends in computer-aided design, manufacturing, and simulation. Topics discussed include computer-aided design of turbine cycle configuration, managing and development of engineering computer systems, computer-aided manufacturing with robots in the automotive industry, and computer-aided design/analysis techniques of composite materials in the cure phase. Papers are also presented on computer simulation of vehicular propulsion systems, the performance of a hydraulic system simulator in a CAD environment, and computer simulation of hovercraft heave dynamics and control.

  10. Relationship between Radiological Stages and Prognoses of Pneumocystis Pneumonia in Non-AIDS Immunocompromised Patients

    Directory of Open Access Journals (Sweden)

    Xiang-Dong Mu

    2016-01-01

    Conclusions: Based on the radiological manifestations, the course of PCP in non-AIDS immunocompromised patients can be divided into three stages: early stage, mid stage, and late stage. The prognoses of patients treated at early stage are good, and those at late stage are poor. Furthermore, the CFR of patients with barotrauma is high.

  11. Tuberculous cerebritis and tuberculoma in a patient with AIDS: Literature review and case report.

    Directory of Open Access Journals (Sweden)

    Saeed Abrishamkar

    2006-11-01

    Full Text Available Tuberculous brain cerebritis, abscess and tuberculoma in AIDS patients are considered as rare conditions and only few cases have been reported in the literature. The present case is a 28-year-old man with AIDS and previous systemic tuberculosis, denied by him and his family. He was admitted to our department due to headache, hemiparesis and seizures. A brain computed tomography (CT scan disclosed a frontal hypodense lesion with a non-homogenous contrast enhancement that was reported as a high grade glioma. Magnetic resonance imaging (MRI showed a diffuse hypointense lesion in right frontal area on T1-weighted, and hyperintense on T2-weighted and flair view, but there was a small paraventricular region with hypointensity on both T1, T2 and flair series, which was also reported to be a high grade glioma. Because of clinical course and imaging findings, the patient was a candidate for operation. After operation, the results of pathology and laboratory examination confirmed the diagnosis of tuberculous brain cerebritis and tuberculoma with positive Acquired Immune Virus (HIV serology. Thus, tuberculous cerebritis, tuberculoma and abscesses should be considered in the differential diagnosis of focal brain lesions in AIDS patients, but AIDS should also be considered in every patient with an uncommon cerebral lesion who is not cooperative with medical healthcare providers. Surgical excision or biopsy and anti-tuberculous treatment are the mainstay in management of these lesions in patients with AIDS. KEY WORDS: AIDS, tuberculoma, tuberculosis cerebritis.

  12. The views of undergraduate nursing students on caring for patients with HIV/AIDS

    Directory of Open Access Journals (Sweden)

    MM Madumo

    2006-09-01

    Full Text Available A qualitative, exploratory and descriptive study was conducted with the purpose of exploring and describing the views of undergraduate nursing students on caring for HIV/AIDS patients. The study population consisted of BCur III nursing students studying at the Medical University of Southern Africa (Medunsa. Participants were purposively selected. Focus group interviews were used as a data collection instrument. Guided by a group moderator and responding to a central research question, participants shared their views about caring for HIV/AIDS patients. Tesch’s qualitative method of data analysis, as described by Cresswell (1994:155, was used to analyse the data. Caring for HIV/AIDS patients evoked emotions such as fear, anger and frustration among undergraduate nursing students. Students expressed needs such as the acquisition of knowledge and a reduction in the stigmatisation of patients with HIV/ AIDS, while the data analysis revealed demands such as more intensive clinical accompaniment by lecturers and antiretroviral therapy delivery by government. Suggested solutions included student participation in HIV/AIDS prevention campaigns and the upholding of patients’ rights. Curriculum innovation was recommended to improve students’ knowledge of HIV/AIDS and to ensure the provision of quality care for these patients.

  13. Causes of Death in HIV Patients and the Evolution of an AIDS Hospice: 1988–2008

    Directory of Open Access Journals (Sweden)

    Ann Stewart

    2012-01-01

    Full Text Available This paper reports on the transformation that has occurred in the care of people living with HIV/AIDS in a Toronto Hospice. Casey House opened in the pre-HAART era to care exclusively for people with HIV/AIDS, an incurable disease. At the time, all patients were admitted for palliative care and all deaths were due to AIDS-defining conditions. AIDS-defining malignancies accounted for 22 percent of deaths, mainly, Kaposi sarcoma and lymphoma. In the post-HAART era, AIDS-defining malignancies dropped dramatically and non-AIDS-defining malignancies became a significant cause of death, including liver cancer, lung cancer and gastric cancers. In the post-HAART era, people living with HIV/AIDS served at Casey House have changed considerably, with increasing numbers of patients facing homelessness and mental health issues, including substance use. Casey House offers a picture of the evolving epidemic and provides insight into changes and improvements made in the care of these patients.

  14. Patients with Chronic Spinal Cord Injury Exhibit Reduced Autonomic Modulation during an Emotion Recognition Task

    Science.gov (United States)

    Varas-Díaz, Gonzalo; Brunetti, Enzo P.; Rivera-Lillo, Gonzalo; Maldonado, Pedro E.

    2017-01-01

    Spinal cord injury (SCI) is a devastating event for individuals, who frequently develop motor and sensory impairment as well as autonomic dysfunction. Previous studies reported that autonomic activity plays a major role in social cognition and that difficulties in the ability to interpret social information are commonly observed in a variety of mental disorders, which in turn correlate with a poor autonomic nervous system (ANS) regulation. It is well established that subjects with SCI have an alteration in ANS regulation mechanisms. We hypothesized that subjects diagnosed with SCI, who are experiencing a period of adaptation and socio-labor insertion suffer alterations in an emotion recognition task, a component of social cognition, which correlate with poor ANS regulation. We evaluated ANS function by measuring the heart rate variability (HRV) in 18 healthy subjects and 10 subjects with SCI. A 5-min baseline HRV was compared to a task period while performing The reading the mind in the eyes test (RMET). We found that while both groups have similar general performance in the test, healthy subjects responded with greater certainty during the RMET. This level of certainty during the RMET was positively correlated with baseline HRV measures in this group. Also, the group of healthy subjects exhibited higher HRV at baseline than participants with SCI. Finally, the changes in HRV between baseline and task condition were significantly higher in healthy individuals than in SCI participants. Our results show that patients with SCI have low levels of autonomic regulation mechanisms which may promote social cognition problems during their reinsertion to daily life. PMID:28228721

  15. Isolation of Mycobacterium avium complex from bone marrow aspirates of AIDS patients in Brazil.

    Science.gov (United States)

    Barreto, J A; Palaci, M; Ferrazoli, L; Martins, M C; Suleiman, J; Lorenço, R; Ferreira, O C; Riley, L W; Johnson, W D; Galvão, P A

    1993-09-01

    Mycobacterium avium complex (MAC) infection has not been reported as a major opportunistic infection among patients with AIDS in Latin America or Africa. In this study, 125 AIDS patients who had persistent fever, anemia, and leukopenia were examined among 2628 AIDS patients admitted to Instituto de Infectologia Emilio Ribas between May 1990 and April 1992. From the bone marrow aspirates of the 125 patients, MAC was isolated from 23 (18.4%) and Mycobacterium tuberculosis was isolated from 9 (7.2%). Between 1985 and 1990, only 11 MAC isolations among 60,000 cultures obtained from human immunodeficiency virus-seronegative patients were documented in São Paulo. Hence, the minimal estimated rate of MAC infection in AIDS patients in this city was 23/2628, or 0.88%. These findings suggest that MAC infection is an important opportunistic infection, especially among a subset of patients with AIDS in Brazil who have clinical characteristics and risk activities similar to those associated with MAC infections in North America and Europe.

  16. Predictors of HIV/AIDS Related Ocular Manifestations among HIV/AIDS Patients in Felege Hiwot Referral Hospital, Northwest Ethiopia.

    Science.gov (United States)

    Sharew, Guadie; Azage, Muluken

    2015-01-01

    Background. Ocular manifestations in people living with HIV/AIDS are varied and affect almost all the structures of eye leading to visual impairment or blindness. Therefore, the aim of this study was to identify the predictors of HIV related ocular manifestation among ART clinic clients. Methods. Institution based cross-sectional study was employed among ART clients at Felege Hiwot referral hospital, northwest Ethiopia. The study was conducted from 1 January 2013 to 30 January 2013. A total of 369 systematically and randomly selected clients were included in the study. Data were collected using structured questionnaires and ophthalmologic clinical examination. Data were entered and analyzed using SPSS version 16.0. Binary and multivariable logistic regression analyses were computed to identify independent predictors of HIV related ocular manifestation. Results. Twenty-five percent (25.7%) of HIV patients had ocular manifestations. The three most frequent signs were Squamoid Conjuctival growth (26.9%), ophthalmic herpes zoster (22.1%), and Bacterial Conjuctivitis (17.2%). History of eye problem, CD4 count, and visual acuity of the eye were the predictors of HIV related ocular manifestation. Conclusion. In this study, a higher proportion of ocular manifestations were detected in HIV/AIDS patients. Visual acuity and CD4 counts were the independent predictors of ocular manifestations. This finding gives an insight for policy makers and concerned body to integrate ophthalmic examination in ART clinics to improve the health condition of HIV/ADIS patients.

  17. Predictors of HIV/AIDS Related Ocular Manifestations among HIV/AIDS Patients in Felege Hiwot Referral Hospital, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Guadie Sharew

    2015-01-01

    Full Text Available Background. Ocular manifestations in people living with HIV/AIDS are varied and affect almost all the structures of eye leading to visual impairment or blindness. Therefore, the aim of this study was to identify the predictors of HIV related ocular manifestation among ART clinic clients. Methods. Institution based cross-sectional study was employed among ART clients at Felege Hiwot referral hospital, northwest Ethiopia. The study was conducted from 1 January 2013 to 30 January 2013. A total of 369 systematically and randomly selected clients were included in the study. Data were collected using structured questionnaires and ophthalmologic clinical examination. Data were entered and analyzed using SPSS version 16.0. Binary and multivariable logistic regression analyses were computed to identify independent predictors of HIV related ocular manifestation. Results. Twenty-five percent (25.7% of HIV patients had ocular manifestations. The three most frequent signs were Squamoid Conjuctival growth (26.9%, ophthalmic herpes zoster (22.1%, and Bacterial Conjuctivitis (17.2%. History of eye problem, CD4 count, and visual acuity of the eye were the predictors of HIV related ocular manifestation. Conclusion. In this study, a higher proportion of ocular manifestations were detected in HIV/AIDS patients. Visual acuity and CD4 counts were the independent predictors of ocular manifestations. This finding gives an insight for policy makers and concerned body to integrate ophthalmic examination in ART clinics to improve the health condition of HIV/ADIS patients.

  18. PP65 antigenemia in the diagnosis of cytomegalovirus infection in AIDS patients

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    RC Capela

    2012-01-01

    Full Text Available Cytomegalovirus causes significant morbidity and mortality in AIDS patients and those having undergone bone marrow or another transplant. PP65 antigenemia is based on detecting viral antigen in peripheral blood leukocytes through immunochemistry and by monitoring the infection in immunocompromised individuals. The present study aimed to set up this diagnostic technique in AIDS patients with active cytomegalovirus infection and verify its occurrence in the Botucatu region of São Paulo state, Brazil. Fifty patients, 35 men and 15 women aged from 24 to 69 years, were recruited from those attended at the Department of Tropical Diseases of Botucatu Medical School, UNESP, and divided into three groups according to CD4+ T lymphocyte counts and antiretroviral treatment. The control group comprised bone marrow transplant patients. Fourteen AIDS patients with low CD4+ cell counts tested positive for PP65 antigenemia, which could predict cytomegalovirus infection and indicate prophylactic treatment.

  19. Efficacy and safety of omalizumab in patients with chronic urticaria who exhibit IgE against thyroperoxidase

    DEFF Research Database (Denmark)

    Maurer, Marcus; Altrichter, Sabine; Bieber, Thomas

    2011-01-01

    BACKGROUND: A subgroup of patients with chronic spontaneous urticaria (CU) exhibits IgE antibodies directed against autoantigens, such as thyroperoxidase (TPO). We conducted this study to investigate whether such patients with CU with IgE against TPO benefit from treatment with omalizumab, a huma...

  20. The relationship between personality traits and AIDS in patients with human immunodeficiency virus.

    Science.gov (United States)

    Salehi, Bahman; Zarinfar, Nader; Noori, Hasan

    2016-06-01

    This study carried out to survey the relationship between personality traits and Acquired Immunodeficiency Syndrome (AIDS) in patients with human immunodeficiency virus. This case-control study was conducted on 79 AIDS patients of Triangle Clinic in Arak (case group) and 80 healthy people of Valiasr Hospital in Arak (control group). Demographic information checklist and Cloninger' Temperament and Character inventory (TCI) were two instruments applied in the study. SPSS software V.19 and tests independent t-tests, Chi squared and Spearman correlation coefficient were used for data analysis with significant level of innovativeness variables (M:74.12), harm avoidance (M: 65.17), reward dependence (M:50.030), and self-directedness (M:35.02) in case group in comparison with control group was significantly higher, and there was a significant difference between two groups variables (P-0.000). The novelty seeking had the highest average in the AIDS patients with a history of addiction (M:74.00), and there was statistically significant difference between perseverance variable (P-0.021) and cooperativeness variable (P-0.041) in the two groups of AIDS patients. There was a significant relationship between novelty seeking and age at the onset of AIDS (P-0.038), harm avoidance and age at the onset of addiction (P-0.046), persistence and age at the onset of AIDS (P-0.035) and the time infected with HIV (P-0.033). It is found that two groups are different due to the personalities, so it is essential to consider the personality traits in order to prevent AIDS and also successfully treat patients suffering from AIDS.

  1. EVOLUTION OF PATIENTS WITH AIDS AFTER cART: CLINICAL AND LABORATORY EVOLUTION OF PATIENTS WITH AIDS AFTER 48 WEEKS OF ANTIRETROVIRAL TREATMENT

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    Ana Esther Carvalho Gomes Fukumoto

    2013-07-01

    Full Text Available SUMMARY Combination Antiretroviral Therapy (cART aims to inhibit viral replication, delay immunodeficiency progression and improve survival in AIDS patients. The objective of this study was to compare two different schemes of cART, based on plasma viral load (VL and CD4+ T lymphocyte count, during 48 weeks of treatment. For this purpose, 472 medical charts of a Specialized Outpatient Service were reviewed from 1998 to 2005. Out of these, 58 AIDS patients who had received a triple drug scheme as the initial treatment were included in the study and two groups were formed: Group 1 (G1: 47 individuals treated with two nucleoside reverse-transcriptase inhibitors (NRTI and one non-nucleoside reverse-transcriptase inhibitor; Group 2 (G2: 11 patients treated with two NRTI and one protease inhibitor. In G1 and G2, 53.2% and 81.8% respectively were patients with an AIDS-defining disease. The T CD4+ lymphocyte count increased progressively up until the 24th week of treatment in all patients, while VL became undetectable in 68.1% of G1 and in 63.6% of G2. The study concluded that the evolutions of laboratory tests were similar in the two treatment groups and that both presented a favorable clinical evolution.

  2. The effect of treatment with zidovudine with or without acyclovir on HIV p24 antigenaemia in patients with AIDS or AIDS-related complex

    DEFF Research Database (Denmark)

    Pedersen, C; Cooper, D A; Brun-Vézinet, F;

    1992-01-01

    with AIDS, AIDS-related complex (ARC) or Kaposi's sarcoma (KS). DESIGN: Double-blind, placebo-controlled randomized clinical trial of less than or equal to 6 months' therapy. SETTING: Samples were obtained from patients attending teaching hospital outpatient clinics in seven European countries and Australia...

  3. Radiologic diagnosis for AIDS patients complicated with candidal esophagitis

    Institute of Scientific and Technical Information of China (English)

    YANG Gen-dong; LU Pu-xuan; QIN Jing; LIU Shui-teng; ZHAN Neng-yong

    2011-01-01

    Background Candidal esophagitis is the primary infection among all digestive tract opportunistic ones in acquired immunodeficiency syndrome (AIDS) cases. X-ray manifestation reports of it are still rare. This study aimed to conduct a retrospective analysis on the X-ray data of 6 AIDS cases complicated with candidal esophagitis,and to study the X-ray characteristics of it combined with the findings from gastroscopy.Methods Among 6 cases in this series,all cases were confirmed by Shenzhen Center for Disease Control and Prevention (CDC) to be HIV positive and all of them had CD4 cell counts less than 150×106/L. All cases underwent X-ray and gastroscopy,and mycelium were found in the mucous membrane of the esophagus.Results In this series,the findings of the X-ray were as follows:(1) Affected areas:Four cases in the whole esophagus,2 cases in the middle and lower part of esophagus;(2) Abnormal motivity:Six cases had decreased tension,loose walls,weakened peristalsis,decreased number of peristalsis waves and delayed emptying of barium;(3) Abnormal contour:Six cases had the sign of "decorative border" or "brush",two cases had narrowed canal;(4) Abnormal membrane and "cobblestone sign":Six cases had thickened membrane and "cobblestone sign" on the surface of the abnormal membrane. The hyperemia of mucosa was covered tightly with yellow-white pseudomembrane spots. This was in accordance with the small cobblestone-like filling defect found by X-ray.Conclusions If the AIDS cases have dysphagia,and X-ray shows that more than two sections of the esophagus are affected,with decreased motility,the walls in the sign of "brush" or "decorative edges",thickened membrane with "cobblestone sign",candidal esophagitis is highly possible.

  4. Frequncy and etiology of lymphadenopathy in Iranian HIV/AIDS patients

    Institute of Scientific and Technical Information of China (English)

    Azar Hadadi; Sirous Jafari; Zahra Hoseini Jebeli; Reza Hamidian

    2014-01-01

    Objective: To estimate and outline the frequency and etiology of lymphadenopathy in HIV/AIDS patients.Methods:(categorized into three sub-groups: definite, probable and possible) and associated factors of local and generalized lymphadenopathy.Results:This study was conducted on 178 consecutive HIV/AIDS patient files for etiologies lymphadenopathy. HIV in lymphadenopathy(+) patients was most commonly transmitted intravenously (n=49). Generalized and localized lymphadenopathy respectively occurred in 27 (37.50%) and 45 (62.50%) patients, mainly in the cervical region (28.9% for local and 63% for generalized lymphadenopathy). The most common causes of lymphadenopathy were tuberculosis (n=24, 33.3%) and lymphoma (n=12, 16.6%). The frequency of lymphadenopathy was non-significantly higher in patients with AIDS (CD4 count 200 cell/µL). Seventy-two (40.45%) patients including 63 male patients (87.5%) developed Conclusions: Lymphadenopathy in HIV/AIDS patients may reflect a serious condition, most likely tuberculosis and lymphoma. Since patients might underestimate lymphadenopathy, physicians would rather list these entities for diagnosis.

  5. The outcome of Pneumocystis carinii pneumonia in Danish patients with AIDS

    DEFF Research Database (Denmark)

    Pedersen, C; Lundgren, Jens Dilling; Nielsen, T

    1989-01-01

    A total of 100 consecutive patients with AIDS were evaluated for efficacy and safety of treatment and secondary prophylaxis directed against Pneumocystis carinii pneumonia (PCP). 89 episodes of PCP were recorded in 75 patients. 63 of the 75 patients (84%) with a first episode of PCP were discharged....... Of 72 patients with a first episode of PCP who were initially treated with trimethoprim-sulfamethoxazole. 76% completed therapy successfully. Side effects were common, but generally mild and tolerated during continued treatment. 7/11 patients (64%) with a first episode of PCP who required mechanical....../16 (69%) patients who were not receiving prophylaxis (p less than 0.00001). No patients discontinued prophylaxis because of side effects. It is concluded that for most patients with AIDS and PCP, treatment and secondary prophylaxis with TMP-SMZ is safe and effective....

  6. Assistência aos pacientes com HIV/Aids no Brasil Health care to HIV/AIDS patients in Brazil

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    Margareth Crisóstomo Portela

    2006-04-01

    Drug Logistics Management Systems of the National Program for STD/AIDS. The study results indicate good performance of the Brazilian ARV Access Program but access to treatment of opportunistic infections was, however, unsatisfactory. The rates covered by SUS for AIDS hospital admissions remained very low, on average around R$700 in 2004. Health care to HIV/AIDS patients has been considered a citizen's right strongly supported by an effective joint action of the Brazilian government and civil society. The current challenges are fine monitoring of processes and program results and ensuring sustainability of universal free ARV access.

  7. Disseminated Acanthamoeba sinusitis in a patient with AIDS: a possible role for early antiretroviral therapy.

    Science.gov (United States)

    Carter, Wendy W; Gompf, Sandra G; Toney, John F; Greene, John N; Cutolo, Edward P

    2004-01-01

    Acanthamoeba, a free-living ameba, has been reported to infect humans with subacute encephalitis, sinusitis, or keratitis. Multiple cases of Acanthamoeba sinusitis with dissemination have been reported in association with AIDS, with high mortality. We report successful treatment of a 35-year-old woman who presented with sinusitis that progressed to disseminated acanthamebiasis as her initial manifestation of AIDS. To our knowledge, our patient was one of the few and longest-lived survivors of disseminated Acanthamoeba infection with AIDS. As with other opportunistic infections, early aggressive therapy including HAART may alter the outcome in this almost uniformly fatal disease.

  8. Meningitis caused by Alcaligenes xylosoxidans in a patient with HIV/AIDS

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    F. Espinoza-Gómez

    2007-12-01

    Full Text Available The purpose of the present work was to inform about the first case of meningitis associated to the bacteria Alcaligenes xylosoxidans in a patient with HIV/AIDS. The patient was a 46-year-old male, with the antecedent of have been diagnosed for HIV/ AIDS, who attended in the Hospital Universitario de Colima, Mexico, with fever, shock and meningismus. The study of the cerebrospinal fluid showed pleocytosis, elevated protein levels and hypoglycorrhachia. The culture yielded the presence of Alcaligenes xylosoxidans with sensitivity to ciprofloxacin. After 14 days of treatment with this antibiotic, the patient showed neurologic improvement and was able to continue with his outpatient antiretroviral treatment. The present case shows the importance of the inclusion of this bacterium in the differential diagnosis of the neurological infections in HIV/AIDS patients and emphasizes the importance of considering the bacterial meningitis in this population.

  9. Evidence-based patient choice: a prostate cancer decision aid in plain language

    OpenAIRE

    2005-01-01

    Abstract Background Decision aids (DA) to assist patients in evaluating treatment options and sharing in decision making have proliferated in recent years. Most require high literacy and do not use plain language principles. We describe one of the first attempts to design a decision aid using principles from reading research and document design. The plain language DA prototype addressed treatment decisions for localized prostate cancer. Evaluation assessed impact on knowledge, decisions, and ...

  10. Data mining of audiology patient records: factors influencing the choice of hearing aid type

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    Anwar Muhammad N

    2012-04-01

    Full Text Available Abstract Background This paper describes the analysis of a database of over 180,000 patient records, collected from over 23,000 patients, by the hearing aid clinic at James Cook University Hospital in Middlesbrough, UK. These records consist of audiograms (graphs of the faintest sounds audible to the patient at six different pitches, categorical data (such as age, gender, diagnosis and hearing aid type and brief free text notes made by the technicians. This data is mined to determine which factors contribute to the decision to fit a BTE (worn behind the ear hearing aid as opposed to an ITE (worn in the ear hearing aid. Methods From PCA (principal component analysis four main audiogram types are determined, and are related to the type of hearing aid chosen. The effects of age, gender, diagnosis, masker, mould and individual audiogram frequencies are combined into a single model by means of logistic regression. Some significant keywords are also discovered in the free text fields by using the chi-squared (χ2 test, which can also be used in the model. The final model can act a decision support tool to help decide whether an individual patient should be offered a BTE or an ITE hearing aid. Results The final model was tested using 5-fold cross validation, and was able to replicate the decisions of audiologists whether to fit an ITE or a BTE hearing aid with precision in the range 0.79 to 0.87. Conclusions A decision support system was produced to predict the type of hearing aid which should be prescribed, with an explanation facility explaining how that decision was arrived at. This system should prove useful in providing a "second opinion" for audiologists.

  11. Mycobacterium ulcerans infection as a cause of chronic diarrhea in an AIDS patient: A case report

    Institute of Scientific and Technical Information of China (English)

    Jin-Gook Huh; Myoung-Don Oh; You-Sun Kim; Jong-Sung Lee; Tae-Yeob Jeong; Soo-Hyung Ryu; Jung-Hwan Lee; Jeong-Seop Moon; Yun-Kyung Kang; Myung-Shup Shim

    2008-01-01

    Chronic diarrhea is one of the most frequent gastro-intestinal manifestations in acquired immunodeficiency syndrome (AIDS).Protozoa and nontuberculous mycobacteria (NTM) are opportunistic pathogens that can easily infect these patients.Among the NTM,Mycobacterium avium complex (MAC) is the most frequently observed pathogen in HIV-infected patients.However,NTMs other than MAC have not been reported as a gastrointestinal pathogen as yet.We present a case of chronic diarrhea in an AIDS patient in whom Mycobacterium ulcerans and cryptosporidium co-infection is evidenced from colonic tissue.

  12. Unusual pulmonary Enterocytozoon bieneusi microsporidiosis in an AIDS patient: case report and review.

    Science.gov (United States)

    Sodqi, Mustapha; Brazille, Patricia; Gonzalez-Canali, Gustavo; Cornet, Muriel; Piketty, Christophe; Weiss, Laurence

    2004-01-01

    Enterocytozoon bieneusi is an agent of intestinal microsporidiosis leading to chronic diarrhoea in AIDS patients. Pulmonary involvement may occur but remains rare with only 4 cases reported in the literature. We report here the fifth case of pulmonary localization of E. bieneusi in a severe immunocompromized HIV-infected patient with intestinal and pulmonary symptoms.

  13. Peginterferon alfa-2a for AIDS-associated Kaposi sarcoma: experience with 10 patients.

    Science.gov (United States)

    Rokx, Casper; van der Ende, Marchina E; Verbon, Annelies; Rijnders, Bart J A

    2013-11-01

    In this observational cohort study, 10 patients with extensive or treatment-refractory AIDS-associated Kaposi sarcoma were treated with peginterferon alfa-2a. Tumor responses were observed in 9 patients with a median progression-free survival of 645 days. Peginterferon alfa-2a could be an effective therapy for extensive or treatment-resistant Kaposi sarcoma.

  14. Trends in survival of Danish AIDS patients from 1981 to 1989

    DEFF Research Database (Denmark)

    Pedersen, C; Gerstoft, J; Tauris, P;

    1990-01-01

    % (3-31%) at 2 years prior to 1986, 32% (16-49%) in 1986 and 52% (34-69%) in 1987, whereas survival remained stable for patients with other AIDS-indicative diseases. Survival was similar for patients who were diagnosed with Kaposi's sarcoma alone and PCP alone. Independent predictors of a shortened...

  15. Salvage trial of trimetrexate-leucovorin for the treatment of cerebral toxoplasmosis in patients with AIDS

    DEFF Research Database (Denmark)

    Masur, H; Polis, M A; Tuazon, C U;

    1993-01-01

    The clinical efficacy of trimetrexate, a dihydrofolate reductase inhibitor with potent in vitro antitoxoplasma activity, was assessed in 9 sulfonamide-intolerant patients with AIDS and biopsy-proven cerebral toxoplasmosis. The 9 patients were treated for 28-149 days with trimetrexate (30-280 mg/m...

  16. Acute upper gastrointestinal bleeding in patients with AIDS: a relatively uncommon condition associated with reduced survival.

    Science.gov (United States)

    Parente, F; Cernuschi, M; Valsecchi, L; Rizzardini, G; Musicco, M; Lazzarin, A; Bianchi Porro, G

    1991-01-01

    To determine the cumulative incidence of acute upper gastrointestinal bleeding and its effect upon survival in patients with AIDS, 453 consecutive AIDS patients diagnosed in our hospital between June 1985 and March 1989 were followed for a median period of six months (maximum 42 months). The cumulative probability of acute gastrointestinal bleeding was 3% at six months and 6% at 14 months. This event was associated with significantly reduced survival. Independent risk factors for bleeding were: severe thrombocytopenia at the time of diagnosis and non-Hodgkin's lymphoma as the first clinical manifestation of AIDS. The potential causes of bleeding were investigated in all cases by emergency endoscopy or by necropsy examination in those patients whose clinical condition precluded the procedure. In nine of 15 patients, bleeding was due to lesions specifically associated with AIDS, but in the remainder the source of bleeding was not a direct consequence of HIV infection. We conclude that acute upper gastrointestinal bleeding rarely complicates the course of AIDS, but its occurrence is associated with decreased survival. As many of the causes are potentially treatable, a complete diagnostic approach is indicated in these patients, except those who are terminally ill. PMID:1916503

  17. A Review of Shared Decision-Making and Patient Decision Aids in Radiation Oncology.

    Science.gov (United States)

    Woodhouse, Kristina Demas; Tremont, Katie; Vachani, Anil; Schapira, Marilyn M; Vapiwala, Neha; Simone, Charles B; Berman, Abigail T

    2017-01-30

    Cancer treatment decisions are complex and may be challenging for patients, as multiple treatment options can often be reasonably considered. As a result, decisional support tools have been developed to assist patients in the decision-making process. A commonly used intervention to facilitate shared decision-making is a decision aid, which provides evidence-based outcomes information and guides patients towards choosing the treatment option that best aligns with their preferences and values. To ensure high quality, systematic frameworks and standards have been proposed for the development of an optimal aid for decision making. Studies have examined the impact of these tools on facilitating treatment decisions and improving decision-related outcomes. In radiation oncology, randomized controlled trials have demonstrated that decision aids have the potential to improve patient outcomes, including increased knowledge about treatment options and decreased decisional conflict with decision-making. This article provides an overview of the shared-decision making process and summarizes the development, validation, and implementation of decision aids as patient educational tools in radiation oncology. Finally, this article reviews the findings from decision aid studies in radiation oncology and offers various strategies to effectively implement shared decision-making into clinical practice.

  18. The Role of Spirituality in Quality of Life Patients with AIDS/HIV

    Directory of Open Access Journals (Sweden)

    Z Nikmanesh

    2013-01-01

    Full Text Available Introduction: AIDS will change route of life people with disease and to be cause loss of self – esteem, increased vulnerability feeling and confusion thoughts in their. The purpose of this study is investigating the role of spirituality in quality of life of patients with AIDS/HIV. Methods: This study was conducted with a sample of 43 patients with AIDS/HIV in Sistan & Baluchestan province in 1390 that had been selected via method of available sampling. Spirituality was measured using the Spirituality Questionnaire (Parsian and Dunning, 2009 and quality of life was measured using the World Health Organization Quality of Life (WHOQOL-BREF. Data were analyzed using Pearson correlation coefficient,s stepwise multiple regression, t Test and ANOVA. Results: The study results indicated that there is a significant positive relationship between spirituality and quality of life, but there is no significant relationship between demographic variables (gender, marital status, age, and disease duration and quality of life. Results of regression analyses indicated that component of self-awareness is best predictor of physical health, psychological health and social relationships. Also, there was a significant difference among male and female patients in quality of life. Conclusion: According to these results, it can be deduced that spirituality has an impact on quality of life in patients with AIDS/HIV, and it can be used as a coping method for improving mental health and increasing quality of patients' life with AIDS/HIV

  19. A digital patient for computer-aided prosthesis design

    OpenAIRE

    Colombo, Giorgio; Facoetti, Giancarlo; Rizzi, Caterina

    2013-01-01

    This article concerns the design of lower limb prosthesis, both below and above knee. It describes a new computer-based design framework and a digital model of the patient around which the prosthesis is designed and tested in a completely virtual environment. The virtual model of the patient is the backbone of the whole system, and it is based on a biomechanical general-purpose model customized with the patient's characteristics (e.g. anthropometric measures). The software platform adopts com...

  20. Opportunistic Neurologic Infections in Patients with Acquired Immunodeficiency Syndrome (AIDS).

    Science.gov (United States)

    Albarillo, Fritzie; O'Keefe, Paul

    2016-01-01

    Infections of the central nervous system (CNS) in individuals with human immunodeficiency virus (HIV) remain a substantial cause of morbidity and mortality despite the introduction of highly active antiretroviral therapy (HAART) especially in the resource-limited regions of the world. Diagnosis of these infections may be challenging because findings on cerebrospinal fluid (CSF) analysis and brain imaging are nonspecific. While brain biopsy provides a definitive diagnosis, it is an invasive procedure associated with a relatively low mortality rate, thus less invasive modalities have been studied in recent years. Diagnosis, therefore, can be established based on a combination of a compatible clinical syndrome, radiologic and CSF findings, and understanding of the role of HIV in these infections. The most common CNS opportunistic infections are AIDS-defining conditions; thus, treatment of these infections in combination with HAART has greatly improved survival.

  1. Lymphangiectatic Kaposi's sarcoma in a patient with AIDS Sarcoma de Kaposi linfangiectásico em paciente com Aids

    Directory of Open Access Journals (Sweden)

    Mônica Santos

    2013-04-01

    Full Text Available Kaposi's sarcoma is a malignant disease that originates in the lymphatic endothelium. It has a broad spectrum of clinical manifestations. Its four distinct clinical forms are: classic, endemic, iatrogenic and epidemic Kaposi's sarcoma. In non-HIV-associated Kaposi's sarcoma, the disease is typically limited to the lower extremities, but in immunodeficient patients, it is a multifocal systemic disease. The clinical course of the disease differs among patients, ranging from a single or a few indolent lesions to an aggressive diffuse disease. Advanced Kaposi's sarcoma lesions, typically those on the lower extremities, are often associated with lymphedema. In this paper, we report a case of a patient with a rare form of AIDS-associated Kaposi sarcoma called lymphangiectatic Kaposis's sarcoma.O sarcoma de Kaposi é uma neoplasia originária do endotélio linfatico, que apresenta um amplo espectro de manifestações, com quatro formas clínicas: sarcoma de Kaposi clássico, endêmico, iatrogêncio e epidêmico ou associado ao HIV. Em pacientes imunocompetentes, a doença é tipicamente limitada às extremidades. Porém em pacientes imunideprimidos, o sarcoma de Kaposi é uma doença sistêmica multifocal. Apresenta cursos clínicos diferentes, desde simples lesões cutâneas isoladas até lesões agressivas e difusas, com ou sem envolvimento sistêmico. Lesões avançadas de sarcoma de Kaposi, principalmente as localizadas nas extremidades, podem apresentar linfedema. Neste trabalho, reportamos caso de paciente com forma rara de Sarcoma de Kaposi associado a Aids, chamada de sarcoma de Kaposi linfangiectásico.

  2. Vibrant Soundbridge and Bone Conduction Hearing Aid in Patients with Bilateral Malformation of External Ear.

    Science.gov (United States)

    Mondelli, Maria Fernanda Capoani Garcia; Mariano, Thais Cristina Barbosa; Honório, Heitor Marques; Brito, Rubens Vuono de

    2016-01-01

    Introduction Hearing loss is the most common clinical finding in patients with malformation of the external ear canal. Among the possibilities of treatment, there is the adaptation of hearing aids by bone conduction and the adaptation of implantable hearing aids. Objective To assess speech perception with the use of Vibrant Soundbridge (VBS - MED-EL, Innsbruck, Austria) associated with additional amplification in patients with bilateral craniofacial malformation. Method We evaluated 11 patients with bilateral malformation over 12 years with mixed hearing loss or bilateral conductive. They were using the Softband (Oticon Medical, Sweden) and bone conduction hearing aid in the ear opposite the one with the VSB. We performed the evaluation of speech perception using the Hearing in Noise Test. Results Participants were eight men and three women with a mean of 19.5 years. The signal / noise ratio presented significant results in patients fitted with VSB and bone conduction hearing aid. Conclusion The results of speech perception were significantly better with use of VBS combined with bone conduction hearing aids.

  3. Vibrant Soundbridge and Bone Conduction Hearing Aid in Patients with Bilateral Malformation of External Ear

    Directory of Open Access Journals (Sweden)

    Mondelli, Maria Fernanda Capoani Garcia

    2015-10-01

    Full Text Available Introduction Hearing loss is the most common clinical finding in patients with malformation of the external ear canal. Among the possibilities of treatment, there is the adaptation of hearing aids by bone conduction and the adaptation of implantable hearing aids. Objective To assess speech perception with the use of Vibrant Soundbridge (VBS - MED-EL, Innsbruck, Austria associated with additional amplification in patients with bilateral craniofacial malformation. Method We evaluated 11 patients with bilateral malformation over 12 years with mixed hearing loss or bilateral conductive. They were using the Softband (Oticon Medical, Sweden and bone conduction hearing aid in the ear opposite the one with the VSB. We performed the evaluation of speech perception using the Hearing in Noise Test. Results Participants were eight men and three women with a mean of 19.5 years. The signal / noise ratio presented significant results in patients fitted with VSB and bone conduction hearing aid. Conclusion The results of speech perception were significantly better with use of VBS combined with bone conduction hearing aids.

  4. High level HIV-1 DNA concentrations in brain tissues differentiate patients with post-HAART AIDS dementia complex or cardiovascular disease from those with AIDS

    Institute of Scientific and Technical Information of China (English)

    ZHAO Li; GALLIGAN Derek C.; LAMERS Susanna L.; YU Stephanie; SHAGRUN Lamia; SALEMI Marco; MCGRATH Michael S.

    2009-01-01

    Highly active antiretroviral treatment (HAART) has had a significant Impact on survival of individuals with acquired immunodeficiency syndrome (AIDS); however, with the longer life-span of patients with AIDS, there is increasing prevalence of AIDS dementia complex (ADC) and other non-AIDS-defining illness, and cardiovascular diseases (CVD) are also common. The influence of these varied disease processes on HIV-1 DNA concentration in brain tissues has not been thoroughly assessed in the post-HAART era. The purpose of the current study is to clarify the impacts of ADC and other complications of HIV disease on the viral load in the brains in AIDS patients with post-HARRT. We examined autopsy specimens from the brains of thirteen patients who died from complications of AIDS with quantitative poiymerase chain reaction (QPCR). All but one patient had HAART prior to death since 1995. Two patients died with severe CVD, multiple cerebrovascular atherosclerosis (CVA)throughout the brain and five patients died with ADC. Six patients had no ADC/CVA. A QPCR was used to measure the presence of HIV-1 DNA in six brain tissues (meninges, frontal grey matter, frontal white matter, temporal subcortex, cerebellum and basal ganglia). In the post-HARRT era, for non-ADC/CVA patients, HIV-1 DNA concentration in brain tissues was statistically higher than that in patients with ADC. in a new finding, two patients who suffered from severe CVD, especially CVA, also had high concentrations of HIV-1 in brain compartments not showing ADC related changes. To our knowledge,this is the first report of a relationship between the CVA and HIV-1 viral burden in brain. The current observations suggest that HAART-resistant HIV reservoirs may survive within ADC lesions of the brain as well as the macrophage rich atherosclerosis, which needs to be confirmed by more AIDS cases with CVA.

  5. The compassion of concealment: silence between older caregivers and dying patients in the AIDS era, northwest Tanzania

    NARCIS (Netherlands)

    de Klerk, J.

    2012-01-01

    In northwest Tanzania, where AIDS has been present for 25 years, AIDS-related illness is a trigger through which community members discuss personal experiences of loss and assess social relationships. The terminal phase of AIDS demands intimate social relations between patients and caretakers. In th

  6. Areas of normal pulmonary parenchyma on HRCT exhibit increased FDG PET signal in IPF patients

    Energy Technology Data Exchange (ETDEWEB)

    Win, Thida [Lister Hospital, Respiratory Medicine, Stevenage (United Kingdom); Thomas, Benjamin A.; Lambrou, Tryphon; Hutton, Brian F.; Endozo, Raymondo; Shortman, Robert I.; Afaq, Asim; Ell, Peter J.; Groves, Ashley M. [University College London, Institute of Nuclear Medicine, University College Hospital, London (United Kingdom); Screaton, Nicholas J. [Papworth Hospital, Radiology Department, Papworth Everard (United Kingdom); Porter, Joanna C. [University College London, Centre for Respiratory Diseases, University College Hospital, London (United Kingdom); Maher, Toby M. [Royal Brompton Hospital, Interstitial Lung Disease Unit, London (United Kingdom); Lukey, Pauline [GSK, Fibrosis DPU, Research and Development, Stevenage (United Kingdom)

    2014-02-15

    Patients with idiopathic pulmonary fibrosis (IPF) show increased PET signal at sites of morphological abnormality on high-resolution computed tomography (HRCT). The purpose of this investigation was to investigate the PET signal at sites of normal-appearing lung on HRCT in IPF. Consecutive IPF patients (22 men, 3 women) were prospectively recruited. The patients underwent {sup 18}F-FDG PET/HRCT. The pulmonary imaging findings in the IPF patients were compared to the findings in a control population. Pulmonary uptake of {sup 18}F-FDG (mean SUV) was quantified at sites of morphologically normal parenchyma on HRCT. SUVs were also corrected for tissue fraction (TF). The mean SUV in IPF patients was compared with that in 25 controls (patients with lymphoma in remission or suspected paraneoplastic syndrome with normal PET/CT appearances). The pulmonary SUV (mean ± SD) uncorrected for TF in the controls was 0.48 ± 0.14 and 0.78 ± 0.24 taken from normal lung regions in IPF patients (p < 0.001). The TF-corrected mean SUV in the controls was 2.24 ± 0.29 and 3.24 ± 0.84 in IPF patients (p < 0.001). IPF patients have increased pulmonary uptake of {sup 18}F-FDG on PET in areas of lung with a normal morphological appearance on HRCT. This may have implications for determining disease mechanisms and treatment monitoring. (orig.)

  7. Visual Aids for Multimodal Treatment Options to Support Decision Making of Patients with Colorectal Cancer

    Directory of Open Access Journals (Sweden)

    Hofmann Sabine

    2012-10-01

    Full Text Available Abstract Background A variety of multimodal treatment options are available for colorectal cancer and many patients want to be involved in decisions about their therapies. However, their desire for autonomy is limited by lack of disease-specific knowledge. Visual aids may be helpful tools to present complex data in an easy-to-understand, graphic form to lay persons. The aim of the present study was to evaluate the treatment preferences of healthy persons and patients using visual aids depicting multimodal treatment options for colorectal cancer. Methods We designed visual aids for treatment scenarios based on four key studies concerning multimodal treatment of colorectal cancer. The visual aids were composed of diagrams depicting outcome parameters and side effects of two treatment options. They were presented to healthy persons (n = 265 and to patients with colorectal cancer (n = 102. Results Most patients and healthy persons could make immediate decisions after seeing the diagrams (range: 88% – 100%. Patients (79% chose the intensive-treatment option in the scenario with a clear survival benefit. In scenarios without survival benefit, all groups clearly preferred the milder treatment option (range: 78% - 90%. No preference was seen in the scenario depicting equally intense treatment options with different timing (neoadjuvant vs. adjuvant but without survival benefit. Conclusions Healthy persons’ and patients’ decisions using visual aids seem to be influenced by quality-of-life aspects rather than recurrence rates especially in situations without survival benefit. In the future visual aids may help to improve the management of patients with colorectal cancer.

  8. Discriminatory attitudes and practices by health workers toward patients with HIV/AIDS in Nigeria.

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    Chen Reis

    2005-08-01

    Full Text Available BACKGROUND: Nigeria has an estimated 3.6 million people with HIV/AIDS and is home to one out of every 11 people with HIV/AIDS worldwide. This study is the first population-based assessment of discrimination against people living with HIV/AIDS in the health sector of a country. The purpose of this study was to characterize the nature and extent of discriminatory practices and attitudes in the health sector and indicate possible contributing factors and intervention strategies. The study involved a cross-sectional survey of 1,021 Nigerian health-care professionals (including 324 physicians, 541 nurses, and 133 midwives identified by profession in 111 health-care facilities in four Nigerian states. METHODS AND FINDINGS: Fifty-four percent of the health-care professionals (550/1,021 were sampled from public tertiary care facilities. Nine percent of professionals reported refusing to care for an HIV/AIDS patient, and 9% indicated that they had refused an HIV/AIDS patient admission to a hospital. Fifty-nine percent agreed that people with HIV/AIDS should be on a separate ward, and 40% believed a person's HIV status could be determined by his or her appearance. Ninety-one percent agreed that staff and health-care professionals should be informed when a patient is HIV-positive so they can protect themselves. Forty percent believed that health-care professionals with HIV/AIDS should not be allowed to work in any area of health-care that requires patient contact. Twenty percent agreed that many with HIV/AIDS behaved immorally and deserve the disease. Basic materials needed for treatment and prevention of HIV were not adequately available. Twelve percent agreed that treatment of opportunistic infections in HIV/AIDS patients wastes resources, and 8% indicated that treating someone with HIV/AIDS is a waste of precious resources. Providers who reported working in facilities that did not always practice universal precautions were more likely to favor

  9. The DREAM model's effectiveness in health promotion of AIDS patients in Africa.

    Science.gov (United States)

    Magnano San Lio, M; Mancinelli, S; Palombi, L; Buonomo, E; Altan, A Doro; Germano, P; Magid, N A; Pesaresi, A; Renzi, E; Scarcella, P; Zimba, I; Marazzi, M C

    2009-03-01

    This study evaluates the effectiveness of a holistic model for treating people living with AIDS in Africa; the model aims to improve knowledge about AIDS prevention and care, increase trust in the health centre, impact behaviour, and promote a high level of adherence to HAART. The study took place in the context of the DREAM (Drug Resource Enhancement against AIDS and Malnutrition) programme in Mozambique, designed by the Community of Sant'Egidio to treat HIV patients in Africa. It provides patients with free anti-retroviral drugs, laboratory tests (including viral load), home care and nutritional support. This is a prospective study involving 531 patients over a 12-month period. The patients, predominantly poor and with a low level of education, demonstrated a good level of knowledge about AIDS (more than 90% know how it is transmitted) and trust in the treatment, with a relatively small percentage turning to traditional healers. Overall the patients had a low level of engaging in risky sexual behaviour and a very good level of adherence to HAART (69.5% of the 531 subjects had a pill count higher than 95%). The positive results of the programme's educational initiatives were confirmed with the patients' good clinical results.

  10. Chronic Inflammatory Periodontal Disease in Patients Diagnosed with Human Immunodeficiency Virus/AIDS in Cienfuegos

    OpenAIRE

    Nivia Gontán Quintana; Alain Soto Ugalde; Elena Idaisy Otero Salabarría

    2013-01-01

    Background: human immunodeficiency virus increases patients´ susceptibility to infections. Consequently, a high incidence of periodontal diseases is observed among them. It is often associated with other lesions of the oral mucous. Objective: to determine the evolution of chronic inflammatory periodontal disease in patients diagnosed with human immunodeficiency virus/AIDS.Methods: a case series study involving HIV-positive patients who attended the Stomatology consultation in Cienfuegos was c...

  11. Nef does not contribute to replication differences between R5 pre-AIDS and AIDS HIV-1 clones from patient ACH142

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    Rekosh David

    2008-05-01

    Full Text Available Abstract AIDS-associated, CCR5-tropic (R5 HIV-1 clones, isolated from a patient that never developed CXCR4-tropic HIV-1, replicate to a greater extent and cause greater cytopathic effects than R5 HIV-1 clones isolated before the onset of AIDS. Previously, we showed that HIV-1 Env substantially contributed to the enhanced replication of an AIDS clone. In order to determine if Nef makes a similar contribution, we cloned and phenotypically analyzed nef genes from a series of patient ACH142 derived R5 HIV-1 clones. The AIDS-associated Nef contains a series of residues found in Nef proteins from progressors 1. In contrast to other reports 123, this AIDS-associated Nef downmodulated MHC-I to a greater extent and CD4 less than pre-AIDS Nef proteins. Additionally, all Nef proteins enhanced infectivity similarly in a single round of replication. Combined with our previous study, these data show that evolution of the HIV-1 env gene, but not the nef gene, within patient ACH142 significantly contributed to the enhanced replication and cytopathic effects of the AIDS-associated R5 HIV-1 clone.

  12. Burkitt's lymphoma of the duodenum in a patient with AIDS Linfoma de Burkitt do duodeno em um paciente com AIDS

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    Marcelo Corti

    2007-06-01

    Full Text Available Non-Hodgkin's lymphoma of B-cell type is the second most common neoplasm after Kaposi's sarcoma, among patients with human immunodeficiency virus infection. Most non-Hodgkin's lymphoma cases that are associated with acquired immunodeficiency syndrome involve extranodal sites, especially the digestive tract and the central nervous system. We report a case of primary lymphoma of the duodenum in a patient with AIDS. Upper gastrointestinal endoscopy revealed pseudopolypoid masses found in the second portion of the duodenum. A complete diagnostic study including histological, immunohistochemical and virological analyses showed high-grade B-cell Burkitt's lymphoma. The Epstein-Barr virus genome was detected in biopsies by immunohistochemical and in situ hybridization.O linfoma não-Hodgkin de células B é a segunda neoplasia mais comum em pacientes com infecção pelo vírus da imunodeficiência humana depois do sarcoma de Kaposi. A maioria dos casos de linfoma não-Hodgkin associados com a síndrome da imunodeficiência adquirida envolve locais extraganglionares, especialmente o trato digestivo e o sistema nervoso central. Nós relatamos um caso de linfoma primário do duodeno em um paciente com AIDS. Uma endoscopia digestiva alta mostrou massas pseudopolipóides encontradas na segunda porção do duodeno. Um estudo diagnóstico completo incluindo exames histológicos, imunohistoquímicos e virológicos mostrou um linfoma de células B tipo Burkitt. Detectou-se genoma do vírus Epstein-Barr em biópsias por hibridização in situ e imuno-histoquímica.

  13. Cold urticaria patients exhibit normal skin levels of functional mast cells and histamine after tolerance induction

    DEFF Research Database (Denmark)

    Kring Tannert, Line; Stahl Skov, Per; Bjerremann Jensen, Louise

    2012-01-01

    to cold can be beneficial. The aim was to investigate whether desensitization can lower temperature thresholds and reduce release of histamine in the skin. Cold urticaria patients were subjected to desensitization and assessed for skin responses to cold stimulation and codeine before and after. Histamine...... prevented histamine release after skin exposure to cold. Surprisingly, skin histamine levels and release after codeine injection were found to be normal in desensitized patients....

  14. Analysis of HIV / AIDS Patients Service Management in Paniai Hospital, Paniai, Papua

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    Agus Agus

    2017-02-01

    Full Text Available Clinical Voluntary Counseling Testing (VCT was established in 2009 in hospitals Paniai Papua. VCT Clinic Hospital Papua Paniai aims to prevent and break the chain of transmission of HIV, screening and early diagnosis, ongoing counseling, as well as preventing the transmission of HIV infection from mother to child. VCT is also becoming more access to management for people with HIV, either the antiretroviral drugs, prevention and treatment of opportunistic infections, and the treatment of HIV infection holistically. Objective: The identification of patient care management of HIV / AIDS in patient wards of hospitals Paniai Papua Province. Mixed Methods ie qualitative and quantitative research. The quantitative data obtained from medical records of 287 patients with HIV-AIDS hospitalizations in 2014-2016. The qualitative data obtained from interviews with key informants were 13 people selected by purposive sampling and analyzed descriptively. Characteristics of patients with HIV / AIDS are the patients most aged 25-49 years (54%, female gender (56%, high school (26%, not working (54%, risk factors for heterosexual (74%, tuberculosis coinfection (46%, duration of treatment ARV therapy for less than 1 year (57%, non-compliance with taking medication (61.1%, length of stay of 1-5 days (48%, stage III (65%, CD4 <200 mg (55%, the difference in the payment of fees at the rate parties BPJS RS Rp. 764 715 036. Inputs include human resources, facilities, infrastructure in the service of HIV / AIDS patients in hospitals Paniai accordance Hospital classification type D. Sources of funds from DAU (General Allocation Fund, DAK (Special Allocation Fund, Papua Health Card (KPS as well as the Public Service Board (BLUD. Optimal service process is already running with the service flow and SOP examination and treatment of HIV. Output inpatient care including HIV / AIDS patients were optimal given by SPM (Minimum Service Standards Hospital Health Ministerial Decree No

  15. First aid strategy for severe traumatic patients in hospital

    Institute of Scientific and Technical Information of China (English)

    LI Neng-ping; FANG Wei-min; GU Yong-feng; LU Xiao-bing; CONG Jian-nong; HUI Xiao-ping; LIN Zhao-fen; LI Wen-fang; YANG Xing-yi

    2007-01-01

    Objective: To study the emergency management principles of severe trauma in hospital (injury severity score ≥ 16).Methods: We used "ATP principle" to manage severe traumatic patients. The ATP principle is composed of: 1) attending surgeons offering initial management (A);2 ) teamwork commencement immediately after patients admitted to hospital (T);3) parallel principle, ie,emergency resuscitation, evaluation and laboratory test performed simultaneously (P). Clinical effects before and after applying ATP principle were retrospectively analyzed and compared.Results: During January 1, 2002 to December 31,2003, 338 patients were treated without applying ATP principle, in which ISS was 25.9±6.4, 152 cases died with the mortality being 39.2%, and the time stayed in emergency department and the time to operation room after admission were (102.8±16.7) rmin, (140.3 ±20.6) min,respectively. During January 1, 2004 to December 31,2005, 438 patients were treated based on ATP principle, in which ISS was 28.6±7.8, 87 cases died with the mortality being 19.9%, and the time in emergency department and the time to operation room after admission were (69.5 ±11.5) min, (89.6 ±9.3) min, respectively. ISS showed no significant difference between the two groups (P > 0.05),but the mortality, the time stayed in emergency department and the time to operation room after admission were greatly reduced and showed significant difference between the two groups (P <0.05).Conclusions: Applying ATP principle to treat severe traumatic patients can shorten emergency treatment time in hospital and decrease mortality.

  16. Human herpesvirus 6: report of emerging pathogen in five patients with HIV/AIDS and review of the literature

    Directory of Open Access Journals (Sweden)

    Marcelo Corti

    2011-08-01

    Full Text Available The reactivation of human herpesvirus 6 (HHV-6 in patients with AIDS can result in an acute and severe diffuse meningoencephalitis. We describe the epidemiological, clinical and outcome findings of five patients with diagnosis of HIV/AIDS and central nervous system involvement (CNS due to HHV-6. Fever was present in all the patients. Meningeal compromise, seizures and encephalitis were present in some of the patients. Polymerase chain reaction (PCR of cerebrospinal fluid (CSF specimens was positive for HHV-6 in all the patients. HHV-6 should be included among opportunistic and emerging pathogens that involve the CNS in patients with AIDS.

  17. Research on demands and accessibility of health services for AIDS long-surviving patients with AIDS-nonrelated diseases: a survey in central China

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    Na He

    2014-11-01

    Full Text Available Introduction: Compared with western countries, China started to provide free medicine for AIDS patients years later, which leads to the late emergence of problems on health service demands of AIDS long-surviving patients with non-AIDS-related diseases. Government hasn’t laid enough stress on it. Materials and Methods: The interviews and questionnaire surveys are conducted and analyzed to get information. The interviewees include 81 AIDS long-surviving patients in three villages and several hospitals in Shangcai, Zhumadian, and 18 AIDS-related decision makers and health service providers. Results: There are 79 long-surviving patients out of 81. 58 patients have non-AIDS-related diseases. 21 patients get hypertension and 28 get HCV. 100% patients have been to the clinics with their real-name IC cards for minor illness. 43 patients have been transferred to assigned hospitals at the county level. Seven have the experience utilizing health services in the municipal or provincial assigned hospitals. The problem is on accessibility. 40 patients hope to get more convenient and cheap health services. Among them, 37 say the kinds and the amount of medicine in village clinics are not adequate. Seven give up because of the expensive treatment expense. For 21 patients with hypertension, 3 buy medicine at the county-level hospitals. The other 18 choose to buy at private pharmacy. For 28 patients with HCV, 3 are not aware they actually got HCV. Free hepatic protector medicine is provided at village clinics. Up to 11 patients have not taken any treatment for HCV. Conclusions: Patients with hypertension go to the private pharmacy for medicine instead of higher level hospital because of lack of medicine in clinics, far distance from hospitals, cumbersome procedures in hospitals, limited dosage of prescriptions and too little discount. The situation for patients with HCV is even worse. It is predicted 70% of AIDS long-surviving patients have HCV. The treatment

  18. Patients with sepsis exhibit increased mitochondrial respiratory capacity in peripheral blood immune cells

    DEFF Research Database (Denmark)

    Sjövall, Fredrik; Morota, Saori; Persson, Johan Mikael;

    2013-01-01

    INTRODUCTION: In sepsis, mitochondria have been associated with both initial dysfunction and subsequent upregulation (biogenesis). However, the evolvement of mitochondrial function in sepsis over time is largely unknown, and we therefore investigated mitochondrial respiration in peripheral blood...... immune cells (PBICs) in sepsis patients during the first week after admission to the intensive care unit (ICU). METHODS: PBICs from 20 patients with severe sepsis or septic shock were analyzed with high-resolution respirometry 3 times after admission to the ICU (within 48 hours, days 3 to 4 and days 6...... indicators were found at days 6 to 7; P sepsis displayed higher mitochondrial respiratory capacities compared with controls, due...

  19. The functional status of patients with AIDS attending antiretroviral treatment center

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    T J Thejus

    2009-01-01

    Full Text Available Aims: To assess the functional status of patients with Acquired immunodeficiency syndrome (AIDS registered in the Anti-Retroviral Treatment (ART center. Materials and Methods: Design: Descriptive study. Study setting: ART center in Calicut Medical College, Kerala, India. Subjects: Cohorts of AIDS patients attending the ART center during the year 2007. Data collection: Done prospectively from the secondary data available from the center. Outcome measures: The demographic, morbidity, functional status and laboratory parameters were collected. Data processing was done using Excel datasheet and analysis were done using Epi info 2003. Results: One hundred and ninety-five patients received care during this period; 69% were males. The mean age was 38±9 years; 80% of them were married and in 50% of their spouses also tested positive for HIV. The mean CD4 count was 127 cells/microliter. The majority (90% were categorized as WHO Stage 3 or 4 of HIV. Only 52% of them were able to perform their usual work in or outside their house; the rest were not able to lead an economically productive life. Thirty-six per cent were only able to perform activities of daily living; 12% were bedridden.The functional status of the patients positively correlated with WHO disease stage ( P = < 0-0001, and CD4 count and hemoglobin levels negatively correlated with staging ( P = < 0.001. 62% are having any of the opportunistic infections. Conclusion: Fifty per cent of the AIDS patients are disabled and need support and care. As AIDS is a growing problem, community-based palliative care for AIDS patients should be strengthened in India.

  20. Initial study of magnetic resonance diffusion tensor imaging in brain white matter of early AIDS patients

    Institute of Scientific and Technical Information of China (English)

    XUAN Ang; WANG Guang-bin; SHI Da-peng; XU Jun-ling; LI Yong-li

    2013-01-01

    Background HIV is a neurotropic virus which can cause brain white matter demyelination,gliosis,and other pathological changes that appear as H IV encephalitis or AIDS dementia.The purpose of this study was to investigate the change of the diffused condition of water molecules in brain white matter in early acquired immune deficiency syndrome (AIDS) patients using MR diffusion tensor imaging (DTI).Methods DTI examinations were performed on a Siemens 3.0T MR scanner in 23 AIDS patients with normal brain appearance by conventional MRI and 20 healthy volunteers as the control group.Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were measured in nine regions; corpus callosum (CC) knee,CC body,CC splenium,periventricular white matter,frontal lobe white matter,parietal lobe white matter,occipital lobe white matter,and the anterior and posterior limbs of the internal capsule.The mean FA and ADC values from each region were compared in three groups:the symptomatic,asymptomatic and the control.Results The mean FA values were significantly lower and the mean ADC values were significantly higher in all nine regions in patients in the symptomatic group than in the asymptomatic and control group patients.In the asymptomatic group,the mean FA values were significantly lower and the mean ADC values were significantly higher at the CC knee,CC body,CC splenium,periventricular white matter,frontal lobe white matter and parietal lobe white matter,than in the control group.There were no significant differences at other regions between the two groups.Conclusions The diffused changes of water molecules in brain white matter in AIDS patients are related to brain white matter regions.DTI examination can detect the brain white matter lesions early in AIDS patients.

  1. Assessing the impact of HAART on the incidence of defining and non-defining AIDS cancers among patients with HIV/AIDS: a systematic review.

    Science.gov (United States)

    Cobucci, Ricardo Ney Oliveira; Lima, Paulo Henrique; de Souza, Pollyana Carvalho; Costa, Vanessa Viana; Cornetta, Maria da Conceição de Mesquita; Fernandes, José Veríssimo; Gonçalves, Ana Katherine

    2015-01-01

    After highly active antiretroviral therapy (HAART) became widespread, several studies demonstrated changes in the incidence of defining and non-defining AIDS cancers among HIV/AIDS patients. We conducted a systematic review of observational studies evaluating the incidence of malignancies before and after the introduction of HAART in people with HIV/AIDS. Eligible studies were searched up to December 2012 in the following databases: Pubmed, Embase, Scielo, Cancerlit and Google Scholar. In this study, we determined the cancer risk ratio by comparing the pre- and post-HAART eras. Twenty-one relevant articles were found, involving more than 600,000 people with HIV/AIDS and 10,891 new cases of cancers. The risk for the development of an AIDS-defining cancer decreased after the introduction of HAART: Kaposi's sarcoma (RR=0.30, 95% CI: 0.28-0.33) and non-Hodgkin's lymphoma (RR=0.52, 95% CI: 0.48-0.56), in contrast to invasive cervical cancer (RR=1.46, 95% CI: 1.09-1.94). Among the non-AIDS-defining cancers, the overall risk increased after the introduction of HAART (RR=2.00, 95% CI: 1.79-2.23). The incidence of AIDS-defining cancers decreased and the incidence of non-AIDS-defining cancers increased after the early use of HAART, probably due to better control of viral replication, increased immunity and increased survival provided by new drugs.

  2. Immuno-virological discordance and the risk of non-AIDS and AIDS events in a large observational cohort of HIV-patients in Europe

    DEFF Research Database (Denmark)

    Zoufaly, Alexander; Cozzi-Lepri, Alessandro; Reekie, Joanne;

    2014-01-01

    BACKGROUND: The impact of immunosuppression despite virological suppression (immuno-virological discordance, ID) on the risk of developing fatal and non-fatal AIDS/non-AIDS events is unclear and remains to be elucidated. METHODS: Patients in EuroSIDA starting at least 1 new antiretroviral drug.......94-2.17, p = 0.095) after controlling for current CD4 count. ID was not associated with the risk of AIDS events (aRR 0.76, 95% CI 0.41-1.38, p = 0.361). CONCLUSION: Compared to CD4 responders, patients with immuno-virological discordance may be at increased risk of developing non-AIDS events. Further studies...

  3. Laser Therapy for an Obstructing Primary Tracheal Lymphoma in a Patient With AIDS

    Directory of Open Access Journals (Sweden)

    Brian E Louie

    2005-01-01

    Full Text Available A patient with AIDS presented with progressive dyspnea leading to respiratory failure with near complete airway obstruction due to primary tracheal lymphoma. Laser therapy was used locally to debulk the tumour, which facilitated extubation and led to definitive treatment with chemotherapy. Alternatives for local airway control are discussed.

  4. Predictors of Medication Adherence in an AIDS Clinical Trial: Patient and Clinician Perceptions

    Science.gov (United States)

    Cox, Lisa E.

    2009-01-01

    This article presents data from an AIDS clinical trial that evaluated 238 (60 percent nonwhite) patients infected with HIV and their clinician's perceptions of medication adherence and visit attendance in relationship to lifestyle, psychosocial, and health belief model (HBM) variables. Twelve sites collected data via a prospective, multisite…

  5. INTESTINAL AND PULMONARY INFECTION BY Cryptosporidium parvum IN TWO PATIENTS WITH HIV/AIDS

    Science.gov (United States)

    REINA, Fábio Tadeu Rodrigues; RIBEIRO, Camila Aparecida; de ARAÚJO, Ronalda Silva; MATTÉ, Maria Helena; CASTANHO, Roberto Esteves Pires; TANAKA, Ioshie Ibara; VIGGIANI, Ana Maria Ferreira Sornas; MARTINS, Luciamáre Perinetti Alves

    2016-01-01

    We describe two patients with HIV/AIDS who presented pulmonary and intestinal infection caused by Cryptosporidium parvum, with a fatal outcome. The lack of available description of changes in clinical signs and radiographic characteristics of this disease when it is located in the extra-intestinal region causes low prevalence of early diagnosis and a subsequent lack of treatment. PMID:27007564

  6. Co-infection of disseminated histoplasmosis and tuberculosis in an AIDS patient

    Directory of Open Access Journals (Sweden)

    Bruno Tomazini

    2013-10-01

    Full Text Available Histoplasmosis is a fungal disease caused by the dimorphic fungus Histoplasma capsulatum, recognized as an AIDS-defining illness since the Center for Disease Control’s revision criteria in 1985. This infection is reported to be present in 5-20% of AIDS patients, and in 95% of the cases it is manifested in its disseminated form. Serum antibodies and/or antigen research can make diagnosis, but the demonstration of the agent by culture or histopathological examination remains the gold standard methods. Co-infections in patients with AIDS are well known; however, reports on disseminated tuberculosis and histoplasmosis are scarce. The authors report the case of a female patient who presented a short-course history of weight loss, fever, and mild respiratory symptoms, with hepatosplenomegaly and lymphadenopathy. Laboratory workup called attention to anemia, altered liver, canalicular enzymes, liver function tests, high titer of lactate dehydrogenase (LDH, and pulmonary nodules on thoracic computed tomography. Incidental finding of yeast forms within the leukocytes during a routine blood cell count highlighted the diagnosis of histoplasmosis. The patient started receiving amphotericin B but succumbed soon after. The authors emphasize the possibility of this co-infection, the diagnosis of severe infection through the finding of yeast forms within peripheral leukocytes, and for the high titer of LDH in aiding the differential diagnosis.

  7. Secondary mania due to AIDS and cryptococcal meningitis in a 78-year-old patient.

    Science.gov (United States)

    Chou, Po-Han; Ouyang, Wen-Chen; Lan, Tsuo-Hung; Chan, Chin-Hong

    2016-03-01

    We report a 78-year-old man without past psychiatric history who experienced his first manic episode successfully treated with quetiapine and lorazepam, but was ultimately found to have AIDS and Cryptococcus neoformans meningitis. Our presented case highlights the importance of comprehensive differential diagnoses to rule out secondary causes of psychiatric symptoms presenting for the first time in elderly patients.

  8. Plasmid profile of bacteria isolated from tears of HIV/AIDS patients

    Directory of Open Access Journals (Sweden)

    O B Ajayi

    2009-01-01

    Full Text Available Objective: The purpose of this study is to determine the presence and transfer of plasmids in bacteria isolated from tears of HIV/AIDS patients, their sensitivity and resistance to commercially available antibiotics. Design: This was a cross sectional experimental study. Materials and methods:One hundred tears samples from HIV/ AIDS patients and fifty tears samples from HIV/AIDS negative patients were screened for resistance to 14 commercially available antibiotics using disc diffusion method. Result: Three multiple antibiotics resistant strains of staphylococcus aureus and four multiple antibiotics resistance strains of Pseudomonas aeruginosa were identified. staphylococcus aureus strains showed 100% resistance to Ampiclox and erythromycin, 66.6% to Perfloxacin, amoxicillin and septrin, 33.33% to ciprofloxacin. Pseudomonas aeruginosa strains showed 100% resistance to streptomycin, amoxicillin, septrin and chloramphenicol. Only I strain of staphylococcus aureus showed presence of plasmid which was not transferable to Escherichia coli because of presence of disulphide cross--linked cell wall. Other strains of both staphylococcus aureus and Pseudomonas aeruginosa remained resistant after curing . Conclusion: Further studies are needed in this area to show if antibiotic resistance in HIV/AIDS positive patients could be as a result of plasmid as well as other factors.

  9. MRI of infections and neoplasms of the spine and spinal cord in 55 patients with AIDS

    Energy Technology Data Exchange (ETDEWEB)

    Thurnher, M.M. [Neuroradiology Section, Department of Radiology, University Hospital Vienna (Austria); Post, M.J.D. [Department of Radiology, Neuroradiology Section, University of Miami School of Medicine, Miami, FL (United States); Jinkins, J.R. [Neuroimaging Research, Department of Radiology, Nebraska Medical Center, Omaha, NE (United States)

    2000-08-01

    Our purpose was to describe the range of MRI findings in infectious and neoplastic involvement of the spine and spinal cord in symptomatic patients with the acquired immunodeficiency syndrome (AIDS). MRI studies in 55 patients with AIDS and neurological signs and symptoms thought to be related to the spine or spinal cord were reviewed. We categorized the findings according to the spinal compartment involved. There were 29 patients with extradural, 11 with intradural-extramedullary and 9 with intramedullary disease. In 6 patients more than one compartment was involved simultaneously, and patients presented with multiple lesions in the same compartment. The most common causes of extradural disease were bone lesions (28); an epidural mass was seen in 14 and spondylodiscitis in 4 patients. Cytomegalovirus polyradiculitis was the most common cause of intradural-extramedullary disease (in 10 cases); herpes radiculitis was seen in two, and tuberculous infection in another two. In three cases leptomeningeal contrast enhancement was due to lymphoma. Human immunodeficiency virus (HIV) myelitis was seen in two patients, presumed vacuolar myelopathy in two, toxoplasma myelitis in four, intramedullary lymphoma in one, and herpes myelitis in one. Familiarity with the various potential pathological entities that can affect the spine and spinal cord in the AIDS population and their imaging characteristics is crucial for initiation of further diagnostic tests and appropriate medical or surgical treatment. (orig.)

  10. [Organization of therapeutic aid to patients with hereditary neuromuscular diseases].

    Science.gov (United States)

    Kalinin, V A; Temin, P A; Arkhipov, B A; Zavadenko, N N

    1989-01-01

    The paper summarizes experience gained for many years by the All-Union Research Methodological Center for Study of Hereditary Neuromuscular Diseases. The specialists of the Center render counselling and therapeutic assistance to patients afflicted with neuromuscular diseases. The counselling and diagnostic services are characterized by the fact that it is based on the activity of a large hospital intended for the treatment of various diseases. The problems which are being solved by the out- and inpatient services of the Center are considered in detail. The advantages of the setting up of the common in- and outpatient complex on the basis of the hospital intended for the treatment of various diseases are described.

  11. Patient-cooperative control increases active participation of individuals with SCI during robot-aided gait training

    OpenAIRE

    Duschau-Wicke Alexander; Caprez Andrea; Riener Robert

    2010-01-01

    Abstract Background Manual body weight supported treadmill training and robot-aided treadmill training are frequently used techniques for the gait rehabilitation of individuals after stroke and spinal cord injury. Current evidence suggests that robot-aided gait training may be improved by making robotic behavior more patient-cooperative. In this study, we have investigated the immediate effects of patient-cooperative versus non-cooperative robot-aided gait training on individuals with incompl...

  12. Adverse effects associated with intravenous pentamidine isethionate as treatment of Pneumocystis carinii pneumonia in AIDS patients

    DEFF Research Database (Denmark)

    Balslev, U; Nielsen, T L

    1992-01-01

    To evaluate the adverse effects of intravenous pentamidine isethionate, a retrospective study was carried out over a four-year period. Twenty-one acquired immunodeficiency syndrome (AIDS) patients received intravenous pentamidine as treatment of Pneumocystis carinii pneumonia (PCP). This was 13......% of the total number of patients with PCP in the department during that period. Four patients died during treatment and were not evaluated for side effects. Thirteen patients (13/17 = 76%) suffered from one or more minor side effects. The most common of these were gastrointestinal discomfort, pancreatitis......, nephro- and hepatotoxicity. Five patients (5/17 = 29%) experienced a major adverse effect. These were cardiac arrest (one patient), severe hypoglycaemia (one patient) and severe pancreatitis (three patients). In two patients, discontinuation of treatment was necessary due to adverse reactions. As long...

  13. Survey on adherence to AIDS care among AIDS patients%艾滋病病人关怀依从性现状

    Institute of Scientific and Technical Information of China (English)

    杨国莉; 刘艳; 严谨

    2013-01-01

    艾滋病(AIDS)病人良好的关怀依从性可以产生积极的健康结果,对AIDS病人的关怀依从性现状进行梳理,发现病人在依从性上存在的问题,分析其原因,并提出相应的对策,为给病人提供高质量的关怀提供依据.%Adherence to regular medical care among acquired immunodeficiency syndrome (AIDS) patients has been shown to be linked with positive health outcomes. This article examines the available literature and research on adherence to HIV care among AIDS patients. To identify the problems of keeping patients adhering to the care, also analyze the reasons behind, and then recommend some solutions, in order to provide the patients with regular and high-quality care.

  14. Flexible fiberoptic bronchoscopy service; an aid to patient management

    LENUS (Irish Health Repository)

    Marathe, N

    2016-02-01

    The study illustrates advantages of Fiberoptic Bronchoscopy, a new service started at St. Luke’s General Hospital in patient care since April 2014. Retrospective review of Bronchoscopies and referrals to Tertiary care unit for Bronchoscopy, prior and after initiation of service at St. Luke’s Hospital were studied. In total, 106 procedures were performed out of which 103(98%) were for diagnostic purpose. Common indications for bronchoscopy were functional airway assessment in 38 cases (35%) of chronic cough, 26 cases (24.8%) of suspected malignancy. The average time taken for procedure was 15 + 1 minute with overall rate of complication recorded in 1 case (0.95%). 32(30%) inpatients were referred before bronchoscopy services were started locally. Fifteen (14%) patients were referred for Endobronchial Ultrasound (EBUS) after diagnostic procedure performed at St. Luke’s Hospital. To conclude, Bronchoscopy is a safe procedure used for diagnosis of various Lung conditions. The services offered locally reduced the time and cost involved in referrals. The diagnostic bronchoscopies performed for malignancy at St. Luke’s Hospital have rightly increased references for EBUS at Tertiary care Unit

  15. Dengue Patients Exhibit Higher Levels of PrM and E Antibodies Than Their Asymptomatic Counterparts

    OpenAIRE

    Adeline Syin Lian Yeo; Anusyah Rathakrishnan; Seok Mui Wang; Sasheela Ponnampalavanar; Rishya Manikam; Jameela Sathar; Santha Kumari Natkunam; Shamala Devi Sekaran

    2015-01-01

    Dengue virus infection is a common tropical disease which often occurs without being detected. These asymptomatic cases provide information in relation to the manifestation of immunological aspects. In this study, we developed an ELISA method to compare neutralizing effects of dengue prM and E antibodies between dengue patients and their asymptomatic household members. Recombinant D2 premembrane (prM) was constructed, cloned, and tested for antigenicity. The recombinant protein was purified a...

  16. Disseminated cryptococcosis and fluconazole resistant oral candidiasis in a patient with acquired immunodeficiency syndrome (AIDS).

    Science.gov (United States)

    Kothavade, Rajendra J; Oberai, Chetan M; Valand, Arvind G; Panthaki, Mehroo H

    2010-10-28

    Disseminated cryptococcosis and recurrent oral candidiasis was presented in a-heterosexual AIDS patient. Candida tropicalis (C.tropicalis) was isolated from the oral pseudomembranous plaques and Cryptococcus neoformans (C. neoformans) was isolated from maculopapular lesions on body parts (face, hands and chest) and body fluids (urine, expectorated sputum, and cerebrospinal fluid). In vitro drug susceptibility testing on the yeast isolates demonstrated resistance to fluconazole acquired by C. tropicalis which was a suggestive possible root cause of recurrent oral candidiasis in this patient.

  17. Vitiligo patient-derived keratinocytes exhibit characteristics of normal wound healing via epithelial to mesenchymal transition.

    Science.gov (United States)

    Banerjee, Poulomi; Venkatachalam, Sandhyaa; Mamidi, Murali Krishna; Bhonde, Ramesh; Shankar, Krupa; Pal, Rajarshi

    2015-05-01

    Vitiligo is an autoimmune disorder that leads to depigmentation of skin via melanocyte dysfunction. Keratinocyte-induced toxicity is one among the several etiological factors implicated for vitiligo, and hence, autologous keratinocyte grafting is projected as one of the primary mode of treatment for vitiligo. However, reports indicate that perilesional keratinocytes not only display signatures of apoptosis but also could secrete cytokines and mediators which have antagonistic effect on proliferation or survival. Therefore, we investigated how vitiligo patients' derived keratinocytes respond to surplus amounts of inflammatory cytokines and whether they recapitulate events that take place during conventional wound healing. The primary objective of our study was to determine whether keratinocytes isolated from a vitiligo patient would undergo epithelial-mesenchymal transition similar to their normal counterparts upon induction with inflammatory cytokines such as TGF-b1 and EGF. We found that these keratinocytes undergo EMT during wound repair accompanied with increase in the levels of mesenchymal markers and ECM proteins; decrease in the levels of epithelial markers and enhanced migratory ability. Besides, we also demonstrated that EMT induction leads to activation of SMAD and MAPK pathways via Ras, Raf, PAI 1, Snail, Slug and ZO1. To our knowledge, this is the first report on the characterization of primary keratinocytes isolated from vitiligo patients with respect to their wound healing capacity.

  18. Dengue patients exhibit higher levels of PrM and E antibodies than their asymptomatic counterparts.

    Science.gov (United States)

    Yeo, Adeline Syin Lian; Rathakrishnan, Anusyah; Wang, Seok Mui; Ponnampalavanar, Sasheela; Manikam, Rishya; Sathar, Jameela; Kumari Natkunam, Santha; Sekaran, Shamala Devi

    2015-01-01

    Dengue virus infection is a common tropical disease which often occurs without being detected. These asymptomatic cases provide information in relation to the manifestation of immunological aspects. In this study, we developed an ELISA method to compare neutralizing effects of dengue prM and E antibodies between dengue patients and their asymptomatic household members. Recombinant D2 premembrane (prM) was constructed, cloned, and tested for antigenicity. The recombinant protein was purified and tested with controls by using an indirect ELISA method. Positive dengue serum samples with their asymptomatic pair were then carried out onto the developed ELISA. In addition, commercially available recombinant envelope (E) protein was used to develop an ELISA which was tested with the same set of serum samples in the prM ELISA. Asymptomatic individuals showed preexisting heterotypic neutralizing antibodies. The recombinant prM was antigenically reactive in the developed ELISA. Dengue patients had higher prM and E antibodies compared to their household members. Our study highlights the neutralizing antibodies levels with respect to dengue prM and E between dengue patients and asymptomatic individuals.

  19. Seropositivity ofChlamydophila pneumoniae immunoglobulin G antibody of HIV/AIDS patients in Abuja, Nigeria

    Institute of Scientific and Technical Information of China (English)

    Yakubu Boyi Ngwai; Izebe KS; Ijele IG; Ishaleku D; Inyang US

    2010-01-01

    Objective:To detect IgG antibody toChlamydophila pneumoniae(CP)in sera ofHIV/AIDS patients and provide rationale for inclusion of routine screening for anti-CP antibodies and anti-chlamydial agents in the Nigerian NationalHIV/AIDS Management Plan.Methods: Serum samples from34 consentingHIV/AIDS patients attended a Government-approved Antiretroviral Treatment Facility in Abuja were screened by enzyme-linked immunosorbent assay for anti-CP IgG antibody using ImmunoComb® Chlamydia Bivalent IgG Test kit (Orgenics, Israel).Results:Anti-CP IgG antibody was detected in20 (58.8%)of34 patients tested. The detection rate was higher among the males(8/13; 61.5%) than the females (12/21; 57.1%). Patients of the age group 16-30 years had the highest(7/10; 70%) detection of anti-CP IgG antibody.Conclusions:The result of the present study suggests the presence of anti-CP antibodies in sera of the HIV/AIDS patients, and reinforces the need for routine screening for anti-CPantibodies as a necessary intervention to reduce the burden ofChlamydophila pneumoniae (C. pneumoniae) infections and to reduceHIV-positive morbidity in Nigeria. The outcome of this study also provides justification for the possible inclusion of anti-chlamydial agents in the NationalHIV/AIDS Management Plan to provide prophylaxis against or treat activeC. pneumoniae infections.

  20. Cutaneous gallium uptake in patients with AIDS with mycobacterium avium-intracellulare septicemia

    Energy Technology Data Exchange (ETDEWEB)

    Allwright, S.J.; Chapman, P.R.; Antico, V.F.; Gruenewald, S.M.

    1988-07-01

    Gallium imaging is increasingly being used for the early detection of complications in patients with AIDS. A 26-year-old homosexual man who was HIV antibody positive underwent gallium imaging for investigation of possible Pneumocystis carinii pneumonia. Widespread cutaneous focal uptake was seen, which was subsequently shown to be due to mycobacterium avium-intracellulare (MAI) septicemia. This case demonstrates the importance of whole body imaging rather than imaging target areas only, the utility of gallium imaging in aiding the early detection of clinically unsuspected disease, and shows a new pattern of gallium uptake in disseminated MAI infection.

  1. Knowledge, attitudes and personal beliefs about HIV and AIDS among mentally ill patients in Soweto, Johannesburg

    Directory of Open Access Journals (Sweden)

    G Jonsson

    2011-09-01

    Full Text Available Aim. The aim of the study was to determine knowledge, attitudes and personal beliefs regarding HIV and AIDS in a group of mentally ill patients attending outpatient clinics in Soweto, Johannesburg. Method. All patients attending four randomly chosen clinics in Soweto were invited to complete a self-administered questionnaire after obtaining informed written consent. The 63-item questionnaire, developed from others specifically for this study, included questions on socio-demographic and clinical characteristics; knowledge on how HIV is acquired and spread; attitudes and beliefs regarding HIV and AIDS; and condom usage. The statements in the knowledge sections were used to calculate a composite score, which if greater than or equal to 75% was defined as ‘adequate knowledge’. Results. A total of 1 151 patients with mental illness participated in the study. The mean age was 41.9 years (standard deviation 11.6 and the majority were males (50%; single (55%, and had achieved only a secondary level of education (53.3%. Overall, most of the study population did not believe in the myths surrounding the spread and acquisition of HIV and AIDS. There were however, significant associations between a low level of education and the belief that HIV is acquired from mosquito bites (odds ratio (OR 1.61; 95% CI 1.19 - 2.18; p=0.002 and through masturbation or body rubbing (OR 1.76; 95% CI 1.34 - 2.33; p=0.000. Although more than 90% of the patients were aware of the facts regarding the spread of HIV, approximately 40% did not believe that one could acquire HIV through a single sexual encounter. The composite scoring for knowledge showed that less than half the patients had adequate knowledge of HIV/AIDS. This was significantly associated with gender and level of education: females were 1.6 times (p<0.0004 and patients with Grade 8 or higher education 1.5 times more knowledgeable (p=0.002. Conclusion. Among mentally ill patients there is a both a lack of

  2. T-CELL RESPONSE OF ADVANCED AIDS PATIENTS AFTER HIGHLY ACTIVE ANTIRETROVIRAL THERAPY

    Institute of Scientific and Technical Information of China (English)

    Ai-xia Wang; Tai-sheng Li; Yun-zhen Cao; Yang Han; Zhi-feng Qiu; Jing Xie

    2005-01-01

    Objective To investigate the response on late stage Chinese AIDS patients after highly active antiretroviral therapy (HAART).Methods From October 2002 to March 2004, 20 cases of late stage Chinese AIDS patients were selected to participate in this opened and randomised study, we purposely chose those with CD4+ T cell counts < 100/mm3. All of them had one or two opportunistic infections and none had been treated with anti-HIV drugs. All patients were tested with CD4+(naive CD4+ T cell defined by CD45RA+ and CD62L+, memory CD4+ T cell defined by CD45RA-), CD8+ T cell,plasma HIV viral load, and clinical manifestations on before, during, and after HAART (5 different regimes) on 1, 3, 6, 9,and 12 months.Results Before HAART mean CD4+ T cell counts were 32 ± 31 (range 2-91)/mm3, and plasma HIV viral load were 5.07±0.85(range 2.04-5.70) log copies/mL. In 1 month's time patients treated with HAART had mean CD4+ and CD8T cell counts increasing rapidly. After 1 month the increasing speed turned to slow down, but HIV viral load decreased predominantly within the first 3 months. The major part of increasing CD4+ T cells were memory CD4+ T cells, as for naive CD4+ T cells increasing low and slow. Clinical symptoms and signs improved, and opportunistic infections reduced. The quality of life will be far much better than before. Each patient was followed for 12 months, and had finished 12 months' HAART.Conclusion This is the first report in China that late stage Chinese AIDS patients after HAART could have their immune reconstitution. The regular pattern is similar to what had been reported in Western countries and also in China. So it is worth to treat late stage Chinese AIDS patients with HAART.

  3. Changing mortality profile among HIV-infected patients in Rio de Janeiro, Brazil: shifting from AIDS to non-AIDS related conditions in the HAART era.

    Directory of Open Access Journals (Sweden)

    Beatriz Grinsztejn

    Full Text Available INTRODUCTION: We describe temporal trends in the mortality rates and factors associated with AIDS and non-AIDS related mortality at the Evandro Chagas Clinical Research Institute (IPEC, Oswaldo Cruz Foundation (FIOCRUZ. METHODS: Adult patients enrolling from 1986 through 2009 with a minimum follow up of 60 days were included. Vital status was exhaustively checked using patients' medical charts, through active contact with individuals and family members and by linkage with the Rio de Janeiro Mortality database using a previously validated algorithm. The CoDe protocol was used to establish the cause of death. Extended Cox proportional hazards models were used for multivariate modeling. RESULTS: A total of 3530 individuals met the inclusion criteria, out of which 868 (24.6% deceased; median follow up per patient was 3.9 years (interquartile range 1.7-9.2 years. The dramatic decrease in the overall mortality rates was driven by AIDS-related causes that decreased from 9.19 deaths/100PYs n 1986-1991 to 1.35/100PYs in 2007-2009. Non-AIDS related mortality rates remained stable overtime, at around 1 death/100PYs. Immunodeficiency significantly increased the hazard of both AIDS-related and non-AIDS-related causes of death, while HAART use was strongly associated with a lower hazard of death from either cause. CONCLUSIONS: Our results confirm the remarkable decrease in AIDS-related mortality as the HIV epidemic evolved and alerts to the conditions not traditionally related to HIV/AIDS which are now becoming more frequent, needing careful monitoring.

  4. STD Clinic Patients' Awareness of Non-AIDS Complications of HIV Infection

    Science.gov (United States)

    Castro, José Guillermo; Granovsky, Inna; Jones, Deborah; Weiss, Stephen M.

    2016-01-01

    Participants were recruited from a sexually transmitted disease (STD) clinic in Florida and were assessed regarding the knowledge and awareness of non-AIDS conditions associated with HIV infection. Questionnaires were administered before and after a brief information session on non-AIDS conditions associated with HIV infection. Participants included men (n = 46) and women (n = 51). Prior to the information session, at baseline, only 34% of the participants were worried about HIV infection. Most participants (82%) agreed that HIV could be treated with antiretroviral therapy (ART), while only 38% were aware that HIV-associated conditions cannot be easily treated with ART. After the information session, almost all participants reported they were concerned regarding the risk of HIV infection. High-risk patients may have limited knowledge about the consequences of HIV infection beyond the traditional AIDS-associated conditions. Increased awareness of these less known consequences of HIV infection may decrease the potential for complacency regarding acquiring HIV infection. PMID:25331221

  5. Emerging Intestinal Microsporidia Infection in HIV(+/AIDS Patients in Iran: Microscopic and Molecular Detection.

    Directory of Open Access Journals (Sweden)

    Hamed Mirjalali

    2014-06-01

    Full Text Available Species of Microsporidia have been known as opportunistic obligate intracellular parasites particularly in immunocompromised patients. Enterocytozoon bieneusi is one of most prevalent intestinal microsporida parasites in HIV(+/AIDS patients. In this study, intestinal microsporidia infection was determined in HIV(+/AIDS patients using microscopic and molecular methods.Stool samples were collected from HIV(+/AIDS patients during 12 months. All of the stool specimens washed with PBS (pH: 7.5. Slim slides were prepared from each sample and were examined using light microscope with 1000X magnification. DNA extraction carried out in microscopic positive samples. DNA amplification and genus/species identification also performed by Nested-PCR and sequencing techniques.From 81 stool samples, 25 were infected with microsporidia species and E. bieneusi were identified in all of positive samples. No Encephalitozoon spp. was identified in 81 collected samples using specific primers.E. bieneusi is the most prevalent intestinal microsporidia in immunocompromised patients of Iran. On the other hand, Nested-PCR using specific primers for ssu rRNA gene is an appropriate molecular method for identification of E. bieneusi.

  6. Quality of life in HIV/AIDS patients: A cross-sectional study in south India

    Directory of Open Access Journals (Sweden)

    Nirmal B

    2008-01-01

    Full Text Available With developing countries on the wave of a HIV epidemic, issues like quality of life (QOL have come to fore. We aimed to assess the quality of life in human immunodeficiency virus (HIV/acquired immune deficiency syndrome (AIDS patients at antiretroviral therapy (ART clinic in a tertiary healthcare centre in South India. The study was conducted on 60 HIV/AIDS patients attending ART clinic at a tertiary health hospital, Chennai, South India. QOL was evaluated using the WHO QOL-BREF (Field trial version instrument using 26 items grouped under 4 domains, namely physical health, psychological well-being, social relationships, and environment on 60 HIV/AIDS patients. Standard error of the difference between means was employed to find out significant difference between domain scores and clinical categories. QOL scores were highest for environmental domain which is 46.19 (0-100 scale. QOL scores were significantly lower among persons with lower CD4 counts ( P < 0.001. Women had lower QOL scores than men despite having less advanced disease. Patients with better educational background had significantly higher psychological domain scores. Also, a supportive family kept environmental domain scores better ( P < 0.001. A need for good healthcare support system was perceived. Better education helps the patient to cope with the disease well. Family support is essential for healthier environment.

  7. Clinical analysis of neurological system complications in AIDS and HIV positive patients

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective:To report the clinical manifestations of AIDS with nervous system complications. Methods:We collected the clinical material of AIDS and HIV positive patients who were admitted to our hospital from January 1998 to July 2006, and retrospectively analyzed the 39 cases having nervous system complications, among 146 cases in total. Results:Among 39 cases, there were 3 cases of HIV dementia, 1 case of vacuolar myelopathy, 3 cases of Gullain-barre syndrome, 3 cases of myopathy and 26 cases of secondary opportunistic infection of CNS,including 9 cases of tuberculosis, 6 cases of cryptococcus, 5 cases of toxoplasma, 3 cases of herpes zoster virus, 2 cases of herpes simples virus, 1 case of cytomegalovirus, 1 case of progressive multifocal leukoencencephalitis. 2 cases with central nervous system lymphoma.Among them 12 patients gave up treatment, other patients received anti-HIV treatment and antimicroorganism treatment. 5 patients died of respiratory failure, 2 patients died of multiple organs failure. Conclusion:Up to now, AIDS still has not very good management. So prevention is very important.

  8. Hypertrophic herpes simplex simulating anal neoplasia in AIDS patients: report of five cases.

    Science.gov (United States)

    Nadal, Sidney R; Calore, Edenilson E; Manzione, Carmen R; Horta, Sergio C; Ferreira, Aurea F; Almeida, Lis V

    2005-12-01

    Five patients (4 males; mean age, 46.4 years) with painful verrucous perianal lesions caused by herpes simplex virus are described. All patients had had AIDS for a long time and were using highly active antiretroviral therapy. CD4+ counts ranged from 73 to 370/mm3. All lesions were submitted to resection under subdural anesthesia. Histologic examinations revealed epithelial hyperplasia and dense inflammatory process, composed mainly of lymphocytes and plasma cells, extended just to the hypodermis. Immunohistochemistry was positive for herpes simplex virus Type 2 in four patients and for herpes simplex virus Type 1 in one patient, and did not detect human papillomavirus antigens. Three patients had recurrences after 3, 10, and 12 months. Resection was performed on two patients; one had a new recurrence after three months. Oral acyclovir eliminated the lesion in the third patient. The analysis of our patients suggests that herpes simplex virus, Types 1 and 2, may cause verrucous lesions simulating neoplasia in patients with AIDS using antiretroviral therapy.

  9. Male patients with terminal renal failure exhibit low serum levels of antimüllerian hormone

    Directory of Open Access Journals (Sweden)

    Dag Eckersten

    2015-02-01

    Full Text Available Male reproductive function is impaired during end-stage renal disease (ESRD. Disturbance of the hypothalamic-pituitary-gonadal axis, and therefore the regulation of sex hormones, is one of the major causes. Our focus was to include antimüllerian hormone (AMH and inhibin B concentrations. Twenty male patients on hemodialysis, median age 40 (26-48 years, were analyzed for follicle-stimulating hormone (FSH, luteinizing hormone (LH, prolactin, sex hormone-binding globulin (SHBG, testosterone, estradiol, AMH and inhibin B levels. We used 144 proven fertile men, median age 32 (19-44 years as a control group and analyzed differences using multiple linear regression. Males with ESRD demonstrated higher mean values for prolactin, 742 versus normal 210 mIE l−1 (95% confidence interval (CI: 60.3, 729, LH, 8.87 versus normal 4.5 IE l−1 (95% CI: 2.75, 6.14, and estradiol 89.7 versus normal 79.0 pmol l−1 (95% CI: −1.31, −0.15. Mean value for AMH was lower, 19.5 versus normal 47.3 pmol l−1 (95% CI: −37.6, −11.6. There were no differences found for FSH, SHBG, inhibin B and testosterone. The most important difference was found for AMH, a marker of Sertoli cell function in the testes, which decreased by close to 60% when compared with controls. Combined with an increase in LH, these findings may indicate a dysfunction of Sertoli cells and an effect on Leydig cells contributing to a potential mechanism of reproductive dysfunction in men with ESRD.

  10. Male patients with terminal renal failure exhibit low serum levels of antimüllerian hormone

    Institute of Scientific and Technical Information of China (English)

    Dag Eckersten; Aleksander Giwercman; Anders Christensson

    2015-01-01

    Male reproductive function is impaired during end‑stage renal disease (ESRD). Disturbance of the hypothalamic‑pituitary‑gonadal axis, and therefore the regulation of sex hormones, is one of the major causes. Our focus was to include antimüllerian hormone (AMH) and inhibin B concentrations. Twenty male patients on hemodialysis, median age 40 (26–48) years, were analyzed for follicle‑stimulating hormone (FSH), luteinizing hormone (LH), prolactin, sex hormone‑binding globulin (SHBG), testosterone, estradiol, AMH and inhibin B levels. We used 144 proven fertile men, median age 32 (19–44) years as a control group and analyzed differences using multiple linear regression. Males with ESRD demonstrated higher mean values for prolactin, 742 versus normal 210 mIE l−1 (95% confidence interval (CI): 60.3, 729), LH, 8.87 versus normal 4.5 IE l−1 (95% CI: 2.75, 6.14), and estradiol 89.7 versus normal 79.0 pmol l−1 (95% CI: −1.31, −0.15). Mean value for AMH was lower, 19.5 versus normal 47.3 pmol l−1 (95% CI: −37.6,−11.6). There were no differences found for FSH, SHBG, inhibin B and testosterone. The most important difference was found for AMH, a marker of Sertoli cell function in the testes, which decreased by close to 60% when compared with controls. Combined with an increase in LH, these findings may indicate a dysfunction of Sertoli cells and an effect on Leydig cells contributing to a potential mechanism of reproductive dysfunction in men with ESRD.

  11. Exploration into informing patients of the AIDS%艾滋病告知的管理

    Institute of Scientific and Technical Information of China (English)

    李箭; 沈阿丹; 席云珍; 张凤川; 朱会英

    2012-01-01

    OBJECTIVE To explore the skills of informing the patients with HIV infection and AIDS patients, so as to prevent medical accidents. METHODS The monitoring of AIDS, epidemiology investigation, and skills of informing the patdical, with. AIDS were gtrengthened; the skills of informing the patients with AIDS were also raised. A staff trainning class for the occupational exposure to AIDS was started and the disinfection and isolation of blood-borne diseases including AIDS were seriously conducted. RESULTS From Jan. to Dec. 2010, totally 315 staff' passed the assessment of occupational expesure to AIDS after the receiving the training, and 63 persons were satisfied in the epidemiology investigation and patient informing. The management and information of AIDS worked smoothly. CONCLUSION It ia necessary te make epidemiology investigation and notification of the victims with HIV infection and AIDS inl accordance with national management laws of infectious diseases to ensure medical safety and aware the citizens with the significance of the prevention and cure of AIDS.%目的 探讨对人类免疫缺陷病毒(HIV)感染者和艾滋病(AIDS)患者告知的技巧,预防医疗事故发生.方法 加强对艾滋病监测、流行病学调查及对艾滋病患者进行告知的管理;提高对艾滋病患者进行告知的技巧同时,预防医疗事故发生;举办预防艾滋病职业暴露培训班,提高医务人员预防艾滋病职业暴露的知识水平;做好医院预防艾滋病等血源性疾病的消毒隔离工作.结果 2010年1-12月该院培训考核医务人员预防艾滋病感染职业暴露315人次均合格,对临床艾滋病患者流行病学调查及告知63人次均满意,使艾滋病管理及告知工作顺利.结论 根据国家传染病管理法,做好艾滋病病毒感染者和艾滋病患者的流行病学调查及告知工作,对保障医疗安全,提高全民的预防艾滋病感染预防治疗意识是很有必要的.

  12. Consequence on Treatment of TB Patients Affected by HIV/AIDS A Conceptual Research

    Directory of Open Access Journals (Sweden)

    Sarder N. Uddin

    2006-01-01

    Full Text Available Mycobacterium tuberculosis is an ancient malady, which is one of the world’s most wide spread infectious bacterial agents. Fully one-third of the world’s population is already infected with Mycobacterium tuberculosis, with the greatest burden of disease and infection borne by people in developing countries. Tuberculosis disease is still out of control. Alarming spread of Human Immunodeficiency Virus (HIV and emergence of drug resistance is now further complicating the major problem. HIV not only makes the diagnosis of TB more difficult; it contributes to an increase in TB incidence. The rate of breakdown to clinical TB in individuals infected both with HIV and tuberculosis is many times higher than in those without HIV. The present vaccine is not sufficient to reduce the death rate by eradicating TB with HIV/AIDS. The present review is based on the prevention and treatment of TB patient and co-infected with HIV/AIDS and effect of HIV/AIDS on the treatment and prevention of TB. It will help assuming idea about future steps in prevention and treatment of TB among HIV/AIDS patients.

  13. [Sexually transmitted diseases in patients infected with HIV/AIDS in the State of Pernambuco, Brazil].

    Science.gov (United States)

    Rodrigues, E H; Abath, F G

    2000-01-01

    The data was obtained retrospectively from clinical records concerning 399 HIV infected patients. The HIV infected individuals predominated in the age group ranging from 20 to 40 years (73.4%) and 75% were male. The was no difference in the ratio of male and female patients regarding asymptomatic HIV infection or AIDS. The cases of HIV without AIDS concentrated in the age group ranging from 20-29 years while AIDS predominated in the age group ranging from 30-39 years. Only 0.8% were hemophilic, 3.5% injected drugs and 4.8% had hemotransfusions in the last 5 years. Regarding sexual behavior, 33% were heterosexuals, 11% bisexuals, 23% homosexuals and 33% did not disclose their sexual behavior. The presence of syphilis was the most frequent combination found (8.8%), followed by herpes (5.8%) and genital candidiasis (4.3%). Our results suggest an association between genital candidiasis and AIDS, although this was not demonstrated for the other STDs studied.

  14. Emergence of Azoles Resistance Candida species in Iranian AIDS defined patients with oropharyngeal candidiasis

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    Farzad Katiraee

    2015-09-01

    Conclusion: Based on the findings, it can be concluded that screening of resistant Candida isolates by disk diffusion or broth dilution method is essential for the surveillance and prevention of antifungal resistance in patient management. Although nystatin is widely used in clinical practice for HIV patients in Iran, no evidence of enhanced resistance against this agent was found on the other hand, resistance to azole antifungals, particularly fluconazole, increased. Considering the lack of resistance to caspofungin, administration of this agent is suggested for the treatment of OPC in AIDS patients.

  15. Neuroleptic malignant syndrome in an AIDS patient: clinical and pathological findings.

    Science.gov (United States)

    Gabellini, A S; Pezzoli, A; De Massis, P; Casadei, G; Grillo, A; Sacquegna, T

    1994-09-01

    Neuroleptic malignant syndrome (NMS) has been recently described following therapy with non strictly neuroleptic drugs that alter dopaminergic function, such as sulpiride and metoclopramide, and might occur more easily in patients with functional or organic brain disorders. We observed an AIDS patient who suffered from NMS following treatment with clotiapine for insomnia and agitation. Two months later, he presented with a similar syndrome following antiemetic treatment with alizapride. On both occasions, the symptoms completely regressed after the administration of dopaminergic and muscle relaxant drugs. The patient died of pneumonia one month after the last episode. The present paper describes the clinical and pathological findings.

  16. High level HIV-1 DNA concentrations in brain tissues differentiate patients with post-HAART AIDS dementia complex or cardiovascular disease from those with AIDS

    Institute of Scientific and Technical Information of China (English)

    GALLIGAN; Derek; C.; LAMERS; Susanna; L.; YU; Stephanie; SHAGRUN; Lamia; SALEMI; Marco; MCGRATH; Michael; S.

    2009-01-01

    Highly active antiretroviral treatment(HAART) has had a significant impact on survival of individuals with acquired immunodeficiency syndrome(AIDS);however,with the longer life-span of patients with AIDS,there is increasing prevalence of AIDS dementia complex(ADC) and other non-AIDS-defining illness,and cardiovascular diseases(CVD) are also common.The influence of these varied disease processes on HIV-1 DNA concentration in brain tissues has not been thoroughly assessed in the post-HAART era.The purpose of the current study is to clarify the impacts of ADC and other complications of HIV disease on the viral load in the brains in AIDS patients with post-HARRT.We examined autopsy specimens from the brains of thirteen patients who died from complications of AIDS with quantitative polymerase chain reaction(QPCR).All but one patient had received HAART prior to death since 1995.Two patients died with severe CVD,multiple cerebrovascular atherosclerosis(CVA) throughout the brain and five patients died with ADC.Six patients had no ADC/CVA.A QPCR was used to measure the presence of HIV-1 DNA in six brain tissues(meninges,frontal grey matter,frontal white matter,temporal subcortex,cerebellum and basal ganglia).In the post-HARRT era,for non-ADC/CVA patients,HIV-1 DNA concentration in brain tissues was statistically higher than that in patients with ADC.In a new finding,two patients who suffered from severe CVD,especially CVA,also had high concentrations of HIV-1 in brain compartments not showing ADC related changes.To our knowledge,this is the first report of a relationship between the CVA and HIV-1 viral burden in brain.The current observations suggest that HAART-resistant HIV reservoirs may survive within ADC lesions of the brain as well as the macrophage rich atherosclerosis,which needs to be confirmed by more AIDS cases with CVA.

  17. Effectiveness of Two Topical Anaesthetic Agents used along with Audio Visual Aids in Paediatric Dental Patients

    Science.gov (United States)

    Dhawan, Jayata; Kumar, Dipanshu; Anand, Ashish; Tangri, Karan

    2017-01-01

    Abstract Introduction Topical anaesthetic agents enable pain free intraoral procedures, symptomatic pain relief for toothache, superficial mucosal lesions and pain related to post extraction time. Most common anxiety provoking and fearful experience for children in dental operatory is administration of local anaesthesia because on seeing the needle, children usually become uncooperative. One of recent trend of behaviour management technique is using non-aversive techniques out of which audiovisual distraction has emerged as a very successful technique for managing children in dental settings. Audio visual distraction could decrease the procedure related anxiety of patients undergoing dental treatment and can be very relaxing for highly anxious patients. Aim The aim of the present study was to compare the efficacy of topical anaesthetics EMLA (Eutectic Mixture of Local Anaesthetics) cream and benzocaine (20%) gel in reducing the pain during the needle insertion with and without the use of Audio Visual (AV) aids. Materials and Methods The study was conducted on 120 children, the age range of 3-14 years attending the outpatient department for their treatment. EMLA and benzocaine gel (20%) were assessed for their effectiveness in reducing the pain on needle insertion during local anaesthesia administration. Based on the inclusion and the exclusion criteria, children requiring local anaesthesia for the dental treatment were randomly divided into four equal groups of 30 children based upon whether AV aids were used or not. AV aids were given using Sony Vaio laptop with earphones with nursery rhymes and cartoon movies DVD. The pain assessment was done by using the Visual Analogue Scale (VAS) scale and measurement of the physiological responses of pulse rate and oxygen saturation were done by pulse oximeter. Results There was a statistically significant difference in the mean pain score, pulse rate and mean oxygen saturation rate when it was compared between the four

  18. Usefulness of the HIV Dementia Scale in Nigerian patients with HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Olubunmi A Ogunrin

    2009-11-01

    Full Text Available Objective: Information on the cognitive complications of HIV/AIDS from sub-Saharan Africa, where statistics on HIV is alarming, is sparse because of lack of validated cognitive tools. This study assessed the usefulness and predictive validity of the HIV Dementia Scale (HDS as a screening tool among HIV-positive Nigerian Africans. Design: HIV-positive patients were randomly selected over a period of two months. Setting: The HIV/AIDS outpatient clinic of the University teaching hospital, Benin City, Nigeria. Subjects: Asymptomatic and symptomatic HIV-positive patients were compared with age, sex and level of education-matched controls. Outcome measures: Cognitive performances on the modified HIV Dementia scale. Results: The performances of 160 HIV-positive (comprising 80 asymptomatic and 80 symptomatic subjects were compared with 80 age, sex and level of education-matched HIV-negative subjects on the HDS. The mean HDS scores (maximum =12 were 10.78±1.18 (comparison subjects, 8.85±1.38 (asymptomatic and 5.2±1.13 (symptomatic; p<0.01. The HDS has a sensitivity of 97.3%, specificity of 80.4%, accuracy of 91.9% and predictive value positive of 91.4% and negative of 93.2%. Conclusion: The utility of the HIV Dementia Scale as a sensitive screening tool for patients with HIV/AIDS in sub-Saharan Africa was evident but insensitive to memory impairment among asymptomatic HIV patients.

  19. Evaluation of seroepidemiological toxoplasmosis in HIV/AIDS patients in the south of Brazil.

    Science.gov (United States)

    Xavier, Graciela Augusto; Cademartori, Beatris Gonzalez; Cunha Filho, Nilton Azevedo da; Farias, Nara Amélia da Rosa

    2013-01-01

    Toxoplasmosis is considered one of the opportunistic infections for individuals with the Acquired Immunodeficiency Syndrome (AIDS), and is also a major cause of morbidity and mortality. The aim of this study was to evaluate the prevalence of neurotoxoplasmosis, ocular toxoplasmosis and antibodies for Toxoplasma gondii in HIV-positive patients attending the SAE (Specialized Assistance Service for HIV/AIDS), as well as to associate their serological profile with epidemiological and clinical data. A total of 250 patients participated in the study from December, 2009 to November, 2010. Serological analysis was performed using the indirect immunofluorescent technique; epidemiological data were gathered by a questionnaire, and clinical history was based on the analysis of medical charts. Prevalence of seropositivity was 80%, with history of neurotoxoplasmosis in 4.8% and of ocular toxoplasmosis in 1.6% of the patients. The Highly Active Antiretroviral Treatment (HAART) was not used by 32% of the patients, 18.4% of the patients had CD4+ T- lymphocyte count less than 200 cells/mm³ and 96.8% of them were not aware of the modes of disease transmission. These findings led us to conclude that the study population is at high risk of clinical toxoplasmosis, because of both reactivation of infection in the seropositive patients who do not make a regular use of HAART, and primo-infection in seronegative patients worsened by an unawareness of the modes of infection reported in this study.

  20. Cerebral Toxoplasmosis in a Patient with AIDS on F-18 FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hae Won; Won, Kyung Sook; Choi, Byung Wook; Zeon, Seok Kil [Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2010-04-15

    The distinction between primary central nervous system (CNS) lymphoma and nonmalignant lesions due to opportunistic infections, in particular cerebral toxoplasmosis, is important because of the different treatments involved. A 32-year-old patient with AIDS was hospitalized for intermittent headaches. Brain magnetic resonance imaging (MRI) showed a small well-enhanced nodular lesion in the right frontal lobe. A fluorine-18 fluorodeoxyglucose (F-18 FDG) position emission tomography (PET)/ computed tomography (CT) scan showed moderate FDG uptake in the nodular lesion of the right frontal lobe. We present a case of cerebral toxoplasmosis in a patient with acquired immunodeficiency syndrome (AIDS) and the usefulness of F-18 FDG PET/CT in the differential diagnosis of the cerebral toxoplasmosis will be discussed.

  1. Balancing the presentation of information and options in patient decision aids: an updated review

    OpenAIRE

    Abhyankar, P.; Volk, R.J.; Blumenthal-Barby, J.; Bravo, P.; A. Buchholz; Ozanne, E.; Vidal, D.C.; Col, N; Stalmeier, P F M

    2013-01-01

    Background Standards for patient decision aids require that information and options be presented in a balanced manner; this requirement is based on the argument that balanced presentation is essential to foster informed decision making. If information is presented in an incomplete/non-neutral manner, it can stimulate cognitive biases that can unduly affect individuals’ knowledge, perceptions of risks and benefits, and, ultimately, preferences. However, there is little clarity about what const...

  2. Isolated Kaposi sarcoma of the finger pulp in an AIDS patient.

    Science.gov (United States)

    Aïm, F; Rosier, L; Dumontier, C

    2012-02-01

    A 63-year-old woman with long-standing AIDS and previous Kaposi sarcomas of the lower limb presented to our consultation complaining of a painful left ring finger with pulp enlargement. X-rays revealed an osteolytic lesion of the distal phalanx. We suspected an isolated osseous Kaposi sarcoma and at surgery we found a hemorrhagic lesion with bone extension into the phalanx. Bone involvement is rare in Kaposi sarcoma and even rarer in patients without a cutaneous location.

  3. Characteristics of Patients with Hearing Aids according to the Degree and Pattern of Hearing Loss

    OpenAIRE

    Byun, Young Seok; Kim, Sung Su; Park, Sang Hyun; Park, Eun Bin; Kim, Ho Joong; Kim, Sang Hoon; Yeo, Seung Geun

    2016-01-01

    Background and Objectives This study was designed to assess the characteristics of patients according to the degree and audiogram shape of hearing loss and the association of these characteristics with hearing aids (HA) choice, return rate, and cause of return. Subjects and Methods This study included 460 individuals who received HAs from 2011 to 2015. The relationships between type of HA and age, primary and accompanying symptoms, HA choice and return and cause of return were evaluated accor...

  4. Crofelemer for the treatment of chronic diarrhea in patients living with HIV/AIDS

    OpenAIRE

    Patel TS; Crutchley RD; Tucker AM; Cottreau J; Garey KW

    2013-01-01

    Twisha S Pate, Rustin D Crutchley, Anne M Tucker, Jessica Cottreau, Kevin W Garey Department of Clinical Sciences and Administration, College of Pharmacy, University of Houston, Houston, TX, USA Abstract: Diarrhea is a common comorbidity present in patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) who are treated with highly active antiretroviral therapy. With a multifactorial etiology, this diarrhea often becomes difficult to manage. In addition, some...

  5. Molecular epidemiology of Cryptosporidium in HIV/AIDS patients in Malaysia.

    Science.gov (United States)

    Asma, I; Sim, B L H; Brent, R D; Johari, S; Yvonne Lim, A L

    2015-06-01

    Cryptosporidiosis is a particular concern in immunocompromised individuals where symptoms may be severe. The aim of this study was to examine the epidemiological and molecular characteristics of Cryptosporidium infections in HIV/AIDS patients in Malaysia in order to identify risk factors and facilitate control measures. A modified Ziehl-Neelsen acid fast staining method was used to test for the presence of Cryptosporidium oocysts in the stools of 346 HIV/AIDS patients in Malaysia. Standard coproscopical methods were used to identify infections with other protozoan or helminths parasites. To identify the species of Cryptosporidium, DNA was extracted and nested-PCR was used to amplify a portion of the SSU rRNA gene. A total of 43 (12.4%) HIV-infected patients were found to be infected with Cryptosporidium spp. Of the 43 Cryptosporidium-positive HIV patients, 10 (23.3%) also harboured other protozoa, and 15 (34.9%) had both protozoa and helminths. The highest rates of cryptosporidiosis were found in adult males of Malay background, intravenous drug users, and those with low CD4 T cell counts (i.e., < 200 cells/mm3). Most were asymptomatic and had concurrent opportunistic infections mainly with Mycobacterium tuberculosis. DNA sequence analysis of 32 Cryptosporidium isolates identified C. parvum (84.3%), C. hominis (6.3%), C. meleagridis (6.3%), and C. felis (3.1%). The results of the present study revealed a high prevalence of Cryptosporidium infection in hospitalized HIV/AIDS patients. The results also confirmed the potential significance of zoonotic transmission of C. parvum in HIV infected patients, as it was the predominant species found in this study. However, these patients were found to be susceptible to a wide range of Cryptosporidium species. Epidemiological and molecular characterization of Cryptosporidium isolates provides clinicians and researchers with further information regarding the origin of the infection, and may enhance treatment and control

  6. The impact on patient trust of legalising physician aid in dying

    Science.gov (United States)

    Hall, M; Trachtenberg, F; Dugan, E

    2005-01-01

    Objective: Little empirical evidence exists to support either side of the ongoing debate over whether legalising physician aid in dying would undermine patient trust. Design: A random national sample of 1117 US adults were asked about their level of agreement with a statement that they would trust their doctor less if "euthanasia were legal [and] doctors were allowed to help patients die". Results: There was disagreement by 58% of the participants, and agreement by only 20% that legalising euthanasia would cause them to trust their personal physician less. The remainder were neutral. These attitudes were the same in men and women, but older people and black people had more agreement that euthanasia would lower trust. However, overall, only 27% of elderly people (age 65+) and 32% of black people thought that physician aid in dying would lower trust. These views differed with physical and mental health, and also with education and income, with those having more of these attributes tending to view physician aid in dying somewhat more favourably. Again, however, overall views in most of these subgroups were positive. Views about the effect of physician aid in dying on trust were significantly correlated with participants' underlying trust in their physicians and their satisfaction with care. In a multivariate regression model, trust, satisfaction, age, and white/black race remained independently significant. Conclusion: Despite the widespread concern that legalising physician aid in dying would seriously threaten or undermine trust in physicians, the weight of the evidence in the USA is to the contrary, although views vary significantly. PMID:16319229

  7. Primary aspergilloma and subacute invasive aspergillosis in two AIDS patients Aspergiloma primário e aspergilose invasiva subaguda em dois pacientes com AIDS

    Directory of Open Access Journals (Sweden)

    Roberto Martinez

    2009-02-01

    Full Text Available Although uncommon, invasive aspergillosis in the setting of AIDS is important because of its peculiar clinical presentation and high lethality. This report examines two AIDS patients with a history of severe cellular immunosuppression and previous neutropenia, who developed subacute invasive aspergillosis. One female patient developed primary lung aspergilloma, with dissemination to the mediastinum, vertebrae, and spine, which was fatal despite antifungal treatment. The second patient, who had multiple cavitary brain lesions, and eye and lung involvement, recovered following voriconazole and itraconazole, and drugs for increasing neutrophil and CD4+ lymphocyte levels. These cases demonstrate the importance of Aspergillus infections following neutropenia in AIDS patients, and emphasize the need for early and effective antifungal therapy.A aspergilose invasiva em pacientes com aids, embora incomum, é relevante pela apresentação clínica peculiar e alta letalidade. Este relato descreve os casos de dois pacientes com aids com grave imunossupressão celular e neutropenia prévia, os quais tiveram aspergiloma pulmonar primário, com disseminação para mediastino, vértebras e medula espinhal, evoluindo para óbito apesar do tratamento antifúngico. O segundo paciente, que tinha lesões cavitárias múltiplas no cérebro e infecção ocular e pulmonar, recuperou-se após tratamento com voricanazol, itraconazol e com drogas para aumentar o número de neutrófilos e de linfócitos CD4+. Estes casos demonstram o risco de infecção por Aspergillus após episódios de neutropenia em pacientes com aids e alertam para o início precoce de terapia antifúngica eficaz.

  8. AIDS Cholangiopathy in an Asymptomatic, Previously Undiagnosed Late-Stage HIV-Positive Patient from Kenya

    Directory of Open Access Journals (Sweden)

    Yiming Gao

    2011-01-01

    Full Text Available AIDS-associated cholangiopathy is a form of biliary tract inflammation with stricture formation seen in AIDS patients who are severely immunosuppressed. It is no longer common in countries in which HAART therapy is widely employed but is still seen in underdeveloped countries. The majority of patients are symptomatic at the time of presentation. Herein, we describe a seventy-four-year-old woman who presented with unilateral leg swelling after a prolonged airplane flight. She was otherwise entirely asymptomatic. Routine laboratory testing was notable for a hypochromic microcytic anemia, slight leukopenia, and mild hypoalbuminemia. Liver enzymes were all elevated. Deep venous thrombosis was confirmed, and a CT scan of the chest disclosed no pulmonary emboli. However, the visualized portion of the abdomen showed dilatation of the common bile and pancreatic ducts. This was confirmed on ultrasonography and MRCP, and no obstructive lesions were noted. An ERCP revealed a dilated common bile duct without filling defects or strictures. A balloon occlusion cholangiogram showed strictures and beading of the intrahepatic ducts. Shortly thereafter, serology for HIV returned positive along with a depressed CD4 cell count, and the patient was diagnosed with AIDS-associated cholangiography.

  9. Design and fabrication of facial prostheses for cancer patient applying computer aided method and manufacturing (CADCAM)

    Science.gov (United States)

    Din, Tengku Noor Daimah Tengku; Jamayet, Nafij; Rajion, Zainul Ahmad; Luddin, Norhayati; Abdullah, Johari Yap; Abdullah, Abdul Manaf; Yahya, Suzana

    2016-12-01

    Facial defects are either congenital or caused by trauma or cancer where most of them affect the person appearance. The emotional pressure and low self-esteem are problems commonly related to patient with facial defect. To overcome this problem, silicone prosthesis was designed to cover the defect part. This study describes the techniques in designing and fabrication for facial prosthesis applying computer aided method and manufacturing (CADCAM). The steps of fabricating the facial prosthesis were based on a patient case. The patient was diagnosed for Gorlin Gotz syndrome and came to Hospital Universiti Sains Malaysia (HUSM) for prosthesis. The 3D image of the patient was reconstructed from CT data using MIMICS software. Based on the 3D image, the intercanthal and zygomatic measurements of the patient were compared with available data in the database to find the suitable nose shape. The normal nose shape for the patient was retrieved from the nasal digital library. Mirror imaging technique was used to mirror the facial part. The final design of facial prosthesis including eye, nose and cheek was superimposed to see the result virtually. After the final design was confirmed, the mould design was created. The mould of nasal prosthesis was printed using Objet 3D printer. Silicone casting was done using the 3D print mould. The final prosthesis produced from the computer aided method was acceptable to be used for facial rehabilitation to provide better quality of life.

  10. 1970s and 'Patient 0' HIV-1 genomes illuminate early HIV/AIDS history in North America.

    Science.gov (United States)

    Worobey, Michael; Watts, Thomas D; McKay, Richard A; Suchard, Marc A; Granade, Timothy; Teuwen, Dirk E; Koblin, Beryl A; Heneine, Walid; Lemey, Philippe; Jaffe, Harold W

    2016-11-03

    The emergence of HIV-1 group M subtype B in North American men who have sex with men was a key turning point in the HIV/AIDS pandemic. Phylogenetic studies have suggested cryptic subtype B circulation in the United States (US) throughout the 1970s and an even older presence in the Caribbean. However, these temporal and geographical inferences, based upon partial HIV-1 genomes that postdate the recognition of AIDS in 1981, remain contentious and the earliest movements of the virus within the US are unknown. We serologically screened >2,000 1970s serum samples and developed a highly sensitive approach for recovering viral RNA from degraded archival samples. Here, we report eight coding-complete genomes from US serum samples from 1978-1979-eight of the nine oldest HIV-1 group M genomes to date. This early, full-genome 'snapshot' reveals that the US HIV-1 epidemic exhibited extensive genetic diversity in the 1970s but also provides strong evidence for its emergence from a pre-existing Caribbean epidemic. Bayesian phylogenetic analyses estimate the jump to the US at around 1970 and place the ancestral US virus in New York City with 0.99 posterior probability support, strongly suggesting this was the crucial hub of early US HIV/AIDS diversification. Logistic growth coalescent models reveal epidemic doubling times of 0.86 and 1.12 years for the US and Caribbean, respectively, suggesting rapid early expansion in each location. Comparisons with more recent data reveal many of these insights to be unattainable without archival, full-genome sequences. We also recovered the HIV-1 genome from the individual known as 'Patient 0' (ref. 5) and found neither biological nor historical evidence that he was the primary case in the US or for subtype B as a whole. We discuss the genesis and persistence of this belief in the light of these evolutionary insights.

  11. Timed up & go test score in patients with hip fracture is related to the type of walking aid

    DEFF Research Database (Denmark)

    Kristensen, Morten T; Bandholm, Thomas; Holm, Bente;

    2009-01-01

    Kristensen MT, Bandholm T, Holm B, Ekdahl C, Kehlet H. Timed Up & Go test score in patients with hip fracture is related to the type of walking aid. OBJECTIVE: To determine the relationship between Timed Up & Go (TUG) test scores and type of walking aid used during the test, and to determine...

  12. Oesophagobronchial fistula caused by varicella zoster virus in a patient with AIDS: a unique case

    Science.gov (United States)

    Moretti, F; Uberti-Foppa, C; Quiros-Roldan, E; Fanti, L; Lillo, F; Lazzarin, A

    2002-01-01

    Human herpesvirus oesophagitis in human immunodeficiency virus positive patients is caused by cytomegalovirus and herpes simplex virus; no cases of oesophagitis and oesophagobrochial fistula as a result of varicella zoster virus (VZV) have been reported to date. This report describes the case of a patient with a 2–3 mm deep oesophageal ulcer whose viral culture was positive for VZV. The patient was treated with acyclovir with resolution of the symptomatology. After the end of the induction treatment, because of the onset of fever and fits of coughing during eating, the patient underwent oesophagography, which showed an ulcer with an oesophagobronchial fistula in the middle and lower third of the oesophagus. This case report stresses the role of VZV infection as a possible cause of oesophagobronchial fistula, a rare but benign condition in patients with AIDS. PMID:11986352

  13. Intestinal parasites infections in hospitalized AIDS patients in Kinshasa, Democratic Republic of Congo

    Directory of Open Access Journals (Sweden)

    Wumba R.

    2010-12-01

    Full Text Available To determine the prevalence and the species spectrum of intestinal parasites (IP involved in hospitalized AIDS patients, a prospective observational and cross-sectional study was carried out in the four main hospitals in Kinshasa, Democratic Republic of the Congo. From November 2006 through September 2007, a single stool sample was collected from 175 hospitalized AIDS patients older than 15 years. Parasites were detected by light microscopy, including Ziehl-Neelsen, Fungi-Fluor, modified trichrome stains, and by immunofluorescence antibody tests and PCR for species diagnosis of microsporidia. At baseline, 19 patients (10.8 % were under antiretroviral therapy and 156 (89.2 % were eligible for ART. The main diagnosis for justifying hospitalization was intestinal infection associated with diarrhea in 87 out of 175 (49.7 %. 47 out of 175 (26.9 % were found to harbor an IP, and 27 out of 175 (15.4 % were infected with at least one opportunistic IP (OIP. Prevalence rate for OIP were 9.7 %, 5.1 %, 1.7 % and 0.6 % for Cryptosporidium sp., Enterocytozoon bieneusi, Isospora belli and Encephalitozoon intestinalis respectively. Considering patients with diarrhea only, prevalence rate were 12.6 %, 4.6 %, 3.4 % and 1.1 % respectively. The other IP observed were Entamoeba histolytica/Entamoeba dispar in nine cases (5.1 %, Ascaris lumbricoïdes in seven cases (4.0 %, Giardia intestinalis in three cases (1.7 %, hookworm in two cases (1.1 % and Trichiuris trichiura, Enterobius vermicularis, Schistosoma mansoni in one patient each (0.6 %. No significant relationship was established between any individual IP and diarrhea. These results underline the importance of OIP in symptomatic AIDS patients regardless of diarrhea at the time of the hospitalisation, and showed that routine microscopic examination using stains designed for Cryptosporidium spp. or the microsporidia should be considered due to the absence of clinical markers.

  14. Exhibit Engineering

    DEFF Research Database (Denmark)

    Mortensen, Marianne Foss

    ) a synthesis of the findings from the first two studies with findings from the literature to generate two types of results: a coherent series of suggestions for a design iteration of the studied exhibit as well as a more general normative model for exhibit engineering. Finally, another perspective...

  15. Rupioid histoplasmosis: first case reported in an AIDS patient in Argentina Histoplasmose rupioide: primeiro caso relatado em um paciente com AIDS na Argentina

    Directory of Open Access Journals (Sweden)

    Marcelo Corti

    2010-10-01

    Full Text Available Disseminated histoplasmosis is a relatively common AIDS-defining illness, occurring in almost 4% of patients living in endemic areas and it may be the first clinical expression of the HIV infection. A broad spectrum of clinical skin lesions associated with Histoplasma capsulatum infection have been described in AIDS patients, such as erythematous macules, papules, nodules, and pustules. Herpetic, acneiform, erythema multiforme-like, molluscum contagiosum-like, vasculitic, and exfoliative forms have also been reported. To our knowledge, this is the first case of disseminated histoplasmosis in an AIDS patient presented as a rupioid eruption.A histoplasmose disseminada é uma das doenças associadas à AIDS e relativamente comum, ocorrendo em quase 4% dos pacientes que vivem em áreas endêmicas e pode ser a primeira expressão clínica da infecção pelo HIV. Amplo espectro de lesões de pele associadas com a infecção pelo Histoplasma capsulatum têm sido descritas nos pacientes com AIDS, tais como máculas eritematosas, pápulas, nódulos e pústulas. Foram também relatadas lesões herpéticas, acneiformes, similares ao eritema multiforme, similares ao molusco contagioso, vasculíticas e esfoliativas. Em nosso conhecimento este é o primeiro caso de histoplamose disseminada em paciente com AIDS que se apresenta como erupção de aspecto rupióide.

  16. Risk factors related to hypertension among patients in a cohort living with HIV/AIDS

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    Evanizio Roque de Arruda Junior

    2010-06-01

    Full Text Available INTRODUCTION: Studies disagree as to whether there is a greater prevalence of hypertension among HIV/AIDS patients and the role of antiretroviral therapy. OBJECTIVE: Evaluate the prevalence of hypertension and risk factors in a cohort of HIV-infected patients, with emphasis on antiretroviral therapy. METHOD: Case-control study conducted at baseline of a cohort, between June/2007 and December/2008 in Pernambuco/Brazil. Blood pressure was classified as normal, prehypertension, and hypertension. RESULTS: Of 958 patients, 245 (25.6% had hypertension (cases, 325 (33.9% had prehypertension, and 388 (40.5% were normotensive (controls. Comparison between hypertensive and normotensive patients showed that traditional factors, such as age > 40 (OR = 3.06, CI = 1.91-4.97, male gender (OR = 1.85, CI = 1.15-3.01, BMI > 25 (OR = 5.51, CI = 3.36-9.17, and triglycerides > 150 mg/dL (OR = 1.69, CI = 1.05-2.71, were independently associated with hypertension. Duration of antiretroviral therapy and CD4 > 200 cells/mm³ were associated with hypertension in univariate analysis, but did not remain in final model. Type of antiretroviral schema and lipodystrophy showed no association with hypertension. CONCLUSION: Hypertension in HIV/AIDS patients is partially linked to invariable factors, such as age and sex. Efforts should be directed toward controlling reversible factors, particularly excessive weight gain and unsuitable diet.

  17. HIV/AIDS related mortality among adult medical patients in a tertiary health institution in South-South, Nigeria

    Institute of Scientific and Technical Information of China (English)

    Gyuse AN; Bassey IE; Udonwa NE; Okokon IB; Philip-Ephraim EE

    2010-01-01

    Objective: To determine the causes of death among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients as a step to planning strategies to improve mortality from this condition.Methods: This study retrospectively analyzed the mortality pattern of adult HIV/AIDS patients in the University of Calabar Teaching Hospital from January 2005 to December 2007. The data were obtained from sexually transmitted infection/acquired immunodeficiency syndrome (STI/AIDS) clinic register, admissions and discharge/death registers as well as the patients' case records and the hospitals monthly mortality reviews. Information obtained included age, sex, diagnosis and cause(s) of death. The causes of death considered were the directcauses of death, since the originating antecedent cause of death is the same in all the patients, in this case, HIV/AIDS. Data was analysed using Epi Info 2002.Results: The total number of mortalities during the study period was 350,100 were HIV positive representing 28.6% of all deaths. While advanced HIV/AIDS disease was the leading cause of death in our study representing 27.0%, tuberculosis was the single leading cause of deaths in HIV/AIDS patients constituting about 24.0% of deaths. This was followed by sepsis and septicaemia (13.0%), meningitis and encephalitis, and anaemia accounting for 11.0%, while respiratory diseases constituted 5.0% of the mortality burden. The highest number of deaths occurred in those aged between 21-50 years (82.0%).Conclusions: The study has shown that HIV/AIDS is a major cause of morbidity and mortality in our hospital. The causes of death reflect the varied spectrum of infection and other forms of organ involvement that affect HIV/AIDS patients. The present dismal situation of adult patients living with HIV/AIDS calls for enhanced strategies to decrease the mortality trend observed in Nigeria and sub-Saharan Africa.

  18. Serological markers for inflammatory bowel disease in AIDS patients with evidence of microbial translocation.

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    Anupa Kamat

    Full Text Available BACKGROUND: Breakdown of the gut mucosal barrier during chronic HIV infection allows translocation of bacterial products such as lipopolysaccharides (LPS from the gut into the circulation. Microbial translocation also occurs in inflammatory bowel disease (IBD. IBD serological markers are useful in the diagnosis of IBD and to differentiate between Crohn's disease (CD and ulcerative colitis (UC. Here, we evaluate detection of IBD serological markers in HIV-infected patients with advanced disease and their relationship to HIV disease markers. METHODS: IBD serological markers (ASCA, pANCA, anti-OmpC, and anti-CBir1 were measured by ELISA in plasma from AIDS patients (n = 26 with low CD4 counts (<300 cells/µl and high plasma LPS levels, and results correlated with clinical data. For meta-analysis, relevant data were abstracted from 20 articles. RESULTS: IBD serological markers were detected in approximately 65% of AIDS patients with evidence of microbial translocation. An antibody pattern consistent with IBD was detected in 46%; of these, 75% had a CD-like pattern. Meta-analysis of data from 20 published studies on IBD serological markers in CD, UC, and non-IBD control subjects indicated that IBD serological markers are detected more frequently in AIDS patients than in non-IBD disease controls and healthy controls, but less frequently than in CD patients. There was no association between IBD serological markers and HIV disease markers (plasma viral load and CD4 counts in the study cohort. CONCLUSIONS: IBD serological markers may provide a non-invasive approach to monitor HIV-related inflammatory gut disease. Further studies to investigate their clinical significance in HIV-infected individuals are warranted.

  19. Relationship between Radiological Stages and Prognoses of Pneumocystis Pneumonia in Non-AIDS Immunocompromised Patients

    Institute of Scientific and Technical Information of China (English)

    Xiang-Dong Mu; Peng Jia; Li Gao; Li Su; Cheng Zhang; Ren-Gui Wang; Guang-Fa Wang

    2016-01-01

    Background:Although radiological features ofpneumocystis pneumonia (PCP) in non-Acquired Immune Deficiency Syndrome (AIDS) immunocompromised patients have been reported by other authors,there were no studies on the radiological stages of PCP previously.This study aimed to elucidate the radiological stages and prognoses of PCP in non-AIDS immunocompromised patients.Methods:Retrospective analysis ofradiological manifestations and prognoses of 105 non-AIDS PCP immunocompromised patients from August 2009 to April 2016 was conducted.Chest radiograph was divided into three stages:early stage (normal or nearly normal chest radiograph),mid stage (bilateral pulmonary infiltrates),and late stage (bilateral pulmonary consolidations);chest high-resolution computed tomography (HRCT) was also divided into three stages:early stage (bilateral diffuse ground-glass opacity [GGO]),mid stage (bilateral diffuse GGO and patchy consolidations),and late stage (bilateral diffuse consolidations).Results:The case fatality rate (CFR) of all patients was 34.3% (36/105),all of them took routine chest X-ray (CXR),and 84 underwent chest CT examinations.According to the CXR most near the beginning of anti-PCP therapy,18 cases were at early stage and CFR was 0 (0/18,P < 0.0 1),50 cases were at mid stage and CFR was 28.0% (14/50,P > 0.05),and 37 cases were at late stage and CFR was 59.5% (22/37,P < 0.01).According to the chest HRCT most near the beginning ofanti-PCP therapy,40 cases were at early stage and CFR was 20.0% (8/40,P > 0.05),34 cases were at mid stage and CFR was 47.1% (16/34,P > 0.05),and 10 cases were at late stage and CFR was 80.0% (8/10,P < 0.05);barotrauma,including pneumothorax,pneumomediastinum,and pneumohypoderma,was found in 18 cases and the C FR was 77.8% (14/18,P < 0.01).Conclusions:Based on the radiological manifestations,the course of PCP in non-AIDS immunocompromised patients can be divided into three stages:early stage,mid stage,and late stage

  20. Cystatin C Falsely Underestimated GFR in a Critically Ill Patient with a New Diagnosis of AIDS

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    Caitlin S. Brown

    2016-01-01

    Full Text Available Cystatin C has been suggested to be a more accurate glomerular filtration rate (GFR surrogate than creatinine in patients with acquired immunodeficiency syndrome (AIDS because it is unaffected by skeletal muscle mass and dietary influences. However, little is known about the utility of this marker for monitoring medications in the critically ill. We describe the case of a 64-year-old female with opportunistic infections associated with a new diagnosis of AIDS. During her course, she experienced neurologic, cardiac, and respiratory failure; yet her renal function remained preserved as indicated by an eGFR ≥ 120 mL/min and a urine output > 1 mL/kg/hr without diuresis. The patient was treated with nephrotoxic agents; therefore cystatin C was assessed to determine if cachexia was resulting in a falsely low serum creatinine. Cystatin C measured 1.50 mg/L which corresponded to an eGFR of 36 mL/min. Given the >60 mL/min discrepancy, serial 8-hour urine samples were collected and a GFR > 120 mL/min was confirmed. It is unclear why cystatin C was falsely elevated, but we hypothesize that it relates to the proinflammatory state with AIDS, opportunistic infections, and corticosteroids. More research is needed before routine use of cystatin C in this setting can be recommended.

  1. Exploring salivary microbiota in AIDS patients with different periodontal statuses using 454 GS-FLX Titanium pyrosequencing

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    Fang eZhang

    2015-07-01

    Full Text Available Patients with acquired immunodeficiency syndrome (AIDS are at high risk of opportunistic infections. Oral manifestations have been associated with the level of immunosuppression, these include periodontal diseases, and understanding the microbial populations in the oral cavity is crucial for clinical management. The aim of this study was to examine the salivary bacterial diversity in patients newly admitted to the AIDS ward of the Public Health Clinical Center (China. Saliva samples were collected from fifteen patients with AIDS who were randomly recruited between December 2013 and March 2014. Extracted DNA was used as template to amplify bacterial 16S rRNA. Sequencing of the amplicon library was performed using a 454 GS-FLX Titanium sequencing platform. Reads were optimized and clustered into operational taxonomic units for further analysis. A total of 10 bacterial phyla (106 genera were detected. Firmicutes, Bacteroidetes and Proteobacteria were preponderant in the salivary microbiota in AIDS patients. The pathogen, Capnocytophaga sp., and others not considered pathogenic such as Neisseria elongata, Streptococcus mitis and Mycoplasma salivarium but which may be opportunistic infective agents were detected. Dialister pneumosintes, Eubacterium infirmum, Rothia mucilaginosa and Treponema parvum were preponderant in AIDS patients with periodontitis. Patients with necrotic periodontitis had a distinct salivary bacterial profile from those with chronic periodontitis. This is the first study using advanced sequencing techniques focused on hospitalized AIDS patients showing the diversity of their salivary microbiota.

  2. High-resolution computed tomography (HRCT) of lung infections in non-AIDS immunocompromised patients

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    Franquet, Tomas [Universitat Autonoma de Barcelona, Department of Radiology, Thoracic Radiology Section, Hospital de Sant Pau, Barcelona (Spain)

    2006-03-15

    Non-AIDS immunocompromised patients are susceptible to infections by a wide range of organisms. In the past several decades, advances in the treatment of cancer, organ transplantation, and immunosuppressive therapy have resulted in large numbers of patients who develop abnormalities in their immune system. Moreover, mildly impaired host immunity as it occurs in chronic debilitating illness, diabetes mellitus, malnutrition, alcoholism, advanced age, prolonged corticosteroid administration, and chronic obstructive lung disease have also been regarded as predisposing factors of pulmonary infections. Imaging plays a crucial role in the detection and management of patients with pulmonary infectious diseases. When pulmonary infection is suspected, knowledge of the varied radiographic manifestations will narrow the differential diagnosis, helping to direct additional diagnostic measures and serving as an ideal tool for follow-up examinations. Combination of pattern recognition with knowledge of the clinical setting is the best approach to pulmonary infection occurring in the immunocompromised patients. (orig.)

  3. Low plasma concentrations achieved with conventional schedules of administration of ganciclovir in patients with AIDS.

    Science.gov (United States)

    Piketty, C; Bardin, C; Gilquin, J; Mahe, V; Kazatchkine, M D; Chast, F

    1996-07-01

    Plasma concentration of ganciclovir was studied prospectively in 15 AIDS patients treated for acute cytomegalovirus (CMV) retinitis. Ganciclovir was administered at a mean dose of 10.3 +/- 0.6 mg/kg/day. The mean trough plasma concentration was 0.6 +/- 0.3 mg/L (n = 24), and the mean peak concentration was 7.2 +/- 2.4 mg/L (n = 6). In 12 patients, trough concentrations were below the range that has been associated with effective treatment. Low trough concentrations were associated with treatment failure in 6 patients. Following an increase in the daily dose, improvement was observed in 4 of the 6 patients. These results suggest that low plasma ganciclovir levels are associated with the failure of therapy. Monitoring the plasma concentration of ganciclovir may thus be useful before considering the virus to be resistant to the drug or before switching from ganciclovir to foscarnet.

  4. Computer-aided diagnosis system for bone scintigrams from Japanese patients: importance of training database

    DEFF Research Database (Denmark)

    Horikoshi, Hiroyuki; Kikuchi, Akihiro; Onoguchi, Masahisa

    2012-01-01

    Japanese patients. The two CAD softwares were evaluated using the same group of 257 Japanese patients, who underwent bone scintigraphy because of suspected metastases of malignant tumors in 2009. The final diagnostic results made by clinicians were used as gold standard.The Japanese CAD software showed......Computer-aided diagnosis (CAD) software for bone scintigrams have recently been introduced as a clinical quality assurance tool. The purpose of this study was to compare the diagnostic accuracy of two CAD systems, one based on a European and one on a Japanese training database, in a group of bone...... scans from Japanese patients.The two CAD software are trained to interpret bone scans using training databases consisting of bone scans with the desired interpretation, metastatic disease or not. One software was trained using 795 bone scans from European patients and the other with 904 bone scans from...

  5. Human Exhibitions

    DEFF Research Database (Denmark)

    Andreassen, Rikke

    From 1870s to 1910s, more than 50 exhibitions of so-called exotic people took place in Denmark. Here large numbers of people of Asian and African origin were exhibited for the entertainment and ‘education’ of a mass audience. Several of these exhibitions took place in Copenhagen Zoo. Here different...... light on the staging of exhibitions, the daily life of the exhibitees, the wider connections between shows across Europe and the thinking of the time on matters of race, science, gender and sexuality. A window onto contemporary racial understandings, the book presents interviews with the descendants...... of displayed people, connecting the attitudes and science of the past with both our (continued) modern fascination with ‘the exotic’, and contemporary language and popular culture. As such, it will be of interest to scholars of sociology, anthropology and history working in the areas of gender and sexuality...

  6. Palliative care for patients with HIV/AIDS admitted to intensive care units

    Science.gov (United States)

    Souza, Paola Nóbrega; de Miranda, Erique José Peixoto; Cruz, Ronaldo; Forte, Daniel Neves

    2016-01-01

    Objective To describe the characteristics of patients with HIV/AIDS and to compare the therapeutic interventions and end-of-life care before and after evaluation by the palliative care team. Methods This retrospective cohort study included all patients with HIV/AIDS admitted to the intensive care unit of the Instituto de Infectologia Emílio Ribas who were evaluated by a palliative care team between January 2006 and December 2012. Results Of the 109 patients evaluated, 89% acquired opportunistic infections, 70% had CD4 counts lower than 100 cells/mm3, and only 19% adhered to treatment. The overall mortality rate was 88%. Among patients predicted with a terminally ill (68%), the use of highly active antiretroviral therapy decreased from 50.0% to 23.1% (p = 0.02), the use of antibiotics decreased from 100% to 63.6% (p < 0.001), the use of vasoactive drugs decreased from 62.1% to 37.8% (p = 0.009), the use of renal replacement therapy decreased from 34.8% to 23.0% (p < 0.0001), and the number of blood product transfusions decreased from 74.2% to 19.7% (p < 0.0001). Meetings with the family were held in 48 cases, and 23% of the terminally ill patients were discharged from the intensive care unit. Conclusion Palliative care was required in patients with severe illnesses and high mortality. The number of potentially inappropriate interventions in terminally ill patients monitored by the palliative care team significantly decreased, and 26% of the patients were discharged from the intensive care unit. PMID:27737420

  7. Assessment of the risk of pressure ulcer development among hospitalized HIV/Aids patients

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    Silvana Cidral

    2016-02-01

    Full Text Available ABSTRACT Objective: to assess the risk of pressure ulcer development among hospitalized HIV/Aids. Metod: study quantitative descriptive with 35 patients admitted to an infectious diseases hospital in Curitiba-PR-BR. Characterized clinical and epidemiological of patients using a data collection instrument and the Braden Scale. Data was compiled using Excel® and a simple descriptive analysis. Results: two patients were found to have pressure ulcers and the most common comorbidities associated with HIV/Aids were pneumocystis pneumonia, caused by pneumocisti cariini (16, and pulmonary tuberculosis (13. The lowest scores were obtained in the friction and shear subscale, followed by the activity, nutrition, mobility and moisture subscales. The highest score was obtained in the sensory perception subscale. Two patients were classified as 'very high risk', six as 'high risk', three as 'low risk', and the rest as 'no risk'. Conclusion: risk assessment using scales provides objective information to assist with systemized and targeted nursing decision-making.

  8. Mechanisms of motor recovery in chronic and subacute stroke patients following a robot-aided training.

    Science.gov (United States)

    Mazzoleni, S; Puzzolante, L; Zollo, L; Dario, P; Posteraro, F

    2014-01-01

    The aim of this article is to propose a methodology for analyzing different recovery mechanisms in subacute and chronic patients through evaluation of biomechanical parameters. Twenty-five post-stroke subjects, eight subacute and seventeen chronic, participated in the study. A 2-DoF robotic system was used for upper limb training. Two clinical scales were used for assessment. Forces and velocities at the robot's end-effector during the execution of upper limb planar reaching movements were measured. Clinical outcome measures show a significant decrease in motor impairment after the treatment both in chronic and subacute patients (MSS-SE, probot-aided treatment in both groups. Mean values of forces exerted by subacute patients are lower than those observed in chronic patients, both at the beginning and at the end of robotic treatment, as in the latter the pathological pattern is already structured. Our results demonstrate that the monitoring of the forces exerted on the end-effector during robot-aided treatment can identify the specific motor recovery mechanisms at different stages. If the pathological pattern is not yet structured, rehabilitative interventions should be addressed toward the use of motor re-learning procedures; on the other hand, if the force analysis shows a strong pathological pattern, mechanisms of compensation should be encouraged.

  9. [Management of patients with HIV/AIDS by the general practitioner].

    Science.gov (United States)

    Semaille, P

    2011-09-01

    Dealing with HIV/AIDS in primary care encompasses preventive, curative, social and psychological aspects within a framework of a person-centred approach. Antiretroviral treatments enable the control of HIV infection, prevent opportunistic infections, reduce the risk of the sexual transmission and allow patients to "live their life" with an increased life expectancy, active sexuality and need to procreate. The holistic care of patients should always be the primary concern. An increased involvement of GP's in HIV care can raise the quality of care, reduce the stigma and prejudice surrounding HIV. Medical care providers can substantially affect HIV transmission by positively reinforcing changes to safe behavior, by referring patients for specialized services and working in direct collaboration with them, by facilitating partner counselling and testing. It might be considered to create a "path of HIV care" in the perspective of an optimal collaboration between primary care and specialists. However, providers must interweave the" half-baked "science about drug therapies, side effects and drug interactions with the psychosocial and lifestyle factors of the patient. Sometimes it's not easy to find adequate and relevant information about HIV in primary care. This document will provide primary care givers the keys for improvement, increase their basic HIV-related skills (and strengthen their role in HIV/AIDS prevention and follow-up) and make them more confident in their assessments.

  10. Candidiasis in HIV and AIDS Patients Attending the Nylon Health District Hospital in Douala, Cameroon

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    Anna Longdoh Njunda

    2011-12-01

    Full Text Available AIM: Candidiasis is the leading opportunistic mycosis in HIV and AIDS patients. METHOD: In order to determine its prevalence in patients with different CD4+ T cell categories in the Nylon Health District in Douala, a cross-sectional study was carried out whereby 304 HIV positive individuals were recruited between March and August, 2007. They were divided into two groups; those on highly active antiretroviral therapy (HAART and those not on HAART. Three samples constituting mouth, vaginal/urethral swabs and urine were collected from each subject. RESULTS: A total of 204 (67.1% [95% confidence interval (CI: 0.618-0.724] of these patients had more than one predisposing condition to candidiasis, with those on antibiotic therapy having the highest prevalence (63.7% followed by pregnant patients (7.3% (P < 0.05. Candidiasis was more common in patients with low CD4+ T cell count (<200 [66%] than patients with higher CD4+ T cell count (17.9% (P<0.05. One hundred and sixty one (53% of the patients had candidiasis whereby those not on HAART were more frequently infected (69.6% than those on HAART (30.1% (P< 0.05. CONCLUSION: We conclude that candidiasis is a major opportunistic infection in HIV patients and should be checked especially in patients not yet on antiretroviral therapy. [TAF Prev Med Bull 2011; 10(6.000: 701-706

  11. Attitudes of Saudi Nursing Students on AIDS and Predictors of Willingness to Provide Care for Patients in Central Saudi Arabia

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    Mostafa A. Abolfotouh

    2013-08-01

    Full Text Available This study aimed to assess acquired immune deficiency syndrome (AIDS-related knowledge, attitudes, and risk perception among Saudi nursing students, and to identify predictors of their willingness to provide care for patients with AIDS. A cross-sectional study of 260 baccalaureate nursing students at King Saud bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, was done using a previously validated instrument. Students’ knowledge percentage mean score (PMS on AIDS was 72.93 ± 10.67 reflecting an average level of knowledge. There were many misconceptions about how AIDS is transmitted, for example, use of same toilets and bathrooms and washing clothes together (24.9%, swimming (53.7%, and coughing and sneezing (49.6%. Nursing students reported an overall negative attitude toward AIDS, with a PMS of 43.48 ± 9.21. The majority of students agreed that AIDS patients should be isolated from other patients (83%, and should not share the room with other noninfected patients (81.8%, and some reported that people living with AIDS deserve what has happened to them (24.7%. After controlling for confounders, students’ poor knowledge and negative attitude were associated only with having never been given nursing education as their primary university education “Stream 2 students” (p = .012 and p = .01, respectively. These findings have implications for development of teaching strategies and curricular approaches for nursing to address this health care issue.

  12. Online information as a decision making aid for cancer patients: recommendations from the Eurocancercoms project.

    Science.gov (United States)

    Maddock, Carol; Camporesi, Silvia; Lewis, Ian; Ahmad, Kafait; Sullivan, Richard

    2012-05-01

    A pan-European survey was conducted under the auspices of the FP7 Eurocancercoms project during the period September 2010-March 2011. It was designed to broaden public policy understanding of patients' specific needs when seeking online cancer information and aimed to identify gaps in the online cancer information provision across Europe. In this paper we describe the methodology and main findings of the Tenovus survey, and draw some recommendations on the use of online information as a decision making aid for cancer patients and their families, namely: (1) transparency and accountability of the sources of information presented online; (2) accreditation of information by different recognised forms of authority and expertise, i.e. both by health-care professional and by patients/public members belonging to patient advocacy groups; (3) scaling up of information: we envisage a 3-tiered system that would enable patients to access different levels of complexity and volume of information from summary to detailed; (4) embedding of custom search tools and interactive search technologies to allow users to define requirements tailored on their needs and be context-driven; (5) communication across discipline boundaries, as patients' and doctors' online communities have very little or no contact among one another. These recommendations were applied for building the online platform EcancerHub, also under the auspices of the Eurocancercoms project, which by bringing together the different cancer communities seeks to break down traditional information boundaries, and through the interactions produce a surplus knowledge that could aid patients in difficult decision making times.

  13. Ten Years, Forty Decision Aids, And Thousands Of Patient Uses: Shared Decision Making At Massachusetts General Hospital.

    Science.gov (United States)

    Sepucha, Karen R; Simmons, Leigh H; Barry, Michael J; Edgman-Levitan, Susan; Licurse, Adam M; Chaguturu, Sreekanth K

    2016-04-01

    Shared decision making is a core component of population health strategies aimed at improving patient engagement. Massachusetts General Hospital's integration of shared decision making into practice has focused on the following three elements: developing a culture receptive to, and health care providers skilled in, shared decision making conversations; using patient decision aids to help inform and engage patients; and providing infrastructure and resources to support the implementation of shared decision making in practice. In the period 2005-15, more than 900 clinicians and other staff members were trained in shared decision making, and more than 28,000 orders for one of about forty patient decision aids were placed to support informed patient-centered decisions. We profile two different implementation initiatives that increased the use of patient decision aids at the hospital's eighteen adult primary care practices, and we summarize key elements of the shared decision making program.

  14. Chronic Inflammatory Periodontal Disease in Patients Diagnosed with Human Immunodeficiency Virus/AIDS in Cienfuegos

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    Nivia Gontán Quintana

    2013-08-01

    Full Text Available Background: human immunodeficiency virus increases patients´ susceptibility to infections. Consequently, a high incidence of periodontal diseases is observed among them. It is often associated with other lesions of the oral mucous. Objective: to determine the evolution of chronic inflammatory periodontal disease in patients diagnosed with human immunodeficiency virus/AIDS.Methods: a case series study involving HIV-positive patients who attended the Stomatology consultation in Cienfuegos was conducted. The Russell Periodontal Index and the Simplified Oral Hygiene Index were used. Patients were classified taking into account clinical and immunological categories. Statistical processing was performed through SPSS program version 15.0 and Chi-square tests were applied.Results: a high prevalence of chronic inflammatory periodontal disease was observed in patients with human immunodeficiency virus. Correlation with the oral hygiene of the patients studied was found. CD4 count showed no statistical significance in periodontal disease severity. All patients classified as A2 suffer from some stage of periodontal disease, which was the most affected clinical category in spite of presenting mild immunodeficiency.Conclusions: there is a high prevalence of chronic inflammatory periodontal disease in patients diagnosed with Human Immunodeficiency Virus in Cienfuegos and it is correlated with patient’s oral hygiene.

  15. Total and functional parasite specific IgE responses in Plasmodium falciparum-infected patients exhibiting different clinical status

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    Cazenave Pierre-André

    2007-01-01

    Full Text Available Abstract Background There is an increase of serum levels of IgE during Plasmodium falciparum infections in individuals living in endemic areas. These IgEs either protect against malaria or increase malaria pathogenesis. To get an insight into the exact role played by IgE in the outcome of P. falciparum infection, total IgE levels and functional anti-parasite IgE response were studied in children and adults, from two different endemic areas Gabon and India, exhibiting either uncomplicated malaria, severe non cerebral malaria or cerebral malaria, in comparison with control individuals. Methodology and results Blood samples were collected from controls and P. falciparum-infected patients before treatment on the day of hospitalization (day 0 in India and, in addition, on days 7 and 30 after treatment in Gabon. Total IgE levels were determined by ELISA and functional P. falciparum-specific IgE were estimated using a mast cell line RBL-2H3 transfected with a human Fcε RI α-chain that triggers degranulation upon human IgE cross-linking. Mann Whitney and Kruskall Wallis tests were used to compare groups and the Spearman test was used for correlations. Total IgE levels were confirmed to increase upon infection and differ with level of transmission and age but were not directly related to the disease phenotype. All studied groups exhibited functional parasite-specific IgEs able to induce mast cell degranulation in vitro in the presence of P. falciparum antigens. Plasma IgE levels correlated with those of IL-10 in uncomplicated malaria patients from Gabon. In Indian patients, plasma IFN-γ , TNF and IL-10 levels were significantly correlated with IgE concentrations in all groups. Conclusion Circulating levels of total IgE do not appear to correlate with protection or pathology, or with anti-inflammatory cytokine pattern bias during malaria. On the contrary, the P. falciparum-specific IgE response seems to contribute to the control of parasites, since

  16. Oral rinse as a potential method to culture Candida isolate from AIDS patients

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    Desiana Radithia

    2011-12-01

    Full Text Available Background: Candida isolate is easily sampled from oral cavity by swabbing directly on the candidiasis lesion, to be smeared onto slides for direct examination or cultured in a growth medium. This method is by far the gold standard for defining candidiasis diagnosis. However it is difficult to apply on sensitive patients and almost impossible on patients showing no clinical appearance of oral candidiasis. AIDS patients are very prone to candida infection and have a tendency of repetitive infection involving mixed species. As many candida species show different susceptibility to anti-fungal agents, it is necessary to identify the species causing the infection in the management of oral candidiasis. Oral rinse is a suggested method to obtain candida isolate to be cultured for further analysis such as species identification. This method is simple and less risky on infection transmission as less tools are required in the procedure. Purpose: This study aimed to assess the application of oral rinse as an alternative method to culture Candida isolate from AIDS patients. Methods: A cross-sectional observative study was conducted in HIV/AIDS in-Patient Facility of Intermediate Care Unit for Infection Disease, Dr. Soetomo Hospital Surabaya. Fourteen stadium 4 AIDS patients matching criteria were swabbed on 1/3-posterior of the tongue, and then given 10 ml phosphate buffer saline to rinse vigorously for 15 seconds. Both specimens were cultured on Sabouraud’s dextrose agar and colony growth was observed. Results: Candida colonies were able to grow from all 14 isolates (100% by both methods. Qualitatively, cultures from oral rinse specimens were more populated than cultures from swab specimens. Conclusion: Oral rinse is an applicable technique to obtain Candida species isolate. This technique is safe, easy, non-invasive, and needs less tools therefore less risky for HIV transmission.Latar belakang: Isolat Candida mudah diambil dengan cara mengusap lesi

  17. Knowledge and Attitude of Faculty Members Working in Dental Institutions towards the Dental Treatment of Patients with HIV/AIDS

    Science.gov (United States)

    Oberoi, Sukhvinder Singh; Sharma, Nilima; Mohanty, Vikrant; Marya, Charumohan; Rekhi, Amit; Oberoi, Avneet

    2014-01-01

    Background. Dentists have an ethical responsibility to provide treatment to HIV-infected patients, particularly because oral lesions are common among these patients. However, there are no official guidelines as to how to treat people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA) or how to screen for potentially infectious people. Materials and Method. A descriptive cross-sectional questionnaire based study which assessed the knowledge and attitude of the faculty members towards the treatment of patients with HIV/AIDS was carried out in the Sudha Rustagi College of Dental Sciences, Faridabad, and Maulana Azad Institute of Dental Sciences, New Delhi. Results. The willingness to treat patients with HIV was found to be 86.0% among the faculty members in the present study. The majority (79%) of the faculty members thought that treating an HIV-positive patient is ethical responsibility of the dentist. There was a positive attitude (88.0%) among faculty members that routine dental care should be a part of the treatment of patients with HIV/AIDS. Conclusion. The level of knowledge regarding HIV and AIDS was acceptable in the present study. However, continuing dental education (CDE) programmes should be conducted on a regular basis for updating the knowledge level of the faculty members towards the dental treatment of patients with HIV/AIDS patients. PMID:27379262

  18. Posterior reversible encephalopathy syndrome in an AIDS patient with acute renal failure and hypertension

    Directory of Open Access Journals (Sweden)

    Olivia Bargiacchi

    2013-03-01

    Full Text Available Introduction: The posterior reversible encephalopathy syndrome (PRES is a neurological entity characterized by magnetic resonance imaging (MRI evidence of bilateral subcortical edema in the occipital regions of the brain. Case report: We report the case of a female patient with AIDS, pulmonary aspergillosis, CMV infection, and acute renal failure due to Clostridium difficile diarrhea. Her clinical course was complicated by seizures and hypertension. MRI findings were consistent with PRES. The patient was treated with anticonvulsants and antihypertensive agents with clinical improvement. Discussion and conclusions: Few cases of PRES in HIV-infected patients have been described, and it is not clear whether HIV infection is a predisposing factor for this syndrome. The article reviews the literature on PRES in HIV and discusses the role of HIV-associated endothelial damage in the pathogenesis of this syndrome.

  19. Disseminated cutaneous sporotrichosis in a patient with AIDS: report of a case

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    Carvalho Miriam Tomoko Mitsuno

    2002-01-01

    Full Text Available We describe a case report of disseminated cutaneous sporotrichosis as the initial presentation of AIDS in a 24-year-old HIV-positive male patient. He presented multiple ulcerated skin lesions distributed over the face, thorax, legs and arms. Biopsy of one of the cutaneous lesions was suggestive of sporotrichosis and culture isolated Sporothrix schenckii. Itraconazole was started and the lesions progressively resolved after 15 days of medication. The patient was discharged with this medication but he did not return for follow-up. He died three months later in another hospital. Therapy of sporotrichosis in HIV-infected patients remains unclear and the response to therapy is variable. Itraconazole is highly concentrated in the skin and is one of the options for treatment of disseminated sporotrichosis.

  20. [Diabetes mellitus induced by pentamidine, without previous episodes of hypoglycemia, in patients with AIDS].

    Science.gov (United States)

    Santos, I; del Arco, C; García-Polo, I; Noguerado, A; Caso, E; Gómez-Pan, A

    1990-12-01

    The onset of a pneumonia by P. carinii in AIDS patients have force scientist to look for others therapies against this parasite. It is more necessary when the first line treatment which is cotrimoxazol produced secondary effects or not therapeutic effects. Pentamidine which is an agent usually used to treat leishmaniasis and trypanosomiasis, but it is an alternative for P. carinii infection. The problems are the frequent and severe secondary effects when administered by continuous infusions and less when it is inhaled. Between those effects are the changes in carbohydrate metabolism which are 9% of them. It is frequent observe hypoglycemia during infusion following by hyperglycemia in 5% of the cases which convert the patients in diabetic insulinodependent. A case of a patient who developed diabetes mellitus insulinodependent, 10 days after the end of pentamidine treatment, without previous episodes of hypoglycemia, is presented. The medical literature is reviewed.

  1. An overview and discussion of the Patient-Centered Outcomes Research Institute's decision aid portfolio.

    Science.gov (United States)

    Gayer, Christopher C; Crowley, Matthew J; Lawrence, William F; Gierisch, Jennifer M; Gaglio, Bridget; Williams, John W; Myers, Evan R; Kendrick, Amy; Slutsky, Jean; Sanders, Gillian D

    2016-07-01

    Decision aids (DAs) help patients make informed healthcare decisions in a manner consistent with their values and preferences. Despite their promise, DAs developed with public research dollars are not being implemented and adopted in real-world patient care settings at a rate consistent with which they are being developed. To appraise the sum of the parts of the portfolio and create a strategic imperative surrounding future funding, the Patient-Centered Outcomes Research Institute (PCORI) tasked the Duke Evidence Synthesis Group with evaluating its DA portfolio. This paper describes PCORI's portfolio of DAs according to the Duke Evidence Synthesis Group's analysis in the context of PCORI's mission and the field of decision science. The results revealed a diversity within PCORI's portfolio of funded DA projects. Findings support the movement toward more rigorous DA development, assessment and maintenance. PCORI's funding priorities related to DAs are clarified and comparative questions of interest are posed.

  2. [First aid for multiple trauma patients: investigative survey in the Firenze-Bologna area].

    Science.gov (United States)

    Crescioli, G L; Donati, D; Federici, A; Rasero, L

    1999-01-01

    Overall mortality ascribable to multiple traumas, that in Italy is responsible for about 8,000 death/year, is strictly dependent on the function of the so called Trauma Care System. This study reports on an epidemiological survey conducted in the urban area of Florence along a 23-month period (from Jan 97 to Nov 99), with the aim to identify the typology of traumas and the first aid care delivered to the person until hospital admission. These data were compared to those collected in the urban area of Bologna because the composition of the first-aid team is different, being nurses, in Bologna, an integral component of the first aid system. On a total of 118 multiple traumas, 17% was represented by isolated head trauma, while in 72% involvement of other organs was present in addition to the head; 11% of cases were abdominal or thoracic traumas, 1% of lower extremities. In 46% the cause of trauma was a car accident. The complexity of care delivered to the person with trauma was less in the Florence survey, as indicated by the immobilization of patients, performed in only 11% of cases as compared to 47% in Bologna, by the application of the cervical collar, applied in 12% versus 62% of traumas. Although the two samples are not strictly comparable, these data suggest that the presence of nurses in the Trauma Care System can be one of the elements of improvement of the quality of delivered care.

  3. Disseminated paracoccidioidomycosis with peripleuritis in an AIDS patient Paracoccidioidomicosis diseminada con peripleuritis en paciente con SIDA

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    Marcelo Corti

    2004-02-01

    Full Text Available Paracoccidioidomycosis is one of the most frequent systemic and endemic mycoses of Latin America caused by a dimorphic fungus. In AIDS patients, paracoccidioidomycosis appears as a severe and disseminated disease with a wide spectrum of clinical findings. The CD4 counts are usually less than 200 cell/mu L. We present a case of disseminated paracoccidioidomycosis with peripleuritis and subcutaneous abscesses on the chest wall as initial manifestation of AIDS. In endemic countries, paracoccidioidomycosis should be included as an opportunistic infection in AIDS.La paracoccidioidomicosis es una de las micosis sistémicas endémicas más frecuentes de Latinoamérica, causada por un hongo dimorfo. En los pacientes con SIDA se presenta como una enfermedad grave y diseminada, con un amplio espectro de manifestaciones clínicas. Los niveles de linfocitos T CD4 + son habitualmente < de 200 cél/myL. Presentamos un caso de paracoccidioidomicosis diseminada con peripleuritis y abscesos subcutáneos sobre la pared torácica como manifestación inicial del SIDA. En países endémicos, la paracoccidioidomicosis debe incluirse como una complicación oportunista de los pacientes con SIDA.

  4. Major depression in patients with HIV/AIDS and substance abuse.

    Science.gov (United States)

    Berger-Greenstein, Jori A; Cuevas, Carlos A; Brady, Stephen M; Trezza, Glenn; Richardson, Mark A; Keane, Terence M

    2007-12-01

    Previous research has been inconsistent in documenting a strong relationship between depression and HIV/AIDS, although a recent meta-analysis of studies examining this issue indicates that rates of depression are modestly higher for this population. For the current study, conducted from 2001-2004, we sought to examine rates and types of depressive symptoms in a cohort of patients receiving HIV care at two urban medical centers. These patients were participants in an intervention study examining adherence and mental health in persons triply diagnosed with psychiatric disorders, substance use disorders, and HIV/AIDS. Nearly three quarters of these participants were people of color, two thirds described their sexual orientation as heterosexual, and the vast majority were unemployed. We sought to examine the relationship of depression to patients' adherence to antiretroviral medication regimens (highly active antiretroviral therapy [HAART]). Results obtained from structured clinical interviews and self-report questionnaires indicated that study participants experienced high rates of depressive symptoms, and that 72.9% of participants met criteria for major depressive disorder (MDD). The results of this study offer a detailed view of the incidence and nature of MDDs and depressive symptoms for an urban sample of substance-abusing adults with HIV/AIDS. Given the degree to which depressive symptoms and MDD appear to be prevalent for this group, as well as the observation that these symptoms are amenable to treatment, future research should focus on identifying helpful strategies and interventions for treating these symptoms, effective ways of providing linkages to care, and ways in which standardized assessment and treatment protocols might be adapted to better suit this population.

  5. Microbial translocation is associated with increased monocyte activation and dementia in AIDS patients.

    Directory of Open Access Journals (Sweden)

    Petronela Ancuta

    Full Text Available Elevated plasma lipopolysaccharide (LPS, an indicator of microbial translocation from the gut, is a likely cause of systemic immune activation in chronic HIV infection. LPS induces monocyte activation and trafficking into brain, which are key mechanisms in the pathogenesis of HIV-associated dementia (HAD. To determine whether high LPS levels are associated with increased monocyte activation and HAD, we obtained peripheral blood samples from AIDS patients and examined plasma LPS by Limulus amebocyte lysate (LAL assay, peripheral blood monocytes by FACS, and soluble markers of monocyte activation by ELISA. Purified monocytes were isolated by FACS sorting, and HIV DNA and RNA levels were quantified by real time PCR. Circulating monocytes expressed high levels of the activation markers CD69 and HLA-DR, and harbored low levels of HIV compared to CD4(+ T-cells. High plasma LPS levels were associated with increased plasma sCD14 and LPS-binding protein (LBP levels, and low endotoxin core antibody levels. LPS levels were higher in HAD patients compared to control groups, and were associated with HAD independently of plasma viral load and CD4 counts. LPS levels were higher in AIDS patients using intravenous heroin and/or ethanol, or with Hepatitis C virus (HCV co-infection, compared to control groups. These results suggest a role for elevated LPS levels in driving monocyte activation in AIDS, thereby contributing to the pathogenesis of HAD, and provide evidence that cofactors linked to substance abuse and HCV co-infection influence these processes.

  6. A diverse population of Cryptococcus gattii molecular type VGIII in southern Californian HIV/AIDS patients.

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    Edmond J Byrnes

    2011-09-01

    Full Text Available Cryptococcus gattii infections in southern California have been reported in patients with HIV/AIDS. In this study, we examined the molecular epidemiology, population structure, and virulence attributes of isolates collected from HIV/AIDS patients in Los Angeles County, California. We show that these isolates consist almost exclusively of VGIII molecular type, in contrast to the VGII molecular type isolates causing the North American Pacific Northwest outbreak. The global VGIII population structure can be divided into two molecular groups, VGIIIa and VGIIIb. Isolates from the Californian patients are virulent in murine and macrophage models of infection, with VGIIIa significantly more virulent than VGIIIb. Several VGIII isolates are highly fertile and produce abundant sexual spores that may serve as infectious propagules. The a and α VGIII MAT locus alleles are largely syntenic with limited rearrangements compared to the known VGI (a/α and VGII (α MAT loci, but each has unique characteristics including a distinct deletion flanking the 5' VGIII MATa alleles and the α allele is more heterogeneous than the a allele. Our studies indicate that C. gattii VGIII is endemic in southern California, with other isolates originating from the neighboring regions of Mexico, and in rarer cases from Oregon and Washington state. Given that >1,000,000 cases of cryptococcal infection and >620,000 attributable mortalities occur annually in the context of the global AIDS pandemic, our findings suggest a significant burden of C. gattii may be unrecognized, with potential prognostic and therapeutic implications. These results signify the need to classify pathogenic Cryptococcus cases and highlight possible host differences among the C. gattii molecular types influencing infection of immunocompetent (VGI/VGII vs. immunocompromised (VGIII/VGIV hosts.

  7. Usability assessment of ASIBOT: a portable robot to aid patients with spinal cord injury.

    Science.gov (United States)

    Jardón, Alberto; Gil, Ángel M; de la Peña, Ana I; Monje, Concepción A; Balaguer, Carlos

    2011-01-01

    The usability concept refers to aspects related to the use of products that are closely linked to the user's degree of satisfaction. Our goal is to present a functional evaluation methodology for assessing the usability of sophisticated technical aids, such as a portable robot for helping disabled patients with severe spinal cord injuries. The specific manipulator used for this task is ASIBOT, a personal assistance robot totally developed by RoboticsLab at the University Carlos III of Madrid. Our purpose is also to improve some aspects of the manipulator according to the user's perception. For our case study, a population of six patients with spinal cord injury is considered. These patients have been suffering spinal cord injuries for a period of time longer than 1 year before the tests are carried out. The methodology followed for the information gathering is based on the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST). Different daily functions, such as drinking, brushing one's teeth and washing one's face, are considered to assess the user's perception when using ASIBOT as a technical aid. The human factor in this procedure is the main base to establish the specific needs and tools to make the end product more suitable and usable.

  8. PCR-BASED DIAGNOSIS OF A CASE OF HERPETIC WHITLOW IN AN AIDS PATIENT

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    NOGUEIRA Maurício L.

    1998-01-01

    Full Text Available Herpetic infections are common complications in AIDS patients. The clinical features could be uncommon and antiviral chemotherapy is imperative. A rapid diagnosis could prevent incorrect approaches and treatment. The polymerase chain reaction is a rapid, specific and sensible method for DNA amplification and diagnosis of infectious diseases, especially viral diseases. This approach has some advantages compared with conventional diagnostic procedures. Recently we have reported a new PCR protocol to rapid diagnosis of herpetic infections with suppression of the DNA extraction step. In this paper we present a case of herpetic whitlow with rapid diagnosis by HSV-1 specific polymerase chain reaction using the referred protocol.

  9. Ga-67 citrate myocardial uptake in a patient with AIDS, toxoplasmosis, and myocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Memel, D.S.; DeRogatis, A.J.; William, D.C. (St. Luke' s-Roosevelt Hospital Center, New York, NY (USA))

    1991-05-01

    A 38-year-old man with AIDS presented with fever of unknown origin, splenomegaly, anemia, and thrombocytopenia. Admission laboratory data revealed a positive toxoplasmosis titer in the blood. The initial chest x-ray showed small bilateral pleural effusions, a normal cardiac silhouette, no infiltrates, and no interstitial edema. Ga-67 imaging revealed markedly abnormal uptake in the myocardium. A diagnosis of toxoplasmosis myocarditis was made based on laboratory and imaging data. The patient was treated for toxoplasmosis. No myocardial uptake of tracer was demonstrated on a follow-up Ga-67 scan, performed after completion of treatment for toxoplasmosis.

  10. Screening for Cryptococcal Antigenemia in Anti-Retroviral Naïve AIDS Patients in Benin City, Nigeria

    Directory of Open Access Journals (Sweden)

    Favour Osazuwa

    2012-05-01

    Full Text Available Objectives: Cryptococcus neoformans is the most incriminated fungal pathogen causing meningitis in acquired immune deficiency syndrome (AIDS patients, and is known to constitute a major cause of deaths in AIDS patients. This study thus aimed to determine the baseline sero-prevalence of Cryptococcus neoformans infection in anti-retroviral naïve (ART-naïve AIDS patients using the serum Cryptococcal antigen (crag detection method. Baseline effect of variation in CD4 counts, as well as sex and age with sero-positivity for crag were also determined.Methods: This descriptive cross-sectional study included 150 (61 males and 89 females ART-naïve AIDS patients attending the Human Immunodeficiency Virus clinic (HIV at the University of Benin Teaching hospital, Benin City, Nigeria, within the period from February 2011- July 2011. Forty (18 males and 22 females HIV positive outpatients with CD4 counts >200 cells/µl who were ART-naive were recruited and used as controls. The sero-prevalence of crag in the patients and the control group was measured using the cryptococcal antigen latex agglutination system (CALAS (Meridian Bioscience, Europe and CD4 counts were measured using flow cytometry (Partec flow cytometer, Germany.Results: Of the 150 ART-naïve AIDS patients with CD4 counts £200 cells/µL; 19 (12.7% were positive for serum Cryptococcal antigen. ART-naïve AIDS patients with CD4 count ≤50 cells/µl had the highest prevalence of serum crag. Lower CD4 counts were significantly associated with positivity for serum crag (p<0.001. Age and sex had no significant effect on the sero-positivity for serum crag. One (2.5% of the controls was sero-positive for crag. Thus, serum crag was significantly associated with AIDS but not with HIV (p<0.001.Conclusion: This study uncovers a high prevalence of crag in ART- naïve AIDS patients in Benin City. The prevalence of crag was higher in ART-naïve AIDS patients with lower CD4 counts. There is an urgent need to

  11. Adverse Drug Reactions in HIV/AIDS Patients at a Tertiary Care Hospital in Penang, Malaysia.

    Science.gov (United States)

    Khan, Kashifullah; Khan, Amer Hayat; Sulaiman, Syed Azhar; Soo, Chow Ting; Akhtar, Ali

    2016-01-01

    In the current study we explored the occurrence of adverse drug reactions (ADRs) to antiretroviral therapy among human immune-deficiency virus (HIV)/AIDS patients. We concluded an observational retrospective study in all patients who were diagnosed with HIV infection and were receiving highly active antiviral therapy from Jan. 2007 to Dec. 2012 at Hospital Pulau Pinang, Malaysia. Patient socio-demographic details along with clinical features and susceptible ADRs were observed during the study period. Out of 743 patients, 571 (76.9%) were men, and 172 (23.1%) were women. Overall 314 (42.2%) patients experienced ADRs. A total of 425 ADRs were reported, with 311 (73.1%) occurring in men and 114 (26.8%) in women, with a significant statistical relationship (P value (P) = 0.02, OR = 1.21). Overall 239 (56.2%) ADRs were recorded among Chinese, 94 (22.1%) in Malay, and 71 (16.7%) in Indian patients, which had a statistically significant association with ADRs (P = 0.05, OR = 1.50). Out of a total 425 among ADRs, lipodystrophy was recorded in 151 (35.5%) followed by skin rashes in 80 (18.8%), anemia in 74 (17.4%), and peripheral neuropathy in 27 (6.3%) patients. These findings suggest a need of intensive monitoring of ADRs in HIV treatment centres across Malaysia.

  12. Exhibit Engineering

    DEFF Research Database (Denmark)

    Mortensen, Marianne Foss

    of tools and processes to guide the design of educational science exhibits. The guiding paradigm for this development is design-based research, which is characterised by an iterative cycle of design, enactment, and analysis. In the design phase, an educational intervention is planned and carried out based...... on a hypothesised learning process and the means of supporting it. In the enactment phase, the educational intervention is implemented (i.e. the planned lesson is taught, or the museum exhibit is opened to the public). Finally, the analysis phase establishes causality between emergent characteristics...... of the learning outcomes and the design characteristics of the intervention. The analysis process can yield two types of outcomes: Suggestions for the refinement of the specific design in question, and “humble” theory, which is theory that can guide the design of a category of educational interventions...

  13. Gallium scans of the thorax in patients with acquired immune deficiency syndrome (AIDS): Description and utilization

    Energy Technology Data Exchange (ETDEWEB)

    Le, G.; Chen, D.C.P.; Siegel, M.E.

    1984-01-01

    The pattern of distribution of gallium uptake in the thorax was investigated in patients (pts) with AIDS. Eleven pts (ages 18-53), all active homosexual males suspected of having acute pulmonary infection were studied. Ga lung scans were performed at 24-48 and/or 72 hrs. post injection. The diagnosis of AIDS was based on appropriate clinical and laboratory findings. The Ga activity in the lung was graded from zero = background to 4+ which is > liver activity. Eight of eleven pts have positive Ga scan while seven of eleven pts had positive CXR. Six pts had both positive CXR and Ga scan. One pt had a positive Ga scan with negative CXR, and one with positive CXR and negative Ga scan. The positive Ga scans included 3 pts with 4+ diffuse uptake, two pts with 2+ diffuse uptake, two pts with 1+ diffuse uptake, and two with hilar node uptake. Three pts have focal increased uptake superimposed on diffuse uptake. Two pts with 4+ diffuse uptake had mild abnormality on their CXR. One pt with 4+ uptake in the initial scan shows decreased activity on follow-up with clinical improvement after therapy. Thus, all but two pts with positive Ga scans had diffuse lung uptake. These two patients alone had B cell immunoblastic sarcoma and oral candidiasis. The pattern of Ga lung uptake in pts with AIDS reveal that a majority of positive scans are diffuse (6/8) and the intensity may suggest more active disease than CXR (2 normal) and, thus, the study may be useful in detecting changes from atypical pulmonary infection in this population.

  14. A locally produced nutritional supplement in community-based HIV and AIDS patients.

    Science.gov (United States)

    Oguntibeju, Oluwafemi; van den Heever, Wilhelmina Maria Jacoba; Van Schalkwyk, Frances Elizabeth

    2007-04-01

    This study examined the potential effect of a nutritional supplement on the anthropometric profiles (body measurements such as body mass index [BMI], fat percentage and waist-hip ratio) of HIV-positive/AIDS patients and the correlation between anthropometric profile, CD4+T cell count and viral load. At baseline, of the 35 patients recruited into the study, 32 (94.1%) showed a fat percentage below normal range. Twenty-four of the patients (68.6%) had a BMI within normal range, while a greater percentage of the patients had a normal waist-hip ratio. Of the 28 patients that completed the study, 26 (96.3%) reported a fat percentage of below 18.5%. The results showed that 19 (67.9%) of the 28 patients had a BMI within the normal range after nutrient intervention. There was a significant positive correlation between the BMI and fat percentage. At the end of the study the CD4+T cell count showed no correlation with any of the anthropometric indices while the viral load showed a significant negative correlation with the lean body mass and BMI. The short duration of the study probably limited the positive trend of the supplement.

  15. Acute pancreatitis in HIV/AIDS patients: an issue of concern

    Directory of Open Access Journals (Sweden)

    Gordana Dragovic

    2013-06-01

    Full Text Available Pancreatitis is a well-described complication of human immunodeficiency virus (HIV itself and its combination antiretroviral therapy. Historically, this has been predominantly associated with the usage of nucleoside reverse transcriptase inhibitors such as didanosine and stavudine, but only rarely with the usage of protease inhibitors via the induction of hypertriglyceridemia. Pancreatitis rates in HIV/AIDS population may have been exceedingly high because of the comorbid conditions prevalent in HIV/AIDS patients (e.g. ethanol use and biliary disease, and the use of non-combination antiretroviral therapy medications such as pentamidine, corticosteroids, ketoconazole, sulphonamides, metronidazole, isoniazid and opportunistic infections (e.g. cytomegalovirus, cryptosporidiosis, mycobacterial disease. In resource limited settings, where didanosine and stavudine are widely available in cheaper generic fixed dose combinations it is likely that their usage will remain in the first line HIV treatment in common. In such settings management or estimation of a patient's risk of pancreatitis still remains an issue of concern.

  16. The acute care physical therapy HIV/AIDS patient population: a descriptive study.

    Science.gov (United States)

    Kinirons, Stacy A; Do, Sandy

    2015-01-01

    This study was based on an analysis of an existing database compiled from 475 medical records of people living with HIV/AIDS admitted to an acute-care hospital in New York City in 2004. The characteristics of patients with HIV infection that received physical therapy were determined. Differences between patients with HIV infection that did and did not receive physical therapy, as well as predictors of receipt of physical therapy, were identified. The physical therapy subgroup (n = 69) had a mean age of 48.3 years, consisted of more men than women, and was predominately black, with public health insurance. Admissions were commonly due to non-AIDS-defining illness as the primary diagnoses, accompanied by several comorbidities. Admissions often presented with functional deficits, incurred a prolonged length of stay, and required assistance at discharge. Differences existed between the physical therapy subgroup and the non-physical therapy subgroup (n = 406). Predictors of receipt of physical therapy were functional status on admission and length of stay.

  17. Does bioimpedance analysis or measurement of natriuretic peptides aid volume assessment in peritoneal dialysis patients?

    Science.gov (United States)

    Davenport, Andrew

    2013-01-01

    Cardiovascular mortality remains the commonest cause of death for peritoneal dialysis patients. As such, preventing persistent hypervolemia is important. On the other hand, hypovolemia may potentially risk episodes of acute kidney injury and loss of residual renal function, a major determinant of peritoneal dialysis technique survival. Bioimpedance has developed from a single-frequency research tool to a multi-frequency bioelectrical impedance analysis readily available in the clinic and capable of measuring extracellular, intracellular, and total body water. Similarly, natriuretic peptides released from the heart because of myocardial stretch and increased intracardiac volume have also been variously reported to be helpful in assessing volume status in peritoneal dialysis patients. The question then arises whether these newer technologies and biomarkers have supplanted the time-honored clinical assessment of hydration status or whether they are merely adjuncts that aid the experienced clinician.

  18. Immune Restoration Syndrome with disseminated Penicillium marneffei and Cytomegalovirus co-infections in an AIDS patient

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    Wig Naveet

    2007-10-01

    Full Text Available Abstract Background Penicillium marneffei is a dimorphic fungus, endemic in South-east Asia. The fungus causes severe disease in immunocompromised patients such as AIDS. However, no case of immune restoration disease of Penicillium marneffei is reported in literature from a non-endemic area. Case Presentation We report the first case of Penicillium marneffei and Cytomegalovirus infection manifesting as a result of immune restoration one month after initiating HAART. This severely immunocompromised patient had presented with multiple lymphadenopathy, massive hepatosplenomegaly, visual impairment and mild icterus, but no skin lesions. Penicillium marneffei was isolated from lymph node fine-needle aspirates and blood cultures. Conclusion In order to diagnose such rare cases, the clinicians, histopathologists and microbiologists alike need to maintain a strong index of suspicion for making initial diagnosis as well as for suspecting immune reconstitution syndrome (IRS with Penicillium marneffei.

  19. Immune Restoration Syndrome with disseminated Penicillium marneffei and Cytomegalovirus co-infections in an AIDS patient

    Science.gov (United States)

    Gupta, Swati; Mathur, Purva; Maskey, Dipesh; Wig, Naveet; Singh, Sarman

    2007-01-01

    Background Penicillium marneffei is a dimorphic fungus, endemic in South-east Asia. The fungus causes severe disease in immunocompromised patients such as AIDS. However, no case of immune restoration disease of Penicillium marneffei is reported in literature from a non-endemic area. Case Presentation We report the first case of Penicillium marneffei and Cytomegalovirus infection manifesting as a result of immune restoration one month after initiating HAART. This severely immunocompromised patient had presented with multiple lymphadenopathy, massive hepatosplenomegaly, visual impairment and mild icterus, but no skin lesions. Penicillium marneffei was isolated from lymph node fine-needle aspirates and blood cultures. Conclusion In order to diagnose such rare cases, the clinicians, histopathologists and microbiologists alike need to maintain a strong index of suspicion for making initial diagnosis as well as for suspecting immune reconstitution syndrome (IRS) with Penicillium marneffei. PMID:17922912

  20. Patients With Insertional Achilles Tendinopathy Exhibit Differences in Ankle Biomechanics as Opposed to Strength and Range of Motion.

    Science.gov (United States)

    Chimenti, Ruth L; Flemister, A Samuel; Tome, Joshua; McMahon, James M; Houck, Jeff R

    2016-12-01

    Study Design Controlled laboratory study; cross-sectional. Background Little is known about ankle range of motion (ROM) and strength among patients with insertional Achilles tendinopathy (IAT) and whether limited ankle ROM and plantar flexor weakness impact IAT symptom severity. Objectives The purposes of the study were (1) to examine whether participants with IAT exhibit limited non-weight-bearing dorsiflexion ROM, reduced plantar flexor strength, and/or altered ankle biomechanics during stair ascent; and (2) to determine which impairments are associated with symptom severity. Methods Participants included 20 patients with unilateral IAT (mean ± SD age, 59 ± 8 years; 55% female) and 20 individuals without tendinopathy (age, 58.2 ± 8.5 years; 55% female). A dynamometer was used to measure non-weight-bearing ROM and isometric plantar flexor strength. Three-dimensional motion analysis was used to quantify ankle biomechanics during stair ascent. End-range dorsiflexion was quantified as the percentage of non-weight-bearing dorsiflexion used during stair ascent. Group differences were compared using 2-way and 1-way analyses of variance. Pearson correlations were used to test for associations among dependent variables and symptom severity. Results Groups differed in ankle biomechanics, but not non-weight-bearing ROM or strength. During stair ascent, the IAT group used greater end-range dorsiflexion (P = .03), less plantar flexion (P = .02), and lower peak ankle plantar flexor power (P = .01) than the control group. Higher end-range dorsiflexion and lower ankle power during stair ascent were associated with greater symptom severity (Pbiomechanics during stair ascent were linked with greater symptom severity and likely contribute to decreased function. J Orthop Sports Phys Ther 2016;46(12):1051-1060. Epub 29 Oct 2016. doi:10.2519/jospt.2016.6462.

  1. Otolaryngologic manifestations among Hiv/Aids patients in a Nigerian tertiary health institution: an update

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    Jumai, Akande Halima

    2010-12-01

    Full Text Available Introduction/Aim:This study is to determine these manifestations among HIV/AIDS patients in Ilorin to update on previous study. Method:This was a prospective study of all consecutive new patients confirmed to be HIV positive attending the HIV clinic of the University of Ilorin Teaching Hospital, Ilorin, Kwara state, Nigeria between January and July, 2009. These patients were on HAART anti retroviral drug treatment. The information retrieved included the biodata, clinical presentation, otolaryngologic clinical findings, as well as their hearing assessment with Pure tone audiometry. Results:74 out of the 89 HIV patients(82.8% had otorhinolaryngological manifestations with the age range of 3 to 62 years (Mean of 36.4 yrs, SD=2.45±0.02. The modal age range was 21-40 years (59.6% 51males (57.3% and 38 females (42.7% and a sex ratio of 1.3:1. Commonest otorhinolaryngological features included nasal in 45.6% (chronic rhinosinusitis, oral/oropharyngeal in 23.9% (oral candidiasis, otological in 21.5% (Serous otitis media and cervical adenopathy in 9%. Conclusion: Otorhinolaryngological manifestations were found in 74 patients (82.8% and commonest features included chronic sinusitis, oral/pharyngeal candidiasis, serous otitis media with cervical adeopathy in that order. It is important for otolaryngologists to be aware of otolaryngological manifestations, so early diagnosis and timely intervention alongside appropriate anti-retroviral therapy be instituted to improve survival rates.

  2. Epstein-Barr virus-associated adult respiratory distress syndrome in a patient with AIDS: a case report and review

    DEFF Research Database (Denmark)

    Stopyra, G A; Multhaupt, H A; Alexa, L

    1999-01-01

    BACKGROUND: Epstein-Barr virus (EBV) infection has been associated with fatal pneumonitis in immunocompetent patients. We present a case of fatal adult respiratory distress syndrome caused by EBV infection in a patient with acquired immunodeficiency syndrome (AIDS), to our knowledge the first...

  3. Case report - Bilateral renal aspergillosis in a patient with AIDS : A case report and review of reported cases

    NARCIS (Netherlands)

    Oosten, A.W.; Sprenger, H.G.; Van Leeuwen, J.T.M.; Meessen, N.E.L.; Van Assen, S.

    2008-01-01

    Renal aspergillosis is an extremely uncommon complication in HIV-infected patients. In general, prognosis is poor and the need for nephrectomy is emphasized. We report the case of a 37-year-old patient with AIDS since April 2003 (CD4 count 10 cells/mm(3), a high viral load, Candida esophagitis, bila

  4. Enteric parasitic infections in HIV/AIDS patients before and after the highly active antiretroviral therapy

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    Tatiana Paschoalette Rodrigues Bachur

    2008-04-01

    Full Text Available Enteroparasites are related to gastrointestinal alterations among patients with HIV/AIDS, some causing severe manifestations in the period before the institution of the highly active antiretroviral therapy (HAART. The prevalence of enteroparasitoses in patients with HIV/AIDS seen at two hospitals in Ceará , Brazil, was compared in the pre-HAART (Group 1; n = 482 and HAART (Group 2; n = 100 eras. Fecal parasitologic examinations (FPE were performed using the direct, Lutz, Baermann-Moraes and modified Ziehl-Neelsen methods. The following parasites were detected in Groups 1 and 2, respectively: Strongyloides stercoralis - 30.1% and 11% (p<0.0001, Ascaris lumbricoides - 15.6% and 2% (p<0.0001, hookworms - 13.7% and 2% (p<0.0001, Trichuris trichiura - 13.1% and 1% (p<0.0001, Hymenolepis nana - 0 and 1% (p = 0.1718, Giardia duodenalis - 7.9% and 1% (p = 0.0076, Entamoeba histolytica/dispar - 3.3% and 1% (p = 0.3301, Isospora belli - 4.8% and 1% (p = 0.0993, Cryptosporidium sp. - 8.1% and 0 (p = 0.0007, and non-pathogenic protozoans as well. There was a significant reduction in the prevalence of enteroparasites between the eras (63.9% to 24%; p<0.0001. In the HAART era, the following observations were made: greater frequency of enteroparasites in patients without antiretroviral therapy (p = 0.0575, as in those with AIDS (p = 0.08, and diarrhea (36% of the patients; lack of association with positive FPE (p = 0.626; and non-detection of Cryptosporidium sp. Strongyloides stercoralis showed an elevated prevalence in the two eras and was more frequent in men (32.41% than women (19.04% of Group 1 (p = 0.018, a finding suggesting the transmission of the helminth through sodomy. The advent of the HAART modified the profile of opportunistic infections, including parasites, probably due to the reconstitution of cellular immunity and the direct action of HAART on the parasites.

  5. 1970s and ‘Patient 0’ HIV-1 genomes illuminate early HIV/AIDS history in North America

    Science.gov (United States)

    Worobey, Michael; Watts, Thomas D.; McKay, Richard A.; Suchard, Marc A.; Granade, Timothy; Teuwen, Dirk E.; Koblin, Beryl A.; Heneine, Walid; Lemey, Philippe; Jaffe, Harold W.

    2017-01-01

    The emergence of HIV-1 group M subtype B in North American men who have sex with men (MSM) was a key turning point in the HIV/AIDS pandemic. Phylogenetic studies have suggested cryptic subtype B circulation in the United States (US) throughout the 1970s2,3 and an even older presence in the Caribbean3. However, these timing and geographical inferences, based upon partial HIV-1 genomes that postdate the recognition of AIDS in 1981, remain contentious1,4 and the earliest movements of the virus within the US are unknown. We serologically screened >2000 1970s serum samples and developed a highly sensitive new approach for recovering viral RNA from degraded archival samples. Here, we report eight coding-complete genomes from US serum samples from 1978-79 – eight of the nine oldest HIV-1 group M genomes to date. This early, full-genome ‘snapshot’ reveals the US HIV-1 epidemic exhibited surprisingly extensive genetic diversity in the 1970s but also provides strong evidence of its emergence from a pre-existing Caribbean epidemic. Bayesian phylogenetic analyses estimate the jump to the US at ~1970 and place the ancestral US virus in New York City with 0.99 posterior probability support, strongly suggesting this was the crucial hub of early US HIV/AIDS diversification. Logistic growth coalescent models reveal epidemic doubling times of 0.86 and 1.12 years for the US and Caribbean, respectively, suggesting rapid early expansion in each location1. Comparisons with more recent data reveal many of these insights to be unattainable without archival, full-genome sequences. We also recovered the HIV-1 genome from the individual known as ‘Patient 0’5 and show there is neither biological nor historical evidence he was the primary case in the US or for subtype B as a whole. We discuss the genesis and persistence of this belief in the light of these evolutionary insights. PMID:27783600

  6. Caring for terminal AIDS patients: The experiences of caregivers in a palliative care institution

    Directory of Open Access Journals (Sweden)

    Essie Ricks

    2009-04-01

    Full Text Available

    This research focused on the lived experiences of caregivers working with AIDS patients, particularly patients who die from this disease whilst resident in a formal institution. A qualitative, exploratory, descriptive, and contextual research design with a phenomenological approach to inquiry was utilised. Thirteen unstructured interviews, which were audio-taped, were conducted with caregivers working full-time in a formal institution caring for patients who are dying from AIDS. The transcribed interviews were analysed using Tesch’s method of descriptive analysis (in Creswell 1994:115.

    One central theme emerged, namely that in their daily duty (at their place of work, caregivers experienced various challenges as a result of having to deal with the death of their patients suffering from AIDS, and five sub-themes were formulated from further analysis. The five subthemes were:

    • Caregivers experienced emotional challenges in caring for patients dying of AIDS;

    • Caregivers experienced a difference in death and dying of adults as apposed to children;

    • Caregivers experienced the rationalisation of death and dying differently;

    • Caregivers experienced that faith in God give them strength to cope with death and dying;

    • Caregivers experienced caring for patients as fulfilling and meaningful to them despite the sadness of death and dying.

    The participants face the death of their patients daily, from a disease that causes untold suffering to the patients, family members and to the caregivers themselves, who wish they could prevent the anguish, the pain and the inability of the medical profession to do more than they are at present towards curing this disease. They described their emotional experiences, which included the various challenges that they face as a result of having to deal with the death and dying of their patients suffering from AIDS. The information shared by these participants formed

  7. Seroprevalence of IgG and IgM anti-Toxoplasma antibodies in HIV/AIDS patients, northern Iran

    Institute of Scientific and Technical Information of China (English)

    Ahmad Daryani; Mehdi Sharif; Masoumeh Meigouni

    2011-01-01

    Objective:To determine the seroprevalence of anti-Toxoplasma gondii(T. gondii) IgG and IgM antibodies inHIV/AIDS patients and uninfected subjects.Methods: This cross sectional survey was carried out on78 healthy and62 HIV+/AIDS individuals in northern Iran between September 2007 and October2008. Five mL of blood samples were collected from each person in case and control groups. Determination ofCD4+ counts was performed by flow cytometry. The serum separated from blood samples was evaluated by conventionalELISA technique to determine the presence of antibodies toT. gondii.Results: Forty eight out of62 (77.4%) HIV/AIDS serum samples were found positive for anti-T. gondii IgG antibody, compared with59 among78 (75.6%) HIV negative samples from the same area (P>0.05). Six out of62 (9.7%) HIV+/AIDS patients showed anti-T. gondiiIgM antibody in their serum samples, compared with 7 among78 (9%) HIV negative samples(P>0.05). The mean ofCD4+ counts inHIV+/AIDS was(430.8±182.3)cells/μL and in control group was(871.0±243.3)% cells/μL (P<0.01).CD4+ estimation in5 (11.1%)ofHIV+/AIDS patients was<200 cells/μL (P<0.000 1).Conclusions: Seroprevalence of latent toxoplasmosis inHIV patients is high, therefore the prevention of toxoplasmic encephalitis, administration of primary prophylaxis with co-trimoxazole to allHIV+/AIDS patients are necessary.

  8. Anemia in Antiretroviral Naïve HIV/AIDS Patients: A Study from Eastern India

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    Arindam Pande

    2012-01-01

    Full Text Available Background: Hematological manifestations are common throughout the course of HIV infection. Impact of anemia is the most significant among them. The present study was undertaken to evaluate the etiologies underlying anemia in HIV/AIDS. Methods This was a non randomized cross sectional observational study conducted in a tertiary care hospital of India over a period of 2 years. One hundred and fifty HIV patients were screened. Thorough clinical and laboratory evaluation was done in 50 randomly selected anemic cases. Results: Proper etiological diagnosis could be reached in 46 patients. Among them correlation between Hb% and CD4 count was statistically insignificant (p = 0.074, r = 0.47 whereas it was significant with absolute lymphocyte and CD4 count (p = 0.006, r = 0.41. There was better correlation of bone marrow iron status with percent saturation of transferrin (p = 0.003, r = 0.54 than with serum ferritin (p = 0.055, r = 0.09. Bone marrow iron status did not have any relationship with CD4 count. Anemia of chronic disease was the commonest etiology (37% followed by HIV related myelodysplastic syndrome (31%, iron deficiency anemia (13%, bone marrow suppression due to direct involvement by some infective process (7%. Aplastic anemia, multiple myeloma, Hodgkin’s disease, pure red cell aplasia, hemophagocytic lymphohistiocytosis and vitamin B12 deficiency were detected in one case (2% each. Conclusions: Etiologies of anemia in HIV/AIDS are multifactorial with anemia of chronic disease being the commonest. For screening of iron deficiency in this group, percent saturation is a better tool than serum ferritin. Absolute lymphocyte count can sometimes be used as a surrogate marker of immunological status in antiretroviral naïve HIV patients, particularly in resource poor areas.

  9. Evidence-based patient choice: a prostate cancer decision aid in plain language

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    Ohene-Frempong Janet

    2005-06-01

    Full Text Available Abstract Background Decision aids (DA to assist patients in evaluating treatment options and sharing in decision making have proliferated in recent years. Most require high literacy and do not use plain language principles. We describe one of the first attempts to design a decision aid using principles from reading research and document design. The plain language DA prototype addressed treatment decisions for localized prostate cancer. Evaluation assessed impact on knowledge, decisions, and discussions with doctors in men newly diagnosed with prostate cancer. Methods Document development steps included preparing an evidence-based DA in standard medical parlance, iteratively translating it to emphasize shared decision making and plain language in three formats (booklet, Internet, and audio-tape. Scientific review of medical content was integrated with expert health literacy review of document structure and design. Formative evaluation methods included focus groups (n = 4 and survey of a new sample of men newly diagnosed with prostate cancer (n = 60, compared with historical controls (n = 184. Results A transparent description of the development process and design elements is reported. Formative evaluation among newly diagnosed prostate cancer patients found the DA to be clear and useful in reaching a decision. Newly diagnosed patients reported more discussions with doctors about treatment options, and showed increases in knowledge of side effects of radiation therapy. Conclusion The plain language DA presenting medical evidence in text and numerical formats appears acceptable and useful in decision-making about localized prostate cancer treatment. Further testing should evaluate the impact of all three media on decisions made and quality of life in the survivorship period, especially among very low literacy men.

  10. The project “D.E.A.Th. by Eros to Thanatos AIDS and Sexually Transmitted Diseases”. A multimedia exhibition as a means of prevention of sexually transmitted infections

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    Maria Ferrara

    2010-09-01

    Full Text Available

    Background: An educational intervention on Sexually Transmitted Diseases (STDs accompanied by a multimedia exhibition was proposed in order to verify the effectiveness of an exhibition as a tool for prevention, to increase awareness in youth and to evaluate whether it yielded changes in the sexual behaviour of its’ visitors. The Target population were high schools and university students.

    Methods: The Exhibition consisted of a historical overview and four other sections: biological and clinical aspects, epidemiology, prevention and a section called the Red Zone with clear and explicit images relating to STDs. The exhibition was supported by three observational studies carried out on about2000 students of two High Schools and the university in the city of Cassino, Italy. Data collection took place through three different types of “ad hoc” questionnaires. The Statistical analysis carried out was that typical of cross-sectional surveys. We utilized the statistical program Epi-Info 3.5.

    Results: Regarding survey 1, 48% of 529 students taking part said that the exhibition had contributed “enough” for them to acquire new knowledge, 75.2% had already had sexual intercourse and 37.7% of them did not change their sexual habits. Relative to survey 2, 583 responded to the pre test and 403 posttests returned. Regarding knowledge, data obtained from processing of pre-tests showed how 63.9% of the sample did not know how many STDs existed, whilst this value dropped in post test answers to 49.2% . AIDS was the best known disease (96% whilst other STDs were little known. The educational intervention partly increased these percentages. With regard to sexual practices although 43% of the sample claimed to have already had sexual intercourse (66% male and 34% female. The family doctor is seen by a high percentage of young people (70% - 68.6% as the first figure which should address an

  11. Intestinal parasitic infections in HIV/AIDS patients: epidemiological, nutritional and immunological aspects

    Directory of Open Access Journals (Sweden)

    FAM Amâncio

    2012-01-01

    Full Text Available This study applied a socioeconomic questionnaire designed to evaluate the frequency of intestinal parasites and characterize epidemiological, nutritional, and immunological variables in 105 HIV/AIDS patients - with and without parasitic infections, attending the Day Hospital in Botucatu, UNESP, from 2007 to 2008. Body mass index was calculated and the following tests performed: parasitological stool examinations; eosinophil, IgE, CD4+ T and CD8+ T lymphocyte cell counts; albumin test; viral load measure; and TNF-α, IFN-γ, IL-2, IL-5 and IL-10 cytokine levels. Results were positive for parasitic intestinal infections in 12.4% of individuals. Most patients had good socioeconomic conditions with basic sanitation, urban dwellings, treated water supply and sewage, good nutritional and immunological status and were undergoing HAART. Parasites were found at the following frequencies: Entamoeba - five patients (38.5%, Giardia lamblia - four (30.7%, Blastocystis hominis - three (23.0%, Endolimax nana - two (15.4%, and Ascaris lumbricoides - one (7.7%. There were no significant differences between the two groups for eosinophils, albumin, IgE, CD4+ T and CD8+ T lymphocytes, INF-γ, IL-2, or IL-10. Most patients also showed undetectable viral load levels. Significant differences were found for TNF-α and IL-5. These results show the importance of new studies on immunodeficient individuals to increase understanding of such variables.

  12. The Opinion of Professional Caregivers About The Platform UnderstAID for Patients with Dementia

    Science.gov (United States)

    Malak, Roksana; Krawczyk-Wasielewska, Agnieszka; Mojs, Ewa; Grobelny, Bartosz; Głodowska, Katarzyna B.; Millán-Calenti, José Carlos; Núñez-Naveira, Laura; Samborski, Włodzimierz

    2016-01-01

    Background The person with dementia should be treated as an unique person regarding symptoms directly associated with dementia, such as problems with memory, hallucinations, and delusions, as well as other physical, mental, or neurological deficits. The symptoms not directly typical of dementia, such as musculoskeletal disorders or depression, should be also be considered in order to improve the quality of life of a person with dementia. That is why professional caregivers have to broaden their current knowledge not only of medical symptoms but also of the patient’s psychosocial condition and increase their inquisitiveness about the individual condition of the patient. The aim of the study was to get to know the opinion of professional caregivers about the UnderstAID platform and its usefulness for informal caregivers. Material/Methods Participants in the study group consisted of professional caregivers: nurses, sociologists, psychologists, physiotherapists, and occupational therapists, all of whom specialized in geriatrics and had experience in working with people with dementia. All professional caregivers answered 24 questions that refer to positive and negative aspects of the UnderstAID platform. Results The study group of professional caregivers highly appreciated that the application could give support to caregivers (mean score of 4.78; 5 points means that they totally agreed, and 1 point means that they totally disagreed) and that a wide range of multimedia materials helped the informal caregivers to gain a better understanding of the contents (mean score of 4.78). There was a statistically significant correlation between the age of the professional caregivers and the frequency of positive opinions that the UnderstAID application gave support to caregivers of relatives with dementia (p=0.028) and the opinion that videos, photos, and pictures may help the informal caregivers to gain a better understanding of the contents (p=0.028). Conclusions A group of

  13. Patient-cooperative control increases active participation of individuals with SCI during robot-aided gait training

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    Duschau-Wicke Alexander

    2010-09-01

    Full Text Available Abstract Background Manual body weight supported treadmill training and robot-aided treadmill training are frequently used techniques for the gait rehabilitation of individuals after stroke and spinal cord injury. Current evidence suggests that robot-aided gait training may be improved by making robotic behavior more patient-cooperative. In this study, we have investigated the immediate effects of patient-cooperative versus non-cooperative robot-aided gait training on individuals with incomplete spinal cord injury (iSCI. Methods Eleven patients with iSCI participated in a single training session with the gait rehabilitation robot Lokomat. The patients were exposed to four different training modes in random order: During both non-cooperative position control and compliant impedance control, fixed timing of movements was provided. During two variants of the patient-cooperative path control approach, free timing of movements was enabled and the robot provided only spatial guidance. The two variants of the path control approach differed in the amount of additional support, which was either individually adjusted or exaggerated. Joint angles and torques of the robot as well as muscle activity and heart rate of the patients were recorded. Kinematic variability, interaction torques, heart rate and muscle activity were compared between the different conditions. Results Patients showed more spatial and temporal kinematic variability, reduced interaction torques, a higher increase of heart rate and more muscle activity in the patient-cooperative path control mode with individually adjusted support than in the non-cooperative position control mode. In the compliant impedance control mode, spatial kinematic variability was increased and interaction torques were reduced, but temporal kinematic variability, heart rate and muscle activity were not significantly higher than in the position control mode. Conclusions Patient-cooperative robot-aided gait training

  14. Evaluation of glycoprotein B genotypes and load of CMV infecting blood leukocytes on prognosis of AIDS patients

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    Aldo Albuquerque Cunha

    2011-04-01

    Full Text Available BACKGROUND: Cytomegalovirus (CMV remains an important pathogen to immunocompromised patients even in the era of HAART. The present study aimed at evaluating the influence of CMV viral load and its gB genotypes on AIDS patients' outcome. METHODS: Blood samples of 101 AIDS patients were collected and tested for HIV load, CD4 - cell count and opportunistic pathogens, including CMV. Semi-nested PCRs were run to detect CMV genome and in the positive samples, gB genotyping and CMV load were established using enzymatic restriction and real time PCR, respectively. All patients were clinically followed for four years. RESULTS: In thirty patients (31% CMV was detected and all fatal cases (n = 5 occurred in this group of patients (p = 0.007, but only two patients had CMV disease (1.9%. However, viral load was not statistically associated with any analyzed parameter. The most frequently observed CMV genotype was gB2 (45.16% followed by gB3 (35.48%. gB2 genotype was more frequently found in patients with CD4-cell counts under 200 cells/mm³ (p = 0.0017, and almost all fatal cases (80% had gB2 genotype. CONCLUSIONS: Our study suggests that CMV and its polymorphisms in biologically relevant genes, such as the gB encoding ORF, may still influence the prognosis and outcome of AIDS patients. The gB2 genotype was associated to patient's bad outcome.

  15. Knowledge, attitudes and practices towards patients with HIV/AIDS in staff nurses in one university hospital in Sicily

    Directory of Open Access Journals (Sweden)

    Marina Marranzano

    2013-03-01

    Full Text Available Background: nurses’ knowledge, attitudes and practices towards patients with HIV/AIDS are of ongoing interest, especially in developing countries. Nothing or very little is known about Italian nurses.Methods: HIV/AIDS knowledge, attitudes and behaviours of the nurses (n=107 from one university hospital inCatania,Sicily, were documented. Comparisons among nurses belonging to different Operative Units (O.U. were conducted by the chi-square test (P<0.05.Results: although HIV was nurses’ main concern in regard to contracting infections in the workplace (54%, the vast majority of them (98% had never refused an HIV/AIDS patient care assignment. Moreover, despite their concern of being more at risk of contracting HIV than the general population (41%, a not negligible percentage of nurses did not use gloves routinely (21% and only a few treated all patients as potentially HIV-positive (9%. The vast majority of the respondents knew the meaning of AIDS (87% and of a positive serological test (78%. On the contrary, a relatively low percentage of them knew what is the ‘window period’ (62% and were acquainted with HIV pathophysiology (65%. No statistically significant differences in terms of risk perception were found between nurses who had previously attended an HIV/AIDS workshop, lecture or specific course (43% and nurses who did not (57%. Level of knowledge was positively associated to age (P=0.000 and to education (P=0.016, and it was found higher in nurses working in a O.U. of Infectious Diseases.Conclusions: data from our study show that also in developed countries, such as Italy, nurses could have some misconceptions and concerns about HIV/AIDS. The importance of examining the impact of continuing education on nurses’ preparedness to care for patients with HIV/AIDS and to prevent the risks of occupational HIV transmission is discussed. 

  16. Fungal Opportunistic Pneumonias in HIV/AIDS Patients: An Indian Tertiary Care Experience

    Science.gov (United States)

    Mehra, Bhanu; Dhakad, Megh Singh; Goyal, Ritu; Bhalla, Preena; Dewan, Richa

    2017-01-01

    Introduction Opportunistic pneumonias are a major cause of mortality and morbidity in Human Immunodeficiency Virus (HIV) reactive patients. Despite the significant role that fungi play in causation of this opportunistic mycoses, very few Indian studies have attempted to investigate the burden and aetiological spectrum of HIV/AIDS-associated fungal pneumonias. Aim To document the prevalence of fungal aetiology in HIV/AIDS-related opportunistic pneumonias in an Indian setting; and to elucidate the various fungal opportunists responsible for the same. Materials and Methods The present study was a prospective, cross-sectional analysis conducted at Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi from October 2008 to September 2011. Expectorated sputa were collected from 71 HIV reactive patients with a clinical diagnosis of pneumonia and subjected to direct microscopic examination employing Gram stain, 10% KOH wet mount and India ink preparation. In addition, direct immunofluorescence of sputum samples was performed for detection of cysts and trophozoites of Pneumocystis carinii. Also, each sputum sample was inoculated in duplicate onto Sabouraud Dextrose Agar (SDA) for culture. A blood sample was drawn from each patient and a battery of serological tests was performed, including Cryptococcal Antigen Latex Agglutination System (CALASTM) for detection of cryptococcal capsular polysaccharide antigen; Platelia™ Aspergillus EIA for detection of Aspergillus galactomannan antigen; SERION ELISA antigen Candida for detection of Candida antigen and Histoplasma DxSelect™ for detecting antibodies to Histoplasma species. Descriptive statistics were employed to depict results as proportions and figures. Further, arithmetic mean and standard deviation were calculated for central tendencies and median for non-normal/skewed distributions. Results A definite fungal aetiology was established in 25 (35.2%) of 71 HIV reactive patients with pneumonic involvement

  17. Specific cytotoxic T lymphocyte responses in Chinese HIV/AIDS patients

    Institute of Scientific and Technical Information of China (English)

    尚红; 韩晓旭; 王亚男; 周立平; 张子宁; 姜拥军; 张旻; 于旭

    2004-01-01

    Human immunodeficiency virus type 1 (HIV-1)-specific cytotoxic T lymphocytes (CTL) are considered to play a central role in the immune response against HIV-1. During untreated acute HIV-1 infection, virus-specific CTL activity is associated with the initial decrease in viremia.1 After HIV infection, those individuals with a slow progressive course develop stronger CTL responses than those with typical disease progression.2,3 Restoring HIV-1-specific CTL responses have been considered a key factor in immune reconstitution and vaccine development. Here we present the analysis of HIV-1 Gag-specific CTL responses in 23 Chinese HIV/AIDS cases in order to take the initial steps at identifying the epitopes that dominate the CTL response in Chinese patients.

  18. Rapid susceptibility testing of Mycobacterium avium complex and Mycobacterium tuberculosis isolated from AIDS patients

    Science.gov (United States)

    Dhople, Arvind M.

    1994-01-01

    In ominous projections issued by both U.S. Public Health Service and the World Health Organization, the epidemic of HIV infection will continue to rise more rapidly worldwide than predicted earlier. The AIDS patients are susceptible to diseases called opportunistic infections of which tuberculosis and Mycobacterium avium complex (MAC) infection are most common. This has created an urgent need to uncover new drugs for the treatment of these infections. In the seventies, NASA scientists at Goddard Space Flight Center, Greenbelt, MD, had adopted a biochemical indicator, adenosine triphosphate (ATP), to detect presence of life in extraterrestrial space. We proposed to develop ATP assay technique to determine sensitivity of antibacterial compounds against MAC and M. tuberculosis.

  19. Qualitatively Understanding Patients' and Health Professionals' Experiences of the BRECONDA Breast Reconstruction Decision Aid

    DEFF Research Database (Denmark)

    Sherman, Kerry A; Shaw, Laura-Kate; Jørgensen, Lone

    2017-01-01

    OBJECTIVE: Women diagnosed with breast cancer or ductal carcinoma in situ (DCIS), and those with a genetic susceptibility to developing this disease, face the challenging decision of whether or not to undergo breast reconstruction following mastectomy. As part of a large randomized controlled trial......, this qualitative study examined women's experiences of using the Breast RECONstruction Decision Aid (BRECONDA), and health professionals' feedback regarding the impact of this resource on patients' knowledge and decision-making about breast reconstruction. METHOD: Semi-structured interviews were conducted...... with women who accessed the BRECONDA intervention (N = 36), and with their healthcare providers (N = 6). All interviews were transcribed verbatim and subjected to thematic analysis by three independent coders. RESULTS: Participants reported an overall positive impression, with all interviewees endorsing...

  20. Immunological response to hepatitis B vaccination in patients with AIDS and virological response to highly active antiretroviral therapy.

    Science.gov (United States)

    Paitoonpong, Leilani; Suankratay, Chusana

    2008-01-01

    Previous studies showed that an immunological response to hepatitis B virus (HBV) vaccination in patients with AIDS was lower than in the normal population. However, those with virological response to highly active antiretroviral therapy (HAART) may have a normal immunological response to HBV vaccination. In our study, patients with AIDS who had a virological response to HAART and no immunity to HBV received 3 doses of HBV vaccine (20 microg of Engerix-B(R)) on d 0, 30, and 180. Anti-HBs level was measured 1 month after complete vaccination. Of 28 patients, overall response rate to vaccination was 71.4%. The responder group had a significantly higher CD4 count at 1 month after complete vaccination than the non-responder group (466.95+/-146.94 and 335+/-112.62 cells/microl, p =0.035). The patients receiving efavirenz-containing HAART had better response than those without efavirenz-containing HAART (p =0.030). The responder group had received a longer duration of HAART. In conclusion , to our knowledge, ours is the first prospective study to determine the immunological response to HBV vaccination in all patients with AIDS who had maintained the virological response after receiving HAART throughout the study period. Patients with AIDS and virological response to HAART have a good immunological response to HBV vaccination.

  1. Hypomagnesemia is a risk factor for nonrecovery of renal function and mortality in AIDS patients with acute kidney injury.

    Science.gov (United States)

    Santos, M S Biagioni; Seguro, A C; Andrade, L

    2010-03-01

    The objective of the present study was to determine the prevalence of electrolyte disturbances in AIDS patients developing acute kidney injury in the hospital setting, as well as to determine whether such disturbances constitute a risk factor for nephrotoxic and ischemic injury. A prospective, observational cohort study was carried out. Hospitalized AIDS patients were evaluated for age; gender; coinfection with hepatitis; diabetes mellitus; hypertension; time since HIV seroconversion; CD4 count; HIV viral load; proteinuria; serum levels of creatinine, urea, sodium, potassium and magnesium; antiretroviral use; nephrotoxic drug use; sepsis; intensive care unit (ICU) admission, and the need for dialysis. Each of these characteristics was correlated with the development of acute kidney injury, with recovery of renal function and with survival. Fifty-four patients developed acute kidney injury: 72% were males, 59% had been HIV-infected for >5 years, 72% had CD4 counts dialysis, sepsis and hypomagnesemia were all significantly associated with nonrecovery of renal function and with mortality. Nonrecovery of renal function was significantly associated with hypomagnesemia, as was mortality in the multivariate analysis. The risks for nonrecovery of renal function and for death were 6.94 and 6.92 times greater, respectively, for patients with hypomagnesemia. In hospitalized AIDS patients, hypomagnesemia is a risk factor for nonrecovery of renal function and for in-hospital mortality. To determine whether hypomagnesemia is a determinant or simply a marker of critical illness, further studies involving magnesium supplementation in AIDS patients are warranted.

  2. the Diagnostic Value of Brain Magnetic Resonance imaging in Detecting CNS Diseases Among Advanced AiDS Patients

    Institute of Scientific and Technical Information of China (English)

    2014-01-01

    Objective To investigate the diagnostic value of brain magnetic resonance imaging in detecting central nervous system diseases among AIDS patients of different levels of T cells. Methods Total of 164 AIDS patients who did not receive antiviral treatment were divided into 2 groups according to their baseline CD4+T cell counts. Group A had CD4+T cell below or equal to 50 cells/μl (n=81) and group B had CD4+T cells over 50 cells/μl (n=83). All patients underwent brain MRI scan. Imaging analysis and the prevalence of the central nervous system disorders were compared between two groups. Results Among them 48 cases were found of abnormal brain MRI, group A was higher than group B (35.8%vs. 22.9%) although without statistical significance (P = 0.065). Altogether 48 cases were diagnosed as AIDS related central nervous system disorders based on clinical symptoms, signs and laboratory findings. The prevalence of CNS disorders was higher in group A than in group B (41.9%vs. 16.8%) with statistical significance (P<0.01). Conclusions The patients with CD4+T cell count less than or equal to 50 cells/μl had high prevalence of CNS diseases. Brain MRI plays an important role in the diagnosis and differentiation of CNS diseases in advanced AIDS patients. This study suggests patients with low CD4+T cell count (≤ 50/μl) should routinely undergo MRI examination.

  3. Disseminated histoplasmosis in patients with AIDS. Buenos Aires, 2009-2014

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    Adriana G López Daneri

    2016-12-01

    Full Text Available A retrospective study was carried out on 171 cases of disseminated histoplasmosis diagnosed in HIV/AIDS patients during the period 2009-2014. Although HIV diagnosis rates remained stable over the study period, a sensible increase in the number of histoplasmosis cases was observed in the last three years. Disseminated histoplasmosis was prevalent in males with an average age of 37.8 years. At diagnosis, only 54/171 (31.6% were receiving HAART, and CD4+ T-lymphocyte counts ranged from 4 to 264 cells/upsilon. Cutaneous lesions, including ulcerated papules or molluscoid plaques, were present in 110/171 (64.3%, with Histoplasma capsulatum being observed in all skin scraping specimens upon Giemsa staining. Respiratory manifestations were second in frequency with bronchoalveolar lavage showing a high diagnostic performance. Radiological findings included milliary patterns, interstitial infiltrates, and focalized condensations. Out of 141 blood cultures performed, H. capsulatum was isolated in 82 (58.2%. No significant difference in diagnostic performance was found between blood cultures and skin scraping (p = 0.6164. Other opportunistic infections were observed in 70/171 (40.9% prior to or concomitantly with histoplasmosis. Association with Mycobacterium tuberculosis was recorded in 16/171 (9.4% and one had a multi-drug resistant isolate. The severity of histoplasmosis determined the monotherapy with amphotericin B deoxycholate in 115 (67.3%, itraconazole in 42 (24.5%, and combined therapies in 14 (8.2%. Mortality was 19.9% (34/171. Finally, we emphasize that the higher prevalence in the last three years of the study should prompt the medical community to consider the diagnosis of histoplasmosis to reduce mortality of AIDS patients.

  4. The characteristics of HIV and AIDS patients with deep vein thrombosis at Dr. George Mukhari Academic Hospital

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    Indiran Govender

    2015-02-01

    Full Text Available Background: Deep vein thrombosis (DVT is 10 times more prevalent in HIV and AIDS patients than in the general population and is more common in patients with severe immune suppression (CD4 < 200 cells/mL. Opportunistic infections render HIV and AIDS patients susceptible to a hypercoaguable state, including lower protein S levels. Aim and setting: To present the profile of HIV and AIDS patients who developed DVT in the primary care wards of Dr. George Mukhari Academic Hospital (DGMAH, Garankuwa. Methods: Cross-sectional study of clinical records of admitted HIV and AIDS patients without DVT to the primary care wards, DGMAH, from 01 February 2010 to 31 January 2011. Results: Two hundred and twenty-nine patients were admitted and 17 (7.4% developed DVT. Of those that developed DVT, eight (47% had infection with tuberculosis (TB, four (24% had pneumonia and four (24% had gastroenteritis. The risk of developing DVT was 8/94 (8.5% in those with TB, 4/53 (7.5% in those with gastroenteritis and 4/75 (5.3% in those with pneumonia. The mean duration of stay was 14.1 days in those with DVT versus 4.0 days in those without. Conclusion: HIV (and AIDS is a hypercoaguable state and the risk of DVT is relatively high in patients with opportunistic infections. HIV and AIDS patients who are admitted to hospital with opportunistic infections may benefit from anti-thrombotic prophylaxis and further studies are needed to evaluate this.

  5. The experiences of Batswana families regarding hospice care of AIDS patients in the Bophirima district, North West province, South Africa.

    Science.gov (United States)

    Makhele, M F; Mulaudzi, F M

    2012-01-01

    The HIV/AIDS pandemic put significant strain on healthcare services in the country. Hospitals were no longer coping with the escalating number of AIDS patients. This resulted in the early discharge of patients, with some patients, too ill to be nursed at home, being sent to hospices for continued care. The Batswana had mixed feelings about hospice care, because their beliefs on patient care are based on the ubuntu philosophy, which emphasises the principle of caring for one another. The purpose of this study was to explore and describe the experiences of Batswana families regarding hospice care for patients in the Thlabane township in the province of the North West as well as to make recommendations to policy-makers to ensure that hospices are accepted by community members and utilised effectively. A qualitative, explorative, descriptive research design was applied. Purposive sampling was applied to select study participants with whom in-depth unstructured interviews were conducted. A qualitative data analysis was done by categorising, ordering, and summarising the data, and describing the findings. The findings indicated that families of patients in hospice care experienced such care as foreign to their culture. These families also experienced stigmatisation, firstly owing to the stigma associated with AIDS and secondly because they opted for hospice care. However, they also observed the high quality of care provided by the hospice and understood its benefits for AIDS patients. The study concluded that hospice care relieved families of terminally ill AIDS patients of the burden of care and enabled them to keep on working and earning a living. Recommendations to policy-makers included enhancing hospice care and ensuring the provisioning of culturally safe hospice care.

  6. Endobronchial leiomyoma: an unusual non-defining neoplasm in a patient with AIDS Leiomioma endobronquial: rara neoplasia não definida em paciente com AIDS

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    Humberto Metta

    2009-02-01

    Full Text Available Smooth muscle neoplasms are more frequent in human immunodeficiency infected children than in HIV seropositive adults. Endobronchial leiomyoma is a rare benign tumor in HIV infected adult patients. Epstein-Barr virus (EBV has been implicated in the pathogenesis of these tumors. Here we describe an adult patient with HIV infection with atelectasis of the left upper pulmonary lobe as the first clinical expression of an intrabronchial leiomyoma. In this case, we can not show the association with EBV. Our report suggests that smooth muscle tumors as leiomyoma should be included in the differential diagnosis of endobronchial masses in AIDS patients.Neoplasmas da musculatura lisa são mais freqüentes em crianças infectadas pelo vírus da imunodeficiência humana do que em adultos HIV-soropositivos. Leiomioma endobronquial é um tumor benigno em pacientes adultos infectados por HIV. Vírus Epstein-Barr (EBV tem sido implicado na patogenia destes tumores. Descrevemos paciente adulto infectado pelo HIV com atelectasia do lobo pulmonar superior esquerdo como primeira manifestação clínica de leiomioma intrabronquial. Neste caso não pudemos demonstrar a associação com EBV. Nosso relato sugere que tumores de musculatura lisa como leiomioma deveriam ser incluídos no diagnóstico diferencial de massas endobronquiais em pacientes com AIDS.

  7. Interferonγ in patients with HIV/AIDS and suspicion or latent tuberculosis infection

    Institute of Scientific and Technical Information of China (English)

    Guadalupe García-Elorriaga; Mayté Martínez-Velazquez; Veronica Gaona-Flores; Guillermo del Rey-Pineda; César Gonzalez-Bonilla

    2013-01-01

    Objective:To assess the usefulness ofIGRA test(QuantiFERON?-Cell mediated immune) compared with the tuberculin skin test.Methods:A cross-sectional study was carried out in Mexico,25 infected patients withHIV-AIDS and the suspicion or with latent tuberculous infection (LTBI) who were >18 years of age and without treatment for tuberculosis(TB), were enrolled in the study.Results:Median cluster of differentiation(CD4) count was364 cells/μL and median HIV viral load was50 copies/mL.Overall,20 patients(80%) had at least one positive diagnostic test forLTBI: four(16%) had a positive tuberculin skin test and19(76%), a positiveQuantiFERON?-tuberculosis.Conclusions:No agreement is found between the two diagnostic tests:k = -0.004,95% confidence interval(-0.2219,0.2210).Additional longitudinal studies amongHIV-infected populations with high prevalence ofTB are needed to further assess the usefulness of IGRAs in this patient population.

  8. Progressive outer retinal necrosis (PORN) in AIDS patients: a different appearance of varicella-zoster retinitis.

    Science.gov (United States)

    Pavesio, C E; Mitchell, S M; Barton, K; Schwartz, S D; Towler, H M; Lightman, S

    1995-01-01

    Retinal infections caused by the varicella-zoster virus (VZV) have been reported in immunocompetent and immunocompromised individuals. Two cases of a VZV-related retinitis are described with the characteristic features of the recently described progressive outer retinal necrosis (PORN) syndrome. Both patients suffered from the acquired immunodeficiency syndrome (AIDS) with greatly reduced peripheral blood CD4+ T lymphocyte counts, and presented with macular retinitis without vitritis. The disease was bilateral in one case and unilateral in the other. The clinical course was rapidly progressive with widespread retinal involvement and the development of rhegmatogenous retinal detachment with complete loss of vision in the affected eyes despite intensive intravenous antiviral therapy. VZV DNA was identified in vitreous biopsies, by molecular techniques based on the polymerase chain reaction (PCR), in both patients. At present, the use of very high-dose intravenous acyclovir may be the best therapeutic option in these patients for whom the visual prognosis is poor. Intravitreal antiviral drugs could also contribute to the management of these cases.

  9. Characteristics of Patients with Hearing Aids according to the Degree and Pattern of Hearing Loss

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    Byun, Young Seok; Kim, Sung Su; Park, Sang Hyun; Park, Eun Bin; Kim, Ho Joong; Kim, Sang Hoon

    2016-01-01

    Background and Objectives This study was designed to assess the characteristics of patients according to the degree and audiogram shape of hearing loss and the association of these characteristics with hearing aids (HA) choice, return rate, and cause of return. Subjects and Methods This study included 460 individuals who received HAs from 2011 to 2015. The relationships between type of HA and age, primary and accompanying symptoms, HA choice and return and cause of return were evaluated according to the degree and pattern of hearing loss. Results HA type did not differ significantly according to the degree and pattern of hearing loss. Intensity of hearing loss was greater in male than in female (phearing loss intensified, behind-the-ear and in-the-ear types increased and Open type decreased (phearing loss. The main causes of HA return were costs, psychological fears and adaptive failure. Conclusions Choice of HA is affected by age, sex, and degree and pattern of hearing loss. HA for hearing rehabilitation in patients with hearing loss can be personalized according to each patient's characteristics and tendencies. PMID:27942600

  10. Risk factors for intestinal parasitosis among antiretroviral-treated HIV/AIDS patients in Ethiopia.

    Science.gov (United States)

    Mahmud, Mahmud Abdulkader; Bezabih, Afework Mulugeta; Gebru, Rezene Berhe

    2014-10-01

    Summary A cross-sectional survey was conducted to determine the risk factors associated with intestinal parasitosis in HIV/AIDS patients receiving antiretroviral therapy (ART). Socio-demographic information was collected and faecal samples were analysed from 384 randomly selected patients on ART. Data on CD4+ T-cell counts and World Health Organization clinical staging were obtained from the medical records at the hospital. The overall prevalence of intestinal parasitosis was 56% (95% confidence interval [CI]: 51% to 61%). No opportunistic intestinal parasites or Schistosoma haematobium eggs were detected. Unavailability of latrine and lack of hand washing with soap were associated with Entamoeba histolytica/dispar (adjusted odds ratio [AOR], 2.75; 95% CI: 1.77 to 4.27 and AOR, 2.67; 95% CI: 1.60 to 4.44, respectively) and Giardia lamblia (AOR, 2.08; 95% CI: 1.08 to 3.99 and AOR, 2.46; 95% CI: 1.06 to 5.75, respectively) infections. Intestinal parasitosis was significantly associated with low CD4 cell count (p = 0.002). In contrast, intestinal parasitic infections were not associated (p > 0.05) with the World Health Organization disease staging. In summary, poor personal hygiene and sanitation practice contributed to the high prevalence of intestinal parasitosis. Routine diagnosis for intestinal parasitic infections should be performed in patients attending ART clinics in this setting.

  11. Quality of life profile and psychometric properties of the EQ-5D-5L in HIV/AIDS patients

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    Tran Bach

    2012-11-01

    Full Text Available Abstract Objectives We assessed health-related quality of life (HRQOL, its associated factors, and examined measurement properties of the EuroQol - 5 Dimensions - 5 Levels (EQ-5D-5L in HIV/AIDS patients. Methods A cross-sectional multi-site survey was conducted in 1016 patients (age: 35.4 ± 7.0 years; 63.8% male in three epicenters of Vietnam. Internal consistency reliability, convergent validity, and discriminative validity of the EQ-5D-5L and a visual analogue scale (VAS were evaluated. Tobit censored regression models were used to identify predictors of HRQOL in HIV/AIDS patients. Results The mean EQ-5D-5L single index and VAS were 0.65 (95% Confidence Interval (CI = 0.63; 0.67 and 70.3 (95% CI = 69.2; 71.5. Cronbach’s alpha of five dimensions was 0.85. EQ-5D-5L has a good convergent validity with VAS (0.73. It discriminated patients at different HIV/AIDS stages, duration of ART, and CD4 cell count. Predictors of poorer HRQOL included being female, lower education level, unemployment, alcohol and drug use, CD4 Conclusion The EQ-5D-5L has good measurement properties in HIV/AIDS patients and holds potentials for monitoring ART outcomes. Integration of HRQOL measurement using EQ-5D-5L in HIV/AIDS clinical practice could be helpful for economic evaluation of HIV/AIDS interventions.

  12. The Effect Evaluation of Highly Active Antiretroviral Therapy to Patients with AIDS in Hubei Province of China

    Institute of Scientific and Technical Information of China (English)

    Xuehua LI; Yihua XU; Shaofa NIE; Hao XIANG; Chongjian WANG

    2009-01-01

    The effects of highly active antiretroviral therapy (HAART) to patients with AIDS in Hubei province of China were investigated in order to provide scientific evidence to reinforce the management of HAART. Self-made questionnaires and descriptive method of epidemiology were used to collect and describe the changes of clinical symptoms, HIV RNA concentration, and immune function of patients with AIDS. After HAART, the effective rate of fever, cough, diarrhea, lymphadenectasis, weight loss,tetter, debility and fungous infection was 92.4%, 90.85%, 92.91%, 90.73%, 93.69%, 89.04%, 92.34%,and 83.1%, respectively. Of 117 patients with detected HIV RNA concentration, 41.03% had declined over 0.5 log, and 52.99% less than 0.5 log. CD4+T cell count was obviously increased: the average number after HAART for 3 or 6 months was 237/μL (26-755/μL) and 239/μL (17-833/μL), respectively.HAART can improve AIDS patients' clinical symptoms, reduce HIV RNA concentration, and maintain immune function. It is very important for the effectiveness of HAART to raise clinical adherence of pa-tients with AIDS and have a persistent surveillance.

  13. Neurologic cytomegalovirus complications in patients with AIDS: retrospective review of 13 cases and review of the literature

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    Camila Almeida Silva

    2010-12-01

    Full Text Available Neurological disorders caused by Cytomegalovirus (CMV in patients with Acquired Immunodeficiency Syndrome (AIDS are rarely reported in the Highly Active Antiretroviral Therapy (HAART period. The objective of this study was to describe the main clinical and laboratory features of patients with CMV-related neurological complications in HIV-infected patients admitted to a referral center in São Paulo, Brazil. CMV disease requires the identification of the virus in the cerebrospinal fluid (CSF using Polymerase Chain Reaction (PCR. Thirteen cases were identified between January, 2004 and December, 2008. The median age of patients was 38 years and nine (69% were men. At admission all patients were aware of their HIV status and only four (31% patients were on HAART. Patients who were not on antiretroviral therapy before admission received HAART while inpatients. CMV disease was the first AIDS-defining illness in eight (62% patients. The neurologic syndromes identified were diffuse encephalitis (n = 7; 62%, polyradiculopathy (n = 7; 54%, focal encephalitis (rhombencephalitis (n = 1; 8%, and ventriculo-encephalitis (n = 1; 8%. Seven (54% patients presented extra-neural CMV disease and four (31% had retinitis. The median of CD4+ T-cell count was 13 cells/µL (range: 1-124 cells/µL. Overall in-hospital mortality was 38%. Eight patients used ganciclovir or foscarnet (in-hospital mortality: 50% and five patients used ganciclovir and foscarnet (in-hospital mortality: 20%. None of the patients fulfilled the diagnosis criteria of immune reconstitution inflammatory syndrome. Four patients were lost to follow-up, and three patients presented immune recovery and discontinued secondary prophylaxis. Although infrequent, distinct neurological syndromes caused by CMV continue to cause high mortality among AIDS patients. Survival depends upon the use of effective antiviral therapy against CMV and the early introduction of HAART.

  14. The Clinical Usefulness of Ultrasound-Aided Fixation Using an Absorbable Plate System in Patients with Zygomatico-Maxillary Fracture

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    Jong Hun Lee

    2013-07-01

    Full Text Available Background  Ultrasound-aided fixation is a recently developed alternative method of treatment of zygomatico-maxillary (ZM fracture, and it can resolve the problems of excessivetorsion force and subsequent fractures of screws. We conducted this study to evaluate theclinical usefulness of ultrasound-aided fixation as compared with the conventional fixationmethod using a drill and an expanderin patientswith ZMfracture.Methods  We conducted a retrospective study in 35 patientswith ZMfracturewho had beentreated at our hospital during a period ranging fromMarch of 2008 toDecember of 2010. Wedivided them into two groups: an ultrasound-aided fixation group, comprising 13 patientswho underwent ultrasound-aided fixation (SonicWeld Rx, KLS Martin, and a conventionalgroup, comprising 22 patients who underwent conventional fixation (Biosorb FX, LinvatecBiomaterials Ltd.. We compared such variables as sex, direction, age at operation, follow-upperiod, operation duration, number of fixed holes, and time to discharge between the twogroups.Results  The ultrasound-aided fixation reduced the operation duration by about 30 minutesas comparedwith that of conventional fixation. Therewas no significant difference in followup period, number of fixed holes, ortime to discharge between the two groups. Furthermore,therewere no complicationsin either group.Conclusions  The ultrasound-aided fixation offractured ZMbone using an absorbable implantsystemissafe and effective in promptly reducing the bone fracture and providing satisfactorycosmetic outcomes overtime.

  15. A novel first aid stretcher for immobilization and transportation of spine injured patients.

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    Yan-Sheng Liu

    Full Text Available Effective immobilization and transportation are vital to the life-saving acute medical care needed when treating critically injured people. However, the most common types of stretchers used today are wrought with problems that can lead to further medical complications, difficulty in employment and rescue, and ineffective transitions to hospital treatment. Here we report a novel first aid stretcher called the "emergency carpet", which solves these problems with a unique design for spine injured patients. Polyurethane composite material, obtained by a novel process of manually mixing isocyanate and additives, can be poured into a specially designed fabric bag and allowed to harden to form a rigid human-shaped stretcher. The effectiveness of the emergency carpet was examined in the pre-hospital management of victims with spinal fractures. Additionally, it was tested on flat ground and complex terrain as well as in the sea and air. We demonstrated that the emergency carpet can be assembled and solidified on the scene in 5 minutes, providing effective immobilization to the entire injured body. With the protection of the emergency carpet, none of the 20 patients, who were finally confirmed to have spinal column fracture or dislocation, had any neurological deterioration during transportation. Furthermore, the carpet can be handled and transported by multiple means under differing conditions, without compromising immobilization. Finally, the emergency carpet allows the critically injured patient to receive multiple examinations such as X-ray, CT, and MRI without being removed from the carpet. Our results demonstrate that the emergency carpet has ideal capabilities for immobilization, extrication, and transportation of the spine injured patients. Compared with other stretchers, it allows for better mobility, effective immobilization, remarkable conformity to the body, and various means for transportation. The emergency carpet is promising for its

  16. BILATERAL ENDOGENOUS BACTERIAL ENDOPHTHALMITIS SECONDARY TO PNEUMONIA IN AN AIDS PATIENT : A CASE REPORT

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    Rajendra Ku.

    2015-08-01

    Full Text Available INTRODUCTI ON: Endogenous or metastatic endophthalmitis is a very rare sever form of ocular disease which is uncommon now - a - days. Prevalence of endogenous bacterial endophthalmitis is 2 - 8% of all cases of endophthalmitis 1 . Mostly it is associated with chronic disease like diabetes mellitus, renal failure, liver abscesses, prolong placement of catheter, IV line or central venous line, drug abusers and immunocompromise d patients. Gram +bacteria are the most common causative organism of the endogenous bacterial endophthalmitis . 1 A few cases of endogenous bacterial endophthalmitis due to klebsiella pneumonias, a gram - ve organism have been documented and majority of them were in Taiwan . 2, 3,4,5,6, 7 K. pneumonia endophthalmitis is associated with diabetes mellitus and hepatic abscesses can be bilateral and resulted into poor visual outcome . 2,3,4,5,6, 7 K. pneumonia pneumonia has been reported most frequently from patients with alcoholic liver diseases and one of the common cause of acute osteomyelitis and septic arthritis . 8,9 In this scenario we report the case of a Malawian in African Continent who developed bilateral endogenous bacterial endophthalmitis after suffering from pneumonia in immunocompromise state. PURPOSE : to report a case bilateral endogenous endophthalmitis secondary to pneumonia in an AIDS patient . DESIGN : Observational case report . METHODS : A patient with bilateral pain full red eye with diminution of vision was seen in c onsultation by ophthalmology. RESULT : with clinical characteristic and laboratory diagnosis of sputum and blood conf i rmed the causative agent for pneumonia and endophthalmitis is K.pneumonia. CONCLUSION : it is unusual disease, required early detection and prompt treatment.

  17. Assessing the quality of decision support technologies using the International Patient Decision Aid Standards instrument (IPDASi.

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    Glyn Elwyn

    Full Text Available OBJECTIVES: To describe the development, validation and inter-rater reliability of an instrument to measure the quality of patient decision support technologies (decision aids. DESIGN: Scale development study, involving construct, item and scale development, validation and reliability testing. SETTING: There has been increasing use of decision support technologies--adjuncts to the discussions clinicians have with patients about difficult decisions. A global interest in developing these interventions exists among both for-profit and not-for-profit organisations. It is therefore essential to have internationally accepted standards to assess the quality of their development, process, content, potential bias and method of field testing and evaluation. METHODS: Scale development study, involving construct, item and scale development, validation and reliability testing. PARTICIPANTS: Twenty-five researcher-members of the International Patient Decision Aid Standards Collaboration worked together to develop the instrument (IPDASi. In the fourth Stage (reliability study, eight raters assessed thirty randomly selected decision support technologies. RESULTS: IPDASi measures quality in 10 dimensions, using 47 items, and provides an overall quality score (scaled from 0 to 100 for each intervention. Overall IPDASi scores ranged from 33 to 82 across the decision support technologies sampled (n = 30, enabling discrimination. The inter-rater intraclass correlation for the overall quality score was 0.80. Correlations of dimension scores with the overall score were all positive (0.31 to 0.68. Cronbach's alpha values for the 8 raters ranged from 0.72 to 0.93. Cronbach's alphas based on the dimension means ranged from 0.50 to 0.81, indicating that the dimensions, although well correlated, measure different aspects of decision support technology quality. A short version (19 items was also developed that had very similar mean scores to IPDASi and high correlation

  18. Application of diffusion tensor imaging in AIDS patients with brain opportunistic diseases: A comparative study of tuberculosis and toxoplasmosis

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    Xiang-le Chu

    2015-06-01

    Conclusions: Quantitative DTI is valuable for diagnosis and differential diagnosis of patients with AIDS-associated infections, and also could provide references for clinical physicians for proper medications. The quantitative FA value could help better reveal different changes of microstructural integrity between different opportunistic infections.

  19. Treating an HIV/AIDS Patient's PTSD and Medication Nonadherence with Cognitive-Behavioral Therapy: A Principle-Based Approach

    Science.gov (United States)

    Chernoff, Robert A.

    2007-01-01

    HIV/AIDS patients with medication adherence problems are vulnerable to developing drug resistance, immune system degradation, and opportunistic infections. Poor adherence to antiretroviral medication regimens can be aggravated by psychiatric problems, including depression and posttraumatic stress disorder. This article presents the case study of a…

  20. MENINGOENCEPHALITIS DUE TO VARICELLA ZOSTER VIRUS IN AIDS PATIENTS. REPORT OF ELEVEN CASES AND REVIEW OF THE LITERATURE

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    Marcelo CORTI

    2015-12-01

    Full Text Available Neurological complications of varicella-zoster virus (VZV are infrequent and include various clinical pictures. The reactivation of VZV in patients with AIDS is generally associated with an acute and severe meningoencephalitis. We report the epidemiological, clinical and virological data from 11 consecutive patients with diagnosis of HIV/AIDS and central nervous system (CNS involvement due to VZV. All patients were male and seropositive for HIV. The primary risk factor for HIV infection was unprotected sexual contact. The median of CD4 T cell count was 142 cells/µL. All of them presented signs and symptoms of meningoencephalitis. Six patients (54.5% presented pleocytosis; they all showed high CSF protein concentrations with a median of 2.1 g/dL. Polymerase chain reaction of cerebrospinal fluid specimen was positive for VZV in all of them and they were treated with intravenous acyclovir at doses of 30/mg/kg/day for 21 days. Overall survival was 63% (7 of 11 patients. The four dead patients had low cellular counts in CSF, below the median of this parameter. VZV should be included among the opportunistic pathogens that can involve CNS with a diffuse and severe meningoencephalitis in patients with advanced HIV/AIDS disease.

  1. Toxoplasma encephalitis in AIDS patients in São Paulo during 1988 and 1991. A comparative retrospective analysis

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    PASSOS Luciana Neves

    2000-01-01

    Full Text Available We conducted a retrospective analysis of Toxoplasma encephalitis patients from Instituto de Infectologia Emílio Ribas, the main AIDS hospital of São Paulo, Brazil, during two different stages of the HIV epidemics, in 1988 (38 patients and 1991 (33 patients. There were AIDS-related demographic differences, but the clinical presentation and diagnostic efficiency were similar, usually based on tomography and clinical response to therapy, with a clear distinction from other CNS infections, based on clinical and laboratory findings. Specific serologic studies were performed less often in 1991, with a high frequency of therapy change. The direct acute death rate from Toxoplasma encephalitis was high during both periods, i.e. 8/38 in 1988 and 10/33 in 1991. The direct acute death rate for the patients from the two periods as a whole was 25.4% (18/71, related to the time of HIV infection, absence of fever and presence of meningeal irritation at presentation, blood leukocytes higher than 10,000/mm³ and blood lymphocytes lower than 350/mm³. Toxoplasma encephalitis is a preventable disease when adequate prophylactic therapy is used and is relatively easy to treat in diagnosed HIV patients. Unfortunately, this severe and deadly disorder is the HIV diagnostic disease in several patients, and our data support the need for careful management of these patients, especially in those countries with a high toxoplasmosis prevalence where AIDS is concurrent with economic and public health problems.

  2. Toxoplasma encephalitis in AIDS patients in São Paulo during 1988 and 1991. A comparative retrospective analysis.

    Science.gov (United States)

    Passos, L N; Araújo Filho, O F; Andrade Junior, H F

    2000-01-01

    We conducted a retrospective analysis of Toxoplasma encephalitis patients from Instituto de Infectologia Emílio Ribas, the main AIDS hospital of São Paulo, Brazil, during two different stages of the HIV epidemics, in 1988 (38 patients) and 1991 (33 patients). There were AIDS-related demographic differences, but the clinical presentation and diagnostic efficiency were similar, usually based on tomography and clinical response to therapy, with a clear distinction from other CNS infections, based on clinical and laboratory findings. Specific serologic studies were performed less often in 1991, with a high frequency of therapy change. The direct acute death rate from Toxoplasma encephalitis was high during both periods, i.e. 8/38 in 1988 and 10/33 in 1991. The direct acute death rate for the patients from the two periods as a whole was 25.4% (18/71), related to the time of HIV infection, absence of fever and presence of meningeal irritation at presentation, blood leukocytes higher than 10,000/mm3 and blood lymphocytes lower than 350/mm3. Toxoplasma encephalitis is a preventable disease when adequate prophylactic therapy is used and is relatively easy to treat in diagnosed HIV patients. Unfortunately, this severe and deadly disorder is the HIV diagnostic disease in several patients, and our data support the need for careful management of these patients, especially in those countries with a high toxoplasmosis prevalence where AIDS is concurrent with economic and public health problems.

  3. Patient costs associated with accessing HIV/AIDS care in Malawi

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    Andrew D Pinto

    2013-03-01

    difference in total costs per visit between CC and DC. Conclusions: Even within a system of HIV/AIDS care where patients do not pay to see clinicians or for most medications, they still incur costs. We found that most costs are travel related. This has important implications for poorer patients who live at a distance from health facilities for whom these costs may be significant.

  4. Cryptococcal pleuritis containing a high level of adenosine deaminase in a patient with AIDS: a case report.

    Science.gov (United States)

    Yoshino, Yusuke; Kitazawa, Takatoshi; Tatsuno, Keita; Ota, Yasuo; Koike, Kazuhiko

    2010-01-01

    Cryptococcal infection is the 4th most common opportunistic infection in patients with acquired immune deficiency syndrome (AIDS). Although pleural effusion alone is an unusual presentation, we present a case of cryptococcal pleuritis in an AIDS patient which was initially difficult to discriminate from tuberculous pleuritis because of the high level of pleural adenosine deaminase (ADA). Cryptococcus neoformans was detected in the culture of the pleural effusion after the initiation of antituberculous treatment. High levels of ADA in the pleural fluid can be observed in patients with cryptococcal pleuritis, and longer incubation of pleural fluid should be performed in all patients who present with pleuritis associated with a high ADA level as the only significant finding.

  5. Prevention of Pneumocystis carinii pneumonia relapse in AIDS patients. The efficacy and tolerability of low-dose sulfamethoxazole-trimethoprim

    DEFF Research Database (Denmark)

    Nielsen, T L; Jensen, Birgitte Nybo; Nelsing, S

    1993-01-01

    The effectiveness and tolerability of Sulfamethoxazole with Trimethoprim (SMX-TMP), a dose of 400mg/80mg given twice a day as secondary prophylaxis (SP) against Pneumocystis carinii pneumonia (PCP) was assessed retrospectively in 166 AIDS patients. The mean observation period was 9.7 months (range...... effects necessitating cessation of SP with SMX-TMP, was reported in eight patients (5%) (95% CI 2.1%-9.3%)....

  6. Stigma, social reciprocity and exclusion of HIV/AIDS patients with illicit drug histories: A study of Thai nurses' attitudes

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    Stoové Mark A

    2008-08-01

    Full Text Available Abstract Background Stigma is a key barrier for the delivery of care to patients living with HIV/AIDS (PLWHA. In the Asia region, the HIV/AIDS epidemic has disproportionately affected socially marginalised groups, in particular, injecting drug users. The effect of the stigmatising attitudes towards injecting drug users on perceptions of PLWHA within the health care contexts has not been thoroughly explored, and typically neglected in terms of stigma intervention. Methods Semi-structured interviews were conducted with a group of twenty Thai trainee and qualified nurses. Drawing upon the idea of 'social reciprocity', this paper examines the constructions of injecting drug users and PLWHA by a group of Thai nurses. Narratives were explored with a focus on how participants' views concerning the high-risk behaviour of injecting drug use might influence their attitudes towards PLWHA. Results The analysis shows that active efforts were made by participants to separate their views of patients living with HIV/AIDS from injecting drug users. While the former were depicted as patients worthy of social support and inclusion, the latter were excluded on the basis that they were perceived as irresponsible 'social cheaters' who pose severe social and economic harm to the community. Absent in the narratives were references to wider socio-political and epidemiological factors related to drug use and needle sharing that expose injecting drug users to risk; these behaviours were constructed as individual choices, allowing HIV positive drug users to be blamed for their seropositive status. These attitudes could potentially have indirect negative implications on the nurses' opinions of patients living with HIV/AIDS more generally. Conclusion Decreasing the stigma associated with illicit drugs might play crucial role in improving attitudes towards patients living with HIV/AIDS. Providing health workers with a broader understanding of risk behaviours and redirecting

  7. Survey on hearing aid use and satisfaction in patients with presbyacusis

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    Nalini Bhat

    2015-01-01

    Full Text Available Context: Hearing aids (HAs are the principal means of auditory rehabilitation for patients with sensorineural hearing loss. Yet, there are a lot of resistances to use HAs due to the expense, cosmetic concerns and lack of sufficient perceived benefit. A scientific analysis of outcomes in HAs users and the factors involved will lead to a better understanding among the care givers and will ultimately positively influence the outcomes in the HA users. This is the basis of the following study. Aims: (1 To assess the subjective level of satisfaction in patients of presbycusis using mono-aural HAs. (2 To study various attributes in HA users. Settings and Design: Study design - Prospective. Study period - February 2011 to September 2012. Subjects and Methods: The study was done in five basic steps: (1 Selection of subjects based on inclusion criteria. (2 Awareness and counseling regarding HAs. (3 Preintervention assessment. (4 HA fitting, adjustment and rehabilitation. (5 Postintervention assessment. Statistical Analysis Used: Mean, percentage, two-tailed P value using Fischer exact. Results: There was a high level of satisfaction in terms of hearing benefit (74% among users at the end of 4 months. Almost half the subjects reported no problems with their HAs. Subjects with mild hearing impairment were less satisfied with their HAs than the others. Most people under used their HAs even when they were satisfied. Subjects with severe hearing loss used their HAs for longer duration daily. Conclusions: Mono-aural HAs significantly and satisfactorily rehabilitate patients with presbycusis. Mono-aural fitting is a cost effective option, especially in developing countries like ours.

  8. Soporte nutricional en el paciente con SIDA Nutritional support in AIDS patients

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    C. Sánchez Alvarez

    2005-06-01

    Full Text Available Los avances en el tratamiento de los pacientes con infección por HIV han modificado el pronóstico de los mismos, haciendo posible que la presencia de complicaciones agudas en estos pacientes haga considerar su ingreso en UCI. Los pacientes con infección por HIV muestran alteraciones nutricionales sobre las que se añaden los cambios derivados de la enfermedad aguda: por ello, son candidatos a recibir soporte nutricional especializado. La vía enteral deberá ser preferida para el aporte de nutrientes en los casos que lo precisen. Respecto a las características del soporte nutricional, éste deberá adaptarse a la situación metabólica de manera similar a lo recomendado para otras patologías. No se ha demostrado que el empleo de substratos con capacidad fármaconutriente (suplementos de glutamina o arginina o modificaciones en la calidad del componente lipídico mejore la situación inmunológica ni el curso clínico de los pacientes con infección por HIV/SIDA.Advances in HIV infected patients' treatment have modified their prognosis, making possible to consider their admission to the ICU for acute complications. HIV infected patients show nutritional impairments onto which changes due to acute disease are added. Thus, they are candidate to receive specialized nutritional support. The enteral route should be preferred for nutrients supply in case of necessary. With regards to nutritional support characteristics, it should be adapted to the metabolic situation, similarly to what is recommended for other diseases. It has not been demonstrated that the use of substrates with a pharmaco-nutrient capability (glutamine or arginine supplements or modifications in the lipidic component quality will improve the immunological condition or the clinical curse of patients with HIV infection/AIDS.

  9. High incidence of co-infection with Malaria and Typhoid in febrile HIV infected and AIDS patients in Ekpoma, Edo State, Nigeria.

    Science.gov (United States)

    Agwu, E; Ihongbe, J C; Okogun, G R A; Inyang, N J

    2009-04-01

    This survey was designed to determine the prevalence of Plasmodium falciparum and Salmonella Typhi among febrile HIV/AIDS patients in Ekpoma. Malaria and typhoid risk factors in Ekpoma included occupation, poor health facilities and poor sanitation. Malaria and typhoid are highly prevalent among Ekpoma HIV/AIDS patients.

  10. Prevalence of pain in patients with HIV/AIDS: A cross-sectional survey in a South Indian state

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    Shoba N Nair

    2009-01-01

    Secondary - To assess the type, site, severity, management of pain and impact of pain on quality of life in these patients. Design: Multicentre cross-sectional survey (This paper is a pilot study. Settings: ART centre at St. John′s Medical College Hospital, Bangalore and Snehadan, A supportive and care centre for HIV/ AIDS patients at Bangalore. Materials and Methods: Data sheet, Brief pain inventory and Short - Form McGill pain questionnaire. Subjects: This is an ongoing study and the pilot study includes 140 HIV/AIDS patients in different stages of the disease. Results: About 66.7% (28/42 in-patients and 24.5% (24/98 out-patients complained of pain. Of the 52 patients who reported pain, 32% (14/52 reported neuropathic pain and 68% (38/52 reported noci-ceptive pain. Headache was most common followed by pain in the soles of feet and low back. Only 26.9% (17/52 received any form of analgesic. Pain severity significantly affects the quality of life. Conclusions: Pain is a common and debilitating symptom of HIV/AIDS. It is however, under-estimated and under treated.

  11. Impact of gender on the risk of AIDS-defining illnesses and mortality in Danish HIV-1-infected patients

    DEFF Research Database (Denmark)

    Thorsteinsson, Kristina; Ladelund, Steen; Jensen-Fangel, Søren;

    2012-01-01

    Abstract Background: Gender differences in the risk of AIDS-defining illness (ADI) and mortality have been reported in the HIV-1-infected (HIV-positive) population, with conflicting findings. We aimed to assess the impact of gender on the risk of ADI and death in HIV-positive patients infected...... no differences between the 3 risk groups, although we saw a trend towards a higher risk of death in older MSW. MSM had a lower risk of death compared to the background population than women and MSW. Conclusions: In the Danish HIV population, gender has no major impact on progression to AIDS or mortality...

  12. CD4 lymphocyte response following anti-retroviral therapy in HIV/AIDS patients - A study in Osmania General Hospital

    OpenAIRE

    Srinivasa Rao Nanyam; Ravala Siddeswari; Budithi Sudarsi; Barla Suryanarayana; Challagali Prabhu Kumar; Thatikala Abhilash

    2016-01-01

    The present study aims serial four year assessment of CD4 cell response after initiation of anti-retroviral therapy (ART) in patients with HIV/AIDS attending Osmania General Hospital, Hyderabad. It was a retrospective hospital based observational study. We included 110 HIV/AIDS who were on ART. Data was collected over a period of 04 years from 2005 to 2008 in the ART Centre, Upgraded Department of General Medicine, Osmania General Hospital. Data regarding CD4 cell count over 4 years was asse...

  13. Patient satisfaction with HIV/AIDS care and treatment in the decentralization of services delivery in Vietnam.

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    Bach Xuan Tran

    Full Text Available OBJECTIVE: We evaluated the patient satisfaction with HIV/AIDS care and treatment and its determinants across levels of health service administration in Vietnam. METHODS: We interviewed 1016 patients at 7 hospitals and health centers in three epicenters, including Hanoi, Hai Phong, and Ho Chi Minh City. The Satisfaction with HIV/AIDS Treatment Interview Scale (SATIS was developed, and 3 dimensions were constructed using factor analysis, namely "Quality and Convenience"; "Availability and Responsiveness"; and "Competence of health care workers". RESULTS: In a band score of (0; 10, the mean scores of all domains were large; it was the highest in "Competence of health workers" (9.34±0.84, and the lowest in "Quality and Convenience" (9.03±1.04. The percentages of respondents completely satisfied with overall service quality and treatment outcomes were 42.4% and 18.8%, respectively. In multivariate analysis, factors related to higher satisfaction included female sex, older age, and living with spouses or partners. Meanwhile, lower satisfaction was found among patients who were attending provincial and district clinics; in the richest group; had higher CD4 count; and drug users. CONCLUSION: This study highlights the importance of improving the quality of HIV/AIDS services at the provincial and district clinics. Potential strategies include capacity building for health workers, integrative service delivery, engagements of family members in treatment supports, and additional attention and comprehensive care for drug users with HIV/AIDS.

  14. The population genetics of Pseudomonas aeruginosa isolates from different patient populations exhibits high-level host specificity.

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    Rosa van Mansfeld

    Full Text Available OBJECTIVE: To determine whether highly prevalent P. aeruginosa sequence types (ST in Dutch cystic fibrosis (CF patients are specifically linked to CF patients we investigated the population structure of P. aeruginosa from different clinical backgrounds. We first selected the optimal genotyping method by comparing pulsed-field gel electrophoresis (PFGE, multilocus sequence typing (MLST and multilocus variable number tandem-repeat analysis (MLVA. METHODS: Selected P. aeruginosa isolates (n = 60 were genotyped with PFGE, MLST and MLVA to determine the diversity index (DI and congruence (adjusted Rand and Wallace coefficients. Subsequently, isolates from patients admitted to two different ICUs (n = 205, from CF patients (n = 100 and from non-ICU, non-CF patients (n = 58, of which 19 were community acquired were genotyped with MLVA to determine distribution of genotypes and genetic diversity. RESULTS: Congruence between the typing methods was >79% and DIs were similar and all >0.963. Based on costs, ease, speed and possibilities to compare results between labs an adapted MLVA scheme called MLVA9-Utrecht was selected as the preferred typing method. In 363 clinical isolates 252 different MLVA types (MTs were identified, indicating a highly diverse population (DI  = 0.995; CI  = 0.993-0.997. DI levels were similarly high in the diverse clinical sources (all >0.981 and only eight genotypes were shared. MTs were highly specific (>80% for the different patient populations, even for similar patient groups (ICU patients in two distinct geographic regions, with only three of 142 ICU genotypes detected in both ICUs. The two major CF clones were unique to CF patients. CONCLUSION: The population structure of P. aeruginosa isolates is highly diverse and population specific without evidence for a core lineage in which major CF, hospital or community clones co-cluster. The two genotypes highly prevalent among Dutch CF patients appeared unique to CF patients

  15. Failure of highly active antiretroviral therapy in reconstituting immune response to Clostridium tetani vaccine in aged AIDS patients.

    Science.gov (United States)

    Andrade, Regis M; Andrade, Arnaldo F B; Lazaro, Marta A; Vieira, Morgana M M; Barros, Priscila O; Borner, Alice R S; Silva-Filho, Renato G; Santos, Juliana O; Brindeiro, Rodrigo M; Tanuri, Amilcar; Bento, Cleonice A M

    2010-05-01

    The purpose of this study was to evaluate the impact of age on tetanus-specific immune response in successfully highly active antiretroviral therapy-treated AIDS patients, using healthy age-matched individuals as controls. Whole Peripheral blood mononuclear cells or CD8(+) cell-depleted peripheral blood mononuclear cells from previously tetanus toxoid (TT)-immunized individuals were activated with TT plus IL-2, and cell proliferation, cytokine production, and in vitro HIV-1 replication were measured. The in vivo magnitude of the humoral immune response was also assessed by antibody measurements. Our results showed that, compared with other groups, both in vitro TT-specific lymphoproliferation and serum antibody concentration were lower in older AIDS patients. Although the IL-1beta and tumour necrosis factor alpha (TNF-alpha) production were higher in cultures from aged HIV-1-infected patients, a dramatic damage on the interferon gamma (IFN-gamma) release was observed, when compared with younger patients. CD8(+) T lymphocytes depletion reduced IL-1beta and TNF-alpha release in the older groups, however, it did not significantly alter their IFN-gamma production. Furthermore, the neutralization of endogenous IL-10 did not change the IFN-gamma deficiency in older AIDS patients. Finally, the lower cellular immune response in this patient group was not related to in vitro HIV-1 replication. The results suggest that successfully highly active antiretroviral therapy-treated aged AIDS patients do not reconstitute the immune response to TT, making them probably more susceptible to tetanus even after vaccination.

  16. The population genetics of Pseudomonas aeruginosa isolates from different patient populations exhibits high-level host specificity

    NARCIS (Netherlands)

    van Mansfeld, R.; Jongerden, I.P.; Bootsma, M.C.; Buiting, A.; Bonten, M.J.M.; Willems, R.J.L.

    2010-01-01

    Objective To determine whether highly prevalent P. aeruginosa sequence types (ST) in Dutch cystic fibrosis (CF) patients are specifically linked to CF patients we investigated the population structure of P. aeruginosa from different clinical backgrounds. We first selected the optimal genotyping meth

  17. [The use of growth hormone to treat endocrine-metabolic disturbances in acquired immunodeficiency syndrome (AIDS) patients].

    Science.gov (United States)

    Spinola-Castro, Angela Maria; Siviero-Miachon, Adriana A; da Silva, Marcos Tadeu Nolasco; Guerra-Junior, Gil

    2008-07-01

    Acquired Immunodeficiency Syndrome (Aids) was initially related to HIV-associated wasting syndrome, and its metabolic disturbances to altered body composition. After Highly Active Antiretroviral Therapy (HAART) was started, malnutrition has declined and HIV-associated lipodystrophy syndrome has emerged as an important metabolic disorder. Aids is also characterized by hormonal disturbances, principally in growth hormone/insulin-like growth factor 1 (GH/IGF-1) axis. The use of recombinant human GH (hrGH) was formerly indicated to treat wasting syndrome, in order to increase lean body mass. Even though the use of hrGH in lipodystrophy syndrome has been considered, the decrease in insulin sensitivity is a limitation for its use, which has not been officially approved yet. Diversity in therapeutic regimen is another limitation to its use in Aids patients. The present study has reviewed the main HIV-related endocrine-metabolic disorders as well as the use of hrGH in such conditions.

  18. [Transcultural adaptation of the HIV/AIDS-Target Quality of Life for HIV/AIDS for the evaluation of patients' quality of life].

    Science.gov (United States)

    Moser, Ana Maria Martins; Traebert, Jefferson

    2011-01-01

    The objectives of this study were to carry out cross-cultural adaptation of the HIV/AIDS-Target Quality of Life Instrument for Portuguese and to observe its psychometric properties. Translations, translations synthesis, back translation, analysis by a committee of specialists, pre-final version test, studies of validity and reliability of the final version were carried out. Psychometric properties were evaluated by the administration of the Brazilian version in 50 consecutive HIV positive patients, from the DST/HIV/AIDS municipal ambulatory of São Miguel do Oeste, Santa Catarina State. The internal consistency was observed by a-Cronbach. The reliability was estimated using the intraclass correlation coefficient and Bland-Altmann diagram. The validity was observed comparing the scores of the questionnaire with the WHOQOL-HIV-Brief through the Spearman rank correlation coefficient. The results pointed out to a-Cronbach of 0.893. The correlations obtained were 0.934 for inter-interviewer and 0.977 for intra-interviewer. The correlation with WHOQOL-HIV-Bref was 0.824. It was concluded that the cross-cultural adaptation process was successful and the adapted questionnaire demonstrated good psychometric properties.

  19. On AIDS Patients Self- discrimination and Elimination Strategies%艾滋病患者的自我歧视及消解策略

    Institute of Scientific and Technical Information of China (English)

    白莉

    2011-01-01

    AIDS Patients Self - discrimination performed as the self - prejudice, fear been exposed, self - acceptance and social relations. Self- discrimination of AIDS patients resulted from the specificity and AIDS itself, the social stigma and social exclusion for AIDS patients. To eliminate the self - discrimination of AIDS Patients, it should strengthen psychological intervention, avoid the stigma for AIDS patients, reduce social exclusion to AIDS patients and fully use the function of nation to eliminate the Self - discrimination for AIDS Patients.%艾滋病患者的自我歧视主要表现在自我偏见、担心公开、自我接受及社会关系等四个方面。艾滋病患者的自我歧视与艾滋病本身的特殊性、社会对艾滋病患者的污名化以及对艾滋病患者的社会排斥密切相关。消解艾滋病患者的自我歧视,必须加强对艾滋病患者的心理干预,消除社会对艾滋病患者的污名,减少对艾滋病患者的社会排斥,充分发挥国家在消解艾滋病患者自我歧视中的作用。

  20. Non Hodgkin's lymphoma with cutaneous involvement in AIDS patients: report of five cases and review of the literature

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    Marcelo Corti

    2010-02-01

    Full Text Available Cutaneous B cell lymphoma (CBCL is a lymphoproliferative disorder of neoplastic B cell of the skin with a wide range of clinical manifestations. Commonly, the clinical features of CBCL are plaques, nodules, or ulcerative lesions. Skin is one of the common sites for extra-nodal lymphomas in patients with AIDS and B cell type is less common than T cell type. Only recently, the existence of B cell lymphomas presenting clinically in the skin without evidence of extra-cutaneous involvement has been accepted as primary CBCL. Here, we are presenting 5 patients with cutaneous involvement in the setting of HIV/AIDS disease. Two of them were primary cutaneous non-Hodgkin lymphomas. All were CBCL; 3 were immunoblastic, 1 was plasmablastic, and the other was a Burkitt lymphoma. We analyzed the epidemiological, clinical, virological, and immunological characteristics of this group of patients.

  1. Implementing emergency manuals: can cognitive aids help translate best practices for patient care during acute events?

    Science.gov (United States)

    Goldhaber-Fiebert, Sara N; Howard, Steven K

    2013-11-01

    In this article, we address whether emergency manuals are an effective means of helping anesthesiologists and perioperative teams apply known best practices for critical events. We review the relevant history of such cognitive aids in health care, as well as examples from other high stakes industries, and describe why emergency manuals have a role in improving patient care during certain events. We propose 4 vital elements: create, familiarize, use, and integrate, necessary for the widespread, successful development, and implementation of medical emergency manuals, using the specific example of the perioperative setting. The details of each element are presented, drawing from the medical literature as well as from our combined experience of more than 30 years of observing teams of anesthesiologists managing simulated and real critical events. We emphasize the importance of training clinicians in the use of emergency manuals for education on content, format, and location. Finally, we discuss cultural readiness for change, present a system example of successful integration, and highlight the importance of further research on the implementation of emergency manuals.

  2. The cost of antiretroviral treatment service for patients with HIV/AIDS in a central outpatient clinic in Vietnam

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    Nguyen LT

    2014-02-01

    Full Text Available Long Thanh Nguyen,1 Bach Xuan Tran,2 Cuong Tuan Tran,1 Huong Thi Le,1 Son Van Tran1 1Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam; 2Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam Introduction: Antiretroviral treatment (ART services are estimated to account for 30% of the total resources needed for human immunodeficiency virus (HIV/acquired immunodeficiency syndrome (AIDS control and prevention in Vietnam during the 2011–2020 timeframe. With international funding decreasing, determining the total cost of HIV/AIDS treatment is necessary in order to develop a master plan for the transition of ART services delivery and management. We analyzed the costs of HIV/AIDS treatment paid by both HIV programs and patients in a central outpatient clinic, and we explored factors associated with the capacity of patients to pay for this service. Methods: Patients (n=315 receiving ART in the Department of Infectious Diseases at Bach Mai Hospital, Hanoi, Vietnam, were interviewed. Patient records and expenses were reviewed. Results: The total cost of ART per patient was US$611 (75% from health care providers, 25% from patients or their families. The cost of a second-line regimen was found to be 2.7 times higher than the first-line regimen cost. Most outpatients (73.3% were able to completely pay for all of their ART expenses. Capacity to pay for ART was influenced by five factors, including marital status, distance from house to clinic, patient's monthly income, household economic condition, and health insurance status. Most of the patients (84.8% would have been willing to pay for health insurance if a copayment scheme for ART were to be introduced. Conclusion: This study provides evidence on payment capacity of HIV/AIDS patients in Vietnam and supplies information on ART costs from both provider and patient perspectives. In particular, results from this study suggest that earlier access to ART

  3. Hypomagnesemia is a risk factor for nonrecovery of renal function and mortality in AIDS patients with acute kidney injury

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    M.S. Biagioni Santos

    2010-03-01

    Full Text Available The objective of the present study was to determine the prevalence of electrolyte disturbances in AIDS patients developing acute kidney injury in the hospital setting, as well as to determine whether such disturbances constitute a risk factor for nephrotoxic and ischemic injury. A prospective, observational cohort study was carried out. Hospitalized AIDS patients were evaluated for age; gender; coinfection with hepatitis; diabetes mellitus; hypertension; time since HIV seroconversion; CD4 count; HIV viral load; proteinuria; serum levels of creatinine, urea, sodium, potassium and magnesium; antiretroviral use; nephrotoxic drug use; sepsis; intensive care unit (ICU admission, and the need for dialysis. Each of these characteristics was correlated with the development of acute kidney injury, with recovery of renal function and with survival. Fifty-four patients developed acute kidney injury: 72% were males, 59% had been HIV-infected for >5 years, 72% had CD4 counts <200 cells/mm³, 87% developed electrolyte disturbances, 33% recovered renal function, and 56% survived. ICU admission, dialysis, sepsis and hypomagnesemia were all significantly associated with nonrecovery of renal function and with mortality. Nonrecovery of renal function was significantly associated with hypomagnesemia, as was mortality in the multivariate analysis. The risks for nonrecovery of renal function and for death were 6.94 and 6.92 times greater, respectively, for patients with hypomagnesemia. In hospitalized AIDS patients, hypomagnesemia is a risk factor for nonrecovery of renal function and for in-hospital mortality. To determine whether hypomagnesemia is a determinant or simply a marker of critical illness, further studies involving magnesium supplementation in AIDS patients are warranted.

  4. Mielitis aguda necrotizante en un paciente con Sida Acute necrotizing myelitis in an AIDS patient

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    M. Corti

    2003-04-01

    Full Text Available Como consecuencia de la infección por el virus de la inmunodeficiencia humana tipo-1 (HIV-1, otros patógenos como citomegalovirus (CMV y herpes simple tipo 1-2 (HSV 1-2 pueden comprometer tanto el sistema nervioso central como el periférico. Estos agentes pueden involucrar también a la médula espinal y causar una mielitis aguda necrotizante. Esta complicación ocurre por lo general en pacientes con enfermedad HIV/sida avanzada y marcada inmunodeficiencia, con recuentos de linfocitos T CD4+ de menos de 50 cél/µL. El cuadro clínico, los cambios en el LCR y las neuroimágenes generan una importante sospecha diagnóstica. Es fundamental el inicio precoz de la terapia antiviral específica. Se presenta un paciente con enfermedad avanzada debida al HIV-1 y mielitis aguda necrotizante por CMV y HSV bajo la forma clínica de síndrome de la cola de caballo.In the setting of HIV infection, cytomegalovirus (CMV and herpes simplex virus type 1-2 (HSV 1-2 can affect both the central and peripheral nervous systems. These agents can involve the spinal cord and produce a necrotizing transverse myelitis. This usually occurs in AIDS patients with severe immunodeficiency: CD4 + lymphocyte counts typically are less than 50 cell/µL. The clinical presentation, CSF and imaging studies can provide a high level of suspicion diagnosis. Prompt initiation of antiviral specific drugs is essential. We report a patient with an acute necrotizing myelitis (cauda equina syndrome secondary to CMV and HSV infections.

  5. Prevalence of Hypertension in HIV/AIDS Patients on Highly Active Antiretroviral Therapy (HAART Compared with HAART-Naive Patients at the Limbe Regional Hospital, Cameroon.

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    Christian Akem Dimala

    Full Text Available Highly active antiretroviral therapy (HAART has greatly reduced the morbidity and mortality of HIV/AIDS patients but has also been associated with increased metabolic complications and cardiovascular diseases. Data on the association between HAART and hypertension (HTN in Africa are scarce.Primarily to compare the prevalence of HTN in HIV/AIDS patients on HAART and HAART-naïve patients in Limbe, Cameroon; and secondarily to assess other socio-demographic and clinical factors associated with HTN in this population.A cross-sectional study was conducted at the Limbe Regional Hospital HIV treatment center between April and June 2013, involving 200 HIV/AIDS patients (100 on first-line HAART regimens for at least 12 months matched by age and sex to 100 HAART-naïve patients. HTN was defined as a systolic blood pressure (BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg.The prevalence of HTN in patients on HAART was twice (38%; 95% CI: 28.5-48.3 that of the HAART-naïve patients (19%; 95% CI, 11.8-28.1, p = 0.003. In multivariate analyses adjusted for age, gender, smoking, family history of HTN, and BMI-defined overweight, HAART was associated with HTN, the adjusted odds ratio of the HAART-treated versus HAART-naïve group was 2.20 (95% CI: 1.07-4.52, p = 0.032. HTN was associated with older age and male gender, in the HAART group and with BMI-defined overweight in the HAART-naïve group.The prevalence of hypertension in HIV/AIDS patients in Limbe stands out to be elevated, higher in patients on HAART compared to those not on treatment. Blood pressure and cardiovascular risk factors should be routinely monitored. Other factors such as diet, weight control and physical exercise should also be considered.

  6. Molecular diversity of serial Cryptococcus neoformans isolates from AIDS patients in the city of São Paulo, Brazil

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    Marilena A Martins

    2007-11-01

    Full Text Available Despite highly active anti-retroviral therapy, cryptococcal meningoencephalitis is the second most prevalent neurological disease in Brazilian AIDS patients, being frequently a defining condition with several episodes. As knowledge of Cryptococcus neoformans isolates in the same episode is critical for understanding why some patients develop several episodes, we investigated the genotype characteristics of C. neoformans isolates in two different situations. By pulsed field gel electrophoresis and random amplifield polymorphic DNA analysis, 54 isolates from 12 patients with AIDS and cryptococcosis were analyzed. Group 1 comprised 39 isolates from nine patients with a single episode and hospitalization. Group 2 comprised 15 isolates from three patients with two episodes and hospitalizations. Except for three patients from group 1 probably infected with a single C. neoformans isolate, the other nine patients probably were infected with multiple isolates selected in different collection periods, or the infecting isolate might have underwent mutation to adapt and survive the host immune system and/or the antifungal therapy. However, the three patients from group 2 presented genetic diversity among isolates collected in both hospitalizations, possibly having hosted the initial isolate in both periods. These data, emphasize that Cryptococcus diversity in infection can contribute to strategies of treatment and prevention of cryptococcosis.

  7. PTCH1 +/- dermal fibroblasts isolated from healthy skin of Gorlin syndrome patients exhibit features of carcinoma associated fibroblasts.

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    Alexandre Valin

    Full Text Available Gorlin's or nevoid basal cell carcinoma syndrome (NBCCS causes predisposition to basal cell carcinoma (BCC, the commonest cancer in adult human. Mutations in the tumor suppressor gene PTCH1 are responsible for this autosomal dominant syndrome. In NBCCS patients, as in the general population, ultraviolet exposure is a major risk factor for BCC development. However these patients also develop BCCs in sun-protected areas of the skin, suggesting the existence of other mechanisms for BCC predisposition in NBCCS patients. As increasing evidence supports the idea that the stroma influences carcinoma development, we hypothesized that NBCCS fibroblasts could facilitate BCC occurence of the patients. WT (n = 3 and NBCCS fibroblasts bearing either nonsense (n = 3 or missense (n = 3 PTCH1 mutations were cultured in dermal equivalents made of a collagen matrix and their transcriptomes were compared by whole genome microarray analyses. Strikingly, NBCCS fibroblasts over-expressed mRNAs encoding pro-tumoral factors such as Matrix Metalloproteinases 1 and 3 and tenascin C. They also over-expressed mRNA of pro-proliferative diffusible factors such as fibroblast growth factor 7 and the stromal cell-derived factor 1 alpha, known for its expression in carcinoma associated fibroblasts. These data indicate that the PTCH1(+/- genotype of healthy NBCCS fibroblasts results in phenotypic traits highly reminiscent of those of BCC associated fibroblasts, a clue to the yet mysterious proneness to non photo-exposed BCCs in NBCCS patients.

  8. Intramedullary abscess resulting from disseminated cryptococcosis despite immune restoration in a patient with AIDS.

    Science.gov (United States)

    Rambeloarisoa, J; Batisse, D; Thiebaut, J-B; Mikol, J; Mrejen, S; Karmochkine, M; Kazatchkine, M D; Weiss, L; Piketty, C

    2002-04-01

    We report on a case of cryptococcal intramedullary abscess, which occurred three years after a disseminated cryptococcosis and two years after a lymph node cryptococcal recurrence in a HIV-infected patient who exhibited a long-standing immune restoration. At the time of diagnosis, CD4(+) lymphocyte-count was 640x10(6)/l and HIV viral load was undetectable. Spinal involvement is rare during cryptococcosis of the central nervous system. As far as we are aware, there is only one case of proven intramedullary cryptococcal abscess reported in the literature and this case is then the second one. The significant and sustained increase in CD4 count following effective antiretroviral therapy was probably associated with only a partial immune restitution that did not allow to avoid the occurrence of the cryptococcal medullar abscess. Finally, this case raises the question of when to stop secondary prophylaxis of cryptococcal disease after increase in CD4 cell count under antiretroviral therapy.

  9. Results of the implantation of bone-anchored hearing aids in patients with treacher-collins syndrome

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    Alexandra Kolontai de Sousa Oliveira1

    2013-04-01

    Full Text Available Introduction: Treacher-Collins syndrome is characterized by craniofacial malformations, narrowing of the external auditory canal (EAC, and, in 30% of cases, agenesis of the canal and ossicular chain defects. The use of hearing aids (HA is not possible in cases in which agenesis or stenosis of the EAC accompanies conductive deafness. In contrast, bone conduction implants such as the Bone Anchored Hearing Aid (BAHA® allow direct stimulation of the cochlea and are thus superior to conventional hearing aids in cases of severe conductive hearing loss. Objective: To present 2 cases of patients with Treacher-Collins syndrome who underwent implantation of BAHA®. Cases Reports: The first patient was a 52-year-old woman diagnosed with Treacher-Collins syndrome who presented with severe bilateral mixed hearing loss and a history of unsuccessful previous use of a bone contact conduction device. The BAHA® implantation was uneventful, and the post-operative results were good. The second patient was a 14-year-old girl who was also diagnosed with Treacher-Collins Syndrome with bilateral moderate conductive hearing loss by audiometry. The use of a bone vibrator contact device did not improve her hearing; however, implantation of a BAHA® resulted in a decreased gap postoperatively. Final comments: BAHA® hearing devices provide adequate rehabilitation and consequent improvement of the quality of life in patients with Treacher-Collins syndrome.

  10. A Comparative Analysis of Intestinal Parasitic Infections between HIV+/AIDS Patients and Non-HIV Infected Individuals

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    EB Kia

    2007-04-01

    Full Text Available Background: The aim of this study was to verify the occurrence of intestinal parasitic infections in human immunodeficiency virus (HIV/acquired immunodeficiency syndrome (AIDS patients in Iran in comparison with non-HIV individuals. Methods: A total of HIV+/AIDS patients (Group I and 1220 clinically healthy individuals (Group II were submitted to coproparasitological examination from 2003 to 2005. Results: The overall prevalence of intestinal parasites in group I and group II was 11.4% and 11.6%, respectively, without significant difference between two groups. The prevalence of infection for each helminth and pathogenic protozoan, in every group, was as follows: Group I: Blastocystis hominis (6.1%; Giardia lamblia (4.2%; Cryptosporidium spp. (0.9%; Isospora belli (0.26%; Strongyloides stercoralis (0.26%; Hymenolepis nana (0.13%; and Rhabditis axei (0.13%. Group II: Blastocystis hominis (6.5%; Giardia lamblia (4.1%; Strongyloides stercoralis (0.33%; Hymenolepis nana (0.16%; and Trichostrongylus sp. (0.16%. Although the prevalence of infection for extracellular parasites was not statistically different between two groups, however, the infection rates for enteric coccidians including Cryptosporidium spp. and I. belli were significantly higher in patients at AIDS stage than Group II. Conclusion: The results emphasize the needs for especial consideration of enteropathogenic intracellular coccidians in immunocompromised patients.

  11. All stories are not alike: a purpose-, content-, and valence-based taxonomy of patient narratives in decision aids.

    Science.gov (United States)

    Shaffer, Victoria A; Zikmund-Fisher, Brian J

    2013-01-01

    The use of patient stories in decision aids is a highly controversial practice. However, the resulting debates and research have yielded little consensus about the impact of patient stories due to vague operational definitions of narratives. In this article, we argue that narratives are not homogeneous in either content or effect and hence should not be considered a single construct in research. The purpose of this article is to provide a taxonomy that guides both the development of decision aids and future research on this topic. We define three dimensions of narratives that are likely to moderate their impact on decision making: 1) the purpose of the narrative, 2) the content of the message, and 3) the evaluative valence, or overall tone, of the message. In addition, we describe predicted effects of different types of narratives on decision making and discuss their potential interactions. Our taxonomy provides a framework that will allow for the precise documentation of different narrative types, the use of appropriate outcome measures, and a systematic evaluation of narratives in all types of decision aids. Failures to recognize the complex structure of narratives will result both in research that does little to inform our understanding of the impact of patient stories and in the use of narratives in patient education materials that have unintended consequences on both decision processes and behavior.

  12. Frequent detection of ‘azole’ resistant Candida species among late presenting AIDS patients in northwest Ethiopia

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    Mulu Andargachew

    2013-02-01

    Full Text Available Abstract Background The chronic use of antifungal agents in the treatment of fungal infection in general and oropharyngeal candidiasis mainly in AIDS patient’s leads to the selection of strain resistant to these therapies and a shift in the spectrum of Candida species. This study determines the species diversity and in vitro susceptibility of Candida isolates from late presenting AIDS patients in northwest Ethiopia. Methods Two hundred and twenty one HIV/AIDS patients were assessed with a standardized evaluation form at enrolment. Oral rinses were cultured on CHROMagar plates at 37°C for 48 hours and Candida species identification were made following standard microbiological techniques. In vitro drug susceptibility tests were made using broth microdilution method. Results The colonization rate of Candida species was found to be 82.3% (177/215. C. albicans was the predominant species isolated from 139 (81% patients but there was a diversity of other species. C. glabrata was the most frequent non-albicans species isolated in 22.5% (40/177 of the patients followed by C. tropicalis 14.1% (27/177, C. krusei 5.6% (10 and other unidentifiable Candida species 4% (7/177. Recurrent episodes of oropharyngeal candidiasis and previous exposure to antifungal drugs were found to be predisposing factors for colonization by non-albicans species. Irrespective of the Candida species identified 12.2% (11/90, 7.7% (7/90 and 4.7% (4 of the isolates were resistant to fluconazole, ketoconazole and itraconazole, respectively. In contrast, resistance to micafungin, amphotericin B and 5-Fluorocytosine was infrequent. Conclusion HIV/AIDS patients are orally colonized by single or multiple albicans and non- albicans Candida species that are frequently resistant to azoles and occasionally to amphotericin B, 5-Fluorocytosine and micafungin. These highlight the need for national surveillance for examining Candida epidemiology and resistance to antifungal drugs.

  13. Musculoskeletal system pathology in aids patients; Patologia del sistema musculosqueletico en pacientes con sida

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    Zabala, R.; Oleaga, L.; Garcia Bolado, A.; Grande, D.; Gorrino, O.; Lecumberri, I. [Hospital de Basurto. Bilbao (Spain)

    2003-07-01

    We studied 22 AIDS patients who presented musculoskeletal system pathology. The affected area underwent simple X-ray and MR. The MR study was performed using a 1 Tesla magnet. T1 and T2 weighted echo spin sequences, as well as sequences of short T1 inversion recovery (STIR). In nine cases, intravenous gadolinium was used at a dose of 0.2cc/kg. The study plane was selected depending on the location of the lesion and surface coils were used when appropriate. In those patients showing pathology which was removed from the appendicular skeleton, the principal magnet was used as both transmitter and receiver. In one case, an On-Tine Tomography (CT) was also carried out. The evaluated ata were: a) localization; b) bony erosion; c) soft-tissue mass; d) articular effusion; e) cartilaginous changes; f) and T2 signals, and g) gadolinium enhancement. A diagnosis was made on the basis of biopsy or clinical culture, and evolution. Spinal cord alterations were the most frequent, being found in 13 cases. Twelve were caused by spondylodiscitis, 10 by tuberculosis, one by staphylococcal infection and one by candidiasis. In all cases, there appeared disk damage, as well as bone marrow signal alterations in the affected area and disks soft-tissue. In the mine cases in which gadolinium was used, the disk, vertebral plates and cases in which gadolinium was used, the disk, vertebral plates and soft-tissue mass heterogeneously enhanced, demonstrating an abscess with ring enhancement, and a central necrotic area in one case. In one patient, a spinal cord alteration due to non-Hodgkin's lymphoma was observed. In six cases,there was observed and infectious arthritis two in coxofemoral joints, three in knees and one in a glenohumeral joint. Isolated germs were staphylococcal in three cases one being Mycobacterium tuberculosis, another being M. kansasii and the third identified as. Candida. In all cases, there was observed joint effusion, synovial thickening, joint cartilage damage and

  14. Saccades to the seeing visual hemifield in hemidecorticate patients exhibit task-dependent reaction times and hypometria.

    Science.gov (United States)

    Herter, Troy M; Guitton, Daniel

    2007-09-01

    In three patients who had one cortical hemisphere removed surgically (hemidecortication), we studied visually-triggered saccades directed contralateral to the intact cortical hemisphere (i.e., ipsilesional saccades). Both saccade reaction times (SRTs) and accuracy of these saccades have been reported as abnormal in hemidecorticate patients, but not monkeys. One explanation for this difference is that deficits in hemidecorticate patients may not have been directly caused by removal of cortical oculomotor structures themselves, but may have been a manifestation of compensatory strategies used to cope with contralesional hemianopia. We hypothesized that deficits in saccade performance to the ipsilesional (seeing) visual hemifield would be directly linked to how easily patients could localize targets in their blind hemifield with searching saccades. To test this hypothesis, we examined how deficits in our patients varied when targets were: (1) randomly presented to either the seeing or blind hemifield for long durations thereby permitting searching saccades in the blind hemifield; (2) presented as in Experiment 1, but briefly flashed thereby removing visual feedback prior to saccade onset thereby rendering searching saccades useless; (3) briefly flashed as in Experiment 2, but at random locations in only the seeing hemifield (blind hemifield irrelevant). Mean SRTs to the seeing hemifield were 165 ms longer than normal in Experiment 2, but only about 40 ms longer in Experiments 1 and 3. Saccade accuracy was characterized by task-dependent hypometria in all three experiments with a mean undershoot of about twice the amplitude variance. The largest undershoots were in Experiments 2 and 3. Our data suggest that deficits resulted from the direct effects of the lesions themselves coupled with context-dependent strategies used to cope with contralesional hemianopia.

  15. 血友病甲合并艾滋病的治疗%Treatment of hemophilia A patients with AIDS

    Institute of Scientific and Technical Information of China (English)

    戴振声; 卢洪洲

    2012-01-01

    血友病甲患者输注凝血因子时易感染人免疫缺陷病毒(HIV),上述患者除接受针对血友病的治疗外,还需接受正规的高效抗反转录病毒治疗(HAART)等.本文综述血友病甲合并艾滋病的临床治疗.%People with hemophilia A may easily suffer from infection of human immunodeficiency virus (HIV) because of the clotting factors infusion frequently. So hemophilia A patients with AIDS should receive additional treatments of HAART . This review summarizes the treatment of hemophilia A patients with AIDS.

  16. Opportunistic infections in relation to antiretroviral status among AIDS patients from south India

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    S Srirangaraj

    2011-01-01

    Full Text Available Background: There is a need to generate data from India on relative frequencies of specific opportunistic infections (OIs in different regions and their relation to the choice of commonly used generic highly active anti-retroviral therapy (HAART regimens. Objectives: To document the prevailing prevalence pattern of OIs both before and after HAART, to look for reduction in OIs following HAART, to assess the risk of developing new OIs within 6 months of HAART initiation and to see if there is any difference in the risk of developing a new OI within 6 months of HAART initiation, for those on Efavirenz (EFV-based regimens and Nevirapine (NVP-based regimens. Materials and Methods: In a prospective observational cohort study conducted in South India involving 108 ART-naive AIDS patients, different pathogens were isolated and identified using standard laboratory techniques. Data analysis was done using SPSS software (version 16.0. Risk of developing an OI after HAART initiation was assessed using the likelihood ratio test from Cox regression models. Results: Tuberculosis (53.4%, oral Candidiasis (27.2% and Herpes Zoster (14.7% were the common infections seen. There was a drastic reduction of 96.59% in OI events after 6 months of HAART. The risk of developing an OI within 6 months of HAART initiation was 5.56%. Time to development of an OI in the first 6 months of HAART was shorter for the NVP-based regimens than with EFV-based regimens, but this difference was not statistically significant (HR=0.891, 95% CI: 0.179-4.429; P=0.888. Conclusion: Tuberculosis is the most important OI before initiation of HAART. Both EFV and NVP-based regimens are equally efficacious in controlling OIs.

  17. The anti-amoebic activity of some medicinal plants used by AIDS patients in southern Thailand.

    Science.gov (United States)

    Sawangjaroen, Nongyao; Phongpaichit, S; Subhadhirasakul, S; Visutthi, M; Srisuwan, N; Thammapalerd, N

    2006-05-01

    The anti-amoebic activities of chloroform, methanol and water extracts from 12 Thai medicinal plants (39 extracts) commonly used by AIDS patients in southern Thailand were screened, at a concentration of 1,000 microg/ml, against Entamoeba histolytica strain HTH-56:MUTM and strain HM1:IMSS growing in vitro. The extracts were incubated with 2x10(5) E. histolytica trophozoites/ml of medium at 37 degrees C under anaerobic conditions for 24 h. The cultures were examined with an inverted microscope and scored (1-4) according to the appearance and numbers of the trophozoites. The extracts that caused inhibition were selected and retested using the same conditions but with concentrations that ranged from 31.25 to 1,000 microg/ml using E. histolytica strain HM1:IMSS, and the IC(50) values for each extract were calculated. The chloroform extracts from Alpinia galanga (IC(50) 55.2 microg/ml), Barleria lupulina (IC(50) 78.5 microg/ml), Boesenbergia pandurata (IC(50) 45.8 microg/ml), Piper betle (IC(50) 91.1 microg/ml) and Piper chaba (IC(50) 71.4 microg/ml) and the methanol extract from B. pandurata (IC(50) 57.6 microg/ml) were all classified as "active", i.e. with an IC(50) of less than 100 microg/ml, whereas those from Murraya paniculata (IC(50) 116.5 microg/ml) and Zingiber zerumbet (IC(50) 196.9 microg/ml) were classified as being "moderately active". The IC(50) of a standard drug, metronidazole, was 1.1 microg/ml.

  18. Empathy and avoidance in treating patients living with HIV/AIDS (PLWHA) among service providers in China

    OpenAIRE

    Lin, Chunqing; Li, Li; WAN, Dai; Wu, Zunyou; Yan, Zhihua

    2012-01-01

    This study aims to investigate health care providers’ empathy levels and its association with avoidance in providing service to patients living with HIV/AIDS (PLWHA) in China. A total of 1760 health service providers were randomly sampled from 40 county hospitals in two provinces of China. Using a self-administered questionnaire, participants’ demographic characteristics, work history, empathy level, and avoidance attitudes toward PLWHA were collected in a cross-sectional survey. Empathy was ...

  19. ShikaniTM Seeing Optical Stylet-aided tracheal intubation in patients with a large epiglottic cyst

    Institute of Scientific and Technical Information of China (English)

    LIN Na; LI Mei; SHI Song; LI Tian-zuo; ZHANG Bing-xi

    2011-01-01

    Large epiglottic cysts can block the glottis,leading to serious consequences.This condition presents a challenge in terms of airway management for anesthesiologists during induction of anesthesia.We report the use of a ShikaniTM Seeing Optical Stylet combined with a Macintosh laryngoscope to aid tracheal intubation in seven patients with large epiglottic cysts.Use of this technique can avoid cyst rupture and allow smooth,safe intubation.

  20. Key findings: a qualitative assessment of provider and patient perceptions of HIV/AIDS in South Africa.

    Science.gov (United States)

    Ransom, James; Johnson, Anton F

    2009-01-01

    In 1997, at the Davos International Economic Forum, Nelson Mandela stated that "the poor, the vulnerable, the unschooled, the socially marginalized, the women, and the children, those who bear the burden of colonial legacy-these are the sectors of society which bear the burden of AIDS" (Richter, 2001). Nearly a decade later, that statement still holds true, especially in Mr. Mandela's home country. South Africa continues to have one of the world's highest prevalence ratios of HIV infection (UNAIDS, 2002). This paper explores the significance of perceptions, knowledge, practices, and attitudes toward HIV/AIDS in two important groups in South Africa: health care providers based in public health clinics and their patients. This paper will assess the provider-patient interaction from the perspective of members of the South African HIV/AIDS treatment and prevention community. The analysis will examine the results of in-depth interviews and focus group discussions with providers and patients, respectively, in two of South Africa's nine provinces. Between December 2002 and April 2003 in Guateng and KwaZulu-Natal provinces, we conducted (1) in-depth interviews of a spectrum of health care providers at five local public health clinics and (2) focus groups of patients who patronize those clinics. The results show that there are gaps in the HIV/AIDS knowledge of some of the health care providers and that the participants' health beliefs and practices are embedded in the social conditions in which they live and work, which has a ripple effect on their risk behaviors and trumps any intervention messages from their health care providers and larger public health intervention messages.

  1. Efficacy of aflibercept on exudative age-related macular degeneration in patients exhibiting complete ranibizumab resistance and tachyphylaxis

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    Gokcen Gokce

    Full Text Available ABSTRACT Purpose: The present study compared the efficacy of aflibercept for neovascular age-related macular degeneration (NV-AMD in patients with complete ranibizumab resistance and tachyphylaxis. Methods: Forty-four eyes of 38 neovascular age-related macular degeneration patients were evaluated. Eyes were divided into a complete resistance group (n=23 eyes and tachyphylaxis group (n=21 eyes. Results: After three injections, eight (38.1% patients in the tachyphylaxis group and nine (39.1% in the complete resistance group presented with macular dryness. After the first injection of aflibercept, the mean visual acuity improved significantly in the tachyphylaxis group (p=0.018 but remained unchanged in the complete resistance group (p=0.37. There was a non-significant trend towards improved mean visual acuity in both groups after the second and third injections relative to the acuity at the final visit for ranibizumab treatment. In the tachyphylaxis group, the presence of subfoveal pigmented epithelium detachment (PED decreased significantly after intravitreal aflibercept treatment. Conclusions: Although treatment with aflibercept yielded generally positive anatomical results in both groups, no significant increase in visual acuity was achieved.

  2. Development of a novel remote-controlled and self-contained audiovisual-aided interactive system for immobilizing claustrophobic patients.

    Science.gov (United States)

    Ju, Harang; Kim, Siyong; Read, Paul; Trifiletti, Daniel; Harrell, Andrew; Libby, Bruce; Kim, Taeho

    2015-05-08

    In radiotherapy, only a few immobilization systems, such as open-face mask and head mold with a bite plate, are available for claustrophobic patients with a certain degree of discomfort. The purpose of this study was to develop a remote-controlled and self-contained audiovisual (AV)-aided interactive system with the iPad mini with Retina display for intrafractional motion management in brain/H&N (head and neck) radiotherapy for claustrophobic patients. The self-contained, AV-aided interactive system utilized two tablet computers: one for AV-aided interactive guidance for the subject and the other for remote control by an operator. The tablet for audiovisual guidance traced the motion of a colored marker using the built-in front-facing camera, and the remote control tablet at the control room used infrastructure Wi-Fi networks for real-time communication with the other tablet. In the evaluation, a programmed QUASAR motion phantom was used to test the temporal and positional accuracy and resolution. Position data were also obtained from ten healthy volunteers with and without guidance to evaluate the reduction of intrafractional head motion in simulations of a claustrophobic brain or H&N case. In the phantom study, the temporal and positional resolution was 24 Hz and 0.2 mm. In the volunteer study, the average superior-inferior and right-left displacement was reduced from 1.9 mm to 0.3 mm and from 2.2 mm to 0.2 mm with AV-aided interactive guidance, respectively. The superior-inferior and right-left positional drift was reduced from 0.5 mm/min to 0.1 mm/min and from 0.4 mm/min to 0.04 mm/min with audiovisual-aided interactive guidance. This study demonstrated a reduction in intrafractional head motion using a remote-controlled and self-contained AV-aided interactive system of iPad minis with Retina display, easily obtainable and cost-effective tablet computers. This approach can potentially streamline clinical flow for claustrophobic patients without a head mask and

  3. Two patients with TAFRO syndrome exhibiting strikingly similar anterior mediastinal lesions with predominantly fat attenuation on chest computed tomography.

    Science.gov (United States)

    Ozawa, Yoko; Yamamoto, Hiroshi; Yasuo, Masanori; Takahashi, Hidekazu; Tateishi, Kazunari; Ushiki, Atsuhito; Kawakami, Satoshi; Fujinaga, Yasunari; Asaka, Shiho; Sano, Kenji; Takayama, Hiroshi; Imamura, Hiroshi; Hanaoka, Masayuki

    2017-03-01

    We herein report on two middle-aged men with TAFRO (thrombocytopenia, anasarca, fever, reticulin fibrosis or renal failure, and organomegaly) syndrome, a unique clinicopathological variant of multicentric Castleman׳s disease recently proposed in Japan. Strikingly similar anterior mediastinal fat swellings with soft tissue density were observed in the patients on chest computed tomography. In TAFRO syndrome, bilateral pleural effusion and slight lymph node swelling are common in the thoracic region; however, anterior mediastinal lesions have not been previously observed. Although the mechanisms of anterior mediastinal lesions have not been defined, these lesions seem to have a close relationship with TAFRO syndrome.

  4. Complexity analysis of EMG signals for patients after stroke during robot-aided rehabilitation training using fuzzy approximate entropy.

    Science.gov (United States)

    Sun, Rui; Song, Rong; Tong, Kai-yu

    2014-09-01

    The paper presents a novel viewpoint to monitor the motor function improvement during a robot-aided rehabilitation training. Eight chronic poststroke subjects were recruited to attend the 20-session training, and in each session, subjects were asked to perform voluntary movements of elbow flexion and extension together with the robotic system. The robotic system was continuously controlled by the electromyographic (EMG) signal from the affected triceps. Fuzzy approximate entropy (fApEn) was applied to investigate the complexity of the EMG segment, and maximum voluntary contraction (MVC) during elbow flexion and extension was applied to reflect force generating capacity of the affected muscles. The results showed that the group mean fApEn of EMG signals from triceps and biceps increased significantly after the robot-aided rehabilitation training . There was also significant increase in maximum voluntary flexion and extension torques after the robot-aided rehabilitation training . There was significant correlation between fApEn of agonist and MVC , which implied that the increase of motorneuron number is one of factors that may explain the increase in muscle strength. These findings based on fApEn of the EMG signals expand the existing interpretation of training-induced function improvement in patients after stroke, and help us to understand the neurological change induced by the robot-aided rehabilitation training.

  5. GM-CSF Exhibits Anti-Inflammatory Activity on Endothelial Cells Derived from Chronic Venous Disease Patients

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    Veronica Tisato

    2013-01-01

    Full Text Available Twenty patients affected by chronic venous disease (CVD in tertiary venous network and/or saphenous vein were analyzed before surgical ablation by echo-color-doppler for the hemodynamic parameters reflux time (RT and resistance index (RI, a negative and a positive prognostic factor, respectively. RT and RI were next correlated with relevant in vitro parameters of venous endothelial cells (VEC obtained from surgical specimens, such as cell migration in response to serum gradient, proliferation index, intercellular adhesion molecule (ICAM-1 and vascular cell adhesion molecule (VCAM-1 expression, as well as cytokines release. Of interest, ICAM-1 expression in patient-derived VEC cultures correlated positively with RT and negatively with RI. Moreover, RT showed a positive correlation with the baseline osteoprotegerin (OPG expression by VEC and an inverse correlation with VEC proliferation index. On the other hand, RI correlated positively with TNF-related apoptosis inducing ligand (TRAIL expression. Among the cytokines released by VEC, GM-CSF showed a positive correlation with VEC proliferation and TRAIL expression and a negative correlation with OPG, ICAM-1 and VCAM-1 expression. Since in vitro recombinant GM-CSF induced VEC proliferation and counteracted the induction of ICAM-1, VCAM-1 and OPG upon exposure to TNF-α, our data suggest an anti-inflammatory activity of GM-CSF on venous endothelial cells.

  6. RAPID COMMUNICATION: Wavelet transform-based prediction of the likelihood of successful defibrillation for patients exhibiting ventricular fibrillation

    Science.gov (United States)

    Watson, J. N.; Addison, P. S.; Clegg, G. R.; Steen, P. A.; Robertson, C. E.

    2005-10-01

    We report on an improved method for the prediction of the outcome from electric shock therapy for patients in ventricular fibrillation: the primary arrhythmia associated with sudden cardiac death. Our wavelet transform-based marker, COP (cardioversion outcome prediction), is compared to three other well-documented shock outcome predictors: median frequency (MF) of fibrillation, spectral energy (SE) and AMSA (amplitude spectrum analysis). Optimum specificities for sensitivities around 95% for the four reported methods are 63 ± 4% at 97 ± 2% (COP), 42 ± 15% at 90 ± 7% (MF), 12 ± 3% at 94 ± 5% (SE) and 56 ± 5% at 94 ± 5% (AMSA), with successful defibrillation defined as the rapid (30 s) spontaneous circulation. This marked increase in performance by COP at specificity values around 95%, required for implementation of the technique in practice, is achieved by its enhanced ability to partition pertinent information in the time-frequency plane. COP therefore provides an optimal index for the identification of patients for whom shocking would be futile and for whom an alternative therapy should be considered.

  7. Cultured myoblasts from patients affected by myotonic dystrophy type 2 exhibit senescence-related features: ultrastructural evidence

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    M. Malatesta

    2011-09-01

    Full Text Available Myotonic dystrophy type 2 (DM2 is an autosomal dominant disorder caused by the expansion of the tetranucleotidic repeat (CCTGn in the first intron of the Zinc Finger Protein-9 gene. In DM2 tissues, the expanded mutant transcripts accumulate in nuclear focal aggregates where splicing factors are sequestered, thus impairing the whole mRNA processing. Interestingly, the ultrastructural alterations in the splicing machinery observed in the myonuclei of DM2 skeletal muscles are reminiscent of the nuclear changes occurring in age-related muscle atrophy. Here, we investigated structural and functional features of satellite cell-derived myoblasts from biceps brachii, in the attempt to investigate cell senescence indices in DM2 patients by ultrastructural cytochemistry. We observed that in satellite cell-derived DM2 myoblasts, cell-senescence alterations and impairment of the pre-mRNA maturation pathways occur earlier than in myoblasts from healthy patients. This suggests that also in vivo the regeneration capability of satellite cells could be reduced in dystrophic muscles.

  8. Clinical outcomes and immune reconstitution in 103 advanced AIDS patients undergoing 12-month highly active antiretroviral therapy

    Institute of Scientific and Technical Information of China (English)

    DAI Yi; QIU Zhi-feng; LI Tai-sheng; HAN Yang; ZUO Ling-yan; XIE Jing; MA Xiao-jun; LIU Zheng-yin; WANG Ai-xia

    2006-01-01

    Background Highly active antiretroviral therapy (HAART) roduces profound suppression of HIV replication, substantial increase in CD4+ T cells, and partial reconstitution of the immune system. However, the numbers of subjects were small in previous Chinese studies. This study evaluated the efficacy and side effects of HAART in Chinese advanced AIDS patients.Methods One hundred and three antiretroviral drug naive AIDS patients were enrolled in this study and were divided into two groups by their baseline CD4+ count: <100 cells/ μl or ≥ 100 cells/μl. Clinical, virological and immunological outcomes were monitored at baseline and at 1, 3, 6, 9 and 12 months during the course of treatment with HAART.Results One patient died and another was lost from the follow-up. For the remaining 101 HIV/AIDS patients at the 12th month during the HAART, the plasma viral load (VL) was reduced to (3.2±0.7) lg copies/ml, the CD4+ count increased to (168±51) cells/μl [among which the naive phenotype (CD45RA+CD62L+) increased to (49±27) cells/μl and the memory phenotype (CD45RA ̄) increased to (119±55) cells/μl], and the percentage of CD4+CD28+ cells increased. At the same time, there was a significant reduction of CD8+ T cell activation. In the 69 patients with the baseline CD4+ count <100 cells/μl, 37 had a VL <50 copies/ml; while in the 34 patients with the baseline CD4+ count ≥ 100 cells/μl, 25 had a VL <50 copies/ml, the difference between the two groups was statistically significant. The CD4+ T cell count showed a two-phase increase during HAART and a significant positive correlation was shown between the change of CD4+ count and plasma VL. Over 12 months of HAART,10 patients had gastrointestinal side effects, 13 peripheral neuritis, 7 hepatic lesions, 8 hematological side effects,8 skin rashes, 10 lipodystrophy and 1 renal calculus.Conclusions Immune reconstitution as well as the significantly improved clinical outcomes is observed in Chinese advanced AIDS

  9. Purified protein derivative skin testing on HIV/AIDS patients and logistic regression analysis of its risk factors

    Institute of Scientific and Technical Information of China (English)

    Fengren Liu; Jianjun Ye; Changfu Xiong; Jiguo Yin; Weihua He; Gaobo Li; Dingyuan Zhao; Linxiang Ye

    2007-01-01

    Objective: To understand the reactivity of purified protein derivative skin test(PPD test) in HIV-infected persons and to determine the influential factors associated with PPD. Methods: 174 HIV/AIDS patients registered in the local center for disease control and prevention(CDC) participated this study from April to June in 2006. Questionnaire, CD4 count and thoracic roentgenogram were performed for all participants. Results: In this study, response rate of questionnaires was 83.65%. The majority of these participants had a different degree of immunodeficiency that accounted for 93.64%. Female patients had a higher CD4 count than that of males. The total positive rate of PPD was 38.15%. Analysis of single factor in our study indicated that CD4 count, previous tuberculosis history, tuberculosis contact history and thoracic roentgenogram manifestation of patients were related to their PPD diameters. Further analysis of multiple factors also supports the previous conclusion that CD4 count and previous tuberculosis history of patients were risk factors in the PPD test. Conclusion: The PPD test of HIV/AIDS patients could be affected by several factors. For persons infected with HIV, the confirmation of latent tuberculosis infection (LTBI) should be considered the combination effect of previous MTB infection and body cellular immune function.

  10. Patient-Centered Robot-Aided Passive Neurorehabilitation Exercise Based on Safety-Motion Decision-Making Mechanism

    Science.gov (United States)

    Duan, Suolin; Yu, Zhuqing

    2017-01-01

    Safety is one of the crucial issues for robot-aided neurorehabilitation exercise. When it comes to the passive rehabilitation training for stroke patients, the existing control strategies are usually just based on position control to carry out the training, and the patient is out of the controller. However, to some extent, the patient should be taken as a “cooperator” of the training activity, and the movement speed and range of the training movement should be dynamically regulated according to the internal or external state of the subject, just as what the therapist does in clinical therapy. This research presents a novel motion control strategy for patient-centered robot-aided passive neurorehabilitation exercise from the point of the safety. The safety-motion decision-making mechanism is developed to online observe and assess the physical state of training impaired-limb and motion performances and regulate the training parameters (motion speed and training rage), ensuring the safety of the supplied rehabilitation exercise. Meanwhile, position-based impedance control is employed to realize the trajectory tracking motion with interactive compliance. Functional experiments and clinical experiments are investigated with a healthy adult and four recruited stroke patients, respectively. The two types of experimental results demonstrate that the suggested control strategy not only serves with safety-motion training but also presents rehabilitation efficacy. PMID:28194413

  11. Patient-Centered Robot-Aided Passive Neurorehabilitation Exercise Based on Safety-Motion Decision-Making Mechanism

    Directory of Open Access Journals (Sweden)

    Lizheng Pan

    2017-01-01

    Full Text Available Safety is one of the crucial issues for robot-aided neurorehabilitation exercise. When it comes to the passive rehabilitation training for stroke patients, the existing control strategies are usually just based on position control to carry out the training, and the patient is out of the controller. However, to some extent, the patient should be taken as a “cooperator” of the training activity, and the movement speed and range of the training movement should be dynamically regulated according to the internal or external state of the subject, just as what the therapist does in clinical therapy. This research presents a novel motion control strategy for patient-centered robot-aided passive neurorehabilitation exercise from the point of the safety. The safety-motion decision-making mechanism is developed to online observe and assess the physical state of training impaired-limb and motion performances and regulate the training parameters (motion speed and training rage, ensuring the safety of the supplied rehabilitation exercise. Meanwhile, position-based impedance control is employed to realize the trajectory tracking motion with interactive compliance. Functional experiments and clinical experiments are investigated with a healthy adult and four recruited stroke patients, respectively. The two types of experimental results demonstrate that the suggested control strategy not only serves with safety-motion training but also presents rehabilitation efficacy.

  12. The Knowledge, Attitude and Behavior of HIV/AIDS Patients’ Family toward Their Patients before and after Counseling

    Directory of Open Access Journals (Sweden)

    Behnam Honarvar

    2010-12-01

    Full Text Available Background: Acquired immunodeficiency may impose considerableconsequences on patients’ family behaviors towardthem. The objective of the present study was to investigatewhether a counseling program at Behavioral Counseling Centerin the city of Shiraz, Iran could change the attitude, knowledgeand behavior of patients' family members.Methods: 125 HIV/AIDS patients’ family members were interviewed,using a valid and reliable questionnaire before andafter performing counseling sessions at Behavioral CounselingCenter. The findings were analyzed using nonparametric tests.Results: The age of the participants was 40±13 years. Sixty fivepercent were female, 63% married and 79% educated. Forty fourpercent of participants had spousal relationships with their patients.Their knowledge about the main routes of HIV transmissionwere 9.76 ± 2.59 and10.64±0.88 before and after counseling,respectively (P=0.028. Supportive behaviors of families towardtheir patients reached to 79% after counseling compared with 44% before that (P=0.004. Belief to isolate the patients and thepractice of this approach at home dropped from 71% to 15% andfrom 29% to 7% after counseling, respectively (P0.05.Conclusion: Ongoing counseling for HIV/AIDS patients’ familiesat Behavioral Counseling Center of Shiraz did advance theirknowledge about AIDS and improved their attitude and behaviortoward their patients However, the counseling program didnot show remarkable success in some aspects such as the removalof fear about HIV spread in the family or the change ofthe patients’ wives attitude to have protected sex with their HIVinfected husbands.Iran J Med Sci 2010; 35(4: 287-292.

  13. Radiographic imaging of aids

    CERN Document Server

    Mahmoud, M B

    2002-01-01

    The acquired immunodeficiency syndrome (AIDS) has impacted the civilized world like no other disease. This research aimed to discuss some of the main aids-related complications and their detection by radiology tests, specifically central nervous system and musculoskeletal system disorders. The objectives are: to show specific characteristics of various diseases of HIV patient, to analyze the effect of pathology in patients by radiology, to enhance the knowledge of technologists in aids imaging and to improve communication skills between patient and radiology technologists.

  14. Opportunistic and other intestinal parasites among HIV/AIDS patients attending Gambi higher clinic in Bahir Dar city, North West Ethiopia

    Institute of Scientific and Technical Information of China (English)

    Abebe Alemu; Yitayal Shiferaw; Gebeyaw Getnet; Aregaw Yalew; Zelalem Addis

    2011-01-01

    Objective:To determine the magnitude of opportunistic and non-opportunistic intestinal parasitic infections amongHIV/AIDS patients in Bahir Dar.Methods: Cross-sectional study was conducted amongHIV/ AIDS patients attending Gambi higher clinic from April1- May30, 2009. Convenient sampling technique was employed to identify the study subjects and hence a total of248subjects were included. A pre-tested structured questionnaire was used to collect socio-demographic data of patients. Stool samples were examined by direct saline, iodine wet mount, formol-ether sedimentation concentration and modified Ziehl-Neelsen staining technique. Results: Out of248 enrolled in the study,171(69.0%) (90 males and81 females) were infected with one or more intestinal parasites. The highest rate of intestinal parasites were observed amongHIV/AIDS patients (80.3%, 151/188), and the infection rate of HIV negative individuals was 33.3% (20/60). Cryptosporidum parvum(43.6%),Isospora belli (15.5%) andBlastocystis hominis (10.5%)were opportunistic parasites that were found only inHIV/AIDS patients.Conclusions:Opportunistic parasite infections are common health problem among HIV/ AIDS patients in the study area. Therefore, early detection and treatment of these parasites are important to improve the quality of life ofHIV/AIDS patients.

  15. TU-PIS-Exhibit Hall-3: Simultaneous tracking of patient and real time staff dose to optimize interventional workflow

    Energy Technology Data Exchange (ETDEWEB)

    Boon, S.

    2015-06-15

    The current clinical standard of organ respiratory imaging, 4D-CT, is fundamentally limited by poor soft-tissue contrast and imaging dose. These limitations are potential barriers to beneficial “4D” radiotherapy methods which optimize the target and OAR dose-volume considering breathing motion but rely on a robust motion characterization. Conversely, MRI imparts no known radiation risk and has excellent soft-tissue contrast. MRI-based motion management is therefore highly desirable and holds great promise to improve radiotherapy of moving cancers, particularly in the abdomen. Over the past decade, MRI techniques have improved significantly, making MR-based motion management clinically feasible. For example, cine MRI has high temporal resolution up to 10 f/s and has been used to track and/or characterize tumor motion, study correlation between external and internal motions. New MR technologies, such as 4D-MRI and MRI hybrid treatment machines (i.e. MR-linac or MR-Co60), have been recently developed. These technologies can lead to more accurate target volume determination and more precise radiation dose delivery via direct tumor gating or tracking. Despite all these promises, great challenges exist and the achievable clinical benefit of MRI-based tumor motion management has yet to be fully explored, much less realized. In this proposal, we will review novel MR-based motion management methods and technologies, the state-of-the-art concerning MRI development and clinical application and the barriers to more widespread adoption. Learning Objectives: Discuss the need of MR-based motion management for improving patient care in radiotherapy. Understand MR techniques for motion imaging and tumor motion characterization. Understand the current state of the art and future steps for clinical integration. Henry Ford Health System holds research agreements with Philips Healthcare. Research sponsored in part by a Henry Ford Health System Internal Mentored Grant.

  16. TU-PIS-Exhibit Hall-1: Tools for Collecting and Analyzing Patient Dose Index Information from Imaging Equipment

    Energy Technology Data Exchange (ETDEWEB)

    Wang, J. [Rush University Medical Center, Chicago, IL (United States); Stanford University: Introduction (United States)

    2015-06-15

    The current clinical standard of organ respiratory imaging, 4D-CT, is fundamentally limited by poor soft-tissue contrast and imaging dose. These limitations are potential barriers to beneficial “4D” radiotherapy methods which optimize the target and OAR dose-volume considering breathing motion but rely on a robust motion characterization. Conversely, MRI imparts no known radiation risk and has excellent soft-tissue contrast. MRI-based motion management is therefore highly desirable and holds great promise to improve radiotherapy of moving cancers, particularly in the abdomen. Over the past decade, MRI techniques have improved significantly, making MR-based motion management clinically feasible. For example, cine MRI has high temporal resolution up to 10 f/s and has been used to track and/or characterize tumor motion, study correlation between external and internal motions. New MR technologies, such as 4D-MRI and MRI hybrid treatment machines (i.e. MR-linac or MR-Co60), have been recently developed. These technologies can lead to more accurate target volume determination and more precise radiation dose delivery via direct tumor gating or tracking. Despite all these promises, great challenges exist and the achievable clinical benefit of MRI-based tumor motion management has yet to be fully explored, much less realized. In this proposal, we will review novel MR-based motion management methods and technologies, the state-of-the-art concerning MRI development and clinical application and the barriers to more widespread adoption. Learning Objectives: Discuss the need of MR-based motion management for improving patient care in radiotherapy. Understand MR techniques for motion imaging and tumor motion characterization. Understand the current state of the art and future steps for clinical integration. Henry Ford Health System holds research agreements with Philips Healthcare. Research sponsored in part by a Henry Ford Health System Internal Mentored Grant.

  17. Human herpes virus-8 DNA in bronchoalveolar lavage samples from patients with AIDS-associated pulmonary Kaposi's sarcoma

    DEFF Research Database (Denmark)

    Benfield, T L; Dodt, K K; Lundgren, Jens Dilling

    1997-01-01

    Kaposi's sarcoma (KS) is the most frequent AIDS-associated neoplasm, and often disseminates to visceral organs, including the lungs. An ante-mortem diagnosis of pulmonary KS is difficult. Recently, DNA sequences resembling a new human herpes virus (HHV-8), have been identified in various forms...... of KS. We hypothesized that these sequences are present in samples obtained by bronchoalveolar lavage (BAL) in patients with pulmonary KS. Utilizing a nested polymerase chain reaction (PCR), 7/12 BAL cell samples from HIV-infected patients with endobronchial KS were positive for HHV-8 DNA. In contrast......, only 2/39 samples from HIV-infected patients without evidence of KS were positive (p = 0.007). Detection of HHV-8 in BAL cells of patients with pulmonary KS was highly specific (95%), with a sensitivity of 58% and a positive predictive value of 78%. In conclusion, HHV-8 is associated with pulmonary KS...

  18. Cryptosporidiosis of the biliary tract mimicking pancreatic cancer in an AIDS patient Criptosporidiose do trato biliar simulando câncer do pâncreas em paciente com AIDS

    Directory of Open Access Journals (Sweden)

    Lenice do Rosário de Souza

    2004-03-01

    Full Text Available Diarrhea caused by Cryptosporidium sp is frequent in patients with AIDS, but involvement of other organs of the digestive tract is uncommon. We report a case of Cryptosporidium-associated obstruction of the biliary tract mimicking cancer of the head of the pancreas in a 43-year-old woman with AIDS.A diarréia causada pelo Cryptosporidium sp é muito freqüente em pacientes com AIDS, mas o envolvimento de outros órgãos do aparelho digestivo é incomum. Relata-se o caso de uma mulher de 43 anos, que tinha AIDS, que apresentava obstrução das vias biliares associada ao Cryptosporidium, simulando câncer da cabeça do pâncreas.

  19. A prospective study of seroprevalence of Toxoplasmosis in general population, and in HIV/AIDS patients in Bombay, India.

    Directory of Open Access Journals (Sweden)

    Meisheri Y

    1997-10-01

    Full Text Available Two hundred and seventy nine sera (age group 13-50 years were tested for antitoxoplasma IgG/IgM antibodies by ELISA techniques; the diagnostic titer for positive test is 10 iu/ml or > 1:100. Sera were obtained from (i 165 (100 men/65 women healthy adult voluntary blood donors (HIV, HBsAg, VDRL negative; (ii 89 consecutive HIV/AIDS patients (82 men/7 women; and (iii 25 patients (HIV negative: 12 men/13 women treated for cerebral Tuberculoma or Neurocysticercosis during this study from January 1996-June 1997. The overall seroprevalence was 30.9% (51/165 in the immunocompetent adult (group i 34% (34/100 men and 26.2% (17/65 in women [range: 10-899 iu/ml; (mean: 376.8]. In HIV infected hosts the seroprevalence [range: 21-340 iu/ml; (mean; 180] was 67.8% (56/82 men, 04/07 women. The seroprevalence was 20.5% (8/39, 32.8% (22/67, 34.8% (16/46 and 38.4% (5/13 in the 2nd, 3rd, 4th and 5th decades respectively in healthy adults. In HIV/AIDS patients, 69% (29/42 in the 3rd and 70.6% (24/34 in 4th decade were seropositive. The risk of cerebral Toxoplasmosis (encephalitis-02, granuloma-24 was 43.3% (26/60, mean 250 iu/ml. The seroprevalence was 28% in group iii (range 12-80 iu/ml, mean 21 iu/ml. Anti-toxo IgM was negative in all. Primary Toxoplasma infection appears to be subclinical and prevalent throughout life. T. gondii has emerged as an important opportunistic infection in HIV/AIDS patients in Bombay. Recrudescence of cerebral toxoplasmosis (CTOX is observed with low IgG response during mid-late stage of the disease, as seen in our patients (mean IgG 250 iu/ml, CD4+ = 283/cmm (range 43-504 in 5 patients. Primary prophylaxis for CTOX seems rationale and can be targeted to asymptomatic HIV/AIDS population at risk who are seropositive for T. gondii (mean IgG 111.5 iu/ml in our study. The very high predictive value of a negative test for TOX remains the best serological parameter for excluding acute episode of TOX.

  20. Electroencephalographic markers of robot-aided therapy in stroke patients for the evaluation of upper limb rehabilitation.

    Science.gov (United States)

    Sale, Patrizio; Infarinato, Francesco; Del Percio, Claudio; Lizio, Roberta; Babiloni, Claudio; Foti, Calogero; Franceschini, Marco

    2015-12-01

    Stroke is the leading cause of permanent disability in developed countries; its effects may include sensory, motor, and cognitive impairment as well as a reduced ability to perform self-care and participate in social and community activities. A number of studies have shown that the use of robotic systems in upper limb motor rehabilitation programs provides safe and intensive treatment to patients with motor impairments because of a neurological injury. Furthermore, robot-aided therapy was shown to be well accepted and tolerated by all patients; however, it is not known whether a specific robot-aided rehabilitation can induce beneficial cortical plasticity in stroke patients. Here, we present a procedure to study neural underpinning of robot-aided upper limb rehabilitation in stroke patients. Neurophysiological recordings use the following: (a) 10-20 system electroencephalographic (EEG) electrode montage; (b) bipolar vertical and horizontal electrooculographies; and (c) bipolar electromyography from the operating upper limb. Behavior monitoring includes the following: (a) clinical data and (b) kinematic and dynamic of the operant upper limb movements. Experimental conditions include the following: (a) resting state eyes closed and eyes open, and (b) robotic rehabilitation task (maximum 80 s each block to reach 4-min EEG data; interblock pause of 1 min). The data collection is performed before and after a program of 30 daily rehabilitation sessions. EEG markers include the following: (a) EEG power density in the eyes-closed condition; (b) reactivity of EEG power density to eyes opening; and (c) reactivity of EEG power density to robotic rehabilitation task. The above procedure was tested on a subacute patient (29 poststroke days) and on a chronic patient (21 poststroke months). After the rehabilitation program, we observed (a) improved clinical condition; (b) improved performance during the robotic task; (c) reduced delta rhythms (1-4 Hz) and increased alpha

  1. Causes of Death among AIDS Patients after Introduction of Free Combination Antiretroviral Therapy (cART in Three Chinese Provinces, 2010-2011.

    Directory of Open Access Journals (Sweden)

    Liyan Wang

    Full Text Available Although AIDS-related deaths have had significant economic and social impact following an increased disease burden internationally, few studies have evaluated the cause of AIDS-related deaths among patients with AIDS on combination anti-retroviral therapy (cART in China. This study examines the causes of death among AIDS-patients in China and uses a methodology to increase data accuracy compared to the previous studies on AIDS-related mortality in China, that have taken the reported cause of death in the National HIV Registry at face-value.Death certificates/medical records were examined and a cross-sectional survey was conducted in three provinces to verify the causes of death among AIDS patients who died between January 1, 2010 and June 30, 2011. Chi-square analysis was conducted to examine the categorical variables by causes of death and by ART status. Univariate and multivariate logistic regression were used to evaluate factors associated with AIDS-related death versus non-AIDS related death.This study used a sample of 1,109 subjects. The average age at death was 44.5 years. AIDS-related deaths were significantly higher than non-AIDS and injury-related deaths. In the sample, 41.9% (465/1109 were deceased within a year of HIV diagnosis and 52.7% (584/1109 of the deceased AIDS patients were not on cART. For AIDS-related deaths (n = 798, statistically significant factors included CD4 count <200 cells/mm3 at the time of cART initiation (AOR 1.94, 95%CI 1.24-3.05, ART naïve (AOR 1.69, 95%CI 1.09-2.61; p = 0.019 and age <39 years (AOR 2.96, 95%CI 1.77-4.96.For the AIDS patients that were deceased, only those who initiated cART while at a CD4 count ≥200 cells/mm3 were less likely to die from AIDS-related causes compared to those who didn't initiate ART at all.

  2. Communicating with Patients Who Have Advanced Dementia: Training Nurse Aide Students

    Science.gov (United States)

    Beer, Laura E.; Hutchinson, Susan R.; Skala-Cordes, Kristine K.

    2012-01-01

    The increase of dementia in older adults is changing how medical care is delivered. Recognizing symptoms of pain, managing behaviors, and providing quality of life for people who have advanced dementia requires a new skill set for caregivers. Researchers in this study targeted nurse aide students to test an educational module's effect on students'…

  3. A Patient Monitoring Tool For An HIV/AIDS Integral Care Model

    Science.gov (United States)

    2007-11-02

    AIDS INTEGRAL CARE MODEL C. Cáceres, E.J. Gómez, F. Del Pozo Grupo de Bioingeniería y Telemedicina , Universidad Politécnica de Madrid, Madrid...Performing Organization Name(s) and Address(es) Grupo de Bioingenieria y Telemedicina Universidad Politecnica de Madrid Madrid, Spain Performing

  4. Psychiatric disorders as first symptom in AIDS patients. A three-case report.

    Science.gov (United States)

    Carrieri, P B; Indaco, A; Perrella, O; Di Pietro, G; Morlino, M; Orefice, G

    1990-04-01

    The authors report three cases of AIDS presenting with psychiatric symptoms. In two cases the initial symptoms were behavioral disorders and grandiose delusion; in the third case, which started with depression, an opportunistic infection of the central nervous system was diagnosed.

  5. PXR and CAR single nucleotide polymorphisms influence plasma efavirenz levels in South African HIV/AIDS patients

    Directory of Open Access Journals (Sweden)

    Swart Marelize

    2012-11-01

    Full Text Available Abstract Background This study investigated variation in NR1I2 and NR1I3 and its effect on plasma efavirenz levels in HIV/AIDS patients. Variability in plasma drug levels has largely led research on identifying causative variants in drug metabolising enzyme (DME genes, with little focus on the nuclear receptor genes NR1I2 and NR1I3, coding for PXR and CAR, respectively, that are involved in regulating DMEs. Methods 464 Bantu-speaking South Africans comprising of HIV/AIDS patients on efavirenz-based treatment (n=301 and 163 healthy subjects were genotyped for 6 SNPs in NR1I2 and NR1I3. 32 of the 301 patients had their DNA binding domains (DBDs in NR1I2 and NR1I3 sequenced. Results Significantly decreased efavirenz plasma concentrations were observed in patients carrying the NR1I3 rs3003596C/C and T/C genotypes (P=0.015 and P=0.010, respectively. Sequencing resulted in the discovery of a further 13 SNPs, 3 of which are novel variants in the DBD of NR1I2. There were significant differences in the distribution of NR1I2 and NR1I3 SNPs between South Africans when compared to Caucasian, Asian and Yoruba population groups. Conclusion For the realisation of personalised medicine, PXR and CAR genetic variation should be taken into consideration because of their involvement in the regulation of DMEs.

  6. A novel activation-induced cytidine deaminase (AID) mutation in Brazilian patients with hyper-IgM type 2 syndrome.

    Science.gov (United States)

    Caratão, Nadine; Cortesão, Catarina S; Reis, Pedro H; Freitas, Raquel F; Jacob, Cristina M A; Pastorino, Antonio C; Carneiro-Sampaio, Magda; Barreto, Vasco M

    2013-08-01

    Activation-induced cytidine deaminase (AID) is a DNA editing protein that plays an essential role in three major events of immunoglobulin (Ig) diversification: somatic hypermutation, class switch recombination and Ig gene conversion. Mutations in the AID gene (AICDA) have been found in patients with autosomal recessive Hyper-IgM (HIGM) syndrome type 2. Here, two 9- and 14-year-old Brazilian sisters, from a consanguineous family, were diagnosed with HIGM2 syndrome. Sequencing analysis of the exons from AICDA revealed that both patients are homozygous for a single C to G transversion in the third position of codon 15, which replaces a conserved Phenylalanine with a Leucine. To our knowledge, this is a new AICDA mutation found in HIGM2 patients. Functional studies confirm that the homologous murine mutation leads to a dysfunctional protein with diminished intrinsic cytidine deaminase activity and is unable to rescue CSR when introduced in Aicda(-/-)stimulated murine B cells. We briefly discuss the relevance of AICDA mutations found in patients for the biology of this molecule.

  7. Patient-Provider Engagement and Chronic Pain in Drug-Using, Primarily African American Persons Living with HIV/AIDS.

    Science.gov (United States)

    Mitchell, Mary M; Nguyen, Trang Q; Maragh-Bass, Allysha C; Isenberg, Sarina R; Beach, Mary Catherine; Knowlton, Amy R

    2016-10-27

    Among disadvantaged persons living with HIV/AIDS (PLHIV), patient-provider engagement, which has been defined as patient-provider relationships that promote the use of health care services and are characterized by active listening and supportive decision making, has been associated with antiretroviral therapy (ART) maintenance and viral suppression. However, chronic pain, depression, and substance use, all of which are prevalent in this population, can reduce the quality of patient-provider engagement. We hypothesized a model in which chronic pain, depression, and substance use would be associated with poorer patient-provider engagement, which would be positively associated with adherence, with the latter associated positively with viral suppression. We analyzed data from the BEACON study, which included surveys from 383 PLHIV who were primarily African American, on ART, and had histories of drug use. Due to six missing cases on the chronic pain variable, we used data from 377 respondents in a structural equation model. Chronic pain and depressive symptoms were significantly associated with poorer patient-provider engagement, while substance use was associated with better engagement. Patient-provider engagement in turn was associated with better ART adherence, which was associated with higher viral suppression. Results suggest the role of chronic pain in poor patient-physician engagement in this population, which has potential implications for quality of HIV patient care and health outcomes. Findings suggest the need for attention to patient-provider engagement in PLHIV.

  8. Public Awareness toward Patients with AIDS%公众对艾滋病患者的认知心理

    Institute of Scientific and Technical Information of China (English)

    王仪

    2011-01-01

    After AIDS was discovered in 1981, it spreads around the world, and maintains the increasing trend in China. By the end of September 2004, a total of 89 067 HIV infection cases were reported in China, but this report is only the tip of the iceberg. Faced with such a special large groups, the level of social and psychological tolerance and care toward HIV/AIDS patients is lower than the demands of patients. Now this enormous contrast has become a problem of social public health and mental disorder. The public awareness levels on HIV/AIDS medical knowledge are generally not high. The incorrect psychological cognition is the social root of prejudice and discrimination. It is important to improve the social and psychological cognition level, promote the social psychological support for patients, guide the public to care this group and give a correct attitude toward AIDS patients, and learn the knowledge a-bout AIDS. Patients and the public should work together to improve the harmonious development of society, as so to achieve the goal of AIDS control and prevention.%艾滋病(AIDS)自1981年被发现后,已在全球肆虐蔓延,在我国也是保持着增长的流行趋势,截至2004年9月底,全国累计报告艾滋病病毒(HIV)感染者89 067例,此报告只是冰山一角.面对这么一个特殊的大群体,中国对HIV/AIDS罹患者的社会心理容忍、支持和关怀程度是低于罹患者本人社会心理支持需求的,这种强烈反差已成为目前我国社会公共卫生和精神障碍问题之一.公众对HIV/AIDS医学问题的社会认知水平普遍认识不高、心理认知不正确是产生偏见、歧视的社会根源.提高社会心理认知水平,促进社会对患者的心理支持,从心理学的角度指导公众关爱这个群体,正确对待AIDS病人,认识AIDS关传播知识,患者和公众齐心协力,使社会和谐发展,进而达到控制和预防AIDS的目的.

  9. AIDS-defining illnesses among patients with HIV in Singapore, 1985 to 2001: results from the Singapore HIV Observational Cohort Study (SHOCS

    Directory of Open Access Journals (Sweden)

    Bellamy Richard

    2004-11-01

    Full Text Available Abstract Background The objective was to describe the causes of initial and overall AIDS-defining disease episodes among HIV patients in Singapore. Methods A retrospective observational cohort study was performed of all adult patients seen at the national HIV referral center between 1985 and 2001. Data were extracted from the patients' records by ten trained healthcare workers. AIDS-defining conditions were established using predefined criteria. Results Among 1504 patients, 834 had experienced one or more AIDS-defining diseases. The most frequent causes of the initial AIDS-defining episode were Pneumocystis carinii pneumonia (35.7%, Mycobacterium tuberculosis (22.7% and herpes simplex (7.4%. In total 1742 AIDS-defining episodes occurred. The most frequent causes were Pneumocystis carinii pneumonia (25.1%, Mycobacterium tuberculosis (16.2% and cytomegalovirus retinitis (9.5%. Conclusions The most frequent causes of AIDS-defining illnesses in Singapore are similar to those reported in the West, prior to the introduction of anti-retroviral therapy. Opportunistic infections remain the most frequent AIDS-defining illnesses.

  10. Longterm Follow-Up of Patients in CSP 298 ’Treatment of Patients with Acquired Deficiency Syndrome (AIDS) and AIDS Related Complex’.

    Science.gov (United States)

    1992-04-01

    Viilti’rding!PA t.IVA,w SW. Koch MA.etF l Zidiisudine Inas\\mptomnatic human immunodeti - ncv virus infectioin a controilled trial in persons w ithbasis...shorter. Viral Resistance. Peripheral blood mononuclear cells (PBMCs) from 393 samples, and the virus recovered from 286 of them, have been shipped to... virus resistance in collaboration with Burroughs Wellcome. We have identified 45 pairs of patients, matched by their CD4 count and length of exposure to

  11. Activation and coreceptor expression of T lymphocytes induced by highly active antiretroviral therapy in Chinese HIV/AIDS patients

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zi-ning; SHANG Hong; JIANG Yong-jun; LIU Jing; DAI Di; DIAO Ying-ying; GENG Wen-qing; JIN Xin; WANG Ya-nan

    2006-01-01

    Background At the end of 2005, 650 000 people lived with human immunodeficiency virus type-1 (HIV-1) in (HAART) supported by the "China CARES" program but the immune responses of HAART were seldom reported. This study investigated the effect of HAART on the activation and coreceptor expression of T lymphocytes in Chinese HIV/AIDS patients and evaluated its effect on immune reconstitution.Methods Seventeen HIV/AIDS patients were enrolled and three-color-flow cytometry was used to detect the activation of HLA-DR CD38 and the coreceptor CCR5, CXCR4 expression on T lymphocytes in whole blood samples taken from the patients before and after 3- or 6-month HAART.Results The activation percents of CD4+, CD8+ T lymphocytes were significantly higher before therapy than the normal controls (HLA-DR/CD4: 40.47± 18.85 vs 11.54±4.10; CD38/CD4: 81.34± 10.86 vs 53.34± 11.44;HLA-DR/CD8:63.94±12.71 vs 25.67±9.18; CD38/CD8:86.56±11.41 vs 58.84±6.16, all P<0.01). After 6-month combined antiretroviral treatment, the activation of T lymphocytes in HIV/AIDS patients was significantly decreased (HLA-DR/CD4:28.31 ± 13.48; CD38/CD4:69.88 ± 12.64; HLA-DR/CD8: 46.56±18.64;CD38/CD8: 70.17± 14.54, all P<0.01 compared with the pre-treatment values). Before the treatment, CCR5 expression on CD8+ T lymphocytes was up-regulated while CXCR4 expression on CD8+ T lymphocytes downregulated in HIV/AIDS patients compared with the normal controls (CD8/CCR5:70.9 1± 10.03 vs 52.70 ±7.68; CD8/CXCR4: 24.14± 11.08 vs 50.05± 11.68, all P<0.01). After 6-month HAART, CCR5 expression on CD8+ T lymphocytes significantly decreased (56.35±12.96, P<0.01), while CXCR4 expression on CD8+ T lymphocytes increased (36.95±9.96, P<0.05) compared with the pre-treatment and the normal controls. A significant statistical relationship was observed between the expression of activation markers, CCR5 and the CD4+ T lymphocyte counts after HAART (P<0.05).Conclusions Reduced activation of T lymphocytes

  12. Evaluation of My Medication Passport: a patient-completed aide-memoire designed by patients, for patients, to help towards medicines optimisation

    Science.gov (United States)

    Barber, Susan; Thakkar, Kandarp; Marvin, Vanessa; Franklin, Bryony Dean; Bell, Derek

    2014-01-01

    Objectives A passport-sized booklet, designed by patients for patients to record details about their medicines, has been developed as part of a wider project focusing on improving prescribing in the elderly (‘ImPE’). We undertook an evaluation of ‘My Medication Passport’ to gain an understanding of its value to patients and how it may be used in communications about medicines. Setting The Passport was launched in secondary care with the initial users being older people discharged home after an admission to one of the four North West London participating Trusts. The uptake subsequently spread to other (community) locations and other age groups. Participants We recruited more than 200 patients from a cohort who had been given a passport as part of the improvement projects at one of four sites. Of them, 63% (133) completed the structured telephone questionnaire including 27% for whom English was not their first language. Approximately half of the respondents were male and 40% were over 70 years of age. Results More than half of the respondents had found their medication passport useful or helpful in some way; 42% through sharing details from it with others (most frequently family, carer or doctor) or using it as a platform for conversations with healthcare professionals. One-third of those questioned carried the passport with them at all times. Conclusions My Medication Passport has been positively evaluated; we have a better understanding of how it is used by patients, what they are recording and how it can be an aid to dialogue about medicines with family, carers and healthcare professionals. Further development and spread is underway including an App for smartphones that will be subject to wider evaluation to include feedback from clinicians. PMID:25138809

  13. Health care students' reactions towards HIV patients: examining prejudice, emotions, attribution of blame and willingness to interact with HIV/AIDS patients.

    Science.gov (United States)

    Philip, Jannel; Chadee, Derek; Yearwood, Rosana Patricia

    2014-01-01

    One of the most pervasive stigmatising conditions in society today is HIV/AIDS. In Trinidad and Tobago, stigma and discrimination are still pervasive especially against persons living with HIV/AIDS (PLHIV) and at-risk groups. HIV stigmatisation takes place at all levels including health care institutions, and is a major obstacle to effective HIV/AIDS prevention and care. This study examined health care students' reactions towards HIV patients. A stratified random sample of 339 health care students from Trinidad was used. A 2 × 2 factorial design using vignettes manipulated a male patient's sexual orientation (heterosexual/homosexual) and HIV onset controllability (high/low). Multivariate analysis of variance and discriminant function analysis were used to analyse the data. There was a significant main effect of HIV onset controllability on participants' attribution of blame, emotions, prejudicial evaluation and willingness to interact with PLHIV, Λ (.64) F(6, 330) = 31.44, p <.001, [Formula: see text] = .37. Attribution of blame and prejudicial evaluation discriminated between reactions to patients in low onset control and high onset control vignettes. Cognitive-affective appraisal processes are instrumental in determining health care providers' reaction towards PLHIV.

  14. Lingual ulcer as the only sign of recurrent mycobacterial infection in an HIV/AIDS-infected patient.

    Science.gov (United States)

    Ramírez-Amador, Velia; Anaya-Saavedra, Gabriela; González-Ramírez, Imelda; Mosqueda-Gómez, Juan Luis; Esquivel-Pedraza, Lilly; Reyes-Gutiérrez, Edgardo; Sierra-Madero, Juan

    2005-01-01

    The report describes an HIV/AIDS patient seen at a referral center in Mexico City, in whom a mycobacterial infection in the oral mucosa, probably tuberculosis (TB) was identified. The purpose is to describe the clinical and histological findings in an HIV-infected patient, who after being treated successfully for tuberculous lymphangitis 4 years ago, presented with a lingual ulcer as the only suggestive sign of recurrence of mycobacterial infection, probably M. tuberculosis. A 39-year-old man seen in the HIV clinic of the Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" in Mexico City since 1991 for HIV infection. In 1999 the patient developed tuberculous lymphangitis; he was managed with a 4-drug regimen for 12 months, with improvement of local and systemic symptoms. In May of 2003, the patient presented a painful superficial lingual ulcer, 0.7 cm in diameter, well circumscribed, crateriform with slightly elevated, irregular and indurated borders, of 4 months duration. The histopathological examination showed chronic granulomatous inflammation with giant multinucleated cells, suggestive of mycobacterial infection, and recurrence of TB was considered. Rifampin, isoniazide, pyrazinamide, ethambutol and streptomycin were administered. The lingual lesion improved with partial healing at the first week and total remission at 45 days after the beginning of the antituberculous treatment. In June, 2003, the patient began highly active antiretroviral therapy (HAART) that included two NRTIs and one NNRTI. At 7 months of follow-up, the patient remains free of lingual lesions. The particularity of the present case is that the lingual ulcer was the only sign of infection by mycobacteria, suggestive of TB, in an HIV/AIDS patient that probably represented a recurrence of a previous episode.

  15. Trends in the HIV and AIDS epidemic in a Puerto Rican cohort of patients: 1992-2005.

    Science.gov (United States)

    Báez-Feliciano, Doris V; Quintana, Rafael; Gómez, María A; Fernández, Diana M; Velázquez, Miriam; Olivares, Eddy; León Valiente, Carlos; Mayor, Angel M; Hunter-Mellado, Robert F

    2006-01-01

    The HIV epidemic is a significant global health care issue. With increasing knowledge and improved therapeutics the natural history of the infection has been modified. In this paper we aim to present the general socio-demographic profile and the clinical and therapeutic spectrum of patients with HIV infection who have visited the Bayamón Health Care facilities over the last 12 years and who are part of the Retrovirus Research Center (RRC). The objectives of the study are: 1) describe changes in the demographic, risk factors and clinical stage of patients with HIV infection initially seen in our center; 2) assess changing trends from the clinical and immunological perspective across time; 3) describe mortality risk of patients particularly after the introduction of antiretroviral therapy (ART). This is a cross-sectional study of 3,569 patients admitted to the RRC at the Universidad Central del Caribe between years 1992 through 2005. The variables studied were demographic, risk factors exposure, HIV status at baseline, clinical and immunological parameters, ART and the mortality risk. Chi square with Cramer's coefficient, Kaplan Meier and Cox proportional hazard ratio analysis were performed. The study revealed that individuals presenting at our health care facilities are older and that the proportion of females has increased. The risk factor profile shows increase in heterosexual contact with the disease. The study found that patients treated with ART had significantly lower mortality risk than those without ART. Patients who arrive to RRC with AIDS and Intravenous Drug Users (IDU) had a higher mortality risk than participants with HIV. The analysis of the trends showed changes in the demographic and clinical profile of patients across the years. HIV/AIDS prevention programs and policies need to be continued in Puerto Rico in order to better control the spread of the epidemic.

  16. Oral manifestations and their correlation to baseline CD4 count of HIV/AIDS patients in Ghana

    Science.gov (United States)

    2017-01-01

    Objectives Acquired immunodeficiency syndrome (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus (HIV). People with AIDS are much more vulnerable to infections, including opportunistic infections and tumors, than people with a healthy immune system. The objective of this study was to correlate oral lesions associated with HIV/AIDS and immunosuppression levels by measuring clusters of differentiation 4 (CD4) cell counts among patients living in the middle western regions of Ghana. Materials and Methods A total of 120 patients who visited the HIV clinic at the Komfo Anokye Teaching Hospital and the Regional Hospital Sunyani of Ghana were consecutively enrolled in this prospective and cross-sectional study. Referred patients' baseline CD4 counts were obtained from medical records and each patient received an initial physician assessment. Intraoral diagnoses were based on the classification and diagnostic criteria of the EEC Clearinghouse, 1993. After the initial assessment, extra- and intraoral tissues from each enrolled patient were examined. Data analyses were carried out using simple proportions, frequencies and chi-square tests of significance. Results Our study included 120 patients, and was comprised of 42 (35.0%) males and 78 (65.0%) females, ranging in age from 21 to 67 years with sex-specific mean ages of 39.31 years (males) and 39.28 years (females). Patient CD4 count values ranged from 3 to 985 cells/mL with a mean baseline CD4 count of 291.29 cells/mL for males and 325.92 cells/mL for females. The mean baseline CD4 count for the entire sample was 313.80 cells/mL. Of the 120 patients we examined, 99 (82.5%) were observed to have at least one HIV-associated intraoral lesion while 21 (17.5%) had no intraoral lesions. Oral candidiasis, periodontitis, melanotic hyperpigmentation, gingivitis and xerostomia were the most common oral lesions. Conclusion From a total of nine oral lesions, six lesions that included oral

  17. Health care and social service providers' observations on the intersection of HIV/AIDS and violence among their clients and patients.

    Science.gov (United States)

    DiStefano, Anthony S; Cayetano, Reggie T

    2011-07-01

    Associations between HIV/AIDS and several forms of violence have been demonstrated in recent research. We conducted qualitative interviews with 30 providers who offered services related to HIV/AIDS or violence to identify specific manifestations of HIV/AIDS-violence intersections, factors that explain why HIV/AIDS and violence intersect in client/patient populations, and the theoretical salience of providers' narratives. Providers confirmed links between HIV/AIDS and violent victimization, and yielded new insights into crossover risk between HIV/AIDS and suicidality, nonsuicidal self-harm, and witnessing and perpetrating violence. We also isolated 20 explanatory factors, including substance use, poor mental health, sex work/trading sex, and sexual orientation/gender identity. Narratives were consistent with syndemics theory, indicating that HIV/AIDS and violence fueled each other's occurrence and magnified the health-related burden on affected client/patient populations, often under conditions of health and social disparity. Providers contribute a novel perspective on our understanding of HIV/AIDS-violence syndemics that shows promise in informing future interventions and practice.

  18. Perfil epidemiológico de pacientes adultos com tuberculose e AIDS no estado do Espírito Santo, Brasil: relacionamento dos bancos de dados de tuberculose e AIDS Epidemiological profile of adult patients with tuberculosis and AIDS in the state of Espírito Santo, Brazil: cross-referencing tuberculosis and AIDS databases

    Directory of Open Access Journals (Sweden)

    Thiago Nascimento do Prado

    2011-02-01

    Full Text Available OBJETIVO: Avaliar o perfil epidemiológico de pacientes com tuberculose (TB e daqueles com TB e HIV no estado do Espírito Santo entre 2000 e 2006. MÉTODOS: Coletamos dados demográficos e clínicos dos pacientes de interesse do Centro de Vigilância Epidemiológica do Estado do Espírito Santo (banco de dados para TB, do Sistema de Informação de Agravos de Notificação, do Sistema de Informação sobre Mortalidade, do Sistema de Controle de Exames Laboratoriais da Rede Nacional de Contagem de Linfócitos CD4+/CD8+ e Carga Viral e do Sistema de Controle Logístico de Medicamentos (bancos de dados para HIV/AIDS. Todos os dados compilados foram cruzados. RESULTADOS: Durante o período do estudo, 9.543 pacientes com TB > 15 anos de idade foram identificados, dos quais 437 (4,6% tinham HIV. A mediana de idade não diferiu entre os pacientes com TB/AIDS e somente com TB (35 anos vs. 38 anos. Dos 437 pacientes com TB/AIDS, 298 (68,2% eram homens, e 156 (35,8% estavam na faixa etária de 30-39 anos. Quanto ao desfecho do tratamento da TB, 79,0% foram curados, 9,7% foram transferidos para outros locais, 6,0% foram a óbito, 5,2% abandonaram o tratamento, e 0,2% desenvolveram TB multirresistente. O óbito foi 4,75 vezes mais comum nos pacientes com TB/AIDS do que naqueles somente com TB. A TB pulmonar representou 82,4% dos casos. A combinação de TB pulmonar e extrapulmonar foi 8,2 vezes mais frequente nos pacientes com TB/AIDS do que naqueles somente com TB (IC95%: 6,2-10,8. CONCLUSÕES: Nossos resultados enfatizam a significância da AIDS em pacientes com TB no Brasil, assim como a importância de se avaliar dados secundários a fim de melhorar a sua qualidade e desenvolver intervenções de saúde públicaOBJECTIVE: To evaluate the epidemiological profile of patients with tuberculosis (TB only and that of patients with TB/AIDS in the state of Espírito Santo, Brazil, between 2000 and 2006. METHODS: For the patients of interest, we collected

  19. [Basis for information transmission with biosignals for development of technical communication aids for handicapped patients].

    Science.gov (United States)

    Wiebe, P

    2000-01-01

    For the design of communication aids controlled by biosignals for the handicapped, an analysis of the aspects of the significance of information is mandatory. The definition of information in its five aspects statistics, syntax, semantics, pragmatics and apobetics, enables us to conclude that the transmission of information is possible only with voluntarily influenceable biosignal components. The voluntary influencing of the biosignal may be interpreted as a modulation of the amplitude density of the Fourier integral. By calculating the highest possible statistical information content of a biosignal, it is possible to estimate the technical complexity of a biosignal-based communication system. The construction of efficient communication aids is possible when many biosignal components that can be readily and rapidly controlled voluntarily are to be found.

  20. Progressive multifocal leukoencephalopathy in a patient with acquired immunodeficiency syndrome (AIDS) manifesting Gerstmann's syndrome.

    Science.gov (United States)

    Saito, H; Sakai, H; Fujihara, K; Fujihara, K; Itoyama, Y

    1998-11-01

    We reported a case of acquired immunodeficiency syndrome (AIDS) via multiple blood transfusions, who manifested progressive multifocal leukoencephalopathy (PML) about 18 months after the development of AIDS. PML initiated with right hemiparesis, dysphasia, and Gerstmann's syndrome and resulted in death within 2 months after the onset. Neuroimaging examinations revealed white matter lesions mainly in the left posterior parietal lobe. The cortical gray matter also showed abnormal signal intensity. Peripheral CD4+ lymphocyte count was 81/microl. Routine cerebrospinal fluid (CSF) examinations were negative. CSF antibodies against herpes simplex virus, varicella-zoster virus, cytomegalovirus, Epstein-Barr virus as well as serum antibody against toxoplasma gondii were negative. Though autopsy or biopsy of the brain was not performed, JC virus genomes were detected in the CSF sample by a polymerase chain reaction, and their sequencing showed unique alterations of the regulatory regions, characteristic to PML-type JC virus.

  1. Assessment and Prognosis Aid Brought on by the Mensurable International Systems for the Attention of Patients Suffering from Neuroictus.

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    Rubén Bembibre Taboada

    2007-05-01

    Full Text Available Background: Assessment and prognosis aid brought on by the mensurable international systems recongized in the attention of patients suffering from neuroictus has its success and mistakes. The emission of a prognosis which establishes a strategy for discapacity seems to be not to proceed with such instruments. In our country was created a system that compiles the above mentioned ratings which make viable to do a research which define the above postulates. Objective: To determine the advantages and disadvantages of the mensurable international systems. Methods: The international instrument system was implemented compiled in one system with 202 cases in a five-month period of time. A characterization of the serie was carried out and tests were applied to determine the correlation coefficient as well as significant statistics results when correlating the instruments wth the state of the patient at the moment of discharging according to Rankin scale. Results: A predominium of ischemic neuroictus of atherothrombosis type was verified in elderly. The discapacity generated by neuroictus was evident. The value in the assessment and the prognosis inference of some international instruments was shown. But there was evidence that they do not give the prognosis of the disability in a sub stratified way. Conclusions: The international measuring instruments in the nueroictus are not effective for the assessment and follow up of the patient. The contributed aid of these instruments in the prognosis emission is inferred and has limitations, so it will be commendable to create a more simple and unique predictable mensurable system.

  2. Effect of HIV-1 Tat on Secretion of TNF-α and IL-1β by U87 Cells in AIDS Patients with or without AIDS Dementia Complex

    Institute of Scientific and Technical Information of China (English)

    ZHAO Li; PUShuangShuang; GAO WenHua; CHIYuanYuan; WENHong Ling; WANG Zhi Yu; SONGYanYan; YU Xue Jie

    2014-01-01

    ObjectiveToexplore the role of HIV-1 tat gene variations in AIDSdementia complex(ADC) pathogenesis. MethodsHIV-1tat genes derived from peripheral spleen and central basal ganglia of anAIDSpatient with ADC and anAIDSpatientwithoutADC were cloned for sequence analysis. HIV-1 tat genesequence alignmentwasperformed by using CLUSTAL W andthephylogentic analysiswas conductedbyusing Neighbor-joining with MEGA4 software.All tat genes wereused to construct recombinant retroviral expressing vector MSCV-IRES-GFP/tat. The MSCV-IRES-GFP/tat was cotransfected into 293T cells with pCMV-VSV-G and pUMVC vectorsto assemble the recombinant retrovirus. After infection of gliomas U87 cells with equal amount of the recombinant retrovirus, TNF-α, and IL-1β concentrations inthe supernatant of U87 cells were determined with ELISA. ResultsHIV-1tat genes derived from peripheral spleen and central basal ganglia ofthe AIDS patient with ADC andtheother onewithoutADCexhibited genetic variations.Tat variations and amino acid mutation sites existed mainly at Tat protein core functional area (38-47aa). All Tat proteinscould induce U87 cells to produce TNF-α and IL-1β, but thelevel of IL-1β production was different among Tatproteins derived fromtheADC patient’s spleen, basal ganglia, andthenon-ADC patient’s spleen.The level ofTat proteinsderived fromtheADC patient’s spleen,basal ganglia, andthenon-ADC patient’sspleen were obviously higher thanthat fromthe non-ADC patient’s basal ganglia. ConclusionTat protein core functional area (38-47aa) mayserve as the key area of enhancing the secretion of IL-1β.This may be related with the neurotoxicity of HIV-1 Tat. ObjectiveToexplore the role of HIV-1 tat gene variations in AIDSdementia complex(ADC) pathogenesis. MethodsHIV-1tat genes derived from peripheral spleen and central basal ganglia of anAIDSpatient with ADC and anAIDSpatientwithoutADC were cloned for sequence analysis. HIV-1 tat genesequence alignmentwasperformed by using CLUSTAL W

  3. Tuberculose associada à AIDS: características demográficas, clínicas e laboratoriais de pacientes atendidos em um serviço de referência do sul do Brasil Tuberculosis associated to AIDS: demographic, clinical and laboratory characteristics of patients cared for at a reference center in the south of Brazil

    Directory of Open Access Journals (Sweden)

    Maria Marta Santos Boffo

    2004-04-01

    profile of patients with tuberculosis and AIDS in the city of Rio Grande by relating demographic, clinical and laboratory data. METHOD: The sample comprised all cases of tuberculosis defined by identification of Mycobacterium tuberculosis that occurred in the AIDS Service of the University Hospital/FURG between September, 1997 and December, 2000, which added to a total of 31 patients confirmed as definite cases of AIDS. Using the Ogawa-Kudoh culture method and the Kinyoun bacilloscopy, 33 clinical pulmonary and extrapulmonary specimens were analyzed. Identification of M. Tuberculosis was made by the usual phenotype methods. The method of proportions was chosen to establish resistance of isolated strains. RESULTS: The mean age was of 33.8±9.9 years, with a man/ woman ratio of 2.87:1 and 80.7% of Caucasians. All patients (n=31 exhibited overall or specific clinical manifestations of turberculosis at the time of suspicion diagnosis. In 20 of the cases risk factors were observed: use of injected drugs, alcoholism, malnutrition, imprisonment. Pulmonary disease occurred in 19 cases, extrapulmonary in 10 and the association of both in two. Lymph node commitment was more frequent among those with extrapulmonary disease. The isolated strains (33 were identified as M. Tuberculosis and 28 were tested and showed sensibility to Isoniazid and Rifampin. CONCLUSION: In AIDS patients, tuberculosis appeared with various clinical manifestations, jeopardizing both men and women of less favored social conditions while at a fully productive stage of their lives.

  4. Evaluation of the current management protocols for prophylaxis against Pneumocystis jiroveci pneumonia and other opportunistic infections in patients living with HIV/AIDS.

    Science.gov (United States)

    Jain, Sheel Bhadra; Wig, Naveet; Nagpal, Sajan Jiv Singh; Mishra, Nitin; Vajpayee, Madhu; Guleria, Randeep; Pandey, Ravindra Mohan; Sharma, Surendra K

    2011-07-01

    Opportunistic infections (OIs) are a leading cause of mortality and morbidity in patients living with HIV/AIDS. Data on the proper administration of prophylactic regimes for the prevention of OIs in such patients are scarce. A total of 205 confirmed HIV-infected patients were enrolled in the study from the inpatient wards and outpatient services. The treatment given to them for the prevention of Pneumocystis carinii (jiroveci) pneumonia was compared with the established guidelines and the proportions of those receiving proper treatment were calculated. Primary prophylaxis was seen to be satisfactory in the case of P. carinii (jiroveci) pneumonia. The prophylaxis was not given properly for tuberculosis and other common OIs. Secondary prophylaxis was up to the mark. Prophylaxis in AIDS patients seems to be a major problem area and a lot of efforts need to be directed toward it since patients suffering from AIDS are bound to have a downhill course despite provision of all available treatment options.

  5. Kaposi’s sarcoma in Brazilian AIDS patients: a study of 144 cases Sarcoma de Kaposi em pacientes com AIDS: estudo de 144 casos

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    Esther G. BIRMAN

    2000-12-01

    Full Text Available One hundred and forty-four Brazilian AIDS patients presenting with Kaposi’s sarcoma (KS were evaluated with respect to the frequency of oral neoplasms and their clinical features. The majority of the patients were young male adults (age range: 21-40 years old, from which 11.1 % presented with oral KS (OKS exclusively. Oral and skin lesions were associated in 25% of the cases, while only four patients showed association between oral and visceral KS; 49.3% of the cases were exclusively dermatological. The hard palate was the main site affected, followed by the oropharynx. The localization of KS was found to be similarly frequent in the tongue, gingiva and other sites of the oral mucosa. Candidosis was the prevailing fungal disease; in 20% of the cases it was restricted to the oral mucosa and in 80% it was systemic. No high frequency of paracoccidioidomicosis and cryptococcosis was detected. The prevailing bacterial disease was Tuberculosis and there was only one case of syphilis. Among the viral diseases, the most frequently detected was herpes simplex, followed by molusco contagiosum, condiloma acuminatum and cytomegaloviroses at lower frequencies. Pneumonia caused by Pneumocystes carinii and toxoplasmosis were also identified. The authors emphasise the importance of oral examination in HIV-infected patients bearing in mind several aspects related especially to KS, and stress the need for an interdisciplinary team in the management of these patients, in order to provide better quality of life as well as rapid diagnosis and treatment.Foram estudados pacientes brasileiros portadores de SIDA apresentando sarcoma de Kaposi (SK. O perfil de idade mostrou um grupo com média de idade entre 21 e 40 anos, sendo que 11,1% da amostra apresentava SK exclusivamente na cavidade bucal, observando-se em 25% da amostra uma associação de lesões bucais e na pele. Somente quatro pacientes apresentaram associação de lesões bucais e viscerais, enquanto 49

  6. The pattern and predictors of mortality of HIV/AIDS patients with neurologic manifestation in Ethiopia: a retrospective study

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    Berhe Tesfaye

    2012-04-01

    Full Text Available Abstract Background Even though the prevalence of HIV infection among the adult population in Ethiopia was estimated to be 2.2% in 2008, the studies on the pattern of neurological manifestations are rare. The aim of this retrospective study was to assess the pattern and predictors of mortality of HIV/AIDS patients with neurologic manifestations. Methods Medical records of 347 patients (age ≥13 years admitted to Tikur Anbesa Hospital from September 2002 to August 2009 were reviewed and demographic and clinical data were collected. Results Data from 347 patients were analysed. The mean age was 34.6 years. The diagnosis of HIV was made before current admission in 33.7% and 15.6% were on antiretroviral therapy (ART. Causes of neurological manifestation were: cerebral toxoplasmosis (36.6%, tuberculous meningitis (22.5%, cryptococcal meningitis (22.2% and bacterial meningitis (6.9%. HIV-encephalopathy, primary central nervous system (CNS lymphoma and progressive multifocal leukoencephalopathy were rare in our patients. CD4 count was done in 64.6% and 89.7% had count below 200/mm3[mean = 95.8, median = 57] and 95.7% were stage IV. Neuroimaging was done in 38% and 56.8% had mass lesion. The overall mortality was 45% and the case-fatality rates were: tuberculous meningitis (53.8%, cryptococcal meningitis (48.1%, cerebral toxoplasmosiss (44.1% and bacterial meningitis (33.3%. Change in sensorium and seizure were predictors of mortality. Conclusions CNS opportunistic infections were the major causes of neurological manifestations of HIV/AIDS and were associated with high mortality and morbidity. Almost all patients had advanced HIV disease at presentation. Early diagnosis of HIV, prophylaxis and treatment of opportunistic infections, timely ART, and improving laboratory services are recommended. Mortality was related to change in sensorium and seizure.

  7. Pathological features of the central nervous system lesions with Epstein-Barr virus in patients with HIV/AIDS

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    Kozko V.N.

    2013-12-01

    Full Text Available Background. HIV infection/AIDS is a social disease and morbidity in some segments of the population is threatening. One of the target organs for HIV is the nervous system. The central nervous system lesion occurring in the form of meningoencephalitison the background of HIV infection is one of the leading death causes in patients with severe immunosuppression. Objective. Reveal the typicalmorphologic changes in the central nervous system during Epstein-Barr virus meningoencephalitis in patients with HIV/AIDS. Methods. Brain tissue and meningesof deceased patients with Epstein-Barr virus meningoencephalitis. Selected 6 deaths – three women and three men, aged 28 to 34 years. Following routine procedure histologic sections were produced, which were stained with hematoxylin and eosin staining, Nissl. Results. We showed signs of development of subacute encephalitis with the presence of giant areas of demyelination by morphological study of the combination of clinical cases of HIV and Epstein-Barr virus infection. In brain tissue we identified giant cells. In addition to this significant feature of the combination of HIV and Epstein-Barr virus infection can be considered productive development of vasculitis with thrombosis and ischemic brain lesions. During histological studies in HIV-infected patients were found: infiltration of the vessel wall by leukocytes, edema and proliferative changes in the intima. All this leads to a narrowing of the lumen and thrombosis with further possible infarct, vessel rupture and hemorrhage. Conclusion. It is established that in case of damage of the central nervous system with Epstein-Barr virus in HIV patients develops subacute giant cell encephalitis with the presence of demyelination areas, a bland astrogliosis, development of productive vasculitis with thrombosis, that complicated by ischemic lesions of the brain.

  8. [Analysis methods for educational needs assessment for family caregivers of HIV positive or AIDS patients in Thailand].

    Science.gov (United States)

    Girault, P; Gagnayre, R; d'Ivernois, J F

    2001-03-01

    Identification of educational needs of natural helpers for the home-based care of persons living with HIV or AIDS. Surin, Thailand. The very significant increase in the number of persons living with aids in Thailand, (1995: 20,154 notified cases; 1996: 23,309 cases; 1997: 25,064 cases), and the insufficiency of medical care for patients within Thailand's health structures, have driven Médecins Sans Frontières (MSF) to put in place since 1996 a home-based care project in Surin province (North-Eastern Thailand). In Thai culture, the sick are commonly cared for by one family member, known as the natural helper. An evaluation of the health situation showed that natural helpers who took care of a family member living with HIV or aids were not prepared for this situation. In order to better define the tasks that they ought to perform, we carried out a needs assessment in three interdependent steps: a records analysis of the activities delegated to natural helpers by nurses; an enquiry on the acceptability of natural helpers to carry out these cares and on the perceived usefulness of being trained; an expert consensus on the cares to be carried out by the natural helpers, obtained by the Delphi method. Twenty seven cares were identified as being able to be provided by natural helpers. They constitute as a list of reference for the training for natural helpers. This work has shown a social coherence between the different actors of the project. At no stage was the role of the natural helpers questioned. On the contrary, natural helpers have a privileged place within the family and in the home-based care programme. Natural helpers will allow continuity of care between the health structures and the patient's home.

  9. Effect of audible and visual reminders on adherence in glaucoma patients using a commercially available dosing aid

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    Lawrence Y Ho

    2008-08-01

    Full Text Available Lawrence Y Ho1, Larissa Camejo1, Malik Y Kahook2, Robert Noecker11UMPC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; 2Rocky Mountain Lions Institute, University of Colorado, CO, USAAbstract: We studied the effects of audible and visual alarms on adherence with a recommended dosing regimen in the management of glaucoma. Forty-two patients were begun on therapy with the Travatan® Dosing Aid (TDA and randomly divided into two observation groups-one with visual and audible alarm functions turned on and the other with alarms off. Dosing information was analyzed for mean rates of adherence, missed days, and dosing at the wrong time. Twenty patients were randomized to the TDA alarm on group and 22 to the alarm off group. The rates of adherence were 87.9% and 79.7% (p = 0.02, rates of missed dosing were 7.6% and 14.4% (p = 0.03, and rates of dosing at the incorrect times were 7.1% and 9.8% (p = 0.19, respectively for alarm on versus alarm off groups. In the alarm on group, the adherence rate was significantly higher and proportion of missed dosing was significantly lower. It is still yet to be determined whether there is a relationship between adherence and progression of glaucoma.Keywords: adherence, glaucoma, Travatan® Dosing Aid, audible alarms, visual alarms

  10. Radiologic findings of an AIDS patient with gastrointestinal mixed infection of cytomegalovirus and Candida

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    Yamamoto, Isamu; Nakajima, Tetsuji.

    1988-08-01

    A radiologic examination was performed on a 50-year-old homosexual man with AIDS in his gastrointestinal tract. Main abnormalities were ulcerative lesions due to mixed infection of cytomegarovirus and Candida. Esophageal involvement was demonstrated as multiple granulations and ulcers ; gastric involvement, as two ulcers ; and intestinal involvement, as only rapid transit of barium. With the lapse of time, esophageal lesions almost disappeared ; while gastric ulcers remained the same and intestinal involvement was exacerbated. The ulcerations of terminal ileum and colon due to severe bleeding and perforation caused the death.

  11. A comparative study of erectile function and use of erectile aids in high-risk prostate cancer patients after robot-assisted laparoscopic prostatectomy

    DEFF Research Database (Denmark)

    Østby-Deglum, Marie; Brennhovd, B.; Axcrona, K.;

    2015-01-01

    Objective. Erectile function with and without use of erectile aids was compared in high-, intermediate- and low-risk prostate cancer patients at a mean of 3 years after robot-assisted laparoscopic prostatectomy (RALP). Materials and methods. A sample of 982 men who underwent RALP at Oslo University...... according to the preoperative D'Amico classification. Based on questionnaire data, two primary outcomes were defined: ability to have intercourse (sufficient erection), and use and effect of erectile aids. Results. Sufficient erection with or without erectile aids was reported by 19% of the high-, 30...

  12. Clinical evaluation of an over-the-counter hearing aid (TEO First®) in elderly patients suffering of mild to moderate hearing loss

    OpenAIRE

    Sacco, Guillaume; Gonfrier, Sébastien; Teboul, Bernard; Gahide, Ivan; Prate, Fredéric; Demory-Zory, Mathilde; Turpin, Jean-Michel; Vuagnoux, Claire; Genovese, Philippe; Schneider, Stéphane; Guérin, Olivier; Guevara, Nicolas

    2016-01-01

    Background Presbycusis has a direct influence on autonomy of the elderly but hearing aids lack of affordability. Moreover a recent review demonstrate that electroacoustic characteristics of OTC hearing aids were generally not suitable for the elderly people. In our study, we assessed the clinical value of a new over-the-counter (OTC) hearing aid device (TEO First®) in the elderly. Method This prospective monocentric open label study included patients over 60 years of age with a mild to modera...

  13. Analysis of causes of death among HIV-infected patients of Kiev Regional AIDS Center during 2013

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    Tetiana Stepchenkova

    2014-11-01

    Full Text Available Ukraine is a leader in Europe in the prevalence of HIV infection. There are up to 270 thousand people, who are living with HIV. Since 1987, in Ukraine, 33,149 HIV-infected people died. During the first six months of 2013, of all the dead, who were suffering from HIV and in need of antiretroviral treatment (ART at the time of death, 41% received treatment and only 5.7% received ART for more than one year. Specialists of Kiev Regional AIDS Center analyzed mortality among the patients of the centre, in order to determine the most frequent cause of death, set the group most at risk and to develop effective measures to reduce mortality among HIV-infected patients. In Kiev AIDS Center, 10,000 people are under medical observation and 4004 of them are taking ART. During 2013, 305 persons died: 217 were women and 88 were men which included 3 children under 14 years. Most of the dead – 272 (89% were aged 25–49. Among the total number of the dead, 125 people (41% were receiving ART, 53 of them (17% were receiving ART for at least one year and 39 of them (13% were receiving ART for less than one month. Hundred and fifty-eight people (52% required ART and 22 (7% did not need therapy. Hundred and ninety-two patients (63% were in four clinical stage of HIV infection. Hundred and ten of them had HIV+TB co-infection. Twenty patients died due to TB and 12 patients died due to hepatitis b virus/hepatitis c virus (HBV/HCV. Among these patients, 87 people (39% were taking ART and 136 persons (61% were in need of ART, but did not get it. Nineteen patients were diagnosed with cancer. Sixteen patients, who were co-infected HIV+TB had a CD4 cell count of more than 300. Based on this analysis, we can conclude that the main causes of high mortality among HIV-infected patients in 2013 were late diagnosis of HIV, besides a large number (52% of patients, who were in need of ART did not take it. A large number (40% among those who died were patients co-infected with HIV

  14. Time to HAART Initiation after Diagnosis and Treatment of Opportunistic Infections in Patients with AIDS in Latin America

    Science.gov (United States)

    Crabtree-Ramírez, Brenda; Caro-Vega, Yanink; Shepherd, Bryan E.; Grinsztejn, Beatriz; Wolff, Marcelo; Cortes, Claudia P.; Padgett, Denis; Carriquiry, Gabriela; Fink, Valeria; Jayathilake, Karu; Person, Anna K.; McGowan, Catherine; Sierra-Madero, Juan

    2016-01-01

    Background Since 2009, earlier initiation of highly active antiretroviral therapy (HAART) after an opportunistic infection (OI) has been recommended based on lower risks of death and AIDS-related progression found in clinical trials. Delay in HAART initiation after OIs may be an important barrier for successful outcomes in patients with advanced disease. Timing of HAART initiation after an OI in “real life” settings in Latin America has not been evaluated. Methods Patients in the Caribbean, Central and South America network for HIV Epidemiology (CCASAnet) ≥18 years of age at enrolment, from 2001–2012 who had an OI before HAART initiation were included. Patients were divided in an early HAART (EH) group (those initiating within 4 weeks of an OI) and a delayed HAART (DH) group (those initiating more than 4 weeks after an OI). All patients with an AIDS-defining OI were included. In patients with more than one OI the first event reported was considered. Calendar trends in the proportion of patients in the EH group (before and after 2009) were estimated by site and for the whole cohort. Factors associated with EH were estimated using multivariable logistic regression models. Results A total of 1457 patients had an OI before HAART initiation and were included in the analysis: 213 from Argentina, 686 from Brazil, 283 from Chile, 119 from Honduras and 156 from Mexico. Most prevalent OI were Tuberculosis (31%), followed by Pneumocystis pneumonia (24%), Invasive Candidiasis (16%) and Toxoplasmosis (9%). Median time from OI to HAART initiation decreased significantly from 5.7 (interquartile range [IQR] 2.8–12.1) weeks before 2009 to 4.3 (IQR 2.0–7.1) after 2009 (p<0.01). Factors associated with starting HAART within 4 weeks of OI diagnosis were lower CD4 count at enrolment (p-<0.001), having a non-tuberculosis OI (p<0.001), study site (p<0.001), and more recent years of OI diagnosis (p<0.001). Discussion The time from diagnosis of an OI to HAART initiation has

  15. Time to HAART Initiation after Diagnosis and Treatment of Opportunistic Infections in Patients with AIDS in Latin America.

    Directory of Open Access Journals (Sweden)

    Brenda Crabtree-Ramírez

    Full Text Available Since 2009, earlier initiation of highly active antiretroviral therapy (HAART after an opportunistic infection (OI has been recommended based on lower risks of death and AIDS-related progression found in clinical trials. Delay in HAART initiation after OIs may be an important barrier for successful outcomes in patients with advanced disease. Timing of HAART initiation after an OI in "real life" settings in Latin America has not been evaluated.Patients in the Caribbean, Central and South America network for HIV Epidemiology (CCASAnet ≥18 years of age at enrolment, from 2001-2012 who had an OI before HAART initiation were included. Patients were divided in an early HAART (EH group (those initiating within 4 weeks of an OI and a delayed HAART (DH group (those initiating more than 4 weeks after an OI. All patients with an AIDS-defining OI were included. In patients with more than one OI the first event reported was considered. Calendar trends in the proportion of patients in the EH group (before and after 2009 were estimated by site and for the whole cohort. Factors associated with EH were estimated using multivariable logistic regression models.A total of 1457 patients had an OI before HAART initiation and were included in the analysis: 213 from Argentina, 686 from Brazil, 283 from Chile, 119 from Honduras and 156 from Mexico. Most prevalent OI were Tuberculosis (31%, followed by Pneumocystis pneumonia (24%, Invasive Candidiasis (16% and Toxoplasmosis (9%. Median time from OI to HAART initiation decreased significantly from 5.7 (interquartile range [IQR] 2.8-12.1 weeks before 2009 to 4.3 (IQR 2.0-7.1 after 2009 (p<0.01. Factors associated with starting HAART within 4 weeks of OI diagnosis were lower CD4 count at enrolment (p-<0.001, having a non-tuberculosis OI (p<0.001, study site (p<0.001, and more recent years of OI diagnosis (p<0.001.The time from diagnosis of an OI to HAART initiation has decreased in Latin America coinciding with the

  16. Creating a Computing Programs Package to Aid in the Assessment and Prognosis of Patients Suffering from Cerebrovascular Diseases

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    Carlos Jaime Geroy Gómez

    2007-05-01

    Full Text Available Fundament: The have an evaluation and prognosis of patients suffering from cerebrovascular diseases in its acute phase is important in order to define the medical management as well as others several aspects. Objective: To create computing programs package to aid in the assessment and prognosis of patients suffering from cerebrovascular diseases. Method: A research and development study to create a package of programs using a C chart computing language (NET language with recognized international scale compendium and the Cuban scale prognosis. Results: A Software which shows in different screens the correspondent variables to the different evaluative scales and the prognosis Cuban scale ¨Stroke¨ is created. It is applicable to every type of patient suffering from cardiovascular diseases and an immediate assessment and prognosis is obtained. It also has a data base. It is applicable in all ictus units of our country and abroad. Conclusions: A unique software was created as a valuable tool to the attention of patients suffering from cardiovascular diseases which permit to obtain a better assessment and prognosis of this kind of patient.

  17. Profile of hemogram and transaminases in dengue-suspected patients at a first-aid health unit

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    Érica Maria da Silva

    2015-04-01

    Full Text Available Current retrospective analysis describes the laboratorial profile of patients hypothetically diagnosed with dengue at a First-Aid Health Unit in Recife, Pernambuco State, Brazil. Results of hemograms were assessed by counting platelets and transaminase dosages, in the first half of 2012. Further, 394 patients (252 females or 64% and 142 males or 34% were listed, mostly during March and April. Hemograms with platelet counting was undertaken with 210 patients (53.3% and hemogram plus transaminases dosages with 184 patients (46.7%. Thrombocytopenia, neutropenia and atypical lymphocytes occurred in both genders. Hematocrits were highest in males and transaminases were more altered in females. Patients attended at the health unit with clinical symptoms of classical dengue had a laboratory profile of non-specific exams which is a feature of infection by the dengue virus. Diagnosis could not be confirmed and the need of a fast test in the health unit services was mandatory. The above avoids dengue cases not being notified and treated or overestimated.

  18. Improving diagnosis of pulmonary tuberculosis among HIV/AIDS patients: literature review and experience in a teaching hospital in Indonesia.

    Science.gov (United States)

    Rewata, Lidya; Rutherford, Merrin; Apriani, Lika; Janssen, Willem; Rahmadi, Andri; Parwati, Ida; Yuwono, Arto; van Crevel, Reinout

    2009-07-01

    HIV infection hampers diagnosis of pulmonary tuberculosis (PTB) because many pathogens cause pulmonary infection in HIV people and the load of Mycobacterium tuberculosis is lower in HIV patients. We conducted a literature review and prospectively examined clinical, radiological, and laboratory diagnosis of PTB in 71 HIV-patients (29 inpatients and 42 outpatients) in a teaching hospital in West Java, Indonesia. For both in- and outpatients, signs and symptoms were sensitive but not specific for PTB. Chest X-ray (CXR) was sensitive but less specific. Among hospitalized PTB suspects, 28,8% could not expectorate sputum. Compared to culture, ZN had a sensitivity of 11.1% and 66.7% for in- and outpatients, respectively. From the literature, fluorescence microscopy, liquid culture, and nucleic acid assays can improve diagnosis of PTB in HIV, while IFNg-release assays lack sensitivity, especially in advanced HIV. The current practice of using CXR and microscopy lacks sensitivity for diagnosing PTB in HIV patients. Sputum culture is more sensitive but slow. Fluorescence microscopy might be a quick, relatively sensitive and feasible option in Indonesia. However, because of the frequent absence of sputum, especially in patients with advanced HIV-AIDS patients, there is an urgent need for alternative diagnostic methods using blood or urine.

  19. Design and development of a decision aid to enhance shared decision making by patients with an asymptomatic abdominal aortic aneurysm

    Directory of Open Access Journals (Sweden)

    Dirk T Ubbink

    2008-11-01

    Full Text Available Dirk T Ubbink1,2, Anouk M Knops1, Sjaak Molenaar1, Astrid Goossens11Department of Quality Assurance and Process Innovation and 2Department of Surgery, Academic Medical Center, Amsterdam, The NetherlandsObjective: To design, develop, and evaluate an evidence-based decision aid (DA for patients with an asymptomatic abdominal aortic aneurysm (AAA to inform them about the pros and cons of their treatment options (ie, surgery or watchful observation and to help them make a shared decision.Methods: A multidisciplinary team defined criteria for the desired DA as to design, medical content and functionality, particularly for elderly users. Development was according to the international standard (IPDAS. Fifteen patients with an AAA, who were either treated or not yet treated, evaluated the tool.Results: A DA was developed to offer information about the disease, the risks and benefits of surgical treatment and watchful observation, and the individual possibilities and threats based on the patient’s aneurysm diameter and risk profile. The DA was improved and judged favorably by physicians and patients.Conclusion: This evidence-based DA for AAA patients, developed according to IPDAS criteria, is likely to be a simple, user-friendly tool to offer patients evidence-based information about the pros and cons of treatment options for AAA, to improve patients’ understanding of the disease and treatment options, and may support decision making based on individual values.Keywords: decision support techniques, research design, program development, abdominal aortic aneurysm, decision making

  20. Resistin and interleukin-6 exhibit racially-disparate expression in breast cancer patients, display molecular association and promote growth and aggressiveness of tumor cells through STAT3 activation.

    Science.gov (United States)

    Deshmukh, Sachin K; Srivastava, Sanjeev K; Bhardwaj, Arun; Singh, Ajay P; Tyagi, Nikhil; Marimuthu, Saravanakumar; Dyess, Donna L; Dal Zotto, Valeria; Carter, James E; Singh, Seema

    2015-05-10

    African-American (AA) women with breast cancer (BC) are diagnosed with more aggressive disease, have higher risk of recurrence and poorer prognosis as compared to Caucasian American (CA) women. Therefore, it is imperative to define the factors associated with such disparities to reduce the unequal burden of cancer. Emerging data suggest that inherent differences exist in the tumor microenvironment of AA and CA BC patients, however, its molecular bases and functional impact have remained poorly understood. Here, we conducted cytokine profiling in serum samples from AA and CA BC patients and identified resistin and IL-6 to be the most differentially-expressed cytokines with relative greater expression in AA patients. Resistin and IL-6 exhibited positive correlation in serum levels and treatment of BC cells with resistin led to enhanced production of IL-6. Moreover, resistin also enhanced the expression and phosphorylation of STAT3, and treatment of BC cells with IL-6-neutralizing antibody prior to resistin stimulation abolished STAT3 phosphorylation. In addition, resistin promoted growth and aggressiveness of BC cells, and these effects were mediated through STAT3 activation. Together, these findings suggest a crucial role of resistin, IL-6 and STAT3 in BC racial disparity.

  1. Attitudes and normative beliefs of nursing students as predictors of intended care behaviors with AIDS patients: a test of the Ajzen-Fishbein theory of reasoned action.

    Science.gov (United States)

    Goldenberg, D; Laschinger, H

    1991-03-01

    Few investigators have studied nurses' or nursing students' responses to caring for AIDS patients. The purpose of this exploratory study was to test the Ajzen-Fishbein (1980) Theory of Reasoned Action in a student nurse population about AIDS patient care. This theory offers an approach to explaining individuals' intentions to engage in certain behaviors as determined by two components: attitudes toward the behavior and subjective norms. Forty-six second-year baccalaureate nursing students completed a questionnaire developed according to guidelines described by Ajzen and Fishbein (alpha reliability range was .69-.85) prior to and following an instructional unit on caring for AIDS patients. Consistent with the theory, students' attitudes and subjective norms were found to be significant predictors of intentions to care for AIDS patients in their clinical experience (R2 = .29, F[1, 43] = 6.63, p less than .003). In addition, qualitative data resembled those in previous reports of fear of contagion among health professionals. The effects of the instructional unit about caring for AIDS patients resulted in significant changes in both attitudes and subjective norms.

  2. Parallel Exhibits: Combining Physical and Virtual Exhibits

    NARCIS (Netherlands)

    L. Lischke; T. Dingler; S. Schneegaß; A. Schmidt; M. van der Vaart; P. Wozniak

    2014-01-01

    People have a special fascination for original physical objects, their texture, and visible history. However, the digitization of exhibits and the use of these data is a current challenge for museums. We believe that museums need to capitalize on the affordances of physical exhibits to help users na

  3. The use of music to aid patients' relaxation in a radiotherapy waiting room

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, Laura [Oncology Department, Cheltenham General Hospital, Sandford Road, Cheltenham, Glos. GL53 7AN (United Kingdom)], E-mail: ljtrooper@hotmail.com; Foster, Irene [Faculty of Health and Social Care, University of West of England, Glenside Campus, Blackberry Hill, Stapleton, Bristol BS16 1DD (United Kingdom)], E-mail: irenejfoster@hotmail.com

    2008-08-15

    Patient-centred practice and increasing user involvement adds impetus to built environmental research within the health care setting. Much work has been centred around stress reduction initiatives for improving health outcomes for patients and staff. This study examined the influence of music choice on patients' anxiety levels whilst seated in a radiotherapy waiting area. Patients' stress levels and perceptions were assessed in the absence/presence of music. The opinions of patients were elicited through a questionnaire following exposure to a range of music types. Music therapy was shown to have clear benefits when individuals enjoyed the music to which they listened. Although clear preferences were indicated, the results were skewed by the negative effects of music not enjoyed by patients. Further investigation needs to take account of the impact of personal variables and the value of 'quiet areas'.

  4. Modified Occlusal Table - An Aid to Enhance Function of Hemimandibulectomy Patient: A Case Report

    Science.gov (United States)

    Thippanna, Roopa Kundur; Dang, Krutika; Hajira, Neha; Sharma, Atulya

    2015-01-01

    Completely edentulous patients who have undergone hemimandibulectomy suffer severe anatomic and functional loss. Functions like mastication, speech and deglutition are severely compromised. The mandibular deviation towards the resected side leads to inefficient mastication. In order to alleviate the difficulties encountered by the patient, construction of a modified occlusal table into conventional complete denture has been described in this article. This simple modification enables the patient to articulate teeth on a broader surface area. The inclines of the cusps also help in mandibular guidance. Thus, prosthetic rehabilitation of hemimandibulectomy patients with two rows of teeth on the unresected side serves to restore function and aaesthetics providing them with an added psychological comfort. PMID:26501024

  5. China vs. AIDS

    Institute of Scientific and Technical Information of China (English)

    LURUCAI

    2004-01-01

    CHINA's first HIV positive diagnosis was in 1985, the victim an ArgentineAmerican. At that time most Chinese,medical workers included, thought of AIDS as a phenomenon occurring outside of China. Twenty years later, the number of HIV/AIDS patients has risen alarmingly. In 2003, the Chinese Ministry of Health launched an AIDS Epidemiological Investigation across China with the support of the WHO and UN AIDS Program. Its results show that there are currently 840,000 HIV carriers, including 80,000 people with full-blown AIDS, in 31 Chinese provinces, municipalities and autonomous regions. This means China has the second highest number of HIV/AIDS cases in Asia and 14th highest in the world. Statistics from the Chinese Venereal Disease and AIDS Prevention Association indicate that the majority of Chinese HIV carriers are young to middle aged, more than half of them between the ages of 20 and 29.

  6. Empathy and avoidance in treating patients living with HIV/AIDS (PLWHA) among service providers in China.

    Science.gov (United States)

    Lin, Chunqing; Li, Li; Wan, Dai; Wu, Zunyou; Yan, Zhihua

    2012-01-01

    This study aims to investigate health care providers' empathy levels and its association with avoidance in providing service to patients living with HIV/AIDS (PLWHA) in China. A total of 1760 health service providers were randomly sampled from 40 county hospitals in two provinces of China. Using a self-administered questionnaire, participants' demographic characteristics, work history, empathy level, and avoidance attitudes toward PLWHA were collected in a cross-sectional survey. Empathy was higher among participants aged 31-40 years, those who had an associated medical degree, and those who had served in the medical profession for less than 20 years. Nurses, younger providers, and providers with lower education tended to avoid contact with PLWHA. Multiple linear regression model showed that a higher level of empathic attitude toward patients was significantly negatively associated with avoidance attitude toward PLWHA. Service providers' empathy level plays an important role in providing quality care to HIV-infected patients. Future stigma reduction interventions should cultivate empathy as a platform for understanding, effective communication, and trusting provider-patient relationships. PLWHA could potentially benefit from attitudinal change in medical settings.

  7. Orbital and Maxillofacial Computer Aided Surgery: Patient-Specific Finite Element Models To Predict Surgical Outcomes

    CERN Document Server

    Luboz, V; Swider, P; Payan, Y; Luboz, Vincent; Chabanas, Matthieu; Swider, Pascal; Payan, Yohan

    2005-01-01

    This paper addresses an important issue raised for the clinical relevance of Computer-Assisted Surgical applications, namely the methodology used to automatically build patient-specific Finite Element (FE) models of anatomical structures. From this perspective, a method is proposed, based on a technique called the Mesh-Matching method, followed by a process that corrects mesh irregularities. The Mesh-Matching algorithm generates patient-specific volume meshes from an existing generic model. The mesh regularization process is based on the Jacobian matrix transform related to the FE reference element and the current element. This method for generating patient-specific FE models is first applied to Computer-Assisted maxillofacial surgery, and more precisely to the FE elastic modelling of patient facial soft tissues. For each patient, the planned bone osteotomies (mandible, maxilla, chin) are used as boundary conditions to deform the FE face model, in order to predict the aesthetic outcome of the surgery. Seven F...

  8. Robot-aided therapy for upper limbs in patients with stroke-related lesions. Brief report of a clinical experience

    Directory of Open Access Journals (Sweden)

    Dall'Armi Valentina

    2011-04-01

    Full Text Available Abstract This study was aimed at verifying the improvement on the motor impairment and functionality in 19 patients with chronic hemiparesis after stroke treated with a robot-aided rehabilitation protocol using the ReoGo™ system (Motorika Medical Ltd, Israel, and at evaluating the persistence of the effects after 1 month. The study also focused on the actual possibility of administering the robot-aided therapy with the ReoGo™ for the upper limbs and on the patients' degree of acceptance and compliance with the treatment. Subjects underwent an assessment prior to the start of the rehabilitation project (T-1, one at the start (T0, one at the end of the treatment (T1 and one after one month from the end of the treatment (T2. The following tests were administered: (i Fugl-Meyer (FM upper limb; Ashworth scale (AS; Functional Independence Measure (FIM™ (T-1 - T2; (ii strength evaluation; Visual Analogue Scale (VAS for pain; Frenchay Arm test (FAT; Box and Block test (BBT; Timed Up and Go (TUG test (T0 - T2. Additionally, the Euro-QoL questionnaire and a VAS for the treatment satisfaction were administered to the subjects. Non-statistical difference of scores at T-1 and T0 on almost the entire battery of tasks suggested a stable patients' performance prior to the start of the rehabilitation. With the exception of the Medical Research Council (MRC and the AS sub-scales measuring -as appropriate- strength and spasticity of the shoulder, triceps and wrist, all scores showed a significant increase between T0 and T1. The improvement on the pain could not be proved significant (p = 0.10. A significant increase between T0 and T2 was found for all assessment scores, with the exception of the MRC for external shoulder rotators (p = 0.05 and of the AS for shoulder (p = 0.32 and wrist (p = 0.08. Substantial stability was observed between T1 and T2. Patients were capable of completing the treatment and showed good participant satisfaction. This pilot study

  9. Britain exhibition at CERN

    CERN Multimedia

    Bertin; CERN PhotoLab

    1969-01-01

    The United Kingdom inaugurated the Industrial Exhibitions in 1968, and it wasn't till 1971 that other countries staged exhibitions at CERN. This photo was taken in 1969, at the second British exhibition, where 16 companies were present.

  10. Research progress on AIDS patients complicated with cryptococcal meningitis%艾滋病合并隐球菌性脑膜炎研究进展

    Institute of Scientific and Technical Information of China (English)

    涂韦; 李玉叶

    2015-01-01

    新生隐球菌是临床上最重要的机会性致病真菌之一,易感染艾滋病患者并引发致死性隐球菌性脑膜炎。近年来,随着艾滋病患者的增多,隐球菌性脑膜炎发生率也显著上升。本文就艾滋病合并隐球菌性脑膜炎的研究现状简要综述。%Cryptococcus neoformans is one of the most important clinical opportunistic pathogenic fungi,which in ̄fects AIDS patients susceptibly and causes fatal cryptococcal meningitis. In recent years,with the increased number of AIDS patients,morbidity of cryptococcal meningitis increased significantly. The research progress on AIDS patients complicated with Cryptococcal meningitis have been briefly reviewed in this paper.

  11. Doenças sexualmente transmissíveis em pacientes infectados com HIV/AIDS no Estado de Pernambuco, Brasil Sexually transmitted diseases in patients infected with HIV/AIDS in the State of Pernambuco, Brazil

    Directory of Open Access Journals (Sweden)

    Eduardo Henrique Gomes Rodrigues

    2000-02-01

    Full Text Available Foram estudados retrospectivamente 399 pacientes diagnosticados como infecção por HIV. Os pacientes infectados predominavam na faixa etária de 20 a 40 anos (73,4%, sendo 75% do sexo masculino. A razão entre pacientes do sexo masculino e feminino não diferiu quando foram consideradas infecção pelo HIV (assintomática e AIDS. Os casos de infecção pelo HIV sem AIDS se concentram no grupo etário de 20-29 anos enquanto que a AIDS predomina na faixa de 30-39 anos. Dentre os pacientes infectados com HIV, apenas 0,8% eram hemofílicos, 3,5% usavam drogas injetáveis e 4,8% foram hemotransfundidos nos últimos 5 anos. 33% eram heterossexuais, 11% bissexuais, 23% homossexuais e 33% não declararam a inclinação sexual. Sífilis foi a associação mais freqüente (8,8%, seguido de herpes (5,8% e candidíase genital (4,3%. Nossos resultados sugerem que existe uma associação entre candidíase genital e AIDS, embora isso não tenha sido observado para as outras DSTs estudadas.The data was obtained retrospectively from clinical records concerning 399 HIV infected patients. The HIV infected individuals predominated in the age group ranging from 20 to 40 years (73.4% and 75% were male. The was no difference in the ratio of male and female patients regarding asymptomatic HIV infection or AIDS. The cases of HIV without AIDS concentrated in the age group ranging from 20-29 years while AIDS predominated in the age group ranging from 30-39 years. Only 0.8% were hemophilic, 3.5% injected drugs and 4.8% had hemotransfusions in the last 5 years. Regarding sexual behavior, 33% were heterosexuals, 11% bisexuals, 23% homosexuals and 33% did not disclose their sexual behavior. The presence of syphilis was the most frequent combination found (8.8%, followed by herpes (5.8% and genital candidiasis (4.3%. Our results suggest an association between genital candidiasis and AIDS, although this was not demonstrated for the other STDs studied.

  12. CD4+ FOXP3+ Regulatory T Cells Exhibit Impaired Ability to Suppress Effector T Cell Proliferation in Patients with Turner Syndrome.

    Directory of Open Access Journals (Sweden)

    Young Ah Lee

    Full Text Available We investigated whether the frequency, phenotype, and suppressive function of CD4+ FOXP3+ regulatory T cells (Tregs are altered in young TS patients with the 45,X karyotype compared to age-matched controls.Peripheral blood mononuclear cells from young TS patients (n = 24, 17.4-35.9 years and healthy controls (n = 16 were stained with various Treg markers to characterize their phenotypes. Based on the presence of thyroid autoimmunity, patients were categorized into TS (- (n = 7 and TS (+ (n = 17. Tregs sorted for CD4+ CD25bright were co-cultured with autologous CD4+ CD25- target cells in the presence of anti-CD3 and -CD28 antibodies to assess their suppressive function.Despite a lower frequency of CD4+ T cells in the TS (- and TS (+ patients (mean 30.8% and 31.7%, vs. 41.2%; P = 0.003 and P < 0.001, respectively, both groups exhibited a higher frequency of FOXP3+ Tregs among CD4+ T cells compared with controls (means 1.99% and 2.05%, vs. 1.33%; P = 0.029 and P = 0.004, respectively. There were no differences in the expression of CTLA-4 and the frequency of Tregs expressing CXCR3+, and CCR4+ CCR6+ among the three groups. However, the ability of Tregs to suppress the in vitro proliferation of autologous CD4+ CD25- T cells was significantly impaired in the TS (- and TS (+ patients compared to controls (P = 0.003 and P = 0.041. Meanwhile, both the TS (- and TS (+ groups had lower frequencies of naïve cells (P = 0.001 for both but higher frequencies of effector memory cells (P = 0.004 and P = 0.002 than did the healthy control group.The Tregs of the TS patients could not efficiently suppress the proliferation of autologous effector T cells, despite their increased frequency in peripheral CD4+ T cells.

  13. Taking a lesson from patients' recovery strategies to optimize training during robot-aided rehabilitation.

    Science.gov (United States)

    Colombo, Roberto; Sterpi, Irma; Mazzone, Alessandra; Delconte, Carmen; Pisano, Fabrizio

    2012-05-01

    In robot-assisted neurorehabilitation, matching the task difficulty level to the patient's needs and abilities, both initially and as the relearning process progresses, can enhance the effectiveness of training and improve patients' motivation and outcome. This study presents a Progressive Task Regulation algorithm implemented in a robot for upper limb rehabilitation. It evaluates the patient's performance during training through the computation of robot-measured parameters, and automatically changes the features of the reaching movements, adapting the difficulty level of the motor task to the patient's abilities. In particular, it can select different types of assistance (time-triggered, activity-triggered, and negative assistance) and implement varied therapy practice to promote generalization processes. The algorithm was tuned by assessing the performance data obtained in 22 chronic stroke patients who underwent robotic rehabilitation, in which the difficulty level of the task was manually adjusted by the therapist. Thus, we could verify the patient's recovery strategies and implement task transition rules to match both the patient's and therapist's behavior. In addition, the algorithm was tested in a sample of five chronic stroke patients. The findings show good agreement with the therapist decisions so indicating that it could be useful for the implementation of training protocols allowing individualized and gradual treatment of upper limb disabilities in patients after stroke. The application of this algorithm during robot-assisted therapy should allow an easier management of the different motor tasks administered during training, thereby facilitating the therapist's activity in the treatment of different pathologic conditions of the neuromuscular system.

  14. Intravenous Foscarnet With Topical Cidofovir for Chronic Refractory Genital Herpes in a Patient With AIDS.

    Science.gov (United States)

    Usoro, Agnes; Batts, Alfreda; Sarria, Juan C

    2015-01-01

    Few case reports have documented the use of topical cidofovir for refractory genital herpes simplex virus (HSV) ulcers in human immunodeficiency virus (HIV) infected patients. This drug formulation lacks a standardized concentration or even a procedural outline as to how it should be compounded. We aim to discuss the utilization of topical cidofovir in addition to presenting a procedural means of compounding it for treatment of refractory genital HSV ulcers. Our patient completed 21 days of intravenous foscarnet and 13 days of topical cidofovir with clinical improvement in the penile and scrotal ulcers. Genital herpes is a concern in patients with HIV because it generally manifests as a persistent infection. Physicians should be aware that when patients fail to respond to the conventional treatment regimens for genital HSV in a timely manner, other options are available, such as topical cidofovir as an adjuvant to systemic antivirals.

  15. Intravenous Foscarnet With Topical Cidofovir for Chronic Refractory Genital Herpes in a Patient With AIDS

    Directory of Open Access Journals (Sweden)

    Agnes Usoro BSN

    2015-12-01

    Full Text Available Few case reports have documented the use of topical cidofovir for refractory genital herpes simplex virus (HSV ulcers in human immunodeficiency virus (HIV infected patients. This drug formulation lacks a standardized concentration or even a procedural outline as to how it should be compounded. We aim to discuss the utilization of topical cidofovir in addition to presenting a procedural means of compounding it for treatment of refractory genital HSV ulcers. Our patient completed 21 days of intravenous foscarnet and 13 days of topical cidofovir with clinical improvement in the penile and scrotal ulcers. Genital herpes is a concern in patients with HIV because it generally manifests as a persistent infection. Physicians should be aware that when patients fail to respond to the conventional treatment regimens for genital HSV in a timely manner, other options are available, such as topical cidofovir as an adjuvant to systemic antivirals.

  16. HIV-specific CD8~+ T cell responses to HXB2 Gag and Nef peptide pools in Chinese HIV/AIDS patients

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    HXB2 is primarily used as a template strain in developing HIV vaccines in Europe and the US. However,it is not yet known whether the strain can induce strong HIV-specific CD8+ T cell responses in Chinese HIV/AIDS patients. In the present study,two groups of subjects were investigated:9 AIDS patients and 7 long-term nonprogressors (LTNPs). HIV-specific CD8+ T cell responses were examined in all patients through the ELISPOT assay. CD4+ T cell counts,CD8+ T cell counts,viral load and HIV subtype of each patient were also measured. Thailand B virus strain was identified among all the patients. The breadth and magnitude of HIV-specific CD8+ T cell responses in the LTNPs group are greater than those in the AIDS group (P<0.01). There is a positive correlation between magnitude of HIV-specific CD8+ T cell responses and CD4+ T cells,and a negative correlation between HIV-specific CD8+ T cell responses and mean viral load. In summary,the HIV-specific CD8+ T cell responses to the HXB2 Gag and Nef peptide pools are considerable in Chinese HIV/AIDS patients infected with Thailand B virus strain. HIV-1 vaccines based on HXB2 strain that can induce extensive immunity may be helpful for Chinese.

  17. Comparison of pp65 antigenemia, quantitative PCR and DNA hybrid capture for detection of cytomegalovirus in transplant recipients and AIDS patients.

    Science.gov (United States)

    Mhiri, Leila; Kaabi, Belhassen; Houimel, Mehdi; Arrouji, Zakia; Slim, Amine

    2007-07-01

    The cytomegalovirus (CMV) antigenemia assay has been used frequently for rapid diagnosis of CMV infection, and antigenemia threshold values are recommended for triggering preemptive therapy. Hybrid capture of CMV's DNA and quantitative polymerase chain reaction (qPCR) are increasingly being adopted for early detection of CMV. The performance of the antigenemia assay, qPCR in plasma and hybrid capture in leukocytes were compared in 110 immunocompromised patients (38 bone-marrow transplants, 50 renal transplants and 22 AIDS patients). The most sensitive test was hybrid capture for transplants, while antigenemia and the qPCR showed similar performance for patients with AIDS. QPCR and hybrid capture thresholds requiring antiviral therapy were calculated using a receiver-operating-characteristic curve for antigenemia values corresponding to 2 positive cells for bone-marrow transplants and to 10 positive cells for renal transplants and AIDS patients. These threshold values varied with the group of patients considered, with corresponding sensitivities higher than 86% and specificities higher than 76% for hybrid capture, and sensitivities higher than 61% and specificities higher than 75% for qPCR in plasma. Hybrid capture in leukocytes can substitute for antigenemia in the case of transplants, and qPCR in plasma can substitute for it in the case of AIDS patients.

  18. HIV-specific CD8~+ T cell responses to HXB2 Gag and Nef peptide pools in Chinese HIV/AIDS patients

    Institute of Scientific and Technical Information of China (English)

    ZHANG HongWei; QIU ZhiFeng; JIAO Yang; WANG AiXia; LI TaiSheng

    2009-01-01

    HXB2 is primarily used as a template strain in developing HIV vaccines in Europe and the US. However, it is not yet known whether the strain can induce strong HIV-specific CD8~+ T cell responses in Chinese HIV/AIDS patients. In the present study, two groups of subjects were investigated: 9 AIDS patients and 7 long-term nonprogressors (LTNPs). HIV-specific CD8~+ T cell responses were examined in all patients through the ELISPOT assay. CD4~+ T cell counts, CD8~+ T cell counts, viral load and HIV subtype of each patient were also measured. Thailand B virus strain was identified among all the patients. The breadth and magnitude of HIV-specific CD8~+ T cell responses in the LTNPs group are greater than those in the AIDS group (P<0.01). There is a positive correlation between magnitude of HIV-specific CD8~+ T cell responses and CD4~+ T cells, and a negative correlation between HIV-specific CD8~+ T cell responses and mean viral load. In summary, the HIV-specific CD8~+ T cell responses to the HXB2 Gag and Nef peptide pools are considerable in Chinese HIV/AIDS patients infected with Thailand B virus strain. HIV-1 vaccines based on HXB2 strain that can induce extensive immunity may be helpful for Chinese.

  19. HHV-8 infection in patients with AIDS-related Kaposi's sarcoma in Brazil

    Directory of Open Access Journals (Sweden)

    Keller R.

    2001-01-01

    Full Text Available The aims of the present study were to determine the prevalence of human herpesvirus type 8 (HHV-8 in HIV-positive Brazilian patients with (HIV+/KS+ and without Kaposi's sarcoma (HIV+/KS- using PCR and immunofluorescence assays, to assess its association with KS disease, to evaluate the performance of these tests in detecting HHV-8 infection, and to investigate the association between anti-HHV-8 antibody titers, CD4 counts and staging of KS disease. Blood samples from 66 patients, 39 HIV+/KS+ and 27 HIV+/KS-, were analyzed for HHV-8 viremia in peripheral blood mononuclear cells by PCR and HHV-8 antigenemia for latent and lytic infection by immunofluorescence assay. Positive samples for latent nuclear HHV-8 antigen (LNA antibodies were titrated out from 1/100 to 1/409,600 dilution. Clinical information was collected from medical records and risk behavior was assessed through an interview. HHV-8 DNA sequences were detected by PCR in 74.3% of KS+ patients and in 3.7% of KS- patients. Serological assays were similar in detecting anti-LNA antibodies and anti-lytic antigens in sera from KS+ patients (79.5% and KS- patients (18.5%. HHV-8 was associated with KS whatever the method used, i.e., PCR (odds ratio (OR = 7.4, 95% confidence interval (CI = 2.16-25.61 or anti-LNA and anti-lytic antibodies (OR = 17.0, 95%CI = 4.91-59.14. Among KS+ patients, HHV-8 titration levels correlated positively with CD4 counts (rho 0.48, P = 0.02, but not with KS staging. HHV-8 is involved in the development of KS in different geographic areas worldwide, as it is in Brazil, where HHV-8 is more frequent among HIV+ patients. KS severity was associated with immunodeficiency, but no correlation was found between HHV-8 antibody titers and KS staging.

  20. [Extraintestinal finding of Isospora belli unizoic cysts in a patient with AIDS: case report].

    Science.gov (United States)

    Frenkel, Jacob K; Silva, Márcia Benedita de Oliveira; Saldanha, João Carlos; de Silva-Vergara, Mario Leon; Correia, Dalmo; Barata, Cristina Hueb; Silva, Eliane Lages; Ramirez, Luis Eduardo; Prata, Aluízio

    2003-01-01

    This report describes the presence of Isospora belli unizoic cysts in mesenteric lymph nodes and of gametocytes in the gallbladder epitelium of a 26 year-old Brazilian male patient with Acquired Immune Deficiency Syndrome. This patient had received treatment for several times with sulfamethoxazole-trimethoprim. It is discussed the significance of I. belli tissue cysts as possible foci of resistance of the parasite and their association with the infection relapse even post-treatment with anticoccidian medication.

  1. Structural modification of serum vitamin D3-binding protein and immunosuppression in AIDS patients.

    Science.gov (United States)

    Yamamoto, N; Naraparaju, V R; Srinivasula, S M

    1995-11-01

    A serum glycoprotein, vitamin D3-binding protein (Gc protein), can be converted by beta-galactosidase of stimulated B lymphocytes and sialidase of T lymphocytes to a potent macrophage-activating factor (MAF), a protein with N-acetylgalactosamine as the remaining sugar moiety. Thus, Gc protein is a precursor for MAF. Treatment of purified Gc protein with immobilized beta-galactosidase and sialidase generates an extremely high-titered MAF (GcMAF). When peripheral blood monocytes/macrophages of 46 HIV-infected patients were treated with GcMAF (100 pg/ml), the monocytes/macrophages of all patients were efficiently activated. However, the MAF precursor activity of plasma Gc protein was low in 16 (35%) of of these patients. Loss of the MAF precursor activity appeared to be due to deglycosylation of plasma Gc protein by alpha-N-acetylgalactosaminidase found in the patient blood stream. Levels of plasma alpha-N-acetylgalactosaminidase activity in individual patients had an inverse correlation with the MAF precursor activity of their plasma Gc protein. Thus, precursor activity of Gc protein and alpha-N-acetylgalactosaminidase activity in patient blood can serve as diagnostic and prognostic indices.

  2. 艾滋病病人口腔护理程序的临床研究%Clinical study on oral nursing program for AIDS patients

    Institute of Scientific and Technical Information of China (English)

    武昆利; 杜映荣; 薛莲; 马光兰; 郭雁

    2014-01-01

    Obj ective:To probe into application effect of oral nursing program for AIDS patients and to search the best scheme for preven-tion and treatment of oral infections and lesions in AIDS patients Methods:A total of 200 cases of AIDS patients who were diagnosed from October in 2011 to March in 2012 were randomly divided into experimental group and control group.The nursing program was a-dopted for oral care of patients in experiment group;the patients in control group received conventional oral care,and then to observe the effect of oral care for both groups of patients and their master of oral care knowledge.Results:After a week of intervention,there was sta-tistically significant difference in efficacy of oral care,oral lesions and oral care health cognitive level between both groups (P<0.01).Con-clusion:Oral nursing program applied for the oral care of AIDS pa-tients can promote the oral health of AIDS patients and help them de-velop good oral hygiene habits.%[目的]探讨应用艾滋病(AIDS)护理程序进行口腔护理的效果,寻找预防 AIDS病人口腔感染及病损的最佳方案。[方法]将2011年10月-2012年3月住院确诊的200例 AIDS 病人随机分为试验组和对照组,试验组采用护理程序对病人进行口腔护理;对照组采用常规口腔护理。观察两组病人口腔护理的效果及病人掌握口腔护理知识的情况。[结果]干预1周后两组病人口腔护理疗效、口腔病损情况差异有统计学意义(P<0.01)。试验组病人第7天对口腔护理健康认知程度明显提高。[结论]AIDS病人口腔护理程序应用于 AIDS 病人口腔护理中,能促进病人口腔健康,帮助病人养成良好的口腔卫生习惯。

  3. Distribution and drug-resistance of pathogens isolated from AIDS patients with bacteremia in Changsha%长沙地区AIDS合并菌血症患者病原菌分布及耐药性

    Institute of Scientific and Technical Information of China (English)

    易璨珺; 苏丽君; 邹海蛟; 王留杰; 左亚婵; 沈晖; 林雪迟

    2012-01-01

    . 23%, 7. 79%, and 5. 19% respectively, bacterial infection was sporadic (18. 18%) ; the major pathogens in blood culture of the other patients was bacteria (91. 42%) , while fungi was 8. 58%; the difference in pathogens in blood culture between two groups was significant (X2= 254. 55,P<0. 01). Penicillium marnef fei exhibited low sensitivity to amphotericin B and fluconazole, while Cryptococcus neoformans and Kluyveromyces marxianus were sensitive to antifungal agents. Conclusion The key to the control of infection in AIDS patients with bacteremia is to strengthen epidemiological survey and find pathogens as soon as possible.

  4. Cultural targeting and tailoring of shared decision making technology: a theoretical framework for improving the effectiveness of patient decision aids in culturally diverse groups.

    Science.gov (United States)

    Alden, Dana L; Friend, John; Schapira, Marilyn; Stiggelbout, Anne

    2014-03-01

    Patient decision aids are known to positively impact outcomes critical to shared decision making (SDM), such as gist knowledge and decision preparedness. However, research on the potential improvement of these and other important outcomes through cultural targeting and tailoring of decision aids is very limited. This is the case despite extensive evidence supporting use of cultural targeting and tailoring to improve the effectiveness of health communications. Building on prominent psychological theory, we propose a two-stage framework incorporating cultural concepts into the design process for screening and treatment decision aids. The first phase recommends use of cultural constructs, such as collectivism and individualism, to differentially target patients whose cultures are known to vary on these dimensions. Decision aid targeting is operationalized through use of symbols and values that appeal to members of the given culture. Content dimensions within decision aids that appear particularly appropriate for targeting include surface level visual characteristics, language, beliefs, attitudes and values. The second phase of the framework is based on evidence that individuals vary in terms of how strongly cultural norms influence their approach to problem solving and decision making. In particular, the framework hypothesizes that differences in terms of access to cultural mindsets (e.g., access to interdependent versus independent self) can be measured up front and used to tailor decision aids. Thus, the second phase in the framework emphasizes the importance of not only targeting decision aid content, but also tailoring the information to the individual based on measurement of how strongly he/she is connected to dominant cultural mindsets. Overall, the framework provides a theory-based guide for researchers and practitioners who are interested in using cultural targeting and tailoring to develop and test decision aids that move beyond a "one-size fits all" approach

  5. HIV感染者/AIDS病人死亡原因的研究进展%Analysis of the causes of death of HIV infectors/AIDS patients

    Institute of Scientific and Technical Information of China (English)

    冯瑞芳; 刘中夫

    2013-01-01

    近年来,随着越来越多的艾滋病病毒(HIV)感染者进入艾滋病(AIDS)发病期,越来越多的感染者死于AIDS相关疾病.另外,随着抗病毒治疗的覆盖率不断扩大,HIV感染者/AIDS病人死于AIDS相关疾病的比例不断降低,而死于其他非AIDS相关疾病的比例却不断升高.文章就当前国内外对HIV感染者/AIDS病人死亡原因的有关研究进展进行综述,为医疗机构加强和提高对重点疾病的诊疗技术水平提供理论支持,也为中国AIDS死因监测的建立提供理论依据.%In recent years, an increasing number of HIV infectors died of AIDS related diseases because more and more HIV infections are progressing into AIDS stage. Furthermore, along with the expanding of antiretroviral therapy coverage, the proportion of HIV infectors/AIDS patients who died of AIDS related diseases was decreasing while the proportion of deaths of non-AIDS related diseases was rising continuously. This paper reviews domestic and oversea reports about progress in researches on the causes of death of HIV infectors/AIDS patients. Hopefully it could provide theoretical support and evidence for medical care facilities to strengthen and enhance their diagnostic and therapeutic ability and also for the establishment of AIDS related death monitoring system in China.

  6. The interplay between socio-demographic variables, nutritional and immune status of HIV-positive/AIDS patients.

    Science.gov (United States)

    Oguntibeju, O O; van den Heever, W M J; Van Schalkwyk, F E

    2007-10-15

    This study examined the association between socio-demographic factors (educational level and employment status) and the nutritional and immune status of 35 HIV-positive/AIDS patients at baseline. Assessment of selected macro-and micronutrient dietary intake was done using a validated food frequency questionnaire. Evaluation of anthropometric profiles (body mass index, waist-hip ratio and percentage of body fat) was also evaluated. A questionnaire was applied to obtain information on the educational level and employment status of the patients. The CD4+ T-cell counts and viral loads of the same patients were determined using the flow cytometry and Polymerase Chain Reaction (PCR) method respectively. An association between educational level and dietary intake was significant (p 0.05) association between the two socio-demographic variables (education and employment) and anthropometric profiles. The association between education, employment and CD4+ T-cell count was not significant (p > 0.05). The viral load showed a significant (p nutritional and immune status. It is suggested that the results of this study should be interpreted with caution. Further studies with larger sample sizes are recommended.

  7. Detection of Emergence Cyclospora cayetanensis in A HIV+ /AIDS Patient with Diarrhea from Tehran: A Case Report

    Directory of Open Access Journals (Sweden)

    Khadijeh KHANALIHA

    2015-10-01

    Full Text Available Coccidian protozoa of Cyclospora cayetanensis are obligate intracellular apicomplexan parasites that infect the mucosal epithelium of the small intestine of immunocompetent and immunocompromised persons. A 25- years old woman from around, Tehran with complaint of faintness and fatigue with HIV positive/AIDS confirmed eight months ago was admitted in Imam Khomeini Hospital, Tehran, Iran in 2014. The patient suffered from intestinal and lung symp-toms like watery diarrhea, flu-like symptoms. The stool was examined by direct preparation and concentration tech-nique, stained with modified acid-fast staining method, and observed with light and then Immunofluorescence micro-scope. The stool cultivation was made in dichromate potassium medium and diagnosis of Cyclospora infection was fi-nally made according to observation of Cyclospora oocysts almost 10 μm in acid-fast staining method and autofluores-cence of Cyclospora under Immunofluorescence microscope. The patient was initially treated with azithromycin, tazocin and fluconazol because of lung lesions and diarrhea and relative remission was observed. Cyclospora sp. causes an intes-tinal infection particularly in immunocompromised patients.

  8. CPAP, effective respiratory support in patients with AIDS-related Pneumocystis carinii pneumonia.

    Science.gov (United States)

    Prevedoros, H P; Lee, R P; Marriot, D

    1991-11-01

    Human Immunodeficiency Virus (HIV) related Pneumocystis carinii pneumonia (PCP) associated with severe respiratory failure is an increasingly common problem in major centres and is associated with a high mortality in previous and recent studies. Early in the epidemic, alternatives to invasive intensive care treatment were utilized in our institution and found to be successful. When respiratory failure developed, mask CPAP was used instead of intubation and ventilation. A retrospective review of 175 cases of HIV infected patients with confirmed first presentation PCP was undertaken. Treatment with our protocol resulted in an overall hospital mortality of 9%. Those patients who did not require supplemental oxygen or respiratory support had no in-hospital mortality. The group who required supplemental oxygen had a mortality of 10%. If respiratory failure supervened (severe respiratory distress, PaO2 less than 50 mmHg, SaO2 less than 90% on mask oxygen), CPAP was introduced. The mortality in this group was 22%. Only two patients were admitted to the intensive care unit for respiratory support after failure of CPAP. Both patients were intubated and received intermittent positive pressure ventilation (IPPV). Both patients died.

  9. Bloodstream Infections among AIDS Patients%艾滋病并发血流感染的临床分析

    Institute of Scientific and Technical Information of China (English)

    励峰; 朱翠云; 黄琴; 孙洪清

    2012-01-01

    Objective To analyze the bloodstream infections( BSI) among AIDS patients,and study its peripheral blood routine test,its pathogens distribution, and its influence to prognosis. Methods A retrospective cohort study was conducted among 144 AIDS inpa-tients from January 2011 to March 2012 in Shanghai Public health center of Fudan University. Results All of 144 cases, the incidence rate of BSI was 19.4% (28/144). The blood cultures contained 33 different pathogens, with 8 staphylococcus strains (24.2% ) ,6 fungi strains ( 18. 2% ) ,6 salmonella strains( 18. 2% ). The peripheral red blood cell count and haematoglobin were 3. 223 × 1012/L,98. 89g/L in patients with BSI and were 3.678 × 1012/L, 109. 94g/L in patients without BSI(f =0.016 and 0.049). The peripheral blood CD4 + lymphocyte counts were 78. 3 × 106/L in patients with BSI and were 98. 75 × 106/L in patients without BS1( P = 0. 422) . The mortality of BSI and non - BSI was 32. 1% and 12. 1% (X2 =6.772, P =0.009). Conclusion The AIDS patients with BSI had a lower red blood cell count and haematoglobin than non - BSI. The common pathogens of BSI were staphylococcus among AIDS patients in our hospital. AIDS patients with BSI had a high rate of mortality. It is necessary to prevent the happening of BSI.%目的 探讨艾滋病患者血流感染的病原菌分布,与外周血细胞的相关性及其对预后的影响.方法 回顾性分析2011年1月~2012年3月在上海市公共卫生临床中心感染科住院的艾滋病并发血流感染的发病率、病原菌分布、与外周血细胞、外周血淋巴细胞计数的相关性以及病死率.结果 144例艾滋病患者中确诊血流感染(血流感染组)有19.4% (28/144),无血流感染(无血流感染组)有80.6%(116/144).培养出33株病原菌,主要是葡萄球菌8株(24.2%);真菌6株(18.2%);沙门菌6株(18.2%).血流感染组平均红细胞计数及血红蛋白分别为3.223×1012/L、98.89g/L,无血流感染组分别为3.678×1012

  10. Antimicrobial therapy for the treatment of opportunistic infections in HIV/AIDS patients: a critical appraisal

    Directory of Open Access Journals (Sweden)

    Seddon J

    2011-04-01

    , AIDS, opportunistic infections, treatment, antimicrobials

  11. Comparative study of levamisole-selenium supplementation effect on CD4 increase in HlV / AIDS patients

    Science.gov (United States)

    Mansouri, Feizollah; Janbakhsh, Alireza; Vaziri, Siavash; Sayad, Babak; Afsharian, Mandana; Hosseinpor, Farzaneh; Mahdavian, Behzad

    2011-01-01

    Background: Given to the abundant incidence of malnutrition in HIV+ patients and its effect on progress of AIDS disease, several studies have recommended supplementation therapy (such as Selenium, Levamisole, Zinc). Methods: This clinical trial was prefunded on patient's with HIV + in Behavior Diseases Consulting Center, Kermanshah, Iran 2006-2007. One hundred-seventy eight out of all patients with CD4 1ess than 350 cell/mm3 who did not receive antiretroviral drugs were in this study. They were divided into four groups: the first group received 200 micg selenium per day, the second group received levamisole 50 mg every other day, and third group received both two drugs. The fourth group was the control group. All four groups were studied for six months. Patients' baseline CD4 and other data were recorded in a form. CD4 was rechecked after six months and collected values were compared with basic values. CD4 changes were compared among all groups, either. Results: One hundred-seventy eight patients initiated treatment and 108 cooperated in the 6-month follow up assessment. Niuety-two (85%) were males and 15% were female. CD4 decreased in control group and Levamisole group during the study which was significant, but 13 units increase was seen in Selenium-Levamisole group. CD4 count decreased 36 units in Selenium group. Comparing CD4 count change among 4 study groups showed that only CD4 change between Selenium-Levamisole group and control group was significant. Conclusion: Regarding to collected results, Selenium-Levamisole supplementation can be used as a supplementation therapy besides antiretroviral therapies. PMID:24024019

  12. Development of Patients' Decision Aid for Older Women With Stage I Breast Cancer Considering Radiotherapy After Lumpectomy

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Jennifer [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); D' Alimonte, Laura [Department of Radiation Therapy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Angus, Jan [Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario (Canada); Paszat, Larry [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Metcalfe, Kelly [Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario (Canada); Whelan, Tim [Department of Radiation Oncology, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario (Canada); Llewellyn-Thomas, Hilary [Department of Community and Family Medicine, The Center of Informed Choice, The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Lebanon, NH (Lebanon); Warner, Eiran [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Franssen, Edmee [Consultant Statistician, Faculty of Medicine, University of Toronto, Toronto, Ontario (Canada); Szumacher, Ewa, E-mail: Ewa.Szumacher@sunnybrook.ca [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)

    2012-09-01

    Purpose: To develop a patient decision aid (PtDA) for older women with Stage I, pathologically node negative, estrogen receptor-positive progesterone receptor-positive breast cancer who are considering adjuvant radiotherapy after lumpectomy and to examine its impact on patients' decision making. Methods and Materials: A PtDA was developed and evaluated in three steps according to the Ottawa Decision Support Framework: (1) needs assessment (n = 16); (2) Pilot I to examine PtDA acceptability (n = 12); and (3) Pilot II, a pretest posttest (n = 38) with older women with estrogen receptor-positive progesterone receptor-positive breast cancer after lumpectomy who were receiving adjuvant radiation therapy. Measures included patients' satisfaction with the PtDA, self-reported decisional conflict, level of distress, treatment-related knowledge, and choice predisposition. Results: The PtDA is a booklet that details each adjuvant treatment option's benefits, risks, and side effects tailored to the patient's clinical profile; includes a values clarification exercise; and includes steps to guide patients towards their decision. On the basis of qualitative comments and satisfaction ratings, all women thought that the PtDA was helpful and informative. In comparison with their baseline scores, patients had a statistically significant (p < 0.05) reduction in decisional conflict (adjusted mean difference [AMD], -7.18; 95% confidence interval [CI], -13.50 to 12.59); increased clarity of the benefits and risks (AMD, -10.86; CI, -20.33 to 21.49); and improved general treatment knowledge (AMD, 8.99; CI, 2.88-10.28) after using the PtDA. General trends were also reported in the patients' choice predisposition scores that suggested potential differences in treatment decision after PtDA use. Conclusions: This study provides evidence that this PtDA may be a helpful educational tool for this group of women. The quality of care for older breast cancer patients may be

  13. Clinical features of AIDS patients with Hodgkin’s lymphoma with isolated bone marrow involvement:report of 12 cases at a single institution

    Institute of Scientific and Technical Information of China (English)

    Marcelo Corti; Maria Villafae; Gonzalo Minue; Ana Campitelli; Marina Narbaitz; Leonardo Gilardi

    2015-01-01

    Objective:To study the main clinical and histopathological features of 12 patients with Hodgkin’s lymphoma (HL) diagnosed primarily from bone marrow (BM) involvement. Methods:We included 12 acquired immunodeficiency syndrome (AIDS) patients with HL assisted in the F. J. Muñiz Infectious Diseases Hospital since January 2002 to December 2013. hTe diagnosis of HL with primary BM involvement in patients was conifrmed by clinical, histopathological, and immunohistochemical ifndings. Results:All patients presented“B”symptoms and pancytopenia. All of them had stage IV neoplasm disease because of BM inifltration. hTe median of CD4+T-cell counts was 114 cells/μL, and mixed cellularity (MC) was the most frequent histopathological subtype of 92%cases. Conclusion:When other causes are excluded, BM biopsy should be performed in AIDS patients with“B”symptoms and pancytopenia to evaluate BM inifltration by atypical lymphocytes.

  14. Fluid input control in burned patients with the aid of ultrasonic arterial blood pressure monitoring.

    Science.gov (United States)

    Banssillon, V; Latarjet, J

    1975-01-01

    Arterial blood pressure is nowadays easily and reliably measured with ultrasonic equipment. It correlates well with blood volume, and may therefore be used to guide fluid infusion in burned patients. Monitoring of blood pressure, instead of application of old-fashioned recipes, helps to avoid dangerous situations of hypovolemia or overload.

  15. Yield of diagnostic tests for opportunistic infections in AIDS: a survey of 33 patients

    DEFF Research Database (Denmark)

    Gøtzsche, P C; Bygbjerg, Ib Christian; Olesen, B;

    1988-01-01

    /prophylaxis without diagnosis could be considered. In 8 autopsies, microscopy was suggestive of cerebral toxoplasmosis, but only 1 patient had presented important clinical symptoms. We suggest a schedule with regular microbiologic and parasitic examinations and few antibody tests, but with more antigen tests....

  16. Pulmonary complications of AIDS: radiologic features. [AIDS

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, B.A.; Pomeranz, S.; Rabinowitz, J.G.; Rosen, M.J.; Train, J.S.; Norton, K.I.; Mendelson, D.S.

    1984-07-01

    Fifty-two patients with pulmonary complications of acquired immunodeficiency syndrome (AIDS) were studied over a 3-year period. The vast majority of the patients were homosexual; however, a significant number were intravenous drug abusers. Thirteen different organisms were noted, of which Pneumocystis carinii was by far the most common. Five patients had neoplasia. Most patients had initial abnormal chest films; however, eight patients subsequently shown to have Pneumocystis carinii pneumonia had normal chest films. A significant overlap in chest radiographic findings was noted among patients with different or multiple organisms. Lung biopsy should be an early consideration for all patients with a clinical history consistent with the pulmonary complications of AIDS. Of the 52 patients, 41 had died by the time this report was completed.

  17. Predictors of loss to follow-up in patients living with HIV/AIDS after initiation of antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Tezera Moshago Berheto

    2014-01-01

    Full Text Available Background: Long-term regular follow up of ART is an important component of HIV care. Patients who are lost to follow-up (LTFU while on treatment compromise their own health and the long-term success of ART programs. Aim: This study was aimed at determining the incidence and risk factors for LTFU in HIV patients on ART at ART clinic of Mizan-Aman General Hospital, Ethiopia. Materials and Methods: A retrospective cohort study of 2133 people living with HIV/AIDS and attending an ART clinic between 2005 and 2013 was undertaken. LTFU was defined as not taking an ART refill for a period of 3 months or longer from the last attendance for refill and not yet classified as ′dead′ or ′transferred-out′. The log-rank test was used to measure differences in time to LTFU between groups and Cox proportional hazards modeling was used to measure predictors of LTFU. Results: Of 2133 patients, 53.9% were female. The mean (SD age of the cohort was 31.5 (8.0, 16 (2.2, and 3.8 (3.0 years for adults, adolescents, and children, respectively. Around 574 (26.7% patients were defined as LTFU. The cumulative incidence of LTFU was 8.8 (95% CIs 8.1-9.6 per 1000 person months. Patients with regimen substitution (HR 5.2; 95% CIs 3.6-7.3, non-isoniazid (INH prophylaxis (HR 3.7; 95% CIs 2.3-6.2, adolescent (HR 2.1; 95% CIs 1.3-3.4, and had a baseline CD 4 count < 200 cells/mm 3 (HR 1.7, 95% CIs 1.3-2.2 were at higher risk of LTFU. WHO clinical stage III (HR 0.6; 95% CIs 0.4-0.9 and IV (HR 0.8; 95% CIs 0.6-1.0 patients at entry were less likely to be LTFU than clinical stage I patients. There was no significant difference in risk of LTFU in males and females. Conclusion: Overall, these data suggested that LTFU in this study was high. Patients phase of life, drug related factors, and clinical stages were associated with LTFU in this study. Effective control measures in the at-risk population need to be implemented to improve retention.

  18. Wording effects and the factor structure of the Hospital Anxiety & Depression Scale in HIV/AIDS patients on antiretroviral treatment in South Africa.

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    Edwin Wouters

    Full Text Available BACKGROUND: Given the immense burden of HIV/AIDS on health systems in sub-Saharan Africa and the intricate link between HIV/AIDS and mental health problems, health care providers need a valid and reliable instrument to assess mental health rapidly. The Hospital Anxiety and Depression Scale (HADS may constitute such an instrument. The aims of this study were to: (1 examine the factor structure of the HADS in a population of South African HIV/AIDS patients on antiretroviral treatment (ART; and (2 identify and control the disturbing influence of systematic wording effects in vulnerable respondent groups. METHODOLOGY/PRINCIPAL FINDINGS: The translated scale was administered to 716 HIV/AIDS patients enrolled in the public sector ART program in South Africa. A combined confirmatory factor analysis and correlated-traits-correlated-methods framework was used to determine the preferred factor structure of the HADS, while controlling for the disturbing influence of systematic wording effects. When assessing the structure without a negative wording factor, all three factor structures displayed an acceptable fit to the data. The three-factor solution best fitted the data. Addition of a method factor significantly improved the fit of all three factor solutions. Using χ(2 difference testing, Razavi's one-factor solution displayed a superior fit compared to the other two factor solutions. CONCLUSIONS: The study outcomes support the use of the HADS as a valid and reliable means to screen for mental health problems in HIV/AIDS patients enrolled in a public-sector ART program in a resource-limited context. The results demonstrate the importance of evaluating and correcting for wording effects when examining the factor structure of the screening instrument in vulnerable patient groups. In light of the inter-relationships between HIV/AIDS and mental health problems and the scarcity of adequate screening tools, additional studies on this topic are required.

  19. Disseminated cutaneous leishmaniasis after visceral disease in a patient with AIDS.

    Science.gov (United States)

    Calza, Leonardo; D'Antuono, Antonietta; Marinacci, Ginevra; Manfredi, Roberto; Colangeli, Vincenzo; Passarini, Beatrice; Orioli, Roberto; Varoli, Ornella; Chiodo, Francesco

    2004-03-01

    Leishmaniasis is emerging as a common and serious opportunistic disease for patients with HIV infection. Almost all cases of HIV-Leishmania coinfection have been described in Mediterranean countries and they occur with various clinical presentations, ranging from typical visceral forms to asymptomatic or atypical cases, including cutaneous and mucocutaneous leishmaniasis. Pentavalent antimony compounds have been the mainstays of antileishmanial therapy for half a century and new lipid formulations of amphotericin B seem reliable, but the most effective treatment remains unknown. We describe a patient who was HIV infected and an intravenous drug user, with an unusual disseminated cutaneous leishmaniasis, after an initial visceral disease and after a 13-month maintenance treatment with liposomal amphotericin. The severe concurrent immunosuppression probably played an essential role in leading to this atypical cutaneous form, characterized by diffuse, nonulcerated, nonscabby maculopapular lesions.

  20. Acute renal failure in an AIDS patient on tenofovir: a case report

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    Kapitsinou Pinelopi P

    2008-03-01

    Full Text Available Abstract Introduction Tenofovir is a potent nucleotide analogue reverse-transcriptase inhibitor used with other antiretroviral agents for the treatment of human immunodeficiency virus (HIV infection. Despite the absence of renal toxicity observed in the major clinical trials of tenofovir, several case reports of acute renal failure (ARF and proximal tubule dysfunction have been described. Case presentation We report a patient who developed ARF and Fanconi syndrome during treatment with tenofovir. Despite severe metabolic acidosis associated with a creatinine of 9.8 mg/dL (866 μmol/L, this patient's condition improved on discontinuation of tenofovir treatment without requiring renal replacement therapy. Conclusion Vigilant screening of kidney function is required regularly after initiation of tenofovir due to possible appearance of renal failure.

  1. Metaphrase: an aid to the clinical conceptualization and formalization of patient problems in healthcare enterprises.

    Science.gov (United States)

    Tuttle, M S; Olson, N E; Keck, K D; Cole, W G; Erlbaum, M S; Sherertz, D D; Chute, C G; Elkin, P L; Atkin, G E; Kaihoi, B H; Safran, C; Rind, D; Law, V

    1998-11-01

    Patient descriptors, or "problems," such as "brain metastases of melanoma" are an effective way for caregivers to describe patients. But most problems, e.g., "cubital tunnel syndrome" or "ulnar nerve compression," found in problem lists in an Electronic Medical Record (EMR) are not comparable computationally--in general, a computer cannot determine whether they describe the same or a related problem, or whether the user would have preferred "ulnar nerve compression syndrome." Metaphrase is a scalable, middleware component designed to be accessed from problem-manager applications in EMR systems. In response to caregivers' informal descriptors it suggests potentially equivalent, authoritative, and more formally comparable descriptors. Metaphrase contains a clinical subset of the 1997 UMLS Metathesaurus and some 10,000 "problems" from the Mayo Clinic and Harvard Beth Israel Hospital. Word and term completion, spelling correction, and semantic navigation, all combine to ease the burden of problem conceptualization, entry and formalization.

  2. Disseminated nocardiosis with psoas abscess in a patient with AIDS: first reported case.

    Science.gov (United States)

    Corti, Marcelo; Solari, Rubén; De Carolis, Luis; Cangelos, Diana; Bianchi, Mario; Negroni, Ricardo

    2008-01-01

    Psoas muscle abscess is an uncommon infection that have been diagnosed increasingly in the last years. We present a case of a patient with advanced human immunodeficiency virus infection who developed a disseminated infection due to Nocardia asteroides sensu stricto type VI with psoas abscess. To our knowledge no other cases of Nocardia psoas abscess in the setting of HIV infection have been reported in the literature.

  3. The spectrum of kidney disease in patients with AIDS in the era of antiretroviral therapy

    Science.gov (United States)

    Wyatt, Christina M.; Morgello, Susan; Katz-Malamed, Rebecca; Wei, Catherine; Klotman, Mary E.; Klotman, Paul E.; D’Agati, Vivette D.

    2009-01-01

    With prolonged survival and aging of the HIV-infected population in the era of antiretroviral therapy, biopsy series have found a broad spectrum of HIV-related and co-morbid kidney disease in these patients. Our study describes the variety of renal pathology found in a prospective cohort of antiretroviral-experienced patients (the Manhattan HIV Brain Bank) who had consented to postmortem organ donation. Nearly one-third of 89 kidney tissue donors had chronic kidney disease, and evidence of some renal pathology was found in 75. The most common diagnoses were arterionephrosclerosis, HIV-associated nephropathy and glomerulonephritis. Other diagnoses included pyelonephritis, interstitial nephritis, diabetic nephropathy, fungal infection and amyloidosis. Excluding 2 instances of acute tubular necrosis, slightly over one-third of the cases would have been predicted using current diagnostic criteria for chronic kidney disease. Based on semi-quantitative analysis of stored specimens, pre-mortem microalbuminuria testing could have identified an additional 12 cases. Future studies are needed to evaluate the cost-effectiveness of more sensitive methods for defining chronic kidney disease, in order to identify HIV-infected patients with early kidney disease who may benefit from antiretroviral therapy and other interventions known to delay disease progression and prevent complications. PMID:19052538

  4. Detection of Dientamoeba fragilis in patients with HIV/AIDS by using a simplified iron hematoxylin technique

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    Juliana Alves Garcia

    2012-04-01

    Full Text Available INTRODUCTION: Studies strongly indicate Dientamoeba fragilis as one of the causes of diarrhea in human immunodeficiency virus (HIV patients. METHODS: The objective of the present study was to evaluate the prevalence of D. fragilis associated with the causes of diarrhea in 82 HIV/ AIDS patients hospitalized at the Instituto de Infectologia Emílio Ribas from September 2006 to November 2008. RESULTS: In total, 105 samples were collected from 82 patients. Unprotected sex was the most frequent cause of HIV infection (46.3%, followed by the use of injectable or non-injectable drugs (14.6%. Patients presented with viral loads of 49-750,000 copies/ mL (average: 73,849 ± 124,850 copies/mL and CD4 counts ranging of 2-1,306 cells/mm³ (average: 159 ± 250 cells/mm³. On an average, the odds of obtaining a positive result by using the other techniques (Hoffman, Pons and Janer or Lutz; Ritchie were 2.7 times higher than the chance of obtaining a positive result by using the simplified iron hematoxylin method. Significant differences were found between the methods (p = 0.003. CONCLUSIONS: The other techniques can detect a significantly greater amount of parasites than the simplified iron hematoxylin method, especially with respect to Isospora belli, Cryptosporidium sp., Schistosoma mansoni, and Strongyloides stercoralis, which were not detected using hematoxylin. Endolimax nana and D. fragilis were detected more frequently on using hematoxylin, and the only parasite not found by the other methods was D. fragilis.

  5. Adherence to antiretroviral therapy and associated factors among patients living with HIV/AIDS in Dessie Referral Hospital, Northern Ethiopia

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    Birhanu Demeke

    2014-09-01

    Full Text Available Background: Antiretroviral therapy has transformed the HIV infection into a chronic manageably disease. Optimal adherence (≥ 95% has required to achieve treatment success; however, still non-adherence remains major problem among patients receiving antiretroviral therapy (ART. The aim of this study was to determine adherences rate and evaluate factors affecting adherence among patients on ART in Dessie Referral Hospital (DRH. Materials and Methods: A cross sectional study employing both qualitative and quantitative methods was used. A total of 130 people living with HIV/AIDS on ART were included. All patients who came to the hospital during study period were considered based on convenient sampling technique. Chi-Square test is used to examine the association of adherence with associated factors. Both data entry and analysis was done using SPSS version 16. Results: Of 130 respondents, 58(44.6% were males and 72(55.4% were females and 107 (82.3% had 100% adherences, 10(7.7% had 95 -100% and the rest, 13(10% had <95% adherences with overall adherence rate of 90% for last month prior to the study period. The main reasons for non-adherence were 12(37.5% forgetfulness, 7(21.8% being away from home and 4 (12.5% being extremely ill. Use of other medications in addition to antiretroviral drugs (p=0.01, treatment fit into daily routines (p=0.01, family disclosure (p=0.01, active substance use (p=0.04 and living condition (p=0.00 were significantly associated with adherence to ART. Conclusion: The self reported adherence rate to ART (90% was found to be relatively higher which needs inclusion of other methods to ensure consistency of this value. Forgetfulness, being away from home and being extremely ill were the foremost reasons for non-adherence. The patients should be encouraged to maintain this high level of adherence.

  6. A 3-YEAR FOLLOW-UP OF A BRAZILIAN AIDS PATIENT WITH PROTRACTED DIARRHEA CAUSED BY Enterocytozoon bieneusi

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    Patrícia BRASIL

    1998-07-01

    Full Text Available Enterocytozoon bieneusi is the most prevalent microsporidian parasite that causes gastrointestinal infection in persons with AIDS. Microsporidia are increasingly recognized as important opportunistic pathogens all over the world but in Brazil only few cases have been reported due either to the non awareness of the clinical presentation of the disease or to difficulties in the laboratory diagnosis. We report a 3-year follow-up of a Brazilian HIV-positive patient in whom microsporidial spores were detected in stools and were identified as E. bieneusi using electron microscopy and PCR. The patient presented with chronic diarrhea, CD4 T-lymphocytes count below 100/mm3 and microsporidial spores were consistently detected in stools. Albendazole was given to the patient in several occasions with transient relief of the diarrhea, which reappeared as soon as the drug was discontinued. Nevertheless, a diarrhea-free period with weight gain up to 18 Kg occurred when a combination of nucleoside and protease inhibitors was initiated as part of the antiviral treatment.Enterocytozoon bieneusi é o mais comum microsporídio agente de infecções gastrointestinais que ocorre predominantemente em pessoas com AIDS. Em todo o mundo os microsporídios são reconhecidos como importantes patógenos oportunistas, entretanto poucos casos já foram diagnosticados no Brasil, provavelmente devido ao pouco conhecimento do quadro clínico que os agentes produzem ou a dificuldades no diagnóstico laboratorial. No presente trabalho relatamos o caso de um paciente brasileiro HIV-positivo acompanhado durante 3 anos, em que foram detectados esporos de microsporídios nas fezes, identificados como Enterocytozoon bieneusi por microscopia eletrônica e PCR. O paciente apresentava diarréia crônica, contagem de linfócitos CD4 abaixo de 100/mm3 e fez uso de albendazol em diferentes ocasiões com melhora transitória da diarréia, que reaparecia logo que a droga era suspensa

  7. Quality of life in HIV/AIDS patients in relation to CD4 count: A cross-sectional study in Mysore district

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    Sudhir Gowda

    2012-01-01

    Full Text Available Background: With the recent advances in clinical tests and treatments for those suffering from HIV/AIDS, the survival of these patients has been increased and their quality of life has become an important focus for researchers and healthcare providers. HIV affects the CD4 cells and CD4 count is the basis on which the ART treatment is started. Objective: To study the relationship of CD4 count with Quality of life of HIV/AIDS patients. Materials and Methods: This cross-sectional study was done in 255 HIV/AIDS patients at ART center in tertiary care hospital, Mysore. WHO-QOL-BREF a summarized quality of life questionnaire was used to assess the Quality of life. CD4 count of each patient was done. Statistical analysis was done using Epi-info software. To test the significance between QoL score and CD4 count, a t test was applied and to see the correlation between QoL score and various domains, Pearson′s correlation co-efficient was calculated. Results: Out of 255 patients, 149 patients had their CD4 count below 350 with a mean QOL score 50.6 and 106 patients had their CD4 count above 350 with a mean QOL score 55.2. A positive correlation was seen with a r value of 0.31. Patients with higher CD4 count had better QOL than those with lower CD4 counts; the t test showed statistically significant association ( P < 0.05 between CD4 count and QOL. Conclusion: Present study has revealed a strong relationship between QOL and CD4 count of HIV/AIDS patients which necessitates pragmatic interventions to improve the CD4 count.

  8. Development and evaluation of a decision aid about fertility preservation for Dutch breast cancer patients : informing patients about fertility preservation

    NARCIS (Netherlands)

    Garvelink, Mirjam Marjolein

    2014-01-01

    In the Netherlands, information provision about fertility preservation (FP) for young women with breast cancer is not sufficient. Since an increasing number of Dutch breast cancer patients will face this preference-sensitive decision each year, there is a clear need for improvement of information pr

  9. 艾滋病患者血流感染的研究%Study of bloodstream infection in HIV/AIDS patients

    Institute of Scientific and Technical Information of China (English)

    杨宗兴; 吴南屏

    2012-01-01

    血流感染(BSI)对艾滋病患者的预后有重要意义,即使在HAART时代,BSI在艾滋病患者的死亡原因中仍排在前三位.国外有较多针对艾滋病患者BSI的研究,而国内这方面的研究较少.此文就艾滋病患者BSI的发病率、病原体、诊断、预后和防治等问题作了综述.%Bloodstream infection(BSI) is of great importance to the prognosis of HIV/AIDS patients,which ranks among the first three causes of death of HIV/AIDS patients even in HAART(highly active antiretroviral therapy)era.Many studies of BSI aiming at HIV/AIDS patients have been conducted abroad,but there are few in China.Now,the studies of BSI of HIV/AIDS patients,the topics involving incidence,pathogens,diagnosis,prognosis,prevention and cure are reviewed in this article.

  10. IDENTIFICATION OF BACTERIA CAUSING DIARRHOEA IN HIV/AIDS PATIENTS AND ITS CORRELATION WITH CD4 COUNT

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    Anand Premanand

    2016-05-01

    Full Text Available BACKGROUND The number of HIV-positive patients is increasing in India. Data on the prevalence of diarrhoea and the spectrum of bacteria responsible for diarrhoea in HIV- positive patients is lacking in our area. The identification of enteric pathogens in patients with HIV/AIDS is important because an increasing array of therapeutic regimens is becoming available to treat many of these infections. Thus, an attempt is done to elucidate the associations between causative bacteria of acute and chronic diarrhoea and CD4 count. METHODS Stool specimens were obtained over a period of eighteen months from HIV infected adults with diarrhoea presenting to Shri B M Patil Medical College Hospital and Research Centre, Vijayapura. In all patients with diarrhoea, stool specimens were examined by microscopy and cultures to identify bacterial pathogens and blood sample was analysed for CD4 count. RESULTS A total of 80 individuals were enrolled in this study. Cases included 46 males and 34 females. Among the cases, maximum subjects were found to be in the age group of 30-40 years in which 23 (62.2% were males and 14 (37.8% were females. 56 had acute and 24 had chronic diarrhoea. The percentages of bacteria isolated were 5 (8.9% in acute and 16 (66.7% in chronic diarrhoea respectively. The most common bacteria isolated was E. Coli (17.5% followed by Klebsiella (5% and Shigella Sps (3.75%. Patients with chronic diarrhoea had lower CD4 cell counts. The maximum bacterial isolation was in the patients whose CD4 cell counts were below 200 cells/mm3. CONCLUSION Bacterial isolation was most strongly associated with low CD4 counts and chronic diarrhoea. E. coli was isolated maximum among all the bacteria in the HIV patients. Over two-thirds of diarrhoeal episodes were undiagnosed, suggesting that unidentified agents or primary HIV enteropathy are important causes of diarrhoea in this population. There is a strong negative association between duration of diarrhoea and CD4

  11. Three generic nevirapine-based antiretroviral treatments in Chinese HIV/AIDS patients: multicentric observation cohort.

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    Taisheng Li

    Full Text Available BACKGROUND: The purpose of this study was to evaluate the efficacy and safety of three nevirapine-based antiretroviral treatments for adult antiretroviral-naïve Chinese patients with HIV-1 infection. METHODOLOGY: This was a prospective, multicenter study. 198 antiretroviral-naïve HIV-1 positive subjects with CD4 lymphocyte counts between 100/ul and 350/ul and plasma HIV-1 RNA levels more than 500 copies/ml were randomized to start three NVP-based antiretroviral treatments: group A, NVP+AZT+ddI; group B, NVP+3TC+d4T; group C, NVP+AZT+3TC. Viral responses, immunologic responses, adverse events and drug resistance were monitored at baseline and the end of week 4, 12, 24, 36, 52. Viralogical response and immunological response were also compared in different strata of baseline CD4 T lymphocyte counts and plasma HIV-1 RNA concentrations. At baseline, the plasma HIV-1 RNA was 4.44+/-0.68, 4.52+/-0.71 and 4.41+/-0.63 lg copies/ml in group A, B and C respectively (p = 0.628. At the end of the study, the plasma viral load reached 2.54+/-1.11, 1.89+/-0.46 and 1.92+/-0.58 lg copies/ml in group A, B and C respectively (p200/ul (subgroup H. But in subgroup L, viral response rate of three groups has no significant statistic difference. There were no statistically significant differences among three groups in immunological response within any of the CD4 or pVL strata. 3 out of 193 patients with available genotype at baseline showed primary drug resistant. Of 26 patients with virologic failure, 17 patients showed secondary drug resistant, 16 subjects in group A and 1 subject in group B. Logistic regression analysis indicated that presence of hepatotoxicity was associated with HCV-Ab positive (OR = 2.096, 95%CI: 1.106-3.973, P = 0.023 and higher CD4 baseline (CD4 count >250/ul (OR = 2.096, 95%CI: 1.07-4.107, P = 0.031. CONCLUSION: Our findings strongly support the use of 3TC+d4T and 3TC+AZT as the nucleoside analogue combination in NVP-based antiretroviral

  12. Gastrointestinal cryptococcoma – Immune reconstitution inflammatory syndrome or cryptococcal relapse in a patient with AIDS?

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    Abdu K. Musubire

    2015-06-01

    Full Text Available The introduction of antiretroviral therapy (ART may lead to unusual paradoxical and unmasking presentations of opportunistic infections. Intra-abdominal cryptococcosis is a rare manifestation of Cryptococcus. We present the case of an HIV-infected patient on ART, with a history of cryptococcal meningitis who presented with subacute, worsening abdominal pain during immune recovery. This evolved into chronic abdominal pain, with thickened bowel, and abdominal lymphadenopathy, while receiving empiric tuberculosis treatment. At 6-months, he developed intestinal perforation due to a histologically confirmed cryptococcoma.

  13. [Prehospital stage of medical aid to patients with acute coronary syndrome and elevated ST segment].

    Science.gov (United States)

    Vertkin, A L; Morozov, S N; Fedorov, A I

    2013-01-01

    We studied effect of time on the outcome of acute coronary syndrome and elevated ST segment at the prehospital stage. Logistic regression analysis revealed two time-dependent predictors: "symptom-needle" time and total call service time. In patients undergoing prehospital thrombolysis, these indices (88 and 85 min respectively) reliably predicted the probability of fatal outcome. Their values of 71 and 77 min respectively predicted the risk of unfavourable outcome. The total call service time may serve as an indicator of the quality of work of an ambulance crew at the prehospital stage of management of acute coronary syndrome with elevated ST segment.

  14. Oral manifestation of HIV/AIDS infections in paediatric Nigerian patients

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    Adetokunbo Rafel Adebola

    2012-01-01

    Full Text Available Background: The aims of this study were to determine the pattern and frequency of oral lesions and to compare the prevalence of HIV-related oral lesions in paediatric Nigerian patients on HAART with those not on HAART. Materials and Methods: All patients aged 15 years and below attending the Infectious Disease Clinic of Aminu Kano Teaching Hospital with a diagnosis of HIV were consecutively examined in a cross-sectional study over a 2-year period. Information was obtained by history, physical examinations, HIV testing, and enumeration of CD+ T cells. The results are presented. A P-value of <0.05 was considered significant. Results: A total of 105 children comprising 63 males and 42 female who met the inclusion criteria participated in the study, mean age in months was 53.3±42.2, with a mean of 3.4±2.2 for male and 2.8±1.8 for female respectively. Oral lesions occurred in 61.9% of the children Overall, 22 (21.0% had at least one oral lesion, 43 (41.0% had multiple lesion. The most common lesion was oral candidiasis (79.1%. The angular cheilitis (43.8% variant was most frequent. The mean CD4 counts were 1138 cells/mm [3] , 913 cells/mm [3] and 629 cells/mm [3] for those without oral lesion, with single lesion and multiple oral lesions respectively. These differences were not statistically significant (ANOVA: F=0.185, df=2, 80, 82, P=0.831. Patients on HAART comprised about 61.9% and these were found to have reduced risk for development of such oral lesions as angular cheilitis (OR=0.76; 95% CI=0.56-1.02; P=0.03, pseudomembranous candidiasis (OR=0.71; 95% CI=0.54-0.94; P=0.024 and HIV-gingivitis (OR=0.59; 95% CI=0.46-0.75; P=0.001. HAART had some beneficial but insignificant effect on development of HIV-periodonttitis (OR=0.60; 95% CI=0.51-0.70; P=0.09. The chances of occurrence of other oral lesions were not significantly reduced by HAART (Kaposi sarcoma, OR=1.24; 95% CI=0.31-5.01; P=0.47, erythematous candidiasis, OR=1.13; 95% CI=0

  15. AIDS in South Africa.

    Science.gov (United States)

    Ijsselmuiden, C; Evian, C; Matjilla, J; Steinberg, M; Schneider, H

    1993-01-01

    The National AIDS Convention in South Africa (NACOSA) in October 1992 was the first real attempt to address HIV/AIDS. In Soweto, government, the African National Congress, nongovernmental organizations, and organized industry and labor representatives worked for 2 days to develop a national plan of action, but it did not result in a united effort to fight AIDS. The highest HIV infection rates in South Africa are among the KwaZulu in Natal, yet the Inkatha Freedom Party did not attend NACOSA. This episode exemplifies the key obstacles for South Africa to prevent and control AIDS. Inequality of access to health care may explain why health workers did not diagnose the first AIDS case in blacks until 1985. Migrant labor, Bantu education, and uprooted communities affect the epidemiology of HIV infection. Further, political and social polarization between blacks and whites contributes to a mindset that AIDS is limited to the other race which only diminishes the personal and collective sense of susceptibility and the volition and aptitude to act. The Department of National Health and Population Development's voluntary register of anonymously reported cases of AIDS specifies 1517 cumulative AIDS cases (October 1992), but this number is low. Seroprevalence studies show between 400,000-450,000 HIV positive cases. Public hospitals cannot give AIDS patients AZT and DDI. Few communities provided community-based care. Not all hospitals honor confidentiality and patients' need for autonomy. Even though HIV testing is not mandatory, it is required sometimes, e.g., HIV testing of immigrants. AIDS Training, Information and Counselling Centers are in urban areas, but not in poor areas where the need is most acute. The government just recently developed in AIDS education package for schools, but too many people consider it improper, so it is not being used. The poor quality education provided blacks would make it useless anyhow. Lifting of the academic boycott will allow South African

  16. Digital collections and exhibits

    CERN Document Server

    Denzer, Juan

    2015-01-01

    Today's libraries are taking advantage of cutting-edge technologies such as flat panel displays using touch, sound, and hands-free motions to design amazing exhibits using everything from simple computer hardware to advanced technologies such as the Microsoft Kinect. Libraries of all types are striving to add new interactive experiences for their patrons through exciting digital exhibits, both online and off. Digital Collections and Exhibits takes away the mystery of designing stunning digital exhibits to spotlight library trea

  17. Ethics on Exhibit

    Science.gov (United States)

    Vick, Randy M.

    2011-01-01

    This article discusses ethical questions raised by an exhibition of work by an artist with a history of mental illness and the exhibition's relevance to art therapy and “outsider art” discourse on the subject. Considerations for how such an exhibit could be handled had the circumstances included an art therapist and art therapy client are…

  18. Etruscan Culture Exhibition

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    EARLY this year an exhibition on the ancient civilization of Etruria was held at the Beijing-based China Millennium Monument.The theme of the exhibition was Etruscan Culture and on show were the most representative cultural and historical relics of this ancient civilization unearthed in the past 20 years. The 349 exhibits from various

  19. Disseminated tuberculosis after extracorporeal shock-wave lithotripsy in an AIDS patient presenting with urosepsis.

    Science.gov (United States)

    Tourchi, Ali; Ebadi, Maryam; Hosseinzadeh, Alireza; Shabaninia, Mahsa

    2014-03-01

    Haematogenous dissemination of undiagnosed urinary tuberculosis after performing extracorporeal shock-wave lithotripsy (ESWL) is extremely rare. Herein, we report a 41-year-old male who presented with urosepsis to the emergency room; catheterization was performed and retention resolved. He had a tattoo on his left arm and a five-year history of intravenous drug use. Blood tests indicated anaemia, leukocytosis, elevated CRP and ESR and mild hyponatraemia; haematuria, moderate bacteriuria and 2+ proteinuria on urinanalysis were observed. Chest X-ray revealed lesions suggestive of miliary tuberculosis, which was confirmed by chest CT scan. Brain CT and MRI suggested brain involvement in the setting of tuberculosis. On further investigations, HIV infection and hepatitis C seropositivity were detected and the patient remained in a coma for five days with a Glasgow Coma Scale of 6/15. Finally, the diagnosis of haematogenous dissemination of tuberculosis following lithotripsy was established. Anti-tuberculosis and anti-retroviral therapy were prescribed and monthly follow-up visits were scheduled. In conclusion, in a patient diagnosed with ureterolithiasis, a thorough history and physical examination, with specific attention to HIV and tuberculosis predisposing factors, should be carried out and preoperative screening tests considering the possibility of urinary tuberculosis are required. Finally, if urinary tuberculosis is detected, ESWL must be postponed until after appropriate treatment of tuberculosis.

  20. Central nervous system involvement in Hodgkin's lymphoma associated with Epstein-Barr virus in a patient with AIDS: case report and review of the literature

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    Marcelo Corti

    2006-12-01

    Full Text Available Intracranial and intraspinal involvement is a rare complication of Hodgkin's disease. We report a case of a patient with diagnosis of AIDS and Hodgkin's lymphoma who developed brain and spinal involvement at the time of the relapse of the neoplasm disease. Mixed cellularity histology was the subtype of Hodgkin's disease in our patient; we identified the Epstein-Barr virus genome in the Reed-Sternberg cells by immunohistochemistry and in situ hybridization.

  1. Encounter Decision Aid vs. Clinical Decision Support or Usual Care to Support Patient-Centered Treatment Decisions in Osteoporosis: The Osteoporosis Choice Randomized Trial II.

    Directory of Open Access Journals (Sweden)

    Annie LeBlanc

    Full Text Available Osteoporosis Choice, an encounter decision aid, can engage patients and clinicians in shared decision making about osteoporosis treatment. Its effectiveness compared to the routine provision to clinicians of the patient's estimated risk of fracture using the FRAX calculator is unknown.Patient-level, randomized, three-arm trial enrolling women over 50 with osteopenia or osteoporosis eligible for treatment with bisphosphonates, where the use of Osteoporosis Choice was compared to FRAX only and to usual care to determine impact on patient knowledge, decisional conflict, involvement in the decision-making process, decision to start and adherence to bisphosphonates.We enrolled 79 women in the three arms. Because FRAX estimation alone and usual care produced similar results, we grouped them for analysis. Compared to these, use of Osteoporosis Choice increased patient knowledge (median score 6 vs. 4, p = .01, improved understanding of fracture risk and risk reduction with bisphosphonates (p = .01 and p<.0001, respectively, had no effect on decision conflict, and increased patient engagement in the decision making process (OPTION scores 57% vs. 43%, p = .001. Encounters with the decision aid were 0.8 minutes longer (range: 33 minutes shorter to 3.0 minutes longer. There were twice as many patients receiving and filling prescriptions in the decision aid arm (83% vs. 40%, p = .07; medication adherence at 6 months was no different across arms.Supporting both patients and clinicians during the clinical encounter with the Osteoporosis Choice decision aid efficiently improves treatment decision making when compared to usual care with or without clinical decision support with FRAX results.clinical trials.gov NCT00949611.

  2. A multiattribute utility evaluation of different methods for the detection of enteric protozoa causing diarrhea in AIDS patients

    Directory of Open Access Journals (Sweden)

    Sundar Shyam

    2010-01-01

    Full Text Available Abstract Background Enteric protozoa and sporozoa have emerged as important opportunistic parasites and can cause fatal infections in AIDS patients. The line of treatment being different for them necessitates an accurate and prompt identification of these to avoid empirical treatment. In this study which is the first of its kind from India we did a comprehensive evaluation of different techniques, comparing them on the basis of the attributes like yield, cost, time taken, expertise and infrastructure. For the first time combination of Calcoflour White and DAPI, a nuclear stain, were used to identify Microsporidia spp. Thus, a diagnostic protocol was devised for rapid, sensitive and cost effective identification of the opportunistic enteric protozoa. Results The organisms isolated from the stool samples of the cases (450 HIV patients were predominantly Cryptosporidium spp., Microsporidia spp. and Cyclospora spp. Interestingly, the control group (200 relatives of the patients who were HIV negative showed a high incidence (21% of Cryptosporidium spp. We found a significant increase in the sensitivity of microscopy in detecting Cryptosporidium spp. and Cyclospora spp. after formol ether concentration. Kinyoun's staining was better compared to Modified safranin staining for Cryptosporidium spp. identification. Although ELISA had a sensitivity of 93.25% and specificity of 97% for Cryptosporidium spp. detection, we ranked Kinyoun's staining better than ELISA because it is not affordable to most of our patients. For detecting Cyclospora cayetanensis, autoflourescence was the easiest and most cost effective method followed by Safranin technique. Combination of Calcoflour White stain and DAPI gave good results for the identification of Microsporidia spp. We assessed the above techniques and graded the attributes in the following descending order: cost effectiveness, sensitivity, ease of use and interpretation, time taken for the procedure and batch

  3. Effect of armodafinil on cognition in patients with HIV/AIDS and fatigue.

    Science.gov (United States)

    McElhiney, Martin; Rabkin, Judith; Van Gorp, Wilfred; Rabkin, Richard

    2013-01-01

    Fatigue and cognitive impairment are common in HIV+ adults and may occur independently or be causally linked. This study examined whether alleviation of fatigue with armodafinil in a placebo-controlled double-blind 4-week trial had an effect on cognitive function among those with and without mild neuropsychological impairment at baseline. Sixty-one patients completed a standard battery of neuropsychological tests at study entry and Week 4: A total of 33 were randomized to armodafinil and 28 to placebo. While there was a significant effect of active medication on fatigue, cognitive performance measured by a global change score did not differ between treatment groups, or in those on active treatment with or without mild neuropsychological impairment.

  4. Uninfected patient can't win damages from doctor with AIDS.

    Science.gov (United States)

    1995-04-07

    The Minnesota Supreme Court has ruled that damages cannot be awarded to a woman who claimed emotional distress after learning her doctor was HIV-positive. The doctor was allowed to continue practicing medicine as long as he took certain precautions and stopped performing surgery, with which he complied. When presented with the "zone of danger" argument, the court said that actual physical contact is not necessary to sustain a claim for emotional distress damages. However, the court said that the plaintiff was never in any imminent peril, citing the numerous resource materials about how HIV is spread. It also was determined that the doctor's conduct did not significantly increase the chance of the patient becoming infected, and he had no obligation to disclose that he was HIV-positive. This determination rendered void the plaintiff's ability to sue through the State's Consumer Fraud Act.

  5. A clinical comparative study of polymerase chain reaction assay for diagnosis of pneumocystis pneumonia in non-AIDS patients

    Institute of Scientific and Technical Information of China (English)

    MU Xiang-dong; WANG Guang-fa; SU Li

    2011-01-01

    Background Pneurnocystis jirovecii pneumonia (PCP) is one of the most common and fatal infections in non-AIDS immunocompromised patients,which is difficult to diagnose by traditional morphologic methods.This study evaluated polymerase chain reaction (PCR) assays of Pneumocystis jirovecii mitochondrial large subunits ribosomal RNA in sputum and bronchioalveolar lavage fluid (BALF) for diagnosing PCP.Methods Sputum and BALF specimens from two groups were collected:one group (PCP group) included 20 patients definitely diagnosed of PCP by Gomori methenamine silver (GMS) stains of BALF;the other group (non-PCP group) included 40 patients.Each specimen was examined by GMS stains and PCR assays.Results GMS stains of BALF in PCP group were 100% positive (20/20),GMS stains of sputum in PCP group were 35% positive (7/20);GMS stains of BALF in non-PCP group were 100% negative (40/40),GMS stains of sputum in non-PCP group were 100% negative (40/40).PCR assays of BALF in PCP group were 100% positive (20/20),PCR assays of sputum in PCP group were 100% positive (20/20);PCR assays of BALF in non-PCP group were 100% negative (40/40),PCR assays of sputum in non-PCP group were 100% negative (40/40).Sensitivity and specificity of PCR assays of sputum and BALF were both 100%;positive and negative predictive values were also both 100%.Conclusion The diagnostic value of PCR assays of Pneumocystisjirovecii mitochondrial large subunits ribosomal RNA on sputum and BALF for pneumocystis pneumonia are both high and equivalent.

  6. Efficacy of amphotericin B in a fat emulsion for the treatment of cryptococcal meningitis in AIDS patients

    Directory of Open Access Journals (Sweden)

    Fernando Góngora Rubio

    2007-04-01

    Full Text Available Several formulae have been developed in an attempt to reduce the toxicity of amphotericin B (AmB, but their high costs preclude widespread use. The aim of this study was to evaluate the efficacy of amphotericin B in a fat emulsion, i.e. Intralipid (AmB-IL, in 37 AIDS patients with cryptococcal meningitis (CM. We retrospectively reviewed data collected in a non-comparative open study between January 1999 and December 2001. The therapeutic cure was defined as complete resolution or improvement of the clinical symptoms or complete absence or improvement of the mycological alterations of the CSF. The outcomes were evaluated at 2 weeks, induction phase (IP, and at the end of treatment or consolidation phase (CP with the last available CSF. Prior to the diagnosis of CM, 72% of patients had had one or more OI and 67.57% had a concomitant OI. The median CD4-cell count was 32 cells/mm³, the median leukocyte count in the CSF was 29 cells/mm³ and the median cumulative dose of AmB-IL was 1,200 mg (300-2,500. The therapeutic cure was 57.14% in the IP and 64.86% in the CP. During IP, 9 patients died (24.32% and 4 (10.81% during the CP (p=0.2. Thus, the overall mortality rate was 35.14%. AmB-IL, an inexpensive preparation, might be an alternative to conventional AmB. Some questions remain such as its compatibility, stability and level of toxicity. The benefit is especially important in developing countries, where no drugs other than AmB are available to treat systemic fungal infections.

  7. Lifetime suicide attempt history, quality of life, and objective functioning among HIV/AIDS patients with alcohol and illicit substance use disorders.

    Science.gov (United States)

    Walter, Kimberly N; Petry, Nancy M

    2016-05-01

    This cross-sectional study evaluated lifetime prevalence of suicide attempts in 170 HIV/AIDS patients with substance use disorders and the impact of suicide attempt history on subjective indices of quality of life and objective indices of cognitive and physical functioning. All patients met the diagnostic criteria for past-year cocaine or opioid use disorders and 27% of patients also had co-occurring alcohol use disorders. Compared to their counterparts without a history of a suicide attempt, patients with a history of a suicide attempt (n = 60, 35.3%) had significantly poorer emotional and cognitive quality of life scores (ps quality-of-life scores. Lifetime suicide attempt status was unrelated to objective indices of cognitive functioning, but there was a non-significant trend (p = .07) toward lower viral loads in those with a lifetime suicide attempt relative to those without. The findings indicate that suicide attempt histories are prevalent among HIV/AIDS patients with substance use disorders and relate to poorer perceived emotional and cognitive quality of life, but not objective functioning. HIV/AIDS patients with substance use disorders should be screened for lifetime histories of suicide attempts and offered assistance to improve perceived emotional and cognitive functioning.

  8. Hepatopulmonary syndrome in a patient with AIDS and virus C cirrhosis (viral cirrhosis type C); Sindrome hepatopulmonar em paciente com cirrose por virus C e SIDA

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, Maria Angelica; Gazzana, Marcelo Basso [Hospital de Clinicas de Porto Alegre, RS (Brazil). Servico de Pneumologia; Barreto, Sergio Saldanha Menna; Knorst, Marli Maria [Rio Grande do Sul Univ., Porto Alegre, RS (Brazil). Faculdade de Medicina. Dept. de Medicina Interna

    2001-02-01

    Hepatopulmonary syndrome is characterized by a triad consisting of liver disorder, pulmonary vascular dilatation, and hypoxaemia. No case of hepatopulmonary syndrome associated with AIDS has been reported so far. In this study, the authors report the case of a 43-year woman with AIDS and virus C cirrhosis taking prophylactic cotrimoxazole for pneumocystosis and retroviral therapy. Upon admission, the patient presented dyspnoea, cyanosis, digital clubbing, vascular spiders, and normal chest examination. Chest X-ray revealed bilateral interstitial infiltration and evidenced increased alveolar-arterial gradient and liver function impairment. Intrapulmonary shunt was evidenced by contrast-enhanced echocardiography and radionuclide perfusion scanning, thus confirming hepatopulmonary syndrome. (author)

  9. Hearing Aids

    Science.gov (United States)

    ... more in both quiet and noisy situations. Hearing aids help people who have hearing loss from damage ... your doctor. There are different kinds of hearing aids. They differ by size, their placement on or ...

  10. AIDS (image)

    Science.gov (United States)

    AIDS (acquired immune deficiency syndrome) is caused by HIV (human immunodeficiency virus), and is a syndrome that ... life-threatening illnesses. There is no cure for AIDS, but treatment with antiviral medicine can suppress symptoms. ...

  11. Epidemiology, clinical, immune, and molecular profiles of microsporidiosis and cryptosporidiosis among HIV/AIDS patients

    Directory of Open Access Journals (Sweden)

    Wumba R

    2012-07-01

    Full Text Available Roger Wumba,1 Benjamin Longo-Mbenza,2 Jean Menotti,3,4 Madone Mandina,5 Fabien Kintoki,5 Nani Hippolyte Situakibanza,1,5 Marie Kapepela Kakicha,6 Josue Zanga,1 Kennedy Mbanzulu-Makola,1 Tommy Nseka,1 Jean Pierre Mukendi,1 Eric Kendjo,7 Jean Sala,1 Marc Thellier7,81Department of Tropical Medicine, Infectious and Parasitic Diseases, Department of Parasitology, University Clinic of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo; 2Faculty of Health Sciences, Walter Sisulu University, Eastern Cape, South Africa; 3Laboratory of Parasitology and Mycology, Saint-Louis Hospital, Public Assistance-Hospitals of Paris, Paris, France; 4Faculty of Medicine, Lariboisière-Saint-Louis, University of Paris VII, Paris, France; 5Department of Internal Medicine, University Clinic of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo; 6Department of Pediatrics, University Clinic of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo; 7National Center for Malaria Research, AP-HP, CHU Pitie Salpêtrière, Paris, France; 8Laboratory of Parasitology and Mycology, Pitié Salpêtrière Hospital, Public Assistance-Hospitals of Paris, Pierre and Marie Curie University, Paris, FranceBackground: The objective of this study was to determine the prevalence of intestinal parasites, with special emphasis on microsporidia and Cryptosporidium, as well as their association with human immunodeficiency virus (HIV symptoms, risk factors, and other digestive parasites. We also wish to determine the molecular biology definitions of the species and genotypes of microsporidia and Cryptosporidium in HIV patients.Methods: In this cross-sectional study, carried out in Kinshasa, Democratic Republic of the Congo, stool samples were collected from 242 HIV patients (87 men and 155 women with referred symptoms and risk factors for opportunistic intestinal parasites. The analysis of feces specimen were performed using Ziehl

  12. Aplastic anemia associated to systemic lupus erythematosus in an AIDS patient: a case report.

    Science.gov (United States)

    de Oliveira, Leonardo Rodrigues; Ferreira, Thaís Camargos; Neves, Fernando de Freitas; Meneses, Antônio Carlos de Oliveira

    2013-01-01

    Aplastic anemia is a bone marrow failure syndrome characterized by peripheral cytopenias and hypocellular bone marrow. Although aplastic anemia is idiopathic in most cases, rheumatic diseases such as systemic lupus erythematosus are recognized as causes of aplastic anemia, with their possible etiological mechanisms being T and B lymphocyte dysfunction and pro-inflammatory cytokines and autoantibody production directed against bone marrow components. In the course of the human immunodeficiency virus infection/acquired immunodeficiency syndrome, the identification of autoantibodies and the occurrence of rheumatic events, in addition to the natural course of systemic lupus erythematosus which is modified by immune changes that are characteristic of human immunodeficiency virus infection/acquired immunodeficiency syndrome, make the diagnosis of systemic lupus erythematosus challenging. This study reports the case of a woman with acquired immunodeficiency syndrome treated with a highly active antiretroviral therapy, who had prolonged cytopenias and hypocellular bone marrow consistent with aplastic anemia. The clinical picture, high autoantibodies titers, and sustained remission of the patient's hematological status through immunosuppression supported the diagnosis of systemic lupus erythematosus-associated aplastic anemia. This is the first report of aplastic anemia concurrent with systemic lupus erythematosus and acquired immunodeficiency syndrome, providing additional evidence that immune dysfunction is a key part of the pathophysiological mechanism of aplastic anemia.

  13. Aid Effectiveness

    DEFF Research Database (Denmark)

    Arndt, Channing; Jones, Edward Samuel; Tarp, Finn

    Controversy over the aggregate impact of foreign aid has focused on reduced form estimates of the aid-growth link. The causal chain, through which aid affects developmental outcomes including growth, has received much less attention. We address this gap by: (i) specifying a structural model of th...

  14. Strategies of people with HIV to confront the stigma associated with HIV/aids. Patients of the general hospital of Huixtla, Chiapas

    Directory of Open Access Journals (Sweden)

    Francisco Chong Villarreal

    2012-01-01

    Full Text Available This article presents results from a study conducted with HIV patients from the General Hospital of Huixtla, Chiapas. Taking conceptual elements from structuration theory, the investigation explores strategies used by people with HIV infection in order to tackle consequences of stigma associated with HIV/aids. For the analysis, we consider three different groups whose experiences and ways to deal with stigmatization associated to HIV/aids differ from each other: women, homosexual men and heterosexual men. The results show that an important strategy used by people with HIV is that, while keeping the diagnosis hidden, they reconstruct within their community the representation of HIV/aids without stigma by means of information about HIV.

  15. Alterações ortopédicas na AIDS Orthopedic complications in HIV patients

    Directory of Open Access Journals (Sweden)

    Ana Lúcia Lei Munhoz Lima

    2009-06-01

    Full Text Available O aumento considerável da expectativa de vida dos pacientes infectados pelo HIV na era do tratamento antirretroviral de alta potência, resulta em importantes alterações metabólicas e osteoarticulares decorrentes do prolongado tempo de infecção viral e desse tratamento. As complicações ortopédicas mais frequentes são as alterações da mineralização óssea, a osteonecrose, síndrome do túnel do carpo e capsulite adesiva glenoumeral, com padrão de apresentação clínica, evolução natural da doença e resposta terapêutica diferentes daqueles da população geral. Os relatos da literatura são iniciais e a experiência do serviço multidisciplinar do Instituto de Ortopedia e Traumatologia da USP permite avanço no conhecimento das diversas patologias envolvidas e o desenvolvimento de protocolos de tratamento adequados a esses diagnósticos.The considerable increase of the life expectancy of HIV-infected patients in the age of highly-powerful antiretroviral treatment results in important metabolic and bone-joint changes resulting from a long-lasting viral infection time and from this treatment. The most common orthopaedic complications are bone mineralization changes, osteonecrosis, carpal tunnel syndrome and gleno-humeral adhesive capsulitis, with different clinical presentation features, natural disease progression and therapeutic response compared to the overall population. Literature reports are initial, and the experience of the multidisciplinary service of the University of São Paulo's Institute of Orthopaedics and Traumatology enables us a more in-depth knowledge about the various pathologies involved and the development of treatment protocols that are appropriate to these diagnoses.

  16. [AIDS research and prevention strategies in Thailand].

    Science.gov (United States)

    Leisch, H

    1997-04-01

    The first case of AIDS was registered in Thailand in 1984; this syndrome was deemed to be mainly a disease affecting homosexuals and foreigners. However, soon thereafter its incidence among prostitutes and intravenous drug users increased. According to 1995 data, the number of AIDS patients was about 20,000 and there were approximately 800,000 HIV-positive people. A 1991 map of the AIDS incidence showed that, after the Bangkok metropolitan area, the province of Chiang Mai in the north exhibited a particularly high rate of infection. According to a medium-range forecast, by the year 2010 there will be close to 2.3 million cumulative HIV infection cases and 1.2 million AIDS cases in Thailand. This corresponds to an infection rate of about 3.2% vs. the present 2%. It is estimated that about 20% of all mortality in the age range of 20-48 years in the year 2000 will be caused by AIDS. In 1995, the prime minister predicted that AIDS would cause a 20% drop of the GDP by 2000. The boom of the economy in the 1980s and the early 1990s led to migration to the cities, where prostitution and drug use are rampant, as well as to the emergence of sex tourism, mainly from Germany (40,000-60,000 Germans traveled to Thailand in 1990). The age-old tradition among married men of seeking out the services of prostitutes, lack of condom use (only 20% of men intend to use it, according to recent studies), and disregard for the AIDS problem among the populace are other factors contributing to the rapid spread of AIDS. UNAIDS has undertaken sex education and other information campaigns to counter the epidemic.

  17. Role of ethical beliefs and attitudes of dental students in providing care for HIV/AIDS patients

    Directory of Open Access Journals (Sweden)

    Saad Ahmed Khan

    2017-01-01

    Conclusion: Dental students’ ethical beliefs about HIV/AIDS were not consistent with the ethical principles as stated in the code of ethics and they held negative attitudes towards PLWHAs. Ethical beliefs were found to be a determinant that may influence future attitudes of these students towards individuals with HIV/AIDS when providing care.

  18. Tratamiento antirretroviral en pacientes con sida y micobacteriosis Anti-retroviral treatment in patients with AIDS and mycobacterial diseases

    Directory of Open Access Journals (Sweden)

    Marcelo E. Corti

    2005-08-01

    Full Text Available La tuberculosis y otras micobacteriosis constituyen asociaciones o coinfecciones frecuentes en pacientes con sida y se asocian con una elevada mortalidad. En esta revisión se actualizan los tratamientos de las principales enfermedades micobacterianas asociadas al sida (tuberculosis y micobacteriosis por Mycobacterium avium, con especial énfasis en las interacciones farmacológicas entre antimicobacterianos, principalmente rifampicina y claritromicina, y fármacos antirretrovirales. Se analizan los esquemas de tratamiento, su duración, la quimioprofilaxis primaria y secundaria y el momento óptimo de iniciación del tratamiento antirretroviral. Finalmente se describe el síndrome inflamatorio de reconstitución inmune y su tratamiento.Tuberculosis and other mycobacterial diseases are frequent coinfections in AIDS patients with an increased related mortality. In this review we have updated the treatment of the main mycobacterial diseases (tuberculosis and Mycobacterium avium disease, under the scope of pharmacological interactions between antimycobacterial drugs, specially rifampicin and clarithromycin, and anti-retroviral drugs. Antimycobacterial treatment schemes, their duration, primary and secondary chemoprophylaxis and the optimal time to start the anti-retroviral therapy are analized. Finally, the immnune reconstitution inflammatory syndrome and its treatment are discussed.

  19. Exhibiting Mozart: Rethinking Biography

    OpenAIRE

    Spring, Ulrike

    2010-01-01

    Abstract: The article analyses the new permanent exhibition in the composer Wolfgang A. Mozart’s apartment in Vienna, opened in 2006, from the curator’s perspective. The exhibition presents an approach to biographical display in which the exhibited person becomes part of a multifaceted web of contexts, and the article argues for the active deployment of the polysemic character of objects as a means of grasping the complexity of a person’s biography. Presenting a concept for the...

  20. Evaluation of alveolar bone grafting in unilateral cleft lip and palate patients using a computer-aided diagnosis system

    Energy Technology Data Exchange (ETDEWEB)

    Sutthiprapaporn, Pipop; Kongsomboon, Supaporn; Limmonthol, Saowaluck; Pisek, Poonsak; Keinprasit, Chutimaporn [Khon Kaen University, Khon Kaen (Thailand); Tanimoto, Keiji; Nakamoto, Takashi [Dept. of Oral and Maxillofacial Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima (Japan)

    2012-09-15

    This study aimed to evaluate the trabecular bone changes after alveolar bone grafting in unilateral cleft lip and palate (UCLP) patients using a computer-aided diagnosis (CAD) system. The occlusal radiographs taken from 50 UCLP patients were surveyed retrospectively. The images were categorized as: 50 images in group 0 (before bone grafting), 33 images in group 1 (one month after bone grafting), 24 images in group 2 (2-4 months after bone grafting), 15 images in group 3 (5-7 months after bone grafting), and 21 images in group 4 (8 or more months after bone grafting). Each image was grouped as either 'non-cleft side' or 'cleft side'. The CAD system was used five times for each side to calculate the pixel area based on the mathematical morphology. Significant differences were found using a Wilcoxon signed ranks test or paired samples t test. The pixel area showed a significant difference between the 'non-cleft side' and 'cleft side' in group 0 (404.27{+-}103.72/117.73{+-}92.25; p=0.00), group 1 (434.29{+-}86.70/388.31{+-}109.51; p=0.01), and group 4 (430.98{+-}98.11/366.71{+-}154.59; p=0.02). No significant differences were found in group 2 (423.57{+-}98.12/383.47{+-}135.88; p=0.06) or group 3 (433.02{+-}116.07/384.16{+-}146.55; p=0.19). Based on the design of this study, alveolar bone grafting was similar to normal bone within 2-7 months postoperatively.

  1. Thyroid cancer patient perceptions of radioactive iodine treatment choice: Follow‐up from a decision‐aid randomized trial

    Science.gov (United States)

    Straus, Sharon; Rodin, Gary; Heus, Lineke; Brierley, James D.; Tsang, Richard W.; Rotstein, Lorne; Ezzat, Shereen; Segal, Phillip; Gafni, Amiram; Thorpe, Kevin E.; Goldstein, David P.

    2015-01-01

    BACKGROUND Patient decision aids (P‐DAs) inform medical decision making, but longer term effects are unknown. This article describes extended follow‐up from a thyroid cancer treatment P‐DA trial. METHODS In this single‐center, parallel‐design randomized controlled trial conducted at a Canadian tertiary/quaternary care center, early‐stage thyroid cancer patients from a P‐DA trial were contacted 15 to 23 months after randomization/radioactive iodine (RAI) decision making to evaluate longer term outcomes. It was previously reported that the use of the computerized P‐DA in thyroid cancer patients considering postsurgical RAI treatment significantly improved medical knowledge in comparison with usual care alone. The P‐DA and control groups were compared for the following outcomes: feeling informed about the RAI treatment choice, decision satisfaction, decision regret, cancer‐related worry, and physician trust. In a subgroup of 20 participants, in‐depth interviews were conducted for a qualitative analysis. RESULTS Ninety‐five percent (70 of 74) of the original population enrolled in follow‐up at a mean of 17.1 months after randomization. P‐DA users perceived themselves to be significantly more 1) informed about the treatment choice (P = .008), 2) aware of options (P = .009), 3) knowledgeable about treatment benefits (P = .020), and 4) knowledgeable about treatment risks/side effects (P = .001) in comparison with controls. There were no significant group differences in decision satisfaction (P = .142), decision regret (P = .199), cancer‐related worry (P = .645), mood (P = .211), or physician trust (P = .764). In the qualitative analysis, the P‐DA was perceived to have increased patient knowledge and confidence in decision making. CONCLUSIONS The P‐DA improved cancer survivors’ actual and long‐term perceived medical knowledge with no adverse effects. More research on the long‐term outcomes of P

  2. Analysis on the imaging features of AIDS with pulmonary fungal infection

    Institute of Scientific and Technical Information of China (English)

    GAO Jian-bo; ZHANG Yong-gao; YUE Song-wei; LI Hong-jun; NING Pei-gang; GUO Hua; XIAO Hui-juan

    2010-01-01

    Background Pulmonary fungal infection is one type of the common opportunistic infections in AIDS patients. The disease is hard to diagnose because of its complicated imaging features. The objective of this study was to investigate the imaging performance characteristics of pulmonary fungal infection in AIDS patients.Methods Fifty-one patients with AIDS complicated with pulmonary fungal infection and 56 patients of non-AIDS with pulmonary fungal infection were examined by CT scans and high-resolution CT scans. The contrast enhanced scans were performed in patients with the mass or suspected enlarged mediastinal lymph nodes. Results were compared between the two groups.Results The most common fungal infection in the two groups of patients was Candida albicans. The infection rates were 54.8% (28 cases) in the group (AIDS patients with pulmonary fungal infection) and 58.3% (32 cases) in another group (non-AIDS patients with pulmonary fungal infection). In the two groups, the difference in diffuse distribution and the difference in incidence of affected upper and lower lobes in the bilateral lung fields were statistically significant. The differences in patchy or large consolidation shadow, cavitas, enlarged lymph nodes in mediastinum and pleural effusion were also significant when comparing the two groups.Conclusions The lesion in most of AIDS patients with pulmonary fungal infection tends to exhibit diffuse distribution,patchy or large consolidation shadow covering a more extensive region. The differences between AIDS with pulmonary fungal infection and non-AIDS with pulmonary fungal infection are statistically significant in lesion location and complicated imaging features. The most common fungal infection in AIDS patients is Candida albicans.

  3. Multifactorial approach and superior treatment efficacy in renal patients with the aid of nurse practitioners. Design of The MASTERPLAN Study [ISRCTN73187232

    Directory of Open Access Journals (Sweden)

    Vervoort Gerald

    2006-03-01

    Full Text Available Abstract Background Patients with chronic kidney disease (CKD are at a greatly increased risk of developing cardiovascular disease. Recently developed guidelines address multiple risk factors and life-style interventions. However, in current practice few patients reach their targets. A multifactorial approach with the aid of nurse practitioners was effective in achieving treatment goals and reducing vascular events in patients with diabetes mellitus and in patients with heart failure. We propose that this also holds for the CKD population. Design MASTERPLAN is a multicenter randomized controlled clinical trial designed to evaluate whether a multifactorial approach with the aid of nurse-practicioners reduces cardiovascular risk in patients with CKD. Approximately 800 patients with a creatinine clearance (estimated by Cockcroft-Gault between 20 to 70 ml/min, will be included. To all patients the same set of guidelines will be applied and specific cardioprotective medication will be prescribed. In the intervention group the nurse practitioner will provide lifestyle advice and actively address treatment goals. Follow-up will be five years. Primary endpoint is the composite of myocardial infarction, stroke and cardiovascular mortality. Secondary endpoints are cardiovascular morbidity, overall mortality, decline of renal function, change in markers of vascular damage and change in quality of life. Enrollment has started in April 2004 and the study is on track with 700 patients included on October 15th, 2005. This article describes the design of the MASTERPLAN study.

  4. Autologous Hematopoietic Stem Cells transplantation and genetic modification of CCR5 m303/m303 mutant patient for HIV/AIDS.

    Science.gov (United States)

    Esmaeilzadeh, Abdolreza; Farshbaf, Alieh; Erfanmanesh, Maryam

    2015-03-01

    HIV and AIDS is one of the biggest challenges all over the world. There are an approximately 34 million people living with the virus, and a large number of them become infected each year. Although there are some antiviral drugs for HIV viral load reduction, they are not sufficient. There is no cure for AIDS. Nowadays natural resistance or immunity has absorbed attentions. Because in some HIV positive patients progression trend is slow or even they indicate resistance to AIDS. One of the most interesting approaches in this category is CCR5 gene. CCR5 is a main cc-chemokine co-receptor that facilitates HIV-1 entry to macrophage and CD4(+) T cells. To now, many polymorphisms have been known by CCR5 gene that produces a truncated protein with no function. So, HIV-1 could not entry to immune-cells and the body resistant to HIV/AIDS. Δ32/Δ32 and m303/m303 homozygotes are example of mutations that could create this resistance mechanism. There is a new treatment, such as Hematopoietic Stem Cell transplantation (HSCT) in Berlin and Boston patients for Δ32/Δ32 mutation. It could eliminate co-receptor antagonist and highly-active-anti retroviral therapy (HAART) drugs problems such as toxicity, low safety and side-effects. Now there, the aim of this hypothesis will be evaluation of a new mutation CCR5 m303/m303 as autologous HSCT. This novel hypothesis indicates that autologous HSCT for m303/m303 could be effective treatment for anyone HIV/AIDS affected patient worldwide.

  5. Detection of the HIV-1 nucleic acid in spermatozoa of HIV/AIDS patients%HIV/AIDS患者精子中病毒核酸的检测

    Institute of Scientific and Technical Information of China (English)

    王典; 李练兵; 侯志伟; 谢庆东; 康祥锦; 黄天华

    2011-01-01

    Objective To detect the presence of HIV - 1 nucleic acid in spermatozoa of HIV/AIDS patients.Methods Spermatozoon samples of 33 HIV/AIDS patients were prepared. Fluorescence in situ hybridization ( FISH ) ,in which biotinylated HIV gag and HIV pol were used as probes, was performed to detect HIV nucleic acid in spermatozoa. Results HIV nucleic acid was detected in spermatozoa of 9 patients( 27. 3% ). Conclusion These results further confirm the presence of HIV nucleic acid in sperm of HIV/AIDS patients and indicates that FISH is a sensitive and reliable method to detect the nucleic acid in sperm.%目的 检测HIV/AIDS患者精子中HIV核酸.方法 制备33例HIV/AIDS患者精子样本,采用荧光原位杂交(FISH),以生物素标记的HIV gag及 HIV pol作为双探针对这些患者精子进行HIV核酸检测.结果 在9例(27.3%)患者中检测到阳性荧光信号.结论 HIV/AIDS患者精子存有HIV核酸;FISH是一种检测HIV/AIDS患者精子病毒核酸灵敏而可靠的方法.

  6. Cytomegalovirus viral load kinetics in patients with HIV/AIDS admitted to a medical intensive care unit: a case for pre-emptive therapy.

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    Simnikiwe H Mayaphi

    Full Text Available BACKGROUND: Cytomegalovirus (CMV infection is associated with severe diseases in immunosuppressed patients; however, there is a lack of data for pre-emptive therapy in patients with HIV/AIDS. METHOD: This was a retrospective study, which enrolled patients diagnosed with HIV/AIDS (CD41,000 copies/ml at baseline testing had significantly higher mortality compared to those who had 5,100 copies/ml and did not receive ganciclovir had 100% mortality compared to 58% mortality in those who received ganciclovir at VLs of >5,100 copies/ml, 50% mortality in those who were not treated and had low VLs of <5,100 copies/ml, and 44% mortality in those who had ganciclovir treatment at VLs of <5,100 copies/ml (p = 0.084, 0.046, 0.037, respectively. CONCLUSION: This study showed a significantly increased mortality in patients with HIV/AIDS who had high CMV VLs, and suggests that a threshold value of 1,000 copies/ml may be appropriate for pre-emptive treatment in this group.

  7. 中外艾滋病人犯罪管控比较研究%Comparative Study on Chinese and Foreign AIDS Patients' Crimes Control

    Institute of Scientific and Technical Information of China (English)

    岳光辉; 刘力皲

    2016-01-01

    Due to the special nature of the AIDS disease, the current relevant functional departments of local govern⁃ments encounter big difficult when they are controlling AIDS patients' crimes, which results in the increasing crime rate of HIV sufferers, and seriously affecting the public safety and social stability. Therefore, we can learn from the ad⁃vanced experience of foreign countries in terms of management and control of AIDS patients, to improve our manage⁃ment and control system of AIDS patients, so that we can not only fully protect the rights of AIDS patients but also pre⁃vente and reduce the AIDS patients' crime rate maximumly.%由于艾滋病病情的特殊性,社会对艾滋病人的歧视,相关法律制度不完善,监管制度缺失,犯罪后的收押场所缺乏,打击力度不够,使得我国基层政府相关职能部门在管控艾滋病人犯罪时遇到很大困难,导致艾滋病人犯罪不断增多,严重影响公共安全与社会稳定。为此,可以借鉴国外在艾滋病人管控方面的先进经验,在实践中不断完善我国艾滋病人管控体系及社会保障机制,设立专门的羁押场所,加强对基层管控人员的业务培训,做到既充分保障艾滋病人应当享有的权利,又最大限度地预防和减少艾滋病人犯罪行为的发生。

  8. 5例艾滋病住院病人自杀原因分析%Analysis of suicide reason of 5 cases of hospitalized patients with AIDS

    Institute of Scientific and Technical Information of China (English)

    刘聪; 李芳; 李全敏; 刘红媚; 于肖楠; 蔡卫平

    2016-01-01

    Objective:To analyze the clinical characteristics and reasons of suicide of the hospitalized patients with acquired immunodeficiency syndrome(AIDS)and provide a reference basis for prevention of suicide.Meth-ods:The suicide incidents of five AIDS patients were by retrospectively investigated by using objective sampling method,the interviews were conducted for the medical staff who knew the suicide incidents.The interview data were analyzed,sorted and refined.Results:AIDS patients’suicide reasons might be:severe illness,loss of treat-ment confidence,the unacceptable AIDS diagnosis and disinformation,poor social support,not timely and effec-tive intervention.Conclusion:It could prevent the AIDS patients’suicide effectively to strengthen the propagan-da of AIDS related knowledge,reconstruct the family and social support system,alleviate disease shame,estab-lish the psychological assessment system of hospitalized AIDS patients,psychological intervention in time and strengthen the hospital safety management.%[目的]分析艾滋病住院病人自杀临床特点及原因,为自杀预防提供参考依据。[方法]采用目的抽样法对5例艾滋病病人自杀事件进行回顾性调查,并对知晓自杀事件的医护人员进行访谈,将访谈的资料进行分析、整理、提炼主题。[结果]艾滋病病人自杀原因可能是:病情重、失去治疗信心、无法接受艾滋病诊断及病耻感、社会支持差、未进行及时有效干预。[结论]通过加强宣传艾滋病相关知识、重建家庭与社会支持体系,减轻病耻感,建立住院艾滋病病人心理评估体系、及时进行心理干预,同时加强医院安全管理,可有效预防住院艾滋病病人的自杀事件。

  9. The clinical characteristics and prognostic significance of AID, miR-181b, and miR-155 expression in adult patients with de novo B-cell acute lymphoblastic leukemia.

    Science.gov (United States)

    Zhou, Guangquan; Cao, Yang; Dong, Weimin; Lin, Yan; Wang, Qi; Wu, Wei; Hua, Xiaoying; Ling, Yun; Xie, Xiaobao; Hu, Shaoyan; Cen, Jiannong; Gu, Weiying

    2017-01-31

    This study aimed to investigate clinical characteristics and prognostic significance of activation-induced cytidine deaminase (AID) gene, miR-181b and miR-155 expression in de novo adult B-cell acute lymphoblastic leukemia (B-ALL) patients. Results showed that AID and miR-155 expression were higher in B-ALL patients than healthy controls, while miR-181b expression was lower in B-ALL patients. In addition, Ph(+) B-ALLs had higher AID expression than Ph(-) B-ALLs, and its high expression was associated with BCR-ABL. Moreover, B-ALL patients with AID(high) or miR-181b(low) expression had a shorter overall survival (OS). AID(high) with miR-181b(low), AID(high) with miR-155(low), miR-181b(low), miR-155(low), AID(high) with miR-181b(low) and miR-155(low) expression were associated with shorter OS. Combination of the three molecules are more accurate predictors for unfavorable OS compared with univariate group. Therefore, AID, miR-181b and miR-155 provide clinical prognosis of adult de novo B-ALL patients and may refine their molecular risk classification.

  10. (Comvivendo com a Aids: perfil dos portadores de HIV/Aids na região Noroeste do Estado do Paraná, 1989-2005 = Living with aids: profile of hiv/aids patients in northwestern Paraná, 1989-2005

    Directory of Open Access Journals (Sweden)

    Sonia Maria Soares dos Santos

    2010-01-01

    collected from the regional database of the Notifiable Diseases Information System (SINAWN, at the Epidemiology Sector of the 14th Regional Health Division. The studied variables were: patient gender, age, occupation and city of residence; how the disease was transmitted, date of diagnosis and notification; and date of death. During the study period, 241 AIDS cases were diagnosed in the region, with a 53% concentration in the county seat; however, in six towns in the region, there were no notifications in the 17 years of the study, which can mean a real absence of cases or ub-notification/exportation of cases. The cases occurred primarily in men, between the ages of 25 and 49, through sexual transmission. However, in the period between 2001 and 2005, an increase was observed in the number of infected women, with a 1.6 male:female ratio; also, there was an increase in heterosexual transmission, affecting homemakers and self-employed individuals. The study detected an expressive number of cases with epidemiological notification of diseases resulting from AIDS on the date of diagnosis or soon thereafter, suggesting the late identification of the disease on individuals who were already in the terminal stages of the disease.

  11. A systematic review of decision aids for patients making a decision about treatment for early breast cancer.

    Science.gov (United States)

    Nicholas Zdenkowski; Butow, Phyllis; Tesson, Stephanie; Boyle, Frances

    2016-04-01

    Several complex treatment decisions may be offered to women with early stage breast cancer, about a range of treatments from different modalities including surgery, radiotherapy, and endocrine and chemotherapy. Decision aids can facilitate shared decision-making and improve decision-related outcomes. We aimed to systematically identify, describe and appraise the literature on treatment decision aids for women with early breast cancer, synthesise the data and identify breast cancer decisions that lack a decision aid. A prospectively developed search strategy was applied to MEDLINE, the Cochrane databases, EMBASE, PsycINFO, Web of Science and abstract databases from major conferences. Data were extracted into a pre-piloted form. Quality and risk of bias were measured using Qualsyst criteria. Results were synthesised into narrative format. Thirty-three eligible articles were identified, evaluating 23 individual treatment decision aids, comprising 13 randomised controlled trial reports, seven non-randomised comparative studies, eight single-arm pre-post studies and five cross-sectional studies. The decisions addressed by these decision aids were: breast conserving surgery versus mastectomy (+/- reconstruction); use of chemotherapy and/or endocrine therapy; radiotherapy; and fertility preservation. Outcome measures were heterogeneous, precluding meta-analysis. Decisional conflict decreased, and knowledge and satisfaction increased, without any change in anxiety or depression, in most studies. No studies were identified that evaluated decision aids for neoadjuvant systemic therapy, or contralateral prophylactic mastectomy. Decision aids are available and improved decision-related outcomes for many breast cancer treatment decisions including surgery, radiotherapy, and endocrine and chemotherapy. Decision aids for neoadjuvant systemic therapy and contralateral prophylactic mastectomy could not be found, and may be warranted.

  12. Experimental and clinical research of HIV-1 resistance in three AIDS patients who had experienced multiple regimens

    Institute of Scientific and Technical Information of China (English)

    LU Jun-feng; LI Jue; LI Han-ping; LIU Si-yang; ZHUANG Dao-ming; LIU Yong-jian; BAO Zuo-yi; LI Lin; WU Hao; LI Jing-yun

    2009-01-01

    @@ Highly active antiretroviral therapy (HAART) for HIV/AIDS has efficiently controlled the progression of the disease, extended life expectancy and decreased HIV/AIDS related morbidity and mortality since the advent of HIV protease inhibitors in 1996.1 Recent emergence of HIV resistance has severely affected the efficacy of antiretroviral therapy. The prevalence of HIV resistance has been increasing from the usage of AZT.

  13. Genetic variation of the HIV-1 integrase region in newly diagnosed anti-retroviral drug-naïve patients with HIV/AIDS in Korea.

    Science.gov (United States)

    Kim, J-Y; Kim, E-J; Choi, J-Y; Kwon, O-K; Kim, G J; Choi, S Y; Kim, S S

    2011-08-01

    The survival time of HIV/AIDS patients in Korea has increased since HAART (highly active anti-retroviral therapy) was introduced. However, the occurrence of drug-resistant strains requires new anti-retroviral drugs, one of which, an integrase inhibitor (INI), was approved by the US Food and Drug Administration (FDA) in 2007. INIs have been used for therapy in many countries and are about to be employed in Korea. Therefore, it is important to identify basic mutant variants prior to the introduction of INIs in order to estimate their efficacy. To monitor potential drug-resistant INI mutations in Korean HIV/AIDS patients, the polymorphism of the int gene was investigated together with the pol gene using a genotypic assay for 75 randomly selected Korean HIV-1 patients newly diagnosed in 2007. The drug-resistant mutation sequences were analysed using the Stanford HIV DB and the International AIDS Society resistance testing-USA panel (IAS-USA). Seventy strains of Korean subtype B were compared with foreign subtype-B strains, and there were no significantly different variants of the int gene region in the study population. Major mutation sites in the integrase (E92Q, F121Y, G140A/S, Y143C/R, Q148H/R/K and N155H) were not detected, and only a few minor mutation sites (L74M, V151I, E157Q, V165I, I203M, S230N and D232N) were identified in 21 strains (28%). Resistance due to mutations in the pol gene was observed in a single strain (1.3%) resistant to protease inhibitors (PIs) and in four strains (5.3%) resistant to reverse transcriptase inhibitors (RTIs). In summary, this demonstrates that INIs will be susceptible to drug naïve HIV/AIDS patients in Korea.

  14. Survival of AIDS patients and characteristics of those who died over eight years of highly active antiretroviral therapy, at a referral center in northeast Brazil

    Directory of Open Access Journals (Sweden)

    Ladjane Santos Wolmer de Melo

    2008-08-01

    Full Text Available Introduction of highly active antiretroviral therapy has resulted in a significant reduction in morbimortality and significant changes in the causes of death among HIV/AIDS patients. For this reason, it has become essential to monitor survival and causes of death. We constructed a survival curve based on 597 adult patients notified as AIDS cases between 1997 and 2004, at the Hospital das Clínicas, Federal University of Pernambuco, Recife, Brazil. Among those patients, 150 (25% progressed to death by December, 2005. Of these, 119 were studied in detail. The data were collected from notification files of the State Health Department and the State Mortality Information System, and were complemented by analysis of medical records. These 597 patients had a survival rate of 88%, 86% and 82% after one, two and five years, respectively, and a 75% likelihood of surviving to 1,984 days (66 months. Most of the deaths occurred during the first months after the diagnosis (median, 129 days. Patients who died were predominantly young men who had sexual exposure and came from Recife (the state capital or its metropolitan region. When the patients were first seen, a large proportion had already presented severe signs of immunodeficiency. Comparing the patients within this group, the characteristics that were associated with lower survival were: male sex, hemoglobin < 10 mg/dL, lymphocytes < 1,000/mm³, use of fewer therapeutic drugs and antiretroviral regimens and non-introduction of protease inhibitors. Most of them died from AIDS-related diseases, particularly undefined respiratory infections.

  15. Test Control Center exhibit

    Science.gov (United States)

    2000-01-01

    Have you ever wondered how the engineers at John C. Stennis Space Center in Hancock County, Miss., test fire a Space Shuttle Main Engine? The Test Control Center exhibit at StenniSphere can answer your questions by simulating the test firing of a Space Shuttle Main Engine. A recreation of one of NASA's test control centers, the exhibit explains and portrays the 'shake, rattle and roar' that happens during a real test firing.

  16. Relation of activation-induced deaminase (AID) expression with antibody response to A(H1N1)pdm09 vaccination in HIV-1 infected patients.

    Science.gov (United States)

    Cagigi, Alberto; Pensieroso, Simone; Ruffin, Nicolas; Sammicheli, Stefano; Thorstensson, Rigmor; Pan-Hammarström, Qiang; Hejdeman, Bo; Nilsson, Anna; Chiodi, Francesca

    2013-04-26

    The relevance of CD4+T-cells, viral load and age in the immunological response to influenza infection and vaccination in HIV-1 infected individuals has previously been pointed out. Our study aimed at assessing, in the setting of 2009 A(H1N1)pdm09 influenza vaccination, whether quantification of activation-induced deaminase (AID) expression in blood B-cells may provide additional indications for predicting antibody response to vaccination in HIV-1 infected patients with similar CD4+T-cell counts and age. Forty-seven healthy controls, 37 ART-treated and 17 treatment-naïve HIV-1 infected patients were enrolled in the study. Blood was collected prior to A(H1N1)pdm09 vaccination and at 1, 3 and 6 months after vaccination. Antibody titers to A(H1N1)pdm09 vaccine were measured by hemagglutination inhibition (HI) assay while the mRNA expression levels of AID were measured by quantitative real time PCR. Upon B-cell activation in vitro, AID increase correlated to antibody response to the A(H1N1)pdm09 vaccine at 1 month after vaccination in all individuals. In addition, the maximum expression levels of AID were significantly higher in those individuals who still carried protective levels of A(H1N1)pdm09 antibodies after 6 months from vaccination. No correlation was found between CD4+T-cell counts or age at vaccination or HIV-1 viral load and levels of A(H1N1)pdm09 antibodies. Assessing AID expression before vaccination may be an additional useful tool for defining a vaccination strategy in immune-compromised individuals at risk of immunization failure.

  17. Hypophyseal pathology in AIDS