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Sample records for brazilian aids patients

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

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    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.

  2. Kaposi’s sarcoma in Brazilian AIDS patients: a study of 144 cases

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    BIRMAN, Esther G.; SILVEIRA, Fernando R. X.; GODOY, Luzia F.; COSTA, Catalina R.

    2000-01-01

    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 derma...

  3. A 3-YEAR FOLLOW-UP OF A BRAZILIAN AIDS PATIENT WITH PROTRACTED DIARRHEA CAUSED BY Enterocytozoon bieneusi

    OpenAIRE

    BRASIL, Patrícia; DE PAIVA, Daurita D.; DE LIMA, Dirce B.; DA SILVA, Edson Jurado; PERALTA, José Mauro; DA SILVA, Alexandre J.; SODRÉ, Fernando C.; VILLELA, Érika Veríssimo; MOURA, Hércules

    1998-01-01

    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 w...

  4. 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

  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. Manifestações orais em pacientes com AIDS em uma população brasileira Oral manifestations in HIV - infected patients in a Brazilian population

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    Lélia Batista de SOUZA

    2000-03-01

    Full Text Available Foram analisados l00 pacientes HIV+/AIDS no Hospital Giselda Trigueiro - Natal/RN, Brasil no período de l996-97 quanto a presença de manifestações orais nestes pacientes. Setenta e quatro pacientes eram do sexo masculino e 26 do feminino. A idade média dos pacientes do sexo masculino foi 40 anos, variando de 24 a 67 anos e no feminino 29,8 anos variando de 17 a 48 anos. As manifestações orais mais freqüentes foram candidíase (homens - 79,7%; mulheres - 80,7%, gengivite e periodontite (homens - 79,7%; mulheres - 73,0%, leucoplasia pilosa (homens - 6,7%; mulheres - 3,8%, herpes labial (homens - 5,4%; mulheres - 7,6%, sarcoma de Kaposi (homens - 6,7%.Verificou-se que 62,2% dos homens eram homo- ou bissexuais e 100% das mulheres eram heterossexuais. Nossos resultados revelam semelhanças com outros trabalhos realizados em pacientes de outras regiões do mundo.One hundred HIV+/AIDS Brazilian patients (74 men and 26 women were examined in the Giselda Trigueiro Hospital, in Natal, Rio Grande do Norte, Brazil in the period from l996 to 1997. The men’s mean age was 40 years, ranging from 24 to 67 years and the women’s was 29.8 years, ranging from 17 to 48 years. One or more oral findings were observed in theses patients. The most common oral lesions were candidiasis (men - 97.2%; women - 80.7%, gingivitis and periodontitis (men - 79.7%; women - 7.3%, hairy leukoplakia (men - 6.7%; women - 3.8%, herpes simplex (men - 5.4%; women - 2.7%, and Kaposi’s sarcoma (men - 6.7%. From the men, 62.1% were homo-/bisexual, and 100% of the women were heterosexual.

  7. Poor diet quality among Brazilian adolescents with HIV/AIDS

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    Luana Fiengo Tanaka

    2015-04-01

    Full Text Available OBJECTIVE: This study aimed to assess diet quality among adolescents with HIV/AIDS. METHOD: A cross-sectional study was conducted involving patients with HIV/AIDS treated in a referral hospital in Sao Paulo, Brazil. Eighty-eight adolescents (10-19 years of age participated in the study. Information on disease history and use of medication were obtained from medical records. The participants responded to two 24-hour diet recalls. Diet quality was assessed by means of the Healthy Eating Index-2005 (HEI-2005 adapted to the Brazilian population. Pearson's correlation coefficients were calculated. Mean HEI-2005 scores were compared according to the independent variables using either the Student's t-test or the Mann-Whitney test. RESULTS: The mean HEI-2005 score was 51.90 (SE = 0.90. The components with the lowest means were whole grains and sodium. Components with highest means were total grains and oils. No correlations were found between the independent variables and HEI score. Adolescents living in foster homes had higher means for total fruit and lower means for meat and beans in comparison to adolescents living with their families. Girls had higher means for milk and lower means for calories from solid fats, alcoholic beverages, and added sugars in comparison to boys. CONCLUSIONS: Adolescents with HIV/AIDS exhibited a similar eating pattern to that of adolescents in the general population: high consumption of added sugar, saturated fat, and sodium, and insufficient ingestion of whole grains and fruits. Special attention should be paid to the diet of adolescents with HIV/AIDS, who are at greater risk of developing cardiovascular and other chronic diseases.

  8. Low incidence of colonization and no cases of disseminated Mycobacterium avium complex infection (DMAC in Brazilian AIDS patients in the HAART era

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    Ângela Gadelha

    Full Text Available OBJECTIVE: Evaluate the incidence of mycobacterial disease and the colonization of the respiratory and gastrointestinal tracts by Mycobacterium avium complex (MAC bacteria in AIDS patients. METHODS: Inclusion criteria: HIV-positive individuals with at least one CD4+ count 100 cells/mm³ (HR = 0.18; CI = 0.05 - 0.70 predicted a lower risk of death (P<0.05 but was not protective for MAC colonization (HR=0.52;CI =0.62 - 4.35, P=0.55. CONCLUSION: The absence of DMAC infection in colonized individuals argues in favor of a HAART protective effect against; DMAC; however, restoration of CD4 counts did not protect patients against MAC colonization.

  9. Low incidence of colonization and no cases of disseminated Mycobacterium avium complex infection (DMAC in Brazilian AIDS patients in the HAART era

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    Gadelha Ângela

    2002-01-01

    Full Text Available OBJECTIVE: Evaluate the incidence of mycobacterial disease and the colonization of the respiratory and gastrointestinal tracts by Mycobacterium avium complex (MAC bacteria in AIDS patients. METHODS: Inclusion criteria: HIV-positive individuals with at least one CD4+ count 100 cells/mm³ (HR = 0.18; CI = 0.05 - 0.70 predicted a lower risk of death (P<0.05 but was not protective for MAC colonization (HR=0.52;CI =0.62 - 4.35, P=0.55. CONCLUSION: The absence of DMAC infection in colonized individuals argues in favor of a HAART protective effect against; DMAC; however, restoration of CD4 counts did not protect patients against MAC colonization.

  10. Information literacy: perceptions of Brazilian HIV/AIDS researchers.

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    Alvarez, Maria do Carmo Avamilano; França, Ivan; Cuenca, Angela Maria Belloni; Bastos, Francisco I; Ueno, Helene Mariko; Barros, Cláudia Renata; Guimarães, Maria Cristina Soares

    2014-03-01

    Information literacy has evolved with changes in lifelong learning. Can Brazilian health researchers search for and use updated scientific information? To describe researchers' information literacy based on their perceptions of their abilities to search for and use scientific information and on their interactions with libraries. Semi-structured interviews and focus group conducted with six Brazilian HIV/AIDS researchers. Analyses comprised the assessment of researchers as disseminators, their interactions with librarians, their use of information and communication technology and language. Interviewees believed they were partially qualified to use databases. They used words and phrases that indicated their knowledge of technology and terminology. They acted as disseminators for students during information searches. Researchers' abilities to interact with librarians are key skills, especially in a renewed context where libraries have, to a large extent, changed from physical spaces to digital environments. Great amounts of information have been made available, and researchers' participation in courses does not automatically translate into adequate information literacy. Librarians must help research groups, and as such, librarians' information literacy-related responsibilities in Brazil should be redefined and expanded. Students must develop the ability to learn quickly, and librarians should help them in their efforts. Librarians and researchers can act as gatekeepers for research groups and as information coaches to improve others' search abilities. © 2013 Health Libraries Group of CILIP and John Wiley & Sons Ltd.

  11. Development of a digital hearing aid to meet the Brazilian Government's Ordinance 587 (APAC).

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    Penteado, Silvio Pires; Bento, Ricardo Ferreira

    2010-01-01

    The treatment of sensorineural hearing loss is based on hearing aids, also known as individual sound amplification devices. The hearing aids purchased by the Brazilian Government, aiming at fulfilling public policies, are based on dedicated components, which bring about benefits, but also render them expensive and may impair repair services after manufacture's warranty expires. to design digital behind-the-ear hearing aids built from standardized components coming from the very supply chain of these manufacturers. experimental. to identify the supply chain of these manufacturers, request samples and set up hearing aids in the laboratory. The developed hearing aids did not show lesser electroacoustic characteristics when compared to those acquired by the Government, also being tested by the same reference international technical standard. It is possible to develop digital behind-the-ear hearing aids based on off-the-shelf components from hearing aid manufacturers' supply chain. Their advantages include low operational costs - for acquisition (with clear advantages for the Government) and service (advantage for the patient).

  12. Radiographic evaluation of AIDS patients

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    Le Blang, S.D.; Witheman, M.L.; Donovan Post, M.J.; Casillas, J.V. [Miami Univ., FL (United States). Dept. of Radiology

    1995-09-01

    Morphological imaging, based on the use of various techniques including ultrasound, X-ray computed tomography (CT), and magnetic resonance imaging (MRI), plays an important role in the characterization, diagnosis and follow-up of patients with Human Immunodeficiency Virus (HIV) infection and Acquired Immunodeficiency Syndrome (AIDS). While the presence of thoracic infections, the most frequently observed illnesses in AIDS patients, can best be performed by using conventional chest films and CT, the assessment of cerebral involvement in AIDS patients - characterized by the presence of focal masses, demyelination, meningitis, and infarction - is best achieved using MRI. The work-up of patients with gastrointestinal symptoms should include the use of ultrasound for the evaluation of visceral involvement and lymphadenopathy, completed by CT to further characterize pathologic conditions in either the bowel or visceral organs. Ultrasound is the screening exam of choice in AIDS patients with suspected renal disease, but other methods may be necessary for the assessment of the complications due to pharmacological treatment. Musculoskeletal complications may require the combined use of all the above methods, since they may be caused by infections, tumors and rheumatologic illness. The use of the radiographic methods for the detection of the numerous forms of infections and malignancies in AIDS patients is described in detail for the various body districts.

  13. Radiographic evaluation of AIDS patients

    International Nuclear Information System (INIS)

    Le Blang, S.D.; Witheman, M.L.; Donovan Post, M.J.; Casillas, J.V.

    1995-01-01

    Morphological imaging, based on the use of various techniques including ultrasound, X-ray computed tomography (CT), and magnetic resonance imaging (MRI), plays an important role in the characterization, diagnosis and follow-up of patients with Human Immunodeficiency Virus (HIV) infection and Acquired Immunodeficiency Syndrome (AIDS). While the presence of thoracic infections, the most frequently observed illnesses in AIDS patients, can best be performed by using conventional chest films and CT, the assessment of cerebral involvement in AIDS patients - characterized by the presence of focal masses, demyelination, meningitis, and infarction - is best achieved using MRI. The work-up of patients with gastrointestinal symptoms should include the use of ultrasound for the evaluation of visceral involvement and lymphadenopathy, completed by CT to further characterize pathologic conditions in either the bowel or visceral organs. Ultrasound is the screening exam of choice in AIDS patients with suspected renal disease, but other methods may be necessary for the assessment of the complications due to pharmacological treatment. Musculoskeletal complications may require the combined use of all the above methods, since they may be caused by infections, tumors and rheumatologic illness. The use of the radiographic methods for the detection of the numerous forms of infections and malignancies in AIDS patients is described in detail for the various body districts

  14. Mental changes in patients with AIDS

    NARCIS (Netherlands)

    Derix, M. M.; de Gans, J.; Stam, J.; Portegies, P.

    1990-01-01

    Mental changes are common in patients with acquired immunodeficiency syndrome (AIDS). Neuropsychological data of 32 patients with AIDS and cognitive symptoms were reviewed. All patients were neurologically examined and ancillary investigations were performed. According to the neuropsychological data

  15. Abdominal ultrasound in AIDS patients

    International Nuclear Information System (INIS)

    Escribano, J.; Gonzalez, J.; Alvarez, M.; Rivero, S.; Raya, J.L.; Ruza, M.

    1998-01-01

    To analyze the ultrasonography findings in abdomen in the AIDS patients in our hospital, as well as the indications for this exploration, assessing the role of abdominal ultrasound (AU). The ultrasonographic and clinical findings in 527 patients who underwent a total of 715 explorations between 1992 and 1996 were studied. Hepatomegaly and/or splenomegaly, usually homogeneous, were observed in nearly half of the studies (45%); one third of the patients with marked splenomegaly presented visceral leishmaniasis. Focal lesions in liver and/or spleen, corresponding to angiomas, abscesses, lymphomatous lesions and metastasis, were detected in 5.7% of the explorations. Thirty-five percent of the AU revealed the presence of lymphadenopathy; nodes measuring over 2.5 cm were usually related to potential treatable infection or neoplasm. Thickening of the gallbladder wall did not usually indicate the presence of acute cholecystitis unless Murphy''s sign was also detected. Bile duct dilation and wall thickening was related to opportunistic cholangitis, and the increase in the echogenicity of the renal parenchyma was linked to AIDS-related nephropathy. Despite the fact that many of findings with AU are nonspecific, we consider that this approach should be the principal diagnostic technique in AIDS patients with suspected abdominal pathology or fever of unknown origin. (Author) 43 refs,

  16. Abdominal imaging in AIDS patients

    International Nuclear Information System (INIS)

    Zhao Dawei; Wang Wei; Yuan Chunwang; Jia Cuiyu; Zhao Xuan; Zhang Tong; Ma Daqing

    2007-01-01

    Objective: To evaluate abdominal imaging in AIDS. Methods: The imaging examinations (including US, CT and MR) of 6 patients with AIDS associated abdominal foci were analysed retrospectively. All the cases were performed US, and CT scan, of which 4 performed enhanced CT scan and 1 with MR. Results: Abdominal tuberculosis were found in 4 patients, including abdominal lymph nodes tuberculosis (3 cases) and pancreatic tuberculosis (1 case). The imaging of lymph nodes tuberculosis typically showed enlarged peripheral tim enhancement with central low-attenuation on contrast-enhanced CT. Pancreatic tuberculosis demonstrated low-attenuation area in pancreatic head and slightly peripheral enhancement. Disseminated Kaposi's sarcoma was seen in 1 case: CT and MRI scan demonstrated tumour infiltrated along hepatic portal vein and bronchovascular bundles. Pelvic tumor was observed in 1 case: CT scan showed large mass with thick and irregular wall and central low attenuation liquefacient necrotic area in the pelvic cavity. Conclusion: The imaging findings of AIDS with abdominal foci is extraordinarily helpful to the diagnosis of such disease. Tissue biopsy is needed to confirm the diagnosis. (authors)

  17. Osseous involvement in AIDS patients

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    Marchiori, Edson; Pereira, Abercio Arantes

    1995-01-01

    The radiological findings of eight patients with the acquired immunodeficiency syndrome (AIDS) who developed bone lesions were analyzed in conjunction with twelve similar published cases. Our series included three patients with lymphoma, two with bacillary angiomatosis, two with tuberculosis and one with staphylococcal osteomyelitis. All the lesions were lithic regardless of the etiology. Both in our cases and in those previously published bone repair was only seen in cases of bacillary angiomatosis treated with erythromycin. No pathognomonic findings were observed. However, the association of skin and bone lesions in immuno deficient patients should always bring the consideration of bacillary angiomatosis in the differential diagnosis. This is particularly relevant since this a condition amenable to treatment once correctly identified. The radiological findings in the lymphoma and tuberculosis patients have not been described previously. (author). 9 refs., 7 figs., 3 tabs

  18. Effect of sociodemographic, clinical-prophylactic and therapeutic procedures on survival of AIDS patients assisted in a Brazilian outpatient clinic Efeitos de fatores sociodemográficos, clínico-profiláticos e terapêuticos na sobrevida de pacientes com aids acompanhados em uma unidade ambulatorial brasileira

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    Dario José Hart Pontes Signorini

    2005-09-01

    Full Text Available The Brazilian AIDS Program offers free and universal access to antiretroviral therapy. This study investigates the influence of sociodemographic, clinical-prophylactic and therapeutic factors on survival, after AIDS diagnosis, in an open cohort of 1,420 patients assisted in a university hospital in the city of Rio de Janeiro (1995 _ 2002. Kaplan-Meier and Cox proportional hazards models were used to estimate the effect of variables in the three dimensions studied. The overall survival time of the upper quartile was 24 months (CI95%= 20.5-27.5, increasing from 14 months, in 1995, to 46 months, in 1998. We found a protective effect of heterosexual behavior against death that could be attributed to the increasing female-to-male sex ratio in the cohort, which coincided with the time of therapy introduction. Low schooling, hospital admission and lack of follow-up were identified as risk factors for death; PCP and Toxoplasmosis prophylaxis were protective. The number of attempts required to consolidate the antiretroviral therapy showed no significant effect on survival. The full model, which includes the number of antiretroviral drugs in the regimen, confirmed the triple therapy as the best regimen. This study brings important information for designing guidelines to deal with different aspects related to the practical management of patients and their behavior, thus contributing to the success of the program of free access to antiretroviral therapy implemented in Brazil.O programa Brasileiro de DST/AIDS oferece acesso livre e universal à terapia anti-retroviral. Este estudo investiga a influência dos fatores sociodemográficos, clínico-profiláticos e terapêuticos na sobrevida, após o diagnóstico de AIDS, em uma coorte aberta de 1.420 pacientes atendida em hospital universitário na Cidade do Rio de Janeiro (1995-2002. Kaplan-Meier e modelo de risco proporcional de Cox foram usados para estimar os efeitos das variáveis nas três dimens

  19. The impact of socio-economic status on incidence of AIDS cases in Brazilian

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    Márcia Regina Godoy

    2013-12-01

    Full Text Available In recent years, many researchers have devoted attention to the issue of the importance of social indicators in disease reduction. The objective of this paper is to analyze the statistical association between the reported AIDS cases and some socioeconomic variables. We analyzed a sample of 1,994 Brazilian municipalities with AIDS cases reported in 1991 and 2000. The variables analyzed are: AIDS incidence rate per capita, illiteracy rate, Gini Index, per capita income, access to electricity and television, life expectancy at birth. The approach used in this study was econometric panel data model. The results of this analysis show that socioeconomic variables are important for understanding the incidence of AIDS cases in Brazil, and are important for the design of public policies to combat the increasing incidence of HIV / AIDS, also show a distinct pattern to found in the literature for African countries.

  20. Umbanda healers as effective AIDS educators: case-control study in Brazilian urban slums (favelas).

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    Nations, M K; de Souza, M A

    1997-01-01

    During a 12-month period (November 1994-October 1995), Afro-Brazilian Umbanda healers (Pais-de-Santo) taught 126 fellow healers from 51 Umbanda centres (terreiros) located in seven overcrowded slums (favelas) (population 104-343) in Brazil's northeast, the biomedical prevention of AIDS, including safe sex practices, avoidance of ritual blood behaviours and sterilization of cutting instruments. A face-to-face educational intervention by healers, marginalized in society yet respected by devotees, which blended traditional healing-its language, codes, symbols and images- and scientific medicine and addressed social injustices and discrimination was utilized in this project supported by the Brazilian Ministry of Health, National Program in STDs/AIDS. Significant increases (P < 0.001) in AIDS awareness, knowledge about risky HIV behaviour, information about correct condom use, and acceptance of lower-risk, alternative ritual blood practices and decreases (P < 0.001) in prejudicial attitudes related to HIV transmission were found among mobilized healers as compared to 100 untrained controls. Respected Afro-Brazilian Pais-de-Santo can be creative and effective partners in national HIV prevention programmes when they are equipped with biomedical information about AIDS.

  1. Hereditary fructose intolerance in Brazilian patients

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    Eugênia Ribeiro Valadares

    2015-09-01

    Results and discussion: Age at diagnosis was between 10 and 32 months and the severity of the disease correlated with the increasing of age at diagnosis. The predominant symptoms were vomiting, weight loss, and hepatomegaly. Severe renal tubular acidosis manifested in one child. All patients had remission of symptoms after dietary modification. The sequencing of the ALDOB gene identified one homozygous patient for the mutation c.524C>A (p.A175D, while the others were compound heterozygous for c.360_363delCAAA (p.N120KfsX32, c.178C>T (p.R60X mutations, c.448G>C (p.A150P and c.524C>A (p.A175D. Clinical improvement of patients after dietary treatment is suggestive of the diagnosis, confirmed by molecular analysis. The prevalence of mutations found in our Brazilian patients is different from those of international literature.

  2. American Tegumentary Leishmaniasis and HIV-AIDS Association in a Tertiary Care Center in the Brazilian Amazon

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    Guerra, Jorge Augusto O.; Coelho, Leíla I. R. C.; Pereira, Flávio R.; Siqueira, André M.; Ribeiro, Rogério L.; Almeida, Thiago Miranda L.; Lacerda, Marcus Vinícius G.; Barbosa, Maria das Graças V.; Talhari, Sinésio

    2011-01-01

    American tegumentary leishmaniasis (ATL) and human immunodeficiency virus (HIV) are both common infectious diseases in the Brazilian Amazon with overlapping expansion areas, which leads to the occurrence of Leishmania/HIV coinfection. Most ATL/HIV–acquired immunodeficiency syndrome (AIDS) association cases have been reported from areas where Leishmania (Viannia) braziliensis is the main pathogen; this finding is in contrast with the Amazon region, where L. (V.) guyanensis is the most implicated agent, implying distinct clinical and therapeutic aspects. We describe 15 cases of ATL/HIV coinfection treated in a tertiary care center in the Brazilian Amazon between 1999 and 2008. Thirteen patients presented with diverse clinical manifestations of cutaneous leishmaniasis, and four of them had disseminated forms; two patients presented with mucosal leishmaniasis (ML). Seven patients required more than one course of treatment. The particularities of ATL/HIV-AIDS association in L. (V.) guyanensis-endemic areas require efforts for an increased understanding of its burden and subsequent improvements in case management. PMID:21896816

  3. HIV/AIDS in childhood and adolescence. Trends in Brazilian scientific production

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    Cristiane Cardoso de Paula

    2013-07-01

    Full Text Available Objective. To analyze the theme HIV/AIDS in childhood and adolescence, its characteristics and trends, in Brazilian scientific production between 1983 and 2010. Methodology. Review of 121 quantitative and qualitative descriptive studies. Results. 81% of the production comes from the South-East/South of the country. In the 1980's, a balance is observed between experience reports (50% and research (50%. Seventy percent of the papers were produced between 2003 and 2010. The most frequent theme analyzed with regard to childhood was care delivery (75%, against prevention in adolescence (72%. Studies related to HIV/ AIDS in emphasized clinical-epidemiological aspects (70%, while sociocultural studies predominated for the adolescent period (90%, with a preventive trend. Conclusion. The scientific production under analysis is coherent with the Brazilian policy to cope with the epidemic and addresses all care levels related to this public health problem.

  4. 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...

  5. The AIDS Epidemic and the Mozambican Society of Medicines: an analysis of Brazilian cooperation.

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    Fedatto, Maíra da Silva

    2017-07-01

    This article analyzes the Brazilian South South Cooperation in Health in Mozambique, specifically the fight against the AIDS Epidemic through the Antiretroviral Factory, in light of the concept of Structural Cooperation in Health, and with a basis in the literature on Cooperation for Development and Global Health. Thus, the article is divided into four parts: (i) a historical-bibliographic review of health as an International Relations issue; (ii) an overview of the field of health in Mozambique; (iii) an historical-political-conceptual debate about both types of International Cooperation for Development: North-South Cooperation and South-South Cooperation; (iv) a study about the antiretroviral factory, better known as the Mozambican Society of Medicines (Sociedade Moçambicana de Medicamentos). Through a case study, our goal is to verify if the Brazilian actions in Mozambique are in accordance with the concepts defended by the Structural Cooperation in Health, as well as to create new inquiries for academic debate.

  6. 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...

  7. Central nervous system paracoccidioidomycosis in an AIDS patient: case report.

    Science.gov (United States)

    Silva-Vergara, Mario León; Rocha, Ivonete Helena; Vasconcelos, Rakel Rocha; Maltos, André Luiz; Neves, Fernando de Freitas; Teixeira, Luciana de Almeida Silva; Mora, Delio José

    2014-02-01

    Up to now, over 200 patients with paracoccidioidomycosis (PCM) associated to HIV infection have already been reported; however, the central nervous system involvement in this coinfection was rarely reported. This paper presents a 35-year-old Brazilian male AIDS patient who developed pulmonary PCM successfully treated with itraconazole. At the antiretroviral therapy starting, he had 32 CD4(+) T cells baseline count and high viral load levels. After 9 months, he presented severe fungal meningoencephalitis diagnosed by sublenticular enhanced nodular lesion at computerized tomography and magnetic resonance brain imaging and a positive Paracoccidiodes brasiliensis smear and culture from cerebrospinal fluid. At the time, a sixfold increase in CD4(+) T cell count and undetectable viral load level were evidenced. The patient received amphotericin B during 1 year presenting slow but progressive clinical improvement, and he is currently asymptomatic and without neurological disabilities. To our knowledge, this is the second case report of a patient with neuroparacoccidioidomycosis associated to HIV infection.

  8. Nosocomial outbreak of cryptosporidiosis in AIDS patients.

    OpenAIRE

    Ravn, P; Lundgren, J D; Kjaeldgaard, P; Holten-Anderson, W; Højlyng, N; Nielsen, J O; Gaub, J

    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 admitted as inpatients during the transmission period of the outbreak (20 June-14 August), of whom 18 (17 with AIDS, one with AIDS related complex), developed cryptosporidiosis. Two further HIV negative s...

  9. 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...... was 83% (10/12 patients) while among patients diagnosed in 1987 or earlier the accuracy was 41% (7/17 patients). Four patients were diagnosed with Pneumocystis carinii pneumonia (PCP) prior to the diagnosis of CNS toxoplasmosis, while among patients with toxoplasmosis as the AIDS-defining diagnosis, 3...

  10. Opportunistic illnesses in Brazilian children with AIDS: results from two national cohort studies, 1983-2007

    Directory of Open Access Journals (Sweden)

    Heukelbach Jorg

    2011-07-01

    Full Text Available Abstract Background HAART has significantly reduced AIDS-related morbidity in children. However, limited evidence is available from developing countries regarding patterns of opportunistic illnesses. We describe these events and their associated factors in children with AIDS in Brazil. Methods This study is based on two representative retrospective multi-center cohorts including a total 1,859 children with AIDS, infected via mother-to-child transmission (MTCT, between 1983-2002. Opportunistic illnesses were described and analyzed over time. The association of demographic, clinical and operational data with the occurrence of opportunistic diseases was assessed. Results In total, 1,218 (65.5% had at least one event of an opportunistic disease. Variables significantly associated with occurrence of these events included: region of residence (OR 2.68-11.33, as compared to the Northern region, age Pneumocystis jirovecii pneumonia (21.9 vs. 13.2%; p Conclusions Despite the significant reduction in recent years, opportunistic illnesses are still common in Brazilian children with AIDS in the HAART era, especially bacterial diseases. The data reinforce the need for scaling up prevention of MTCT, early diagnosis of infection, and improvement of comprehensive pediatric care.

  11. 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...

  12. 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.......05). CONCLUSIONS--The clinical and epidemiological findings indicate that infection was the consequence of very small inocula. Increased sensitivity to cryptosporidiosis may be an unrecognised side effect of oral sulphonamide treatment in patients with AIDS....

  13. 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...... admitted as inpatients during the transmission period of the outbreak (20 June-14 August), of whom 18 (17 with AIDS, one with AIDS related complex), developed cryptosporidiosis. Two further HIV negative subjects (one departmental secretary, one visiting relative) developed cryptosporidiosis. MAIN OUTCOME...... out ice for cold drinks. The mean incubation time was at least 13 days-that is, twice that in HIV-negative patients. Of the 18 patients with AIDS who developed cryptosporidiosis, five recovered, two were symptomless carriers, three died of unrelated causes, and eight died after prolonged diarrhoea...

  14. Nosocomial outbreak of cryptosporidiosis in AIDS patients.

    Science.gov (United States)

    Ravn, P; Lundgren, J D; Kjaeldgaard, P; Holten-Anderson, W; Højlyng, N; Nielsen, J O; Gaub, J

    1991-02-02

    To describe a nosocomial outbreak of cryptosporidiosis during four months after June 1989. A department of infectious diseases in Copenhagen, seeing about half the patients with AIDS in Denmark. 73 HIV antibody negative subjects and 60 antibody positive subjects admitted as inpatients during the transmission period of the outbreak (20 June-14 August), of whom 18 (17 with AIDS, one with AIDS related complex), developed cryptosporidiosis. Two further HIV negative subjects (one departmental secretary, one visiting relative) developed cryptosporidiosis. Cryptosporidia in stool samples, clinical symptoms, CD4 cell count, HIV antigen concentration, chemotherapeutic treatment. The source of the outbreak was identified as ice from an ice machine in the ward, contaminated by an incontinent, psychotic patient with cryptosporidiosis picking out ice for cold drinks. The mean incubation time was at least 13 days-that is, twice that in HIV-negative patients. Of the 18 patients with AIDS who developed cryptosporidiosis, five recovered, two were symptomless carriers, three died of unrelated causes, and eight died after prolonged diarrhoea. Among the 57 exposed HIV antibody positive inpatients (excluding two patients and the index case with cryptosporidiosis diagnosed elsewhere), significantly more of those who developed symptomatic cryptosporidiosis received oral sulphonamides than those who did not (91%, 10/11 v 48%, 21/44, p less than 0.05). The clinical and epidemiological findings indicate that infection was the consequence of very small inocula. Increased sensitivity to cryptosporidiosis may be an unrecognised side effect of oral sulphonamide treatment in patients with AIDS.

  15. International institutions, global health initiatives and the challenge of sustainability: lessons from the Brazilian AIDS programme.

    Science.gov (United States)

    Le Loup, G; Fleury, S; Camargo, K; Larouzé, B

    2010-01-01

    The sustainability of successful public health programmes remains a challenge in low and middle income settings. These programmes are often subjected to mobilization-demobilization cycle. Indeed, political and organizational factors are of major importance to ensure this sustainability. The cooperation between the World Bank and the Brazilian AIDS programme highlights the role of international institutions and global health initiatives (GHI), not only to scale up programmes but also to guarantee their stability and sustainability, at a time when advocacy is diminishing and vertical programmes are integrated within health systems. This role is critical at the local level, particularly when economic crisis may hamper the future of public health programmes. Political and organizational evolution should be monitored and warnings should trigger interventions of GHI before the decline of these programmes.

  16. Pulmonary cryptococcosis in non-AIDS patients

    OpenAIRE

    ,Jin-Quan; Tang,Ke-Jing; Xu,Bing-Ling; Xie,Can-Mao; Light,Richard W.

    2012-01-01

    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 (...

  17. AIDS morbidity and mortality in Brazilian children before and after highly active antiretroviral treatment implementation: an assessment of regional trends.

    Science.gov (United States)

    Ramos, Alberto Novaes; Matida, Luiza Harunari; Hearst, Norman; Heukelbach, Jorg

    2011-09-01

    The objective of this study was to analyze regional trends over time of acquired immunodeficiency syndrome (AIDS) cases and deaths in Brazilian children, before and after implementation of free access to highly active antiretroviral treatment (HAART). We performed a nation-wide study with an ecologic design and a time-series analysis of AIDS incidence and mortality rates in children (0-12 years of age), using polynomial regression models. Data were obtained from official national databases on age group, residence region, and year of AIDS diagnosis and death (1984-2008). Between 1984 and 2008, 14,314 (2.7%) AIDS cases and 5041 deaths (2.3% of all AIDS-related deaths) were reported in Brazilian children. Incidence after 1996 was reduced by 23%, as compared with the pre-HAART era. The mortality rate observed in the HAART era was reduced by 63.6%. There was a significant reduction in the incidence in the Southeast and Central-West regions (P region showed an increase in the pre-HAART era (P region showed a stabilization trend (P region, the incidence of AIDS increased in the 0 to 4 years subgroup. A reduction of AIDS mortality in the Southeast (P regions (P regions maintained an increasing mortality trend (P regional differences continue to exist. These reflect structural factors, different transmission dynamics, and operational issues. There is a need for improving the health service network with special emphasis on the less developed regions.

  18. 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...... admitted as inpatients during the transmission period of the outbreak (20 June-14 August), of whom 18 (17 with AIDS, one with AIDS related complex), developed cryptosporidiosis. Two further HIV negative subjects (one departmental secretary, one visiting relative) developed cryptosporidiosis. MAIN OUTCOME...... MEASURES--Cryptosporidia in stool samples, clinical symptoms, CD4 cell count, HIV antigen concentration, chemotherapeutic treatment. RESULTS--The source of the outbreak was identified as ice from an ice machine in the ward, contaminated by an incontinent, psychotic patient with cryptosporidiosis picking...

  19. 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...

  20. Brain CT in patients with AIDS

    International Nuclear Information System (INIS)

    Giacomazzi, A.; Pereira, A.A.; Luca, V. de; Araujo Pinheiro, R.S. de; Peixoto, C.A.; Domingues, R.

    1989-01-01

    The authors report the computed tomography findings in 25 patients with AIDS and neurologic symptoms. They show the high incidence of focal lesions (thirteen cases) and the presence of cerebral atrophy in six cases. The focal lesions appeared as low-density masses, with or without enhancement after the injection of contrast medium. (author)

  1. Spouse-aided therapy with depressed patients

    NARCIS (Netherlands)

    EmanuelsZuurveen, L; Emmelkamp, PMG

    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

  2. Nitric oxide synthase expression and apoptotic cell death in brains of AIDS and AIDS dementia patients

    NARCIS (Netherlands)

    Vincent, V. A.; de Groot, C. J.; Lucassen, P. J.; Portegies, P.; Troost, D.; Tilders, F. J.; van Dam, A. M.

    1999-01-01

    To determine the occurrence and cellular localization of inducible nitric oxide synthase (iNOS), NOS activity and its association with cell death in brains of AIDS and AIDS dementia complex (ADC) patients. Post-mortem cerebral cortex tissue of eight AIDS patients, eight ADC patients and eight

  3. CFD aided analysis of a scaled down model of the Brazilian Multipurpose Reactor (RMB) pool

    International Nuclear Information System (INIS)

    Schweizer, Fernando L.A.; Lima, Claubia P.B.; Costa, Antonella L.; Veloso, Maria A.F.

    2013-01-01

    Research reactors are commonly built inside deep pools that provide radiological and thermal protection and easy access to its core. Reactors with thermal power in the order of MW usually use an auxiliary thermal-hydraulic circuit at the top of its pool to create a purified hot water layer (HWL). Thermal-hydraulic analysis of the flow configuration in the pool and HWL is paramount to insure radiological protection. A useful tool for these analyses is the application of CFD (Computational Fluid Dynamics). To obtain satisfactory results using CFD it is necessary the verification and validation of the CFD numerical model. Verification is divided in code and solution verifications. In the first one establishes the correctness of the CFD code implementation and in the former estimates the numerical accuracy of a particular calculation. Validation is performed through comparison of numerical and experimental results. This paper presents a dimensional analysis of the RMB (Brazilian Multipurpose Reactor) pool to determine a scaled down experimental installation able to aid in the HWL numerical investigation. Two CFD models were created one with the same dimensions and boundary conditions of the reactor prototype and the other with 1/10 proportion size and boundary conditions set to achieve the same inertial and buoyant forces proportions represented by Froude Number between the two models. Results comparing the HWL thickness show consistence between the prototype and the scaled down model behavior. (author)

  4. Cryptosporidium oocysts in Ghanaian AIDS patients with diarrhoea ...

    African Journals Online (AJOL)

    Background: Although Cryptosporidium spp. infections in acquired immunodeficiency syndrome patients (AIDS) with chronic diarrhoea have been reported in several African countries, there is no information regarding cryptosporidial diarrhoea in Ghanaian AIDS patients. Objective: To investigate the occurrence of C.

  5. 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.

  6. Pulmonary cryptococcosis in non-AIDS patients.

    Science.gov (United States)

    Yu, Jin-Quan; Tang, Ke-Jing; Xu, Bing-Ling; Xie, Can-Mao; Light, Richard W

    2012-01-01

    To investigate the clinical features, management, and prognosis of pulmonary cryptococcosis in non-acquired immunodeficiency syndrome (AIDS) patients. 24 cases of pulmonary cryptococcosis with accurate pathological diagnosis were retrospectively studied. 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. Non-AIDS patients with pulmonary cryptococcosis have a good prognosis with appropriate management. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

  7. Pulmonary cryptococcosis in non-AIDS patients

    Directory of Open Access Journals (Sweden)

    Jin-Quan

    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.

  8. Varied appearance of lymphoma in patients with AIDS

    International Nuclear Information System (INIS)

    Sider, L.; Weiss, A.

    1988-01-01

    Lymphoma is frequently present in patients with acquired immunodeficiency (AIDS). But unlike in the general population, the appearance of lymphoma in patients with AIDS is extremely varied. The computed tomographic scans, chest radiographs, and subsequent hospital courses of 15 patients with AIDS-related lymphoma are presented. The patients presented with isolated pleural effusion (six patients), pleural and pericardial effusion (one patient), pulmonary infiltrates (five patients), and mediastinal adenopathy (three patients). This varied manner of presentation of lymphoma in AIDS patients should be recognized if diagnosis is to be made in the earlier stages of presentation

  9. Prosthodontic rehabilitation of AIDS Patients: An Overview

    Directory of Open Access Journals (Sweden)

    Y K Singla

    2018-01-01

    Full Text Available Procurement for high standard of oral hygiene is a cardinal requirement for any individual and dentists constantly aim to provide optimal treatment to their patients. However, when it comes to treat patients with immunocompromised diseases, particularly those attached with social stigma like AIDS/HIV, there remain doubts and hesitations. This may lead the dentists to break the ethical responsibility by abjuring or not providing adequate treatment to these patients. Such situations can easily be avoided with absolute knowledge and awareness among the oral health-care providers including prosthodontist regarding the disease process, its connotations and measures to be taken during their treatment. This article summarizes the fundamental points in the prosthodontic management of immunocompromised patients which in the opinion of the author may be easily consolidated in dental practice.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. [Nurses' experiences with euthanasia in AIDS patients].

    Science.gov (United States)

    van der Brug, Y M; de Lange, J; Philipsen, H

    1996-08-01

    This article describes the experiences of nurses concerning the activities related to euthanasia of patients with aids. The nurses were employed in departments where relatively young, mature people wanted to arrange their own death. Our findings are based on six in-depth interviews with experienced nurses, that are part of a qualitative study into the experiences of nurses in taking leave of terminal patients with aids. The research strategy was based on the Grounded Theory. In order to analyse the experiences of the nurses, four phases were distinguished: set date and time unto application of lethal agent; application unto becoming unconscious; unconsciousness to death; death until transferring the body from the unit. Feelings that occur when taking leave of the patient, if not already taken care of at an earlier instant, play a major role in the phase from application to becoming unconscious. The fact that a deadly agent is being administered can generate feelings of guilt and anxiety. The period from unconsciousness to death is one of waiting. During this period nurses feel alienated and alone. The nurses indicated explicitly that an adequate preparation, evaluation and support are extremely important.

  12. AIDS e doenças oportunistas transmissíveis na faixa de fronteira Brasileira AIDS and transmissible opportunistic diseases in the Brazilian border area

    Directory of Open Access Journals (Sweden)

    Antonio Luiz Rodrigues-Júnior

    2010-10-01

    AIDS cases that had been reported by municipalities in the Brazilian border area. METHODS: Brazilian border area municipalities were grouped into three cultural regions; the source data was AIDS cases registered with the Ministry of Health from 1990 to 2003, which were classified according to CDC-adapted, Rio de Janeiro/Caracas and death criteria; detected communicable opportunistic diseases were categorized into groups according to transmission: 1 inhalation agent; 2 contaminated water and/or food ingestion, and 3 interpersonal contact. The descriptive evaluation considered cultural region, years of schooling, sex and age group. RESULTS: Different AIDS incidence patterns were observed among groups of opportunistic diseases in each cultural region. The extreme southern region showed the greatest incidence of AIDS; the absolute incidence of female cases was greatest in the category of heterosexual transmission; the number of male cases was greatest among intravenous drug users; transmission was most frequent in the interpersonal contact group, particularly incidences of candidiasis; tuberculoses and pneumonias were most frequent in the inhalation agent transmission group; the contaminated water/food ingestion transmission group showed an unchanged pattern of absolute incidence. CONCLUSIONS: The Brazilian border area is a very important and heterogeneous geographic phenomenon; AIDS programs must recognize different cultural geographies.

  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. Analysis of calls to the Mobile First-Aid Medical Services in a Brazilian capital city

    Directory of Open Access Journals (Sweden)

    Marilene Nonnemacher Luchtemberg

    2015-02-01

    Full Text Available It is a documentary study to characterize Mobile First-Aid Medical Services calls that did not provide assistance in the state of Santa Catarina, SC, Brazil from 2007 to 2010. Data were collected from assistance reports, being noticed 393,912 prank phone calls to the institution. The main reason for the assistance not being provided was the removal of the victim by third parties. The others were refusal of care, the removal of the patient and incorrect address. There were significant differences (p<0.05 between the years under study concerning the calls received by the Mobile First-Aid Medical Services and the number of prank phone calls received in the state macro-regions. The results indicate the need of investment in health education activities, reducing costs and increasing effectiveness. It is also necessary to improve communication between Mobile First-Aid Medical Services and the other services (Military Police and Fire Brigade reducing the number of assistance.

  15. Radiographic manifestations of arthritis in AIDS patients

    International Nuclear Information System (INIS)

    Rosenberg, Z.S.; Norman, A.; Solomon, G.

    1988-01-01

    The purpose of this study is to familiarize the radiologist with a newly discovered association between arthritis and acquired immunodeficiency syndrome (AIDS). The authors retrospectively reviewed the clinical and radiographic findings in 31 patients with human immunodeficiency virus (HIV) infection referred to their rheumatology clinic with musculoskeletal complaints. The patients carried a wide range of clinical diagnosis including Reiter syndrome, psoriatic arthritis, undifferentiated seronegative arthritis, isolated enthesopathies, rheumatoid arthritis and osteonecrosis. Radiographs were available in 24 of the 31 patients, and in 20 they showed radiographic features of arthritis, which included soft-tissue swelling periarticular osteoporosis, synovial effusions, sacroiliitis, periosteal reaction, joint space narrowing, marginal erosions, and osteonecrosis. Although the radiographic abnormalities were frequently mild, they were significant, given the short duration of disease in many of their patients (weeks to months) at the time radiographs were obtained. The range of radiographic findings in their series was varied and paralleled the wide range of clinical diagnoses. No findings were pathognomonic for HIV-associated arthritis. Nevertheless, HIV infection needs to be considered in any patient belonging to a recognized risk group who presents with musculoskeletal disease. This is particularly important since immunosupressive drugs used for the treatment of arthritis can be detrimental to patients with HIV infection

  16. Survival differences in European patients with AIDS, 1979-89. The AIDS in Europe Study Group

    DEFF Research Database (Denmark)

    Lundgren, Jens Dilling; Pedersen, C; Clumeck, N

    1994-01-01

    OBJECTIVES--To examine the pattern of survival and factors associated with the outcome of disease in patients with AIDS. DESIGN--Inception cohort. Data collected retrospectively from patients' charts. SETTING--52 clinical centres in 17 European countries. SUBJECTS--6578 adults diagnosed with AIDS...

  17. Study of hearing aid effectiveness and patient satisfaction.

    Science.gov (United States)

    Kayabaşoğlu, Gürkan; Kaymaz, Recep; Erkorkmaz, Ünal; Güven, Mehmet

    2015-01-01

    This study aims to investigate hearing aid using rate, patient satisfaction rate and achievements in social communication of patients by assessing the hearing thresholds before and after device use in patients who were determined as suitable for hearing aid use. Hundred eighty patients who were admitted to Otolaryngology Clinic of Sakarya University Medical Faculty and approved of hearing aid usage between January 2013 and May 2013 were included in the study. Patients (21 males, 26 females; mean age 61.91±12.82; range 24 to 85 years) were performed free field audiometry with and without the device by the same audiometrist and Turkish version of the International Outcome Inventory for Hearing Aids by the same otolaryngologist. Of patients, 14.28% did not obtain the hearing aid even though they received a hearing aid approval report. Assessment of the answers of inventory questions revealed that 87% of patients used hearing aid more than four hours a day, 72% benefited significantly from hearing aid, and 64% had no complaint or had few complaints compared to the before-hearing aid period. Using hearing aid affects daily activities of patients slightly or moderately and increases their communication skills.

  18. Symptoms and sites of pain experienced by AIDS patients

    African Journals Online (AJOL)

    Modern medical AIDS management rightly focuses on the use of ART as well ... the majority of patients with AIDS currently have no access to. ART. Soweto Hospice is set in an urban environment and is a branch of Hospice Witwatersrand in Johannesburg. Soweto ..... 1. UNAIDS. Joint United Nations Program on HIV/AIDS.

  19. Medical students' attitudes toward AIDS and homosexual patients.

    Science.gov (United States)

    Kelly, J A; St Lawrence, J S; Smith, S; Hood, H V; Cook, D J

    1987-07-01

    More than most diseases, acquired immune deficiency syndrome (AIDS) appears to elicit highly negative, fearful, and prejudicial attitudes. In the study reported here, medical students read one of four patient vignettes. The vignettes were identical in content except that the patient was identified as having either AIDS or leukemia as either homosexual or heterosexual. The students then completed a set of objective measures that assessed their attitudes toward the patient portrayed in the vignette. Multivariate and univariate analyses of variance of their responses revealed that the students held negative and prejudiced attitudes toward both the AIDS and homosexual patients. This finding suggests that medical educators should recognize that many students have stigmatizing, negative attitudes toward homosexuals and patients with AIDS. These educators should promote greater sensitivity, knowledge, and understanding among medical students of those at risk for AIDS and AIDS patients.

  20. Estudo comparativo do LCR de pacientes com neurocriptococose sem AIDS e com AIDS Comparison between CSF samples from AIDS and non-AIDS patients with neurocryptococcosis

    Directory of Open Access Journals (Sweden)

    João Baptista dos Reis-Filho

    1994-06-01

    Full Text Available Até a década de 80, antes do surgimento da AIDS, a criptococose era relativamente rara. Verificou-se que esta doença afeta muito frequentemente os pacientes com AIDS e pode ser a primeira manifestação desta síndrome. O objetivo deste trabalho é o de comparar o resultado dos exames das amostras do LCR inicial na meningencefalite por criptococo entre pacientes com e sem AIDS. Este trabalho é baseado no estudo de 41 pacientes com neurocriptococose sem AIDS e de 23 pacientes com neurocriptococose e AIDS. Este estudo permitiu verificar que a reação inflamatória, no sistema nervoso, quando presente, foi de menor intensidade nos pacientes com AIDS; a reação inflamatória esteve presente em todos os pacientes sem AIDS e ausente em 21,7% dos pacientes com AIDS; o quadro inflamatório crônico, semelhante ao da meningencefalite tuberculosa, clássico nas meningencefalites por criptococo, ocorreu raramente nos pacientes com AIDS; em média, o número de criptococos no LCR foi maior nos pacientes com AIDS; pode ser feito diagnóstico presuntivo da AIDS quando o criptococo estiver presente no LCR que não apresenta alterações citológicas e bioquímicas.Neurocryptococcosis was a rare nervous system infection. With the rising number of patients with AIDS it became a very frequent disease. This infection is supposed to infect patients with some kind of immunodeficiency and the CSF alterations often simulate tuberculous meningitis. The purpose of this research was to compare the CSF changes in AIDS and non-AIDS patients with meningoencephalitis caused by Cr. neoformans. There were analysed 41 CSF samples from non-AIDS patients with neurocryptococcosis and 23 CSF samples from AIDS patients with neurocryptococcosis. The results of this research allowed to conclude that the inflammatory changes in the CSF from AIDS patients showed a lower intensity compared to those non-AIDS patients. These results showed as well, that the CSF samples from non-AIDS

  1. Disseminated Strongyloidiasis among HIV/AIDS Patients in Jimma ...

    African Journals Online (AJOL)

    Background and objectives:Strongyloidiasis has become a very important disease in HIV/AIDS patients. Reports pertaining to this aspect are very scarce in Ethiopia. The objective of this study was to determine the prevalence of Strongyloides stercoralis in stool and sputum samples of HIV/AIDS patients. Patients and ...

  2. Opportunistic infections and malignancies in 231 Danish AIDS patients

    DEFF Research Database (Denmark)

    Pedersen, C; Gerstoft, J; Tauris, P

    1990-01-01

    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...

  3. 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.

  4. HLA Haplotypes and Genotypes Frequencies in Brazilian Chronic Periodontitis Patients

    Science.gov (United States)

    Sippert, Emília Ângela; Silva, Cléverson de Oliveira e; Ayo, Christiane Maria; Marques, Silvia Barbosa Dutra; Visentainer, Jeane Eliete Laguila; Sell, Ana Maria

    2015-01-01

    Human leukocyte antigens (HLA) have a pivotal role in immune response and may be involved in antigen recognition of periodontal pathogens. However, the associations of HLA with chronic periodontitis (CP) have not been previously studied in the Brazilian population. In an attempt to clarify the issue of genetic predisposition to CP, we examined the distribution of HLA alleles, genotypes, and haplotypes in patients from Southern Brazil. One hundred and eight CP patients and 151 healthy and unrelated controls with age-, gender-, and ethnicity-matched were HLA investigated by polymerase chain reaction with sequence specific oligonucleotides. To exclude smoking as a predisposing factor, statistical analyses were performed in the total sample and in nonsmoking individuals. The significant results showed a positive association of the A∗02/HLA-B∗40 haplotype with CP (total samples: 4.2% versus 0%, P c = 0.03; nonsmokers: 4.3% versus 0%, P c = 0.23) and a lower frequency of HLA-B∗15/HLA-DRB1∗11 haplotype in CP compared to controls (total samples: 0.0% versus 4.3%, P c = 0.04; nonsmokers: 0 versus 5.1%, P c = 1.0). In conclusion, the HLA-A∗02/B∗40 haplotype may contribute to the development of CP, while HLA-B∗15/DRB1∗11 haplotype might indicate resistance to disease among Brazilians. PMID:26339134

  5. HLA Haplotypes and Genotypes Frequencies in Brazilian Chronic Periodontitis Patients

    Directory of Open Access Journals (Sweden)

    Emília Ângela Sippert

    2015-01-01

    Full Text Available Human leukocyte antigens (HLA have a pivotal role in immune response and may be involved in antigen recognition of periodontal pathogens. However, the associations of HLA with chronic periodontitis (CP have not been previously studied in the Brazilian population. In an attempt to clarify the issue of genetic predisposition to CP, we examined the distribution of HLA alleles, genotypes, and haplotypes in patients from Southern Brazil. One hundred and eight CP patients and 151 healthy and unrelated controls with age-, gender-, and ethnicity-matched were HLA investigated by polymerase chain reaction with sequence specific oligonucleotides. To exclude smoking as a predisposing factor, statistical analyses were performed in the total sample and in nonsmoking individuals. The significant results showed a positive association of the A∗02/HLA-B∗40 haplotype with CP (total samples: 4.2% versus 0%, Pc = 0.03; nonsmokers: 4.3% versus 0%, Pc = 0.23 and a lower frequency of HLA-B∗15/HLA-DRB1∗11 haplotype in CP compared to controls (total samples: 0.0% versus 4.3%, Pc = 0.04; nonsmokers: 0 versus 5.1%, Pc = 1.0. In conclusion, the HLA-A∗02/B∗40 haplotype may contribute to the development of CP, while HLA-B∗15/DRB1∗11 haplotype might indicate resistance to disease among Brazilians.

  6. Addressing health literacy in patient decision aids

    Science.gov (United States)

    2013-01-01

    Background Effective use of a patient decision aid (PtDA) can be affected by the user’s health literacy and the PtDA’s characteristics. Systematic reviews of the relevant literature can guide PtDA developers to attend to the health literacy needs of patients. The reviews reported here aimed to assess: 1. a) the effects of health literacy / numeracy on selected decision-making outcomes, and b) the effects of interventions designed to mitigate the influence of lower health literacy on decision-making outcomes, and 2. the extent to which existing PtDAs a) account for health literacy, and b) are tested in lower health literacy populations. Methods We reviewed literature for evidence relevant to these two aims. When high-quality systematic reviews existed, we summarized their evidence. When reviews were unavailable, we conducted our own systematic reviews. Results Aim 1: In an existing systematic review of PtDA trials, lower health literacy was associated with lower patient health knowledge (14 of 16 eligible studies). Fourteen studies reported practical design strategies to improve knowledge for lower health literacy patients. In our own systematic review, no studies reported on values clarity per se, but in 2 lower health literacy was related to higher decisional uncertainty and regret. Lower health literacy was associated with less desire for involvement in 3 studies, less question-asking in 2, and less patient-centered communication in 4 studies; its effects on other measures of patient involvement were mixed. Only one study assessed the effects of a health literacy intervention on outcomes; it showed that using video to improve the salience of health states reduced decisional uncertainty. Aim 2: In our review of 97 trials, only 3 PtDAs overtly addressed the needs of lower health literacy users. In 90% of trials, user health literacy and readability of the PtDA were not reported. However, increases in knowledge and informed choice were reported in those studies

  7. Donor leucocyte imaging in patients with AIDS: A preliminary report

    International Nuclear Information System (INIS)

    O'Doherty, M.J.; Kent and Canterbury Hospital; Revell, P.; Page, C.J.; Nunan, T.O.; Lee, S.; Mountford, P.J.

    1990-01-01

    Four patients with the acquired immunodeficiency syndrome (AIDS) and fever were investigated using donor leucocyte scans. The lung/liver and lung/spleen uptake ratios in these patients were compared with the uptake ratios in donor leucocyte scans in seven neutropenic (non-AIDS) patients and five patients who had autologous leucocyte scans performed over the same time period. All scans used indium oxine In 111 labelled leucocytes except that for one AIDS patient which used technetium hexamethyl-propylene amine oxide Tc99m labelled donor leucocytes. There were no adverse reactions to the donor cell infusions. Two patients had repeat studies 8 weeks apart (from different donors) without ill effect. There were no differences in the 111 In uptake ratios between the three groups. There were three positive studies in the patients with AIDS, and these elucidated the cause of the pyrexia in all three. The negative case is more difficult to confirm, but the clinical course and the absence of focal disease on post-mortem have been taken to support the scan findings. There was no difference in the acceptibility of the technique or the distribution of the labelled leucocytes between the AIDS and non-AIDS patients. Donor leucocyte imaging of patients with AIDS is probably more effective and considerably less hazardous for technical staff than autologous leucocyte methods. This study demonstrates that the technique can be applied successfully to patients with AIDS. (orig.)

  8. Survival differences in European patients with AIDS, 1979-89. The AIDS in Europe Study Group

    DEFF Research Database (Denmark)

    Lundgren, Jens Dilling; Pedersen, C; Clumeck, N

    1994-01-01

    OBJECTIVES--To examine the pattern of survival and factors associated with the outcome of disease in patients with AIDS. DESIGN--Inception cohort. Data collected retrospectively from patients' charts. SETTING--52 clinical centres in 17 European countries. SUBJECTS--6578 adults diagnosed with AIDS....... The regional differences in survival were less pronounced for patients diagnosed in 1989 compared with earlier years. Improved survival in recent years was observed for patients with a variety of manifestations used to define AIDS but was significant only for patients diagnosed with Pneumocystis carinii...... pneumonia. The three year survival, however, remains unchanged over time. CONCLUSIONS--Survival of AIDS patients seems to vary within Europe, being shorter in southern than central and northern Europe. The magnitude of these differences, however, has declined gradually over time. Short term survival has...

  9. Opportunistic infections and malignancies in 231 Danish AIDS patients

    DEFF Research Database (Denmark)

    Pedersen, C; Gerstoft, J; Tauris, P

    1990-01-01

    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......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...

  10. Cryptosporidiosis and Isosporiasis among HIV/AIDS patients in ...

    African Journals Online (AJOL)

    Background and objectives: Cryptosporidosis and isosporiasis are becoming common in subjects with AIDS. Thus a cross-sectional study was conducted to determine the magnitude of Cryptosporidium parvum and Isospora belli infections among HIV/AIDS patients in Jimma, Southwest Ethiopia. Patients and methods: One ...

  11. Neuroimage of the toxoplasmosis in the patient with AIDS

    International Nuclear Information System (INIS)

    Paez, Luis Alfredo; Araque, Julio Mario; Lozano, Alfonso Javier

    2001-01-01

    We performed a review of literature on CNS involvement in AIDS patients. Besides several cases seen in the San Juan de Dios Hospital in Bogota, Colombia, are illustrated with tomographic images. We propose an algorithmic decision tree in the patient with AIDS and neurological symptoms

  12. Cryptosporidiosis and Isosporiasis among HIV/AIDS patients in ...

    African Journals Online (AJOL)

    In addition, 48% of the HIV/AIDS patients were infected with one or more kinds of intestinal parasites: Ascaris lumbricoides, hook worm, Trichuris trichiuria, Strongyloide stercoralis, Schistosoma mansoni and Taenia species. Of all the parasites Cryptosporidium parvum was significantly associated with AIDS patients.

  13. A Multimodal Communication Aid for Global Aphasia Patients

    DEFF Research Database (Denmark)

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

    2004-01-01

    seldom have identical symptoms, the focus of this paper is placed on the development of a highly dedicated communication aid adaptive to the individual patients’ needs. The paper investigates whether or not such a highly dedicated communication aid based on multimodal representations of communicative......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...

  14. 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...

  15. Physicians' intentions and use of three patient decision aids

    Science.gov (United States)

    Graham, Ian D; Logan, Jo; Bennett, Carol L; Presseau, Justin; O'Connor, Annette M; Mitchell, Susan L; Tetroe, Jacqueline M; Cranney, Ann; Hebert, Paul; Aaron, Shawn D

    2007-01-01

    Background Decision aids are evidence based tools that assist patients in making informed values-based choices and supplement the patient-clinician interaction. While there is evidence to show that decision aids improve key indicators of patients' decision quality, relatively little is known about physicians' acceptance of decision aids or factors that influence their decision to use them. The purpose of this study was to describe physicians' perceptions of three decision aids, their expressed intent to use them, and their subsequent use of them. Methods We conducted a cross-sectional survey of random samples of Canadian respirologists, family physicians, and geriatricians. Three decision aids representing a range of health decisions were evaluated. The survey elicited physicians' opinions on the characteristics of the decision aid and their willingness to use it. Physicians who indicated a strong likelihood of using the decision aid were contacted three months later regarding their actual use of the decision aid. Results Of the 580 eligible physicians, 47% (n = 270) returned completed questionnaires. More than 85% of the respondents felt the decision aid was well developed and that it presented the essential information for decision making in an understandable, balanced, and unbiased manner. A majority of respondents (>80%) also felt that the decision aid would guide patients in a logical way, preparing them to participate in decision making and to reach a decision. Fewer physicians (decision aid would improve the quality of patient visits or be easily implemented into practice and very few (27%) felt that the decision aid would save time. Physicians' intentions to use the decision aid were related to their comfort with offering it to patients, the decision aid topic, and the perceived ease of implementing it into practice. While 54% of the surveyed physicians indicated they would use the decision aid, less than a third followed through with this intention

  16. Nontuberculous mycobacteria in non-AIDS patients

    Directory of Open Access Journals (Sweden)

    A. Marinho

    2008-05-01

    Full Text Available Nontuberculous mycobacteria (NTM play an increasingly significant pathogenic role in HIV-positive patients, in patients with chronic lung disease, in other chronic conditions and in the elderly. Aims: Evaluate the importance of NTM isolation in respiratory samples in patients without HIV-infection. Methods: Retrospective evaluation of our hospital patients with no known AIDS, with at least one NTM positive respiratory sample, from 1997-2004. Results: We found 102 patients, with a median age of 63 years; 67% male. Sixty-three (62% had underlying lung disease, mainly tuberculosis sequelae (n = 19. The majority (47% of the isolations were Mycobacterium avium complex (MAC.A diagnosis of Mycobacterium pulmonary disease was made in 16 patients (15.7%, 14 of which met the American Thoracic Society diagnostic criteria. Ten male and 6 female; median age 65 years. Twelve had underlying lung disease. All of them had respiratory infection complaints. Chest X-rays showed mainly pulmonary infiltrates, linear opacities and cavitation. MAC was the cause of mycobacterium respiratory disease in 12 patients (75%. Conclusion: NTM isolation did not equal pulmonary NTM disease in the majority of cases, even in patients with underlying lung disease. MAC was the most commonly isolated agent and its relative importance was higher in the presence of NTM disease. Resumo: As micobactérias não tuberculosas (MNT têm um papel patogénico de importância crescente em doentes com serologia positiva para o vírus da imunodeficiência humana (VIH, em doentes com doença pulmonar crónica, em outras doencas crónicas, e ainda nos idosos. Objectivo: Avaliar a importância do isolamento de MNT em amostras respiratórias em doentes adultos sem infecção VIH. Material e métodos: Estudo retrospectivo dos doentes do Hospital de São João sem infecção VIH conhecida, com pelo menos uma amostra respiratória positiva para MNT, entre 1997 e 2004. Resultados: Foram encontrados 102

  17. Physicians' intentions and use of three patient decision aids

    Directory of Open Access Journals (Sweden)

    Mitchell Susan L

    2007-07-01

    Full Text Available Abstract Background Decision aids are evidence based tools that assist patients in making informed values-based choices and supplement the patient-clinician interaction. While there is evidence to show that decision aids improve key indicators of patients' decision quality, relatively little is known about physicians' acceptance of decision aids or factors that influence their decision to use them. The purpose of this study was to describe physicians' perceptions of three decision aids, their expressed intent to use them, and their subsequent use of them. Methods We conducted a cross-sectional survey of random samples of Canadian respirologists, family physicians, and geriatricians. Three decision aids representing a range of health decisions were evaluated. The survey elicited physicians' opinions on the characteristics of the decision aid and their willingness to use it. Physicians who indicated a strong likelihood of using the decision aid were contacted three months later regarding their actual use of the decision aid. Results Of the 580 eligible physicians, 47% (n = 270 returned completed questionnaires. More than 85% of the respondents felt the decision aid was well developed and that it presented the essential information for decision making in an understandable, balanced, and unbiased manner. A majority of respondents (>80% also felt that the decision aid would guide patients in a logical way, preparing them to participate in decision making and to reach a decision. Fewer physicians ( Conclusion Despite strong support for the format, content, and quality of patient decision aids, and physicians' stated intentions to adopt them into clinical practice, most did not use them within three months of completing the survey. There is a wide gap between intention and behaviour. Further research is required to study the determinants of this intention-behaviour gap and to develop interventions aimed at barriers to physicians' use of decision aids.

  18. Musculoskeletal system pathology in aids patients

    International Nuclear Information System (INIS)

    Zabala, R.; Oleaga, L.; Garcia Bolado, A.; Grande, D.; Gorrino, O.; Lecumberri, I.

    2003-01-01

    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 bony

  19. Use of clozapine in Brazilian patients with Parkinson's disease.

    Science.gov (United States)

    Gomide, Laura; Kummer, Arthur; Cardoso, Francisco; Teixeira, Antonio Lucio

    2008-09-01

    Clozapine has been used as an attempt to manage levodopa complications in advanced Parkinson's disease (PD). To investigate the use of clozapine in this context in a Brazilian sample, a retrospective chart review was carried out at the Movement Disorders Clinic from the Federal University of Minas Gerais. This study enrolled 43 PD patients who used or were in use of clozapine. Patients had a mean age of 64 years and a mean UPDRS score of 55. Clozapine was indicated for dyskinesias in 17 patients, for psychosis in 15 and for both reasons in 11. The average maximum dose was 70 mg/day. Twenty six patients used it for a mean of 3.5 years. Twenty nine presented an improvement of their condition, 9 remained clinically stable. Twenty subjects interrupted the use of clozapine, being 9 due to adverse effects. Clozapine may play a role in the management of motor and psychiatric complications in PD, but it is associated with low tolerability.

  20. Hemochromatosis (HFE gene mutations in Brazilian chronic hemodialysis patients

    Directory of Open Access Journals (Sweden)

    F.V. Perícole

    2005-09-01

    Full Text Available Patients with chronic renal insufficiency (CRI have reduced hemoglobin levels, mostly as a result of decreased kidney production of erythropoietin, but the relation between renal insufficiency and the magnitude of hemoglobin reduction has not been well defined. Hereditary hemochromatosis is an inherited disorder of iron metabolism. The importance of the association of hemochromatosis with treatment for anemia among patients with CRI has not been well described. We analyzed the frequency of the C282Y and H63D mutations in the HFE gene in 201 Brazilian individuals with CRI undergoing hemodialysis. The analysis of the effects of HFE mutations on iron metabolism and anemia with biochemical parameters was possible in 118 patients of this study (hemoglobin, hematocrit, ferritin levels, transferrin saturation, and serum iron. A C282Y heterozygous mutation was found in 7/201 (3.4% and H63D homozygous and heterozygous mutation were found in 2/201 (1.0% and 46/201 (22.9%, respectively. The allelic frequencies of the HFE mutations (0.017 for C282Y mutation and 0.124 for H63D mutation did not differ between patients with CRI and healthy controls. Regarding the biochemical parameters, no differences were observed between HFE heterozygous and mutation-negative patients, although ferritin levels were not higher among patients with the H63D mutation (P = 0.08. From what we observed in our study, C282Y/H63D HFE gene mutations are not related to degrees of anemia or iron stores in CRI patients receiving intravenous iron supplementation (P > 0.10. Nevertheless, the present data suggest that the H63D mutation may have an important function as a modulating factor of iron overload in these patients.

  1. 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...... but should be kept in mind as the disease is a major opportunistic infection in patients with AIDS. Treatment with amphotericin B followed by fluconazole was effective....

  2. burden of intestinal parasites amongst hiv/aids patients attending

    African Journals Online (AJOL)

    boaz

    diarrhea, especially in AIDS patients, although they are thought to cause self limiting diarrhea in immunocompetent individuals. These are referred to as opportunistic parasites [6]. Different species of protozoa have been associated with acute and chronic diarrhea in. HIV infection and AIDS. They include Cryptosporidium.

  3. A Multimodal Communication Aid for Global Aphasia Patients

    DEFF Research Database (Denmark)

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

    2004-01-01

    seldom have identical symptoms, the focus of this paper is placed on the development of a highly dedicated communication aid adaptive to the individual patients’ needs. The paper investigates whether or not such a highly dedicated communication aid based on multimodal representations of communicative...

  4. Cryptosporidium oocysts in Ghanaian AIDS patients with diarrhoea ...

    African Journals Online (AJOL)

    Also, no enterobacteria was found in the HIV-seronegative patients. Conclusion: This study demonstrates the prevalence of Cryptosporidium sp. in both HIV/ AIDS and HIV-seronegative individuals in Ghana. However, there was no statistical association between cryptosporidiosis and HIV/AIDS (p>0.05). East African ...

  5. Nuclear medicine in the management of the aids patient

    International Nuclear Information System (INIS)

    Kramer, E.L.; Sanger, J.J.

    1995-01-01

    For the medical diagnostic imaging specialist in general, and for the nuclear medicine physician specifically, the AIDS epidemic has generated an enormous demand to develop a means of making early diagnoses of the complications of AIDS. For the most part this has meant the early detection, and when possible, the characterization of the opportunistic infections and neoplasms that are a major source of morbidity and mortality for the AIDS patient. Detection of opportunistic infections has been helpful in reclassifying HIV-seropositive patients as having AIDS. This paper reports on nuclear medicine used to evaluate the efficacy and the complications of treatment in human immunodeficiency virus infection. Most recently, functional brain imaging has been used for the diagnosis and follow-up of the AIDS dementia complex. (author). 77 refs., 8 figs

  6. Nuclear medicine in the management of the AIDS patient

    International Nuclear Information System (INIS)

    Kramer, E.L.; Sanger, J.J.

    1990-01-01

    For the medical diagnostic imaging specialist in general, and for the nuclear medicine physician specifically, the AIDS epidemic has generated an enormous demand to develop a means of making early diagnoses of the complications of AIDS. For the most part this has meant the early detection, and when possible, the characterization of the opportunistic infections and neoplasms that are a major source of morbidity and mortality for the AIDS patient. Detection of opportunistic infections has been helpful in reclassifying HIV-seropositive patients as having AIDS. This paper reports on nuclear medicine used to evaluate the efficacy and the complications of treatment in human immunodeficiency virus infection. Most recently, functional brain imaging has been used for the diagnosis and follow-up of the AIDS dementia complex

  7. Smith-Magenis syndrome: clinical evaluation in seven Brazilian patients.

    Science.gov (United States)

    Gamba, B F; Vieira, G H; Souza, D H; Monteiro, F F; Lorenzini, J J; Carvalho, D R; Morreti-Ferreira, D

    2011-10-31

    Smith-Magenis syndrome (SMS) is a complex congenital anomaly characterized by craniofacial anomalies, neurological and behavioral disorders. SMS is caused by a deletion in region 17p11.2, which includes the RAI1 gene (90% of cases), or by point mutation in the RAI1 gene (10% of cases). Laboratory diagnosis is through cytogenetic analysis by GTG banding and molecular cytogenetic analysis by FISH. We carried out an active search for patients in Associations of Parents and Friends of Exceptional Children (APAE) of São Paulo and genetic centers in Brazil. Forty-eight patients were screened for mental retardation, craniofacial abnormalities and stereotyped behavior with a diagnosis of SMS. In seven of them, chromosome banding at high resolution demonstrated chromosome 17p11.2 deletions, confirmed by FISH. We also made a meta-analysis of 165 cases reported between 1982 and 2010 to compare with the clinical data of our sample. We demonstrated differences between the frequencies of clinical signs among the cases reported and seven Brazilian cases of this study, such as dental anomalies, strabismus, ear infections, deep hoarse voice, hearing loss, and cardiac defects. Although the gold standard for diagnosis of SMS is FISH, we found that the GTG banding technique developed to evaluate chromosome 17 can be used for the SMS diagnosis in areas where the FISH technique is not available.

  8. Analysis of spatial diffusion patterns for AIDS cases in some Brazilian States

    OpenAIRE

    Dias, Paulo Roberto Telles Pires; Nobre, Flavio Fonseca

    2001-01-01

    Ações preventivas ainda são essenciais ao controle da epidemia de AIDS; contudo, programas de prevenção eficazes dependem da distribuição correta e eficiente dos recursos de saúde. Assim, informações acerca de onde, quando, com que intensidade e como se difundirá a epidemia são valiosos. Este estudo visou obter melhor compreensão do processo de difusão espacial dos casos de AIDS em quatro Estados brasileiros. Tais padrões foram avaliados qualitativamente - estudo de mapas seqüenciais - e quan...

  9. 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.

  10. Radiological features of pulmonary complications in patients with AIDS

    International Nuclear Information System (INIS)

    Ruebesam, D.; Fuchs, H.F.

    1988-01-01

    Our experience with over 200 AIDS-patients emphasizes the good knowledge in radiological features of pulmonary complications in patients with AIDS for early diagnosis. We show the radiological appearance of the most frequent opportunistic infection of the lung, pneumocystis carinii pneumonia, and the different appearance of the other most frequently seen pulmonary complications as Kaposisarkoma, cytomegaly-virus-pneumonia, non-typical-mycobacteria-infection and tuberculosis. A synopsis over the most important symptoms is made for easier differential diagnosis. (orig.) [de

  11. Nasal colonization with Staphylococcus aureus in individuals with HIV/ AIDS attended in a Brazilian Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Lilian Andreia Fleck Reinato

    2013-12-01

    Full Text Available OBJECTIVE: to evaluate the prevalence of nasal colonization with Staphylococcus aureus in individuals with HIV/AIDS under inpatient treatment in a teaching hospital in the state of São Paulo (Brazil. METHOD: a cross-sectional study undertaken in two units specialized in attending people living with HIV/AIDS, in the period August 2011 - July 2012. Socio-demographic and clinical data was collected through individual interviews and from the medical records; samples of nasal secretion were collected with Stuart swabs on the first day of inpatient treatment. Ethical aspects were respected. RESULT: of the 229 individuals with HIV/AIDS hospitalized in this period, 169 participated in the study, with Staphylococcus aureus being identified in the culture tests of 46 (27.2% of the individuals, resistance to oxacillin being evidenced in 10 (21.8% participants. CONCLUSION: the results of the research indicate that the prevalence of colonization with Staphylococcus aureus in individuals with HIV/AIDS in the specialized units was considered relevant, possibly contributing to future investigations and, moreover, to the implementation of measures to prevent and control this pathogen in this population.

  12. Nasal colonization with Staphylococcus aureus in individuals with HIV/ AIDS attended in a Brazilian teaching hospital.

    Science.gov (United States)

    Reinato, Lilian Andreia Fleck; Pio, Daiana Patrícia Marchetti; Lopes, Letícia Pimenta; Pereira, Fernanda Maria Vieira; Lopes, Ana Elisa Ricci; Gir, Elucir

    2013-01-01

    to evaluate the prevalence of nasal colonization with Staphylococcus aureus in individuals with HIV/AIDS under inpatient treatment in a teaching hospital in the state of São Paulo (Brazil). a cross-sectional study undertaken in two units specialized in attending people living with HIV/AIDS, in the period August 2011 - July 2012. Socio-demographic and clinical data was collected through individual interviews and from the medical records; samples of nasal secretion were collected with Stuart swabs on the first day of inpatient treatment. Ethical aspects were respected. of the 229 individuals with HIV/AIDS hospitalized in this period, 169 participated in the study, with Staphylococcus aureus being identified in the culture tests of 46 (27.2%) of the individuals, resistance to oxacillin being evidenced in 10 (21.8%) participants. the results of the research indicate that the prevalence of colonization with Staphylococcus aureus in individuals with HIV/AIDS in the specialized units was considered relevant, possibly contributing to future investigations and, moreover, to the implementation of measures to prevent and control this pathogen in this population.

  13. Medical Students' Perceptions and Proposed Treatment Strategies for AIDS Patients.

    Science.gov (United States)

    Ladany, Nicholas; Stern, Marilyn

    Research has consistently found that health care providers report having negative attitudes and perceptions toward Acquired Immune Deficiency Syndrome (AIDS) patients. This study was conducted to examine the independent and joint influences of a patient's mode of acquisition of illness (blood transfusion versus sexual promiscuity), patient blame…

  14. Cri du Chat syndrome: Characteristics of 73 Brazilian patients.

    Science.gov (United States)

    Honjo, R S; Mello, C B; Pimenta, L S E; Nuñes-Vaca, E C; Benedetto, L M; Khoury, R B F; Befi-Lopes, D M; Kim, C A

    2018-02-20

    Cri du Chat syndrome (CdCS) is a genetic syndrome caused by deletions in the short arm of chromosome 5. Although the main clinical features of CdCS are well known, the neurocognitive and behavioural characteristics of the phenotype are rarely described in detail in the literature. In this study, we analysed the main phenotypic features of CdCS from a parental perspective. A questionnaire was sent to 700 Brazilian families that were registered in the Brazilian Association of CdCS. The questions involved specific domains of CdCS, such as pregnancy and birth conditions, recurrence of the disease in the family, current major health problems, and aspects of cognitive development. In total, 73 questionnaires were completed: 44 females and 29 males, ranging from 9.5 months old to 40 years old (mean = 13.8 years; median = 12 years). Most of the parents noticed the typical cat-like cry at birth (94.4%). The age at diagnosis of CdCS ranged from the time of birth to 180 months (mean = 14 months; median = 6 months), while one case was diagnosed during pregnancy. In all of the cases, the diagnosis of CdCS was made by G-banding karyotype analysis. In 66.2% of the cases, the parents underwent cytogenetic investigation. A total of 52.1% of the parents answered that they did not remember what the recurrence risk of CdCS was in their family. The main health problems that were reported were as follows: swallowing problems (80.3%), feeding problems (80.3%), congenital heart disease (31.5%), spine abnormalities (28.8%), and neurological symptoms (20.5%), including seizures (11%). The behavioural problems that were reported were as follows: aggressive behaviour, stereotypies, anxiety, phobias, and genital manipulation/masturbation. Neurodevelopmental delay was reported in all of the cases. Independent walking was achieved in 72.2% of the patients. Approximately 50% of the patients never presented expressive language, and most of the patients are dependent on others for

  15. Disseminated paracoccidioidomycosis with peripleuritis in an AIDS patient

    OpenAIRE

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

    2004-01-01

    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, paracoccidio...

  16. Differential characteristics of AIDS patients with a history of imprisonment.

    Science.gov (United States)

    Caylà, J A; Marco, A; Bedoya, A; Guerrero, R; García, J; Martín, V; Jansà, J M; De Olalla, P G; Selwyn, P A

    1995-12-01

    AIDS is among the leading causes of death in prisons, but there is little information about AIDS patients with a history of imprisonment. AIDS patients diagnosed in Barcelona between 1988 and 1993 were studied. Those with prison histories were compared to those without, with respect to epidemiological variables, including survival analysis. 28.5% of 2336 AIDS patients, 49.4% of intravenous drug users (IVDU) and only 2.6% of homosexuals who were not IVDU had a prison history. Those with prison histories, compared to those without, were younger (median age of 30.6 versus 36.4, P homosexuals (87.8% versus 35.8%, OR = 36.9, 95% CI: 22.6-60.8, P < 0.0001), and diagnosed with AIDS because of extrapulmonary tuberculosis (32.0% versus 14.7%, P < 0.001). Among IVDU, those with prison histories were more frequently males (OR: 2.2; 95% CI: 1.6-2.9), lived in the poorest district of Barcelona more frequently than in the richest district (OR: 6.6; 95% CI: 3.4-12.9) and presented with extra-pulmonary tuberculosis more frequently than Pneumocystis carinii pneumonia (OR: 1.7; 95% CI: 1.2-2.4). Longer survival in the prison group did not persist when adjusted for age and AIDS-defining disease. Those with prison histories who presented with AIDS with only extrapulmonary tuberculosis had better probability of survival than those who presented only with P. carinii pneumonia (P < 0.001). AIDS patients in Barcelona with prison histories tended to be younger, more likely to be IVDU, and to present with extrapulmonary tuberculosis as an AIDS-defining illness than other patient groups. Better survival appears to be related to age and AIDS-defining illnesses in the prison group. The fact that half the IVDU AIDS cases had prison histories has important implications for the care and prevention of HIV, tuberculosis, and drug abuse in comparable prison settings.

  17. Blood, sweat and semen: the economy of axé and the response of Afro-Brazilian religions to HIV and AIDS in Recife.

    Science.gov (United States)

    Rios, Luis Felipe; Oliveira, Cinthia; Garcia, Jonathan; Muñoz-Laboy, Miguel; Murray, Laura; Parker, Richard

    2011-01-01

    This article provides an ethnographic analysis of Afro-Brazilian religious responses to the HIV epidemic in Recife. Drawing on participant observation and in-depth interviews conducted with Afro-Brazilian religious leaders and public health officials, it highlights the importance of the axé--a mystical energy manipulated in religious rituals that is symbolically associated with blood, sweat and semen. In an analysis of the relationship formed between the state AIDS programme and Afro-Brazilian religious centres, we conclude that the recognition of native categories and their meanings is one of the key elements to a fruitful dialogue between public health programmes and religious leaders that in the case studied, resulted in the re-signification of cultural practices to prevent HIV. Although the Afro-Brazilian religious leaders interviewed tended to be more open about sexuality and condom promotion, stigma towards people living with HIV (PLHIV) was still present within the religious temples, yet appeared to be more centred upon the perception of HIV as negatively affecting followers' axé than judgement related to how one may have contracted the virus. We discuss the tensions between taking a more liberal and open stance on prevention, while also fostering attitudes that may stigmatise PLHIV, and make suggestions for improving the current Afro-Brazilian response to the epidemic.

  18. KNOWLEDGE MANAGEMENT AND COLLABORATION EFFECTS: SOUTH-SOUTH NGO COLLABORATION: A CASE STUDY ON THE BRAZILIAN INTERDISCIPLINARY AIDS ASSOCIATION

    Directory of Open Access Journals (Sweden)

    Grace Keeney

    2012-06-01

    Full Text Available In June 2008, the Brazilian Interdisciplinary AIDS Association (ABIA and the Indian NGO SAHARA submitted a joint pre-grant opposition to the patent application of Tenofovir Disoproxil Fumarate in India. This joint action provides a pertinent case model of the potential effects of South-South cooperation between civil society groups. In this study, the aim sought to determine the practicality of the methodology and propositions developed in Resources, Knowledge and Influence: the Organizational Effects of Interorganizational Collaboration (Hardy et al., 2003 in predicting the types of collaboration effects that would result from the degree of “involvement” and “embeddedness” of a collaboration. Data collection came from archival research, participant observation research and interviews. Research tasks included an investigation on South-South Cooperation in the area of IP rights and AIDS, compiling an SLR on knowledge management and collaboration theories, creating a chronology of the collaboration and application of aforementioned methodology. Application included (1 implementation of codification methodology based on “involvement” and “embeddedness” and (2 identification of types of effects in collaboration - strategic, knowledge creation or political. During data analysis, these effects were compared with the aims of collaboration. Results were then tested against propositions (Hardy et al., 2003 of the relationship between involvement and embeddedness and the collaborative effects. Findings support three propositions: (1 Collaborations with high levels of involvement will be positively associated with the acquisition of distinctive resources, (2 Collaborations with high levels of involvement and high levels of embeddedness will be positively associated with the creation of knowledge, (3 Collaborations that are highly embedded will be positively associated with an increase of influence.

  19. Cryptococcal Meningitis in a Newly Diagnosed AIDS Patient: A Case ...

    African Journals Online (AJOL)

    BACKGROUND: Cryptococcus neoformans is a very important cause of fungal meningitis in immunosuppressed patients. OBJECTIVE: To describe a case of cryptococcal meningoencephalitis in an HIV/AIDS patient from the University of Ilorin Teaching Hospital. METHODS: An 18 -year -old male student presented with ...

  20. A shift in referral patterns for HIV/AIDS patients.

    Science.gov (United States)

    Fournier, Phillip O; Savageau, Judith A; Baldor, Robert A

    2008-02-01

    With the rapid development (and complex prescribing patterns) of drugs for HIV/AIDS care, it is challenging for physicians to keep current. We conducted a follow-up study to a 1994 cohort study to see how care and referral patterns have changed over the last decade. In this study, we examined how family physicians in Massachusetts were caring for their HIV-infected patients, and to see whether FPs were referring more patients to specialists for care compared with a decade ago. We designed a cross-sectional survey as an 11-year follow-up to a previous study. It was mailed in 2005 to the active membership of the Massachusetts Academy of Family Physicians. Compared with the cohort of 1994, the number of HIV+ patients in individual practices remained about the same, but the number of practices with no AIDS patients was significantly higher. 85.3% of FPs noted that they were more likely to refer HIV/AIDS patients immediately compared with their own practice patterns a decade ago. In this study, 39.0% of current respondents referred HIV+ patients immediately, 57.0% co-managed patients, and 4.1% managed these patients alone (the data for the 1994 cohort was 7.0%, 45.8%, and 47.2%, respectively; P<.0001). Similar changes were seen in regard to care patterns for AIDS patients. Among the current cohort, 61.7% reported that they referred patients immediately, compared with only 18.3% in 1994; 36.8% noted that they co-managed these patients (vs 74.3% in 1994); and only 1.5% reported that they managed these patients alone (vs 7.4% in 1994; P<.0001). A significant shift amongst FPs with regard to their referral patterns for patients with HIV/AIDS has occurred over the last decade. The community health center has emerged as a resource for patients with HIV/AIDS. Funding for specific training programs on HIV/AIDS care should be targeted to community health centers.

  1. Pneumocystis carinii pneumonia in AIDS patients

    DEFF Research Database (Denmark)

    Orholm, Marianne; Nielsen, T L; Holten-Andersen, W

    1992-01-01

    The aim of this study was to evaluate whether the amount of Pneumocystis carinii organisms found at fiberoptic bronchoscopy (FB) performed on HIV-positive patients correlated to the character of the P. carinii pneumonia (PCP). A consecutive series of 105 patients presented with 131 episodes of pu...

  2. Atypical distribution of pneumatosis intestinalis in a patient with AIDS.

    Science.gov (United States)

    Sivarajah, Vernon; Ramamurthy, Nitin Kumar; Rowe, Susan; Devalia, Kalpana

    2013-03-27

    An adult patient who had AIDS was admitted to hospital following a fall in which they sustained a T12 vertebral fracture. The patient incidentally was found to have pneumatosis intestinalis upon a thoracolumbar radiograph taken approximately 2 weeks after their admission to the hospital. At this point in time the patient reported having diarrhoea and a distended abdomen. The patient did not have any other medical history of note. Upon examination the patient appeared comfortable. The patient's abdomen was distended but soft and non-tender. Laboratory investigations revealed a chronic normocytic anaemia and neutropenia. It was likely that the pneumatosis intestinalis was AIDS related. A CT scan confirmed its presence but revealed an atypical distribution. Despite its dramatic appearance, the patient was successfully managed conservatively and remained well during admission.

  3. Gallium-67 scintiscanning of the lungs of AIDS patients

    International Nuclear Information System (INIS)

    Tatsch, K.; Knesewitsch, P.; Kirsch, C.M.; Kueffer, G.; Doerner, G.; Goebel, F.D.

    1988-01-01

    Thirty patients suffering from AIDS have been examined in this study. The stage of infection of the patients was defined according to the criteria of the Center for Disease Control, so that the study covered 22 patients with manifest AIDS, and 8 patients with AIDS-related complex. The lung scans have been made in all patients 48 and 72 hours after i.v. injection of 185 MBq of 67 Ga citrate, taking ventral and dorsal images with the gamma camera. In the scans recorded after 72 hours, ROI technique has been used to quantify the lung uptake and to put it in relation to uptake data of the soft neck tissue. The results show that gallium scintiscanning is far more sensitive in detecting opportunistic pneumonia in AIDS patients than is conventional chest radiography. If the latter detected any signs at all, the gallium scan did so about one to two weeks earlier in about one third of the patients. Pathologic accumulation in the scintiscan exceeding the range shown by the correlated radiograph indicate that in single cases extension of pneumonia can be underestimated when assessed by the radiograph alone. (orig./MG) [de

  4. Brazilian guidelines for endovascular treatment of patients with acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    Octávio Marques Pontes-Neto

    Full Text Available ABSTRACT These guidelines are the result of a joint effort from writing groups of the Brazilian Stroke Society, the Scientific Department of Cerebrovascular Diseases of the Brazilian Academy of Neurology, the Brazilian Stroke Network and the Brazilian Society of Diagnostic and Therapeutic Neuroradiology. Members from these groups participated in web-based discussion forums with predefined themes, followed by videoconference meetings in which controversies and position statements were discussed, leading to a consensus. This guidelines focuses on the implications of the recent clinical trials on endovascular therapy for acute ischemic stroke due to proximal arterial occlusions, and the final text aims to guide health care providers, health care managers and public health authorities in managing patients with this condition in Brazil.

  5. Enhanced mucosal reactions in AIDS patients receiving oropharyngeal irradiation

    International Nuclear Information System (INIS)

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

    1987-01-01

    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

  6. 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.

  7. Patient Concerns Inventory for head and neck cancer: Brazilian cultural adaptation.

    Science.gov (United States)

    Jungerman, Ivy; Toyota, Julia; Montoni, Neyller Patriota; Azevedo, Elma Heitmann Mares; Guedes, Renata Ligia Vieira; Damascena, Aline; Lowe, Derek; Vartanian, José Guilherme; Rogers, Simon N; Kowalski, Luiz Paulo

    2017-04-01

    The purpose of this study was to translate, culturally validate and evaluate the Patients Concerns Inventory - Head and Neck (PCI-H&N) in a consecutive series of Brazilian patients. This study included adult patients treated for upper aerodigestive tract (UADT) cancer. The translation and cultural adaptation of the PCI-H&N followed internationally accepted guidelines and included a pretest sample of patients that completed the first Brazilian Portuguese version of the PCI. Use, feasibility and acceptability of the PCI were tested subsequently in a consecutive series of UADT cancer patients that completed the final Brazilian Portuguese version of the PCI and a Brazilian Portuguese version of the University of Washington Quality of Life Questionnaire (UW-QOL). Associations between physical and socio-emotional composite scores from the UW-QOL and the PCI were analyzed. Twenty (20) patients participated in the pretest survey (translation and cultural adaptation process), and 84 patients were analyzed in the cultural validation study. Issues most selected were: fear of cancer returning, dry mouth, chewing/eating, speech/voice/being understood, swallowing, dental health/teeth, anxiety, fatigue/tiredness, taste, and fear of adverse events. The three specialists most selected by the patients for further consultation were speech therapist, dentist and psychologist. Statistically significant relationships between PCI and UW-QOL were found. The translation and cultural adaptation of the PCI into Brazilian Portuguese language was successful, and the results demonstrate its feasibility and usefulness, making this a valuable tool for use among the Brazilian head and neck cancer population.

  8. 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 ...

  9. Determinants of quality of life in Brazilian patients with myasthenia gravis.

    Science.gov (United States)

    Mourão, Aline Mansueto; Gomez, Rodrigo Santiago; Barbosa, Luiz Sergio Mageste; Freitas, Denise da Silva; Comini-Frota, Elizabeth Regina; Kummer, Arthur; Lemos, Stella Maris Aguiar; Teixeira, Antonio Lucio

    2016-07-01

    The aims of the current study were 1) to evaluate the reliability and validity of the Brazilian version of the 15-item Myasthenia Gravis Quality of Life Scale and 2) to investigate the quality of life of Brazilian patients with myasthenia gravis and its determinants. This cross-sectional study included 69 patients with myasthenia gravis who underwent neurological evaluation and completed questionnaires regarding quality of life (the 36-item Short Form of the Medical Outcomes Study and the 15-item Myasthenia Gravis Quality of Life Scale), anxiety and depressive symptoms. The Brazilian version of the 15-item Myasthenia Gravis Quality of Life Scale showed high internal consistency and good concurrent validity with the 36-item Short Form of the Medical Outcomes Study and its subscales. Determinants of quality of life in Brazilian patients with myasthenia gravis included the current status of myasthenia gravis as assessed by the Myasthenia Gravis Composite, the current prednisone dose and the levels of anxiety and depression. The Brazilian version of the 15-item Myasthenia Gravis Quality of Life Scale is a valid instrument. Symptom severity, prednisone dosage and anxiety and depression levels impact the quality of life of patients with myasthenia gravis.

  10. [Ophthalmological evaluation of patients with AIDS and neurotoxoplasmosis].

    Science.gov (United States)

    Alves, Jane Mary; Magalhães, Vera; Matos, de Marcus Augusto Gomes

    2010-01-01

    To describe fundoscopic findings among patients with AIDS and active-phase neurotoxoplasmosis. A prospective study of case series type was developed, including 70 patients of both sexes and ages ranging from 20 to 63 years who were admitted to the wards of three public hospitals in the city of Recife, Pernambuco, Brazil, from January to October 2008, with diagnoses of AIDS and neurotoxoplasmosis determined according to the criteria of the Centers for Disease Control and Prevention (1992). The patients were characterized by a first episode of neurotoxoplasmosis (65; 92.9%) or recurrence (5; 7.1%), unawareness of having AIDS (23; 32.9%), mean T CD4+ count of 139.8 + or - 3.04 lymphocytes/mm(3) and mean viral load of 137,080 + or - 39,380 copies/ml. All patients underwent ophthalmological examination consisting of ocular inspection, gauging of visual acuity, investigation of ocular extrinsic muscle function and fundoscopy using a binocular indirect ophthalmoscope (model OHM 3.5 Eyetec) and external lens of 20 diopters (Volk). The findings consisted of retinal cotton-wool spot exudates (8.6%), slight diffuse arteriolar constriction (8.6%), retinochoroiditis scars characteristic of ocular toxoplasmosis (5.7%), atrophy of retinal pigment epithelium (2.9%), retinal detachment (2.9%), increased papillary excavation (1.4%), retinal peripheral degeneration (1,4%), macroaneurysm (1.4%), bilateral papilledema (1.4%) and vitreous-retinal traction (1.4%). Patients with AIDS and neurotoxoplasmosis may present fundoscopic abnormalities characteristic of ocular toxoplasmosis, either in active or in scar form, related to HIV or even to other opportunist or systemic diseases, which can be of great aid for integral treatment of patients by a multiprofessional team.

  11. Feasibility of web-based decision aids in neurological patients

    NARCIS (Netherlands)

    van Til, Janine Astrid; Drossaert, Constance H.C.; Renzenbrink, Gerbert J.; Snoek, Govert J.; Dijkstra, Evelien; Stiggelbout, Anne M.; IJzerman, Maarten Joost

    2010-01-01

    Decision aids (DAs) may be helpful in improving patients' participation in medical decision-making. We investigated the potential for web-based DAs in a rehabilitation population. Two self-administered DAs focused on the treatment of acquired ankle-foot impairment in stroke and the treatment of

  12. Scopulariopsis associated meningitis in adult Nigerian AIDS patient ...

    African Journals Online (AJOL)

    Since the advent of HIV/AIDS, many opportunistic organisms have proved to be potential pathogens in infected patients. We present a case report of opportunistic filamentous fungal meningitis caused by Scopulariopsis species in a 38 year old Nigerian male. Keywords: Scopulariopsis species, Meningitis, HIV infection.

  13. Prevalence of pulmonary cryptococcosis in hiv/aids patients | Junaid ...

    African Journals Online (AJOL)

    Cryptococcus neoformans causes both pulmonary and meninges infection in healthy and immunocompromised hosts. The objective of this study was to determine the prevalence of pulmonary cryptococcosis in HIV/AIDS patients and assess the clinical presentations due to the infection. The subjects recruited for this study ...

  14. HIV/AIDS among surgical patients in Butare University Teaching ...

    African Journals Online (AJOL)

    Associated surgical diseases included infection of osteosynthetic material in, chronic osteomyelitis, Pyomyositis and osteonecrosis of the head of femur associated with pyomyositis. Conclusion: With a prevalence of 6.6%, HIV/AIDS is a real and significant problem in surgical practice and patients with HIV admitted to a ...

  15. Youngsters with HIV/AIDS may be your patients.

    Science.gov (United States)

    Waldman, H Barry; Waldman, Michael E

    2004-01-01

    Advances in pharmaceutical "cocktails" are prolonging the lives of hundreds of thousands of US residents, including thousands of children who are infected with HIV/AIDS. The demographic characteristics of the increasing number of these children who are surviving and reside in communities were reviewed to alert pediatric dental practitioners to the reality that these children may be their patients.

  16. Brazilian Green Propolis Improves Antioxidant Function in Patients with Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Zhao, Liting; Pu, Lingling; Wei, Jingyu; Li, Jinghua; Wu, Jianquan; Xin, Zhonghao; Gao, Weina; Guo, Changjiang

    2016-05-13

    Propolis contains a variety of bioactive components and possesses many biological properties. This study was designed to evaluate potential effects of Brazilian green propolis on glucose metabolism and antioxidant function in patients with type 2 diabetes mellitus (T2DM). In the 18-week randomized controlled study, enrolled patients with T2DM were randomly assigned to Brazilian green propolis group (900 mg/day) (n = 32) and control group (n = 33). At the end of the study, no significant difference was found in serum glucose, glycosylated hemoglobin, insulin, aldose reductase or adiponectin between the two groups. However, serum GSH and total polyphenols were significantly increased, and serum carbonyls and lactate dehydrogenase activity were significantly reduced in the Brazilian green propolis group. Serum TNF-α was significantly decreased, whereas serum IL-1β and IL-6 were significantly increased in the Brazilian green propolis group. It is concluded that Brazilian green propolis is effective in improving antioxidant function in T2DM patients.

  17. Bone marrow NMR imaging and scintigraphy in AIDS patients

    International Nuclear Information System (INIS)

    Theisen, P.; Waters, W.; Schicha, H.; Rasokat, H.; Steigleder, G.K.

    1988-01-01

    The examinations were carried out in order to ascertain whether bone marrow abnormalities can be detected in AIDS patients by means of magnetic resonance imaging or scintiscanning. In 16 of the 19 patients the NMR image and/or the scintiscan distinctly revealed bone marrow abnormalities, but there was no exact correlation to be found to immunological parameters, the peripheral blood picture, or the clinical stage of the HIV infection. (orig.) [de

  18. [Cyclospora cayetanensis in patients with AIDS and chronic diarrhea].

    Science.gov (United States)

    Velásquez, Jorge Néstor; Carnevale, Silvana; Cabrera, Marta; Kuo, Lien; Chertcoff, Agustín; Mariano, Marta; Bozzini, Juan Pablo; Etchart, Cristina; Argento, Rosana; di Risio, Cecilia

    2004-01-01

    Cyclospora spp. is a protozoan parasite responsible for significant gastrointestinal disease in patients infected with the human immunodeficiency virus. We report the clinical features of two patients with chronic diarrhea and intestinal cyclosporosis caused by Cyclospora cayetanensis. The average value for CD4 count in these patients was lower than or equal to 100 cells/mm3. The oocysts were detected in smears from stool samples stained with modified acid-fast or safranin technique. Light microscopy revealed parasites in the enterocytes and these parasites were associated with villous atrophy. Cyclospora cayetanensis infection might be an important cause of diarrhea in patients with AIDS in Argentina.

  19. Clinical features of HIV/AIDS patients with digestive diseases

    Directory of Open Access Journals (Sweden)

    YIN Fei

    2016-07-01

    Full Text Available ObjectiveTo analyze the clinical data of patients admitted with an initial diagnosis of digestive diseases who have human immunodeficiency virus (HIV/acquired immune deficiency syndrome (AIDS, and to guide clinical diagnosis. MethodsThe clinical data of HIV/AIDS patients who were hospitalized due to digestive system symptoms from January 1, 2013 to December 31, 2014 were collected, including epidemiological data, clinical symptoms and signs, auxiliary examinations, and complications. The features of each parameter were observed. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsA total of 95 HIV/AIDS patients with digestive diseases were enrolled, and the male/female ratio was 1.4∶1. Among these patients, 57 (60% were aged 30-50 years, 85 (89.47% were Yi people, and 86 (90.53% were farmers. Of all patients, 46 (48.42% were infected via sexual transmission and 44 (46.32% were infected via intravenous drug use. In these patients, common clinical symptoms included abdominal pain (71.58%, pyrexia (43.16%, and diarrhea (17.89%, and common signs included ascites (28.42%, superficial lymphadenectasis (21.05%, and hepatosplenomegaly (16.84%. The auxiliary examination showed a significant increase in globulin. The proportion of patients with opportunistic infection reached 83.16%, mainly lung and digestive tract infections. Among the patients who underwent gastroscopy, 31.58% had mycotic esophagitis. Chronic non-atrophic gastritis, electrolyte disturbance, and intestinal obstruction were commonly seen in patients with noninfectious complications. Of all HIV/AIDS patients, 5474% (52/95 were complicated by HBV and/or HCV infection, and the liver function parameters globulin, total bilirubin, aspartate aminotransferase, alanine aminotransferase, and A/G showed significant differences between these patients and the patients with HIV infection

  20. Judge upholds Maine's denial of service to patient with AIDS.

    Science.gov (United States)

    1995-09-22

    A U.S. District Judge has upheld the Maine Medicaid program's refusal to supply liquid dietary supplements to patients with AIDS-related malnutrition. When the State refused to pay for over-the-counter supplements, [name removed], an AIDS patient, initiated a class-action suit charging that those suffering with clinically documented malnutrition should not be denied a government service. The judge found that required services do not include outpatient prescription drugs nor over-the-counter drugs, such as nutrition supplements. In response to the claimant's argument that Maine's Medicaid program provided supplements to those with end-stage renal disease, the judge reluctantly ruled that the Equal Protection Clause of the 14th Amendment does not forbid a state from choosing one disease at the expense of others.

  1. The Cost of Health Care for AIDS Patients in Saskatchewan

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    Kevin P Browne

    1990-01-01

    Full Text Available The medical records of 19 patients with acquired immune deficiency syndrome (aids were reviewed in an attempt to estimate their health care costs. The patients were all male, members of high risk groups and diagnosed between April 1985 and February 1988. Twelve of the patients died; they lived a mean of 240 days (range 0 to 580 after diagnosis, were admitted three times (range one to six to hospital for 65 total days (range one to 148 for a cost per patient of $33,721 (range $2,768 to $64,981 for inpatient care. They made five (range zero to 25 office visits per patient costing $196 per patient (range $0 to $4,999 for outpatient care. The seven survivors (one was lost to follow-up have lived 375 days (range 186 to 551 since diagnosis, have been admitted to hospital two times (range zero to seven for 30 total days (range zero to 86 for a total cost per patient of $14,223 (range $0 to $39,410 for inpatient care. They have made 11 office/emergency room visits (range zero to 46 costing in total $4322 (range $0 to $13,605 for outpatient care. The total expenditure was $546,332 ($28,754 per patient, of which total fees to physicians were $37,210 (6.8%, and estimated costs of laboratory tests $117,917 (21.6%, drugs $36,930 (6.7%, and medical imaging $20,794 (3.8%. Patients now deceased cost $416,445 (mean $34,704 per patient, accounting for 76.2% of overall expenditures. The average medical/surgical and drug costs per patient day in hospital were greater for aids patients than for the average medical/surgical patient in the authors’ institution.

  2. Opportunistic infection of HIV/AIDS patients in West Papua

    Science.gov (United States)

    Witaningrum, A. M.; Khairunisa, S. Q.; Yunifiar, M. Q.; Bramanthi, R.; Rachman, B. E.; Nasronudin

    2018-03-01

    Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) had a major impact on health problemin Indonesia. HIV type 1 (HIV-1) epidemic is currently infected with HIV viruses developing rapidly in Indonesia.Papua provinces have the highest prevalence rate of human immunodeficiency virus type 1 (HIV-1) infection in Indonesia; however, data on opportunistic infection of HIV-1 are limited. The study using medical records as a research sample was conducted among HIV patients from January 2013 - December 2014 in Sele be Solu hospital among 49 patients. Opportunistic infections commonly occur in HIV-infected patients. The aim of the study was to know theprevalence of opportunistic infection among HIV positive patients in West Papua. Forty-nine HIV-1 patients were collected in Sele be Solu Hospital, West Papua.Opportunistic infection was identified such as tuberculosis, tuberculosis Pulmo, tuberculosis and candidiasis, candidiasis and diarrhea. The clinical sign appeared in HIV infected patients such as itchy, cough and loss weight. The prevalence of opportunistic infection indicated the necessity of monitoring the opportunistic infection of HIV/AIDS patients in Indonesia.

  3. Mental health problem in HIV/AIDS patients

    Science.gov (United States)

    Camellia, V.

    2018-03-01

    People with HIV positive have risk increased mental health problem than the general population. It associated with psychosocial factors, direct neurological effects of the HIV infection and medication. Overall it can make increased morbidity and mortality in HIV positive patients. The more common mental problem in HIV/AIDS people is dementia, delirium, depression, and mania, suicide, psychotic, sleep problem. Both psychopharmacologic and psychotherapeutic treatment strategies often indicate.

  4. 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

  5. AIP mutations in Brazilian patients with sporadic pituitary adenomas: a single-center evaluation

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    Paula Bruna Araujo

    2017-11-01

    Full Text Available Aryl hydrocarbon receptor-interacting protein (AIP gene mutations (AIPmut are the most frequent germline mutations found in apparently sporadic pituitary adenomas (SPA. Our aim was to evaluate the frequency of AIPmut among young Brazilian patients with SPA. We performed an observational cohort study between 2013 and 2016 in a single referral center. AIPmut screening was carried out in 132 SPA patients with macroadenomas diagnosed up to 40 years or in adenomas of any size diagnosed until 18 years of age. Twelve tumor samples were also analyzed. Leukocyte DNA and tumor tissue DNA were sequenced for the entire AIP-coding region for evaluation of mutations. Eleven (8.3% of the 132 patients had AIPmut, comprising 9/74 (12% somatotropinomas, 1/38 (2.6% prolactinoma, 1/10 (10% corticotropinoma and no non-functioning adenomas. In pediatric patients (≤18 years, AIPmut frequency was 13.3% (2/15. Out of the 5 patients with gigantism, two had AIPmut, both truncating mutations. The Y268* mutation was described in Brazilian patients and the K273Rfs*30 mutation is a novel mutation in our patient. No somatic AIP mutations were found in the 12 tumor samples. A tumor sample from an acromegaly patient harboring the A299V AIPmut showed loss of heterozygosity. In conclusion, AIPmut frequency in SPA Brazilian patients is similar to other populations. Our study identified two mutations exclusively found in Brazilians and also shows, for the first time, loss of heterozygosity in tumor DNA from an acromegaly patient harboring the A299V AIPmut. Our findings corroborate previous observations that AIPmut screening should be performed in young patients with SPA.

  6. Diffuse small bowel thickening in aids patient - a case report

    Science.gov (United States)

    2010-01-01

    Background Diarrhea is common in HIV/AIDS patients, caused by both classic enteric pathogens and different opportunistic agents. Infection with these different pathogens may lead to similar radiological findings, thus causing diagnostic confusion. Case presentation A 30-yr-old female with AIDS presented with chronic diarrhea of 4 months duration. She had diffuse small bowel thickening present on CT scan of her abdomen, with stool examination showing no parasites. She was erroneously diagnosed as abdominal tuberculosis and given antituberculosis drugs with which she showed no improvement. Repeat stool examination later at a specialized laboratory revealed Cryptosporidium parvum infection. The patient was given an extended course of nitazoxanide treatment, as her stool examination was positive for Cryptosporidium parvum even after 2 weeks of drug consumption. Parasite clearance was documented after 10 weeks of treatment. Interestingly, the bowel thickening reversed with parasitological clearance. Conclusions Cryptosporidium parvum may lead to small bowel thickening in AIDS patients. This small bowel thickening may reverse following parasitological clearance. PMID:21029408

  7. Diffuse small bowel thickening in aids patient - a case report

    Directory of Open Access Journals (Sweden)

    Hari Samriti

    2010-10-01

    Full Text Available Abstract Background Diarrhea is common in HIV/AIDS patients, caused by both classic enteric pathogens and different opportunistic agents. Infection with these different pathogens may lead to similar radiological findings, thus causing diagnostic confusion. Case presentation A 30-yr-old female with AIDS presented with chronic diarrhea of 4 months duration. She had diffuse small bowel thickening present on CT scan of her abdomen, with stool examination showing no parasites. She was erroneously diagnosed as abdominal tuberculosis and given antituberculosis drugs with which she showed no improvement. Repeat stool examination later at a specialized laboratory revealed Cryptosporidium parvum infection. The patient was given an extended course of nitazoxanide treatment, as her stool examination was positive for Cryptosporidium parvum even after 2 weeks of drug consumption. Parasite clearance was documented after 10 weeks of treatment. Interestingly, the bowel thickening reversed with parasitological clearance. Conclusions Cryptosporidium parvum may lead to small bowel thickening in AIDS patients. This small bowel thickening may reverse following parasitological clearance.

  8. Dyslipidemia in AIDS patients on highly active antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Max Weyler Nery

    Full Text Available Highly active antiretroviral therapy (HAART reduces AIDS-related morbidity and mortality, however it has been associated with metabolic abnormalities. This study estimated the prevalence of lipid abnormalities and related factors among patients on HAART. A cross-sectional study was conducted on adult patients, in central Brazil. Patients were interviewed, and blood obtained for lipids measurement. Dyslipidemia was defined as total cholesterol (TC > 240 mg/dL, low-density lipoprotein (LDL > 160 mg/dL, triglycerides (TG > 200 and/or high-density lipoprotein (HDL < 40 mg/dL. Multiple logistic regression analyses were performed (SPSS 13.0. One hundred and thirteen patients were recruited. Mean age was 39.3 years; 68.1% were males; 50.4% were on nucleoside reverse transcriptase inhibitors (NRTI in combination with non-nucleoside reverse transcriptase inhibitors (NNRTI, while 42.5% were on NRTI in combination with protease inhibitors (PIs. The prevalence of dyslipidemia was 66.7%. Low HDL was the most frequent abnormality (53.5%, followed by high TG (36.1%. Patients on a PI regimen had a 5.2-fold higher risk (95% CI: 1.8-14.8 of dyslipidemia, even after adjusting for sex, age, and duration of HIV infection/AIDS. The study discloses a high prevalence rate of dyslipidemia and points out a need for intervention programs to reduce future cardiovascular events in patients, on HAART.

  9. Data on HLA class I/II profile in Brazilian pemphigus patients

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    Maria José Franco Brochado

    2016-09-01

    Full Text Available Pemphigus are blistering autoimmune diseases related with genetic and environmental factors. Here we describe HLA genotyping in pemphigus patients. First, we review the HLA class I/II data on pemphigus reported in Brazilian samples and then present the HLA class I (-A, -B, -C and class II (-DRB1, -DQA1, -DQB1 alleles related to susceptibility/resistance to pemphigus by comparing 86 patients with pemphigus foliaceus, 83 patients with pemphigus vulgaris, and 1592 controls from the northeastern region of the state of São Paulo, Southeastern Brazil. The data presented here are related to the manuscript “Differential HLA class I and class II associations in Pemphigus Foliaceus and Pemphigus Vulgaris patients from a prevalent Southeastern Brazilian region” Brochado et al. (2016 [1].

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Gross proteinuria is a strong risk predictor for cardiovascular mortality in Brazilian type 2 diabetic patients

    OpenAIRE

    Cardoso, C.R.L.; Salles, G.F.

    2008-01-01

    Increased proteinuria is recognized as a risk predictor for all-cause and cardiovascular mortality in diabetic patients; however, no study has evaluated these relationships in Brazilian patients. The aim of this study was to investigate the prognostic value of gross proteinuria for all-cause and cardiovascular mortalities and for cardiovascular morbidity in a cohort study of 471 type 2 diabetic individuals followed for up to 7 years. Several clinical, laboratory and electrocardiographic varia...

  12. Spirituality and religion in patients with HIV/AIDS.

    Science.gov (United States)

    Cotton, Sian; Puchalski, Christina M; Sherman, Susan N; Mrus, Joseph M; Peterman, Amy H; Feinberg, Judith; Pargament, Kenneth I; Justice, Amy C; Leonard, Anthony C; Tsevat, Joel

    2006-12-01

    Spirituality and religion are often central issues for patients dealing with chronic illness. The purpose of this study is to characterize spirituality/religion in a large and diverse sample of patients with HIV/AIDS by using several measures of spirituality/religion, to examine associations between spirituality/religion and a number of demographic, clinical, and psychosocial variables, and to assess changes in levels of spirituality over 12 to 18 months. We interviewed 450 patients from 4 clinical sites. Spirituality/religion was assessed by using 8 measures: the Functional Assessment of Chronic Illness Therapy-Spirituality-Expanded scale (meaning/peace, faith, and overall spirituality); the Duke Religion Index (organized and nonorganized religious activities, and intrinsic religiosity); and the Brief RCOPE scale (positive and negative religious coping). Covariates included demographics and clinical characteristics, HIV symptoms, health status, social support, self-esteem, optimism, and depressive symptoms. The patients' mean (SD) age was 43.3 (8.4) years; 387 (86%) were male; 246 (55%) were minorities; and 358 (80%) indicated a specific religious preference. Ninety-five (23%) participants attended religious services weekly, and 143 (32%) engaged in prayer or meditation at least daily. Three hundred thirty-nine (75%) patients said that their illness had strengthened their faith at least a little, and patients used positive religious coping strategies (e.g., sought God's love and care) more often than negative ones (e.g., wondered whether God has abandoned me; Pself-esteem, greater life satisfaction, and lower overall functioning (R2=.16 to .74). Mean levels of spirituality did not change significantly over 12 to 18 months. Most patients with HIV/AIDS belonged to an organized religion and use their religion to cope with their illness. Patients with greater optimism, greater self-esteem, greater life satisfaction, minorities, and patients who drink less alcohol tend

  13. High-risk human papillomavirus and cervical lesions among women living with HIV/AIDS in Brazilian Amazon, Brazil.

    Science.gov (United States)

    Silva, Leila da; Miranda, Angélica; Batalha, Rosieny; Ferreira, Luiz; Santos, Mayara; Talhari, Sinésio

    2015-01-01

    The goal of this study was to determine the prevalence of human papillomavirus infection infection and cervical lesions and its associated factors among HIV infected women attending an AIDS clinic in Amazonas state, Brazil. Cross-sectional study. Women attending an AIDS clinic in the city of Manaus between March and December 2011 for gynecological examination were invited to participate. Enrolled patients answered a standardized interview including demographical, behavioral, and clinical data. Additionally, patients underwent a gynecological evaluation with collection of cervical samples for cytological analysis and high-risk human papillomavirus infection hybrid capture. A blood sample was also obtained to determine CD4 and viral load levels. A total of 310 (82.9%) women participated in the study. High-risk human papillomavirus infection was detected in 191 (61.6%) cases; 24 (13.5%) had low-grade squamous intraepithelial lesion (SIL) and 4 (2.2%) high-grade SIL. No invasive cervical cancer was diagnosed. Median age was 32 (interquartile range (IQR): 27-38) years and median of education was 8.5 (IQR 4-11) years of schooling and 56.1% had a monthly income up to US$180. In multivariate analysis, being less than 30 years old [OR=1.7 (95% CI: 1.2-2.4, p=0.005)], high-grade SIL [OR=6.5 (95% CI: 1.6-23.0, p=0.009)], and CD4 counts <200cells/mm(3) [OR=1.6 (95% CI: 1.2-2.0, p<0.001)] were associated with high risk human papillomavirus infection infection. In the present study high-risk human papillomavirus infection was frequent and it was associated to high-SIL. These results show the importance of gynecologic examinations in routine care and follow-up required by those who present with cervical lesions. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  14. [Validation of the Brazilian version of Behavioral Pain Scale in adult sedated and mechanically ventilated patients].

    Science.gov (United States)

    Azevedo-Santos, Isabela Freire; Alves, Iura Gonzalez Nogueira; Cerqueira Neto, Manoel Luiz de; Badauê-Passos, Daniel; Santana-Filho, Valter Joviniano; Santana, Josimari Melo de

    The Behavioral Pain Scale is a pain assessment tool for uncommunicative and sedated Intensive Care Unit patients. The lack of a Brazilian scale for pain assessment in adults mechanically ventilated justifies the relevance of this study that aimed to validate the Brazilian version of Behavioral Pain Scale as well as to correlate its scores with the records of physiological parameters, sedation level and severity of disease. Twenty-five Intensive Care Unit adult patients were included in this study. The Brazilian Behavioral Pain Scale version (previously translated and culturally adapted) and the recording of physiological parameters were performed by two investigators simultaneously during rest, during eye cleaning (non-painful stimulus) and during endotracheal suctioning (painful stimulus). High values of responsiveness coefficient (coefficient=3.22) were observed. The Cronbach's alpha of total Behavioral Pain Scale score at eye cleaning and endotracheal suctioning was 0.8. The intraclass correlation coefficient of total Behavioral Pain Scale score was ≥ 0.8 at eye cleaning and endotracheal suctioning. There was a significant highest Behavioral Pain Scale score during application of painful procedure when compared with rest period (p≤0.0001). However, no correlations were observed between pain and hemodynamic parameters, sedation level, and severity of disease. This pioneer validation study of Brazilian Behavioral Pain Scale exhibits satisfactory index of internal consistency, interrater reliability, responsiveness and validity. Therefore, the Brazilian Behavioral Pain Scale version was considered a valid instrument for being used in adult sedated and mechanically ventilated patients in Brazil. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  15. PINP as an aid for monitoring patients treated with teriparatide.

    Science.gov (United States)

    Tsujimoto, Mika; Chen, Peiqi; Miyauchi, Akimitsu; Sowa, Hideaki; Krege, John H

    2011-04-01

    Biochemical markers of bone turnover may be useful aids for managing patients with osteoporosis. A 12-month, phase 3, multicenter trial of Japanese patients at high risk of fracture was conducted to assess the effects of teriparatide 20 μg/day on BMD, serum markers of bone turnover, and safety. Two-hundred and seven subjects (93% female; median age 70 years) were randomized in double-blind fashion 2:1 to teriparatide versus placebo. Bone turnover markers including procollagen type I N-terminal propeptide (PINP), bone-specific alkaline phosphatase (bone ALP) and type I collagen cross-linked C-telopeptide (CTX) were collected at baseline, 1, 3, 6, and 12 months. Lumbar spine, femoral neck, and total hip BMD were measured at baseline, 3, 6, and 12 months. Increases in PINP at 1 month correlated best with increases in lumbar spine BMD at 12 months (r=0.76; P10 μg/L at 1, 3, and 6 months were 3%, 0%, and 2% in the placebo, and 93%, 87%, and 83% in the teriparatide group. The proportions of patients with an increase in PINP >10 μg/L at either 1 or 3 months were 3% in the placebo and 95% in the teriparatide group (P10 μg/L at 1 or 3 months and an increase in lumbar spine BMD ≥3% at 12 months was 0% of placebo group patients and 92% of teriparatide group patients (P<0.001). These data confirm a strong relationship between early change in PINP and later change in lumbar spine BMD during teriparatide therapy. Also, these results suggest that monitoring with PINP and lumbar spine BMD successfully identifies positive responses in most patients taking teriparatide and negative responses in most patients not taking teriparatide. PINP monitoring may be a useful aid in the management of patients with osteoporosis during teriparatide treatment. Copyright © 2010 Elsevier Inc. All rights reserved.

  16. Video-based patient decision aids: A scoping review.

    Science.gov (United States)

    Winston, Karin; Grendarova, Petra; Rabi, Doreen

    2017-10-18

    This study reviews the published literature on the use of video-based decision aids (DA) for patients. The authors describe the areas of medicine in which video-based patient DA have been evaluated, the medical decisions targeted, their reported impact, in which countries studies are being conducted, and publication trends. The literature review was conducted systematically using Medline, Embase, CINAHL, PsychInfo, and Pubmed databases from inception to 2016. References of identified studies were reviewed, and hand-searches of relevant journals were conducted. 488 studies were included and organized based on predefined study characteristics. The most common decisions addressed were cancer screening, risk reduction, advance care planning, and adherence to provider recommendations. Most studies had sample sizes of fewer than 300, and most were performed in the United States. Outcomes were generally reported as positive. This field of study was relatively unknown before 1990s but the number of studies published annually continues to increase. Videos are largely positive interventions but there are significant remaining knowledge gaps including generalizability across populations. Clinicians should consider incorporating video-based DA in their patient interactions. Future research should focus on less studied areas and the mechanisms underlying effective patient decision aids. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Prevalence and factors associated with lipodystrophy in AIDS patients

    Directory of Open Access Journals (Sweden)

    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.

  18. Abdominal ultrasonography in HIV/AIDS patients in southwestern Nigeria

    International Nuclear Information System (INIS)

    Obajimi, Millicent O; Ogunseyinde, Ayotunde O; Aken'Ova, Yetunde A; Adewole, Isaac F; Atalabi, Mojisola O; Ogbole, Godwin I; Adeniji-Sofoluwe, Adenike T; Agunloye, Atinuke M; Adekanmi, Ademola J; Osuagwu, Yvonne U; Olarinoye, Sefiat A; Olusola-Bello, Mojisola A

    2008-01-01

    Though the major target of the HIV-virus is the immune system, the frequency of abdominal disorders in HIV/AIDS patients has been reported to be second only to pulmonary disease. These abdominal manifestations may be on the increase as the use of antiretroviral therapy has increased life expectancy and improved quality of life. Ultrasonography is an easy to perform, non invasive, inexpensive and safe imaging technique that is invaluable in Africa where AIDS is most prevalent and where sophisticated diagnostic tools are not readily available. Purpose: To describe the findings and evaluate the clinical utility of abdominal ultrasonography in HIV/AIDS patients in Ibadan, Nigeria A Prospective evaluation of the abdominal ultrasonography of 391 HIV-positive patients as well as 391 age and sex-matched HIV-negative patients were carried out at the University College Hospital, Ibadan. Of the 391 cases studied, 260 (66.5%) were females; the mean age was 38.02 years, (range 15–66 years). The disease was most prevalent in the 4th decade with an incidence of 40.4%. Compared with the HIV-negative individuals, the HIV+ group of patients had a significantly higher proportion of splenomegaly (13.5% vs. 7.7%; p < 0.01), lymphadenopathy (2.0% vs. 1.3%; p < 0.70), and renal abnormalities (8.4% vs. 3.8%; p < 0.02). There were no differences in hepatic and pancreatic abnormalities between the HIV+ and HIV- groups. There were significantly fewer gallstones in the HIV+ group (1.4% vs. 5.1%; p < 0.01). AIDS is a multi-systemic disease and its demographic and clinical pattern remains the same globally. Ultrasonography is optimally suited for its clinical management especially in Africa. Its accuracy and sensitivity may be much improved with clinico-pathologic correlation which may not be readily available in developing countries; further studies may provide this much needed diagnostic algorithms

  19. Self-Reported Periodontitis and Complications in Type 1 Diabetes Patients: A Brazilian Nationwide Survey.

    Science.gov (United States)

    Oliveira, Luciano Santos; Lira-Junior, Ronaldo; Figueredo, Carlos Marcelo; Gomes, Marília Brito; Fischer, Ricardo Guimarães

    2016-01-01

    This study aimed to evaluate the possible association between periodontitis and systemic complications in a Brazilian type 1 diabetes population. A multicentre, sectional study was carried out in 28 public clinics located in 20 Brazilian cities. Data from 3,591 patients were obtained (56.0% females, 57.2% Caucasians), with an average age of 21.2 ± 11.7 years and whose mean duration of type 1 diabetes was 9.6 ± 8.1 years. Periodontitis was evaluated through self-report. Odds ratios (OR) and 95% confidence intervals were calculated to evaluate the association between periodontitis and systemic diabetes complications (chronic micro and macrovascular complications and hospitalizations by hyperglycemia and diabetic ketoacidosis). The prevalence of periodontitis was 4.7% (n=170). Periodontitis patients had mean age of 27.4 ± 12.9. This group was older (pperiodontitis. Systolic and diastolic blood pressures were significantly increased in periodontitis patients (pPeriodontitis patients had increased odds of microvascular complications (2.43 [1.74-3.40]) and of hospitalizations related to hyperglycemia (2.76 [1.72-4.42]) and ketoacidosis (2.72 [1.53-4.80]). In conclusion, periodontitis was associated to systemic complications in Brazilian type 1 diabetes patients.

  20. Patterns of neuropsychiatric sub-syndromes in Brazilian and Norwegian patients with dementia.

    Science.gov (United States)

    Truzzi, Annibal; Ulstein, Ingun; Valente, Letice; Engelhardt, Eliasz; Coutinho, Evandro Silva Freire; Laks, Jerson; Engedal, Knut

    2013-02-01

    Neuropsychiatric symptoms (NPS) affect the majority of patients who have dementia. Neuropsychiatric sub-syndromes with symptoms that occur together and have common neurobiological correlates have been identified. There are scarce data regarding the comparison of the pattern of the neuropsychiatric sub-syndromes in distinct ethnical and cultural populations. We aim at comparing the pattern of the NPS, and the factor analysis of the Neuropsychiatric Inventory (NPI-10) in two samples of outpatients with dementia living in Brazil and Norway. This is a cross-sectional study. The sample consists of 168 Brazilian and 155 Norwegian demented patients from psychogeriatric facilities and community-based educational programs. Brazilian patients were diagnosed with Alzheimer's disease (63.7%), vascular dementia (15.5%), or mixed dementia (20.8%), whereas the diagnoses of Norwegian patients were Alzheimer's disease (97.4%) and mixed dementia (2.6%). Principal component analysis with the Varimax rotation was used for factor analysis of the NPI-10. Apathy (80.4 %), agitation/aggression (45.8%), and aberrant motor behavior (45.8%) were the most common symptoms in the Brazilian sample. Apathy (72.3%), dysphoria (61.9%), and anxiety (52.3%) were the most frequent symptoms in the Norwegian sample. Factor analysis of the NPI-10 revealed three syndromes for the Brazilian (Psychosis, Mood, Psychomotor) and Norwegian (Psychosis, Mood, Frontal) groups. The frequency of individual NPS may differ among distinct populations. However, Psychosis and Depression are common sub-syndromes in diverse ethnical and cultural patients with dementia. Our findings support the syndromic approach for the clinical assessment of the patients with dementia.

  1. 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.

  2. Prevalence of Metabolic Syndrome and its components in a Brazilian sample of pemphigus patients*

    Science.gov (United States)

    Ambiel, Marcela Vendruscolo; Roselino, Ana Maria

    2014-01-01

    BACKGROUND Pemphigus foliaceus and pemphigus vulgaris are endemic in the northeastern region of São Paulo State, Brazil. They are treated mainly with systemic corticosteroids, which may provoke osteoporosis; atherosclerosis, higher blood pressure, insulin resistance, glucose intolerance, hyperlipidemia and abdominal obesity. These side effects of corticoids also constitute criteria for the diagnosis of metabolic syndrome. OBJECTIVE The prevalence of metabolic syndrome and each component of metabolic syndrome in Pemphigus foliaceus and pemphigus vulgaris groups was compared with Brazilian casuistic samples. METHODS Data of 147 patients (pemphigus foliaceus 48.9% and pemphigus vulgaris 51.1%) were compiled from medical records regarding metabolic syndrome and its components, and included in the analysis. RESULTS There was no significant difference regarding the prevalence of metabolic syndrome in pemphigus groups compared with the Brazilian casuistic samples. The analysis of each component of metabolic syndrome showed a higher prevalence of: higher blood pressure in male subjects with pemphigus vulgaris, and in pemphigus foliaceus in both genders; diabetes mellitus in both genders for pemphigus vulgaris and pemphigus foliaceus; obesity in females for pemphigus vulgaris and pemphigus foliaceus, and hypertriglyceridemia in both genders for pemphigus vulgaris and pemphigus foliaceus groups that were statistically significant compared to the Brazilian reports. Furthermore, the study noted a higher incidence of cardiovascular events in both genders in pemphigus foliaceus and pemphigus vulgaris groups than in Brazilian casuistic samples. CONCLUSION The components of metabolic syndrome are more numerous in pemphigus when compared with Brazilian casuistic samples. Future studies are necessary to assure that metabolic syndrome may be associated with pemphigus per se, including a greater casuistic sample of patients who have not taken corticoids. PMID:25184914

  3. Fatal pulmonary Kaposi sarcoma in an HIV seronegative AIDS patient.

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    Zhang, Hong; Wang, Huan-Ling; Zhong, Ding-Rong; Liu, Yan; Li, Ning-Ning; Zhang, Wei; Xiao, Yi; Li, Tai-Sheng

    2017-11-01

    Although HIV antibody tests have been widely accepted in clinical diagnosis of HIV infection, they may not be sufficient to diagnose all subjects with HIV infection. Except negative result of antibody test in the well-known" acute window phase", in rare cases, patients do not develop HIV antibodies despite demonstrable infection. Primary pulmonary Kaposi sarcoma (KS) without mucocutaneous involvement accounts for only 0-15% of all AIDS-related KS. KS is rare among Chinese subjects, especially in persons of Han descent. A case of seronegative AIDS with primary pulmonary Kaposi sarcoma (KS) was reported. It's a 46-year-old Chinese man presented with sore throat, hemoptysis, fever, dyspnea and multiple lung nodules. The lung lesions grew over a 5-month period so as the symptoms worsened. The possibility of AIDS was discounted by his physicians because of the repeatedly negative HIV antibodies tests despite the ELISA tests or Western blot tests. Histopathologic diagnosis of fine needle lung biopsy in local hospital was undetermined. After admission, HIV infection was eventually confirmed by plasma HIV RNA testing. Histopathologic diagnosis of Lung Kaposi sarcoma was made through repeated fine needle aspiration biopsy as well as the review of former one. Multiple antibiotics and chemotherapy were administrated with no clinical effect due to advanced stage and the patient passed away soon after diagnosis. This is the first case of seronegative HIV-1 infection with presentation of primary pulmonary KS. This case underscores the importance of plasma RNA test in conjunction with HIV antibody test for some rare patients with HIV infection who present with severe immunodeficiency and opportunistic infections or malignancy. © 2016 John Wiley & Sons Ltd.

  4. Liver transplantation in HIV-positive patients: the position of the Brazilian groups.

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    Brandão, Ajacio Bandeira de Mello; Mariante-Neto, Guilherme

    2005-01-01

    Patients infected with the human immunodeficiency virus (HIV) have generally been excluded from consideration for liver transplantation. Recent advances in the management and prognosis of these patients suggest that this policy must be reevaluated. To identify the current position of Brazilian transplant centers concerning liver transplantation in asymptomatic HIV-infected patients with end-stage liver disease. A structured questionnaire was submitted by e-mail to Brazilian groups who perform liver transplantation and were active in late 2003, according to the Brazilian Association of Organ Transplantation. Of the 53 active groups, 30 e-mail addresses have been found of professionals working in 41 of these groups. Twenty-one responses (70%) were obtained. Most of the professionals (62%) reported that they do not include HIV-infected patients in waiting lists for transplants, primarily on account of the limited world experience. They also reported, however, that this issue will soon be discussed by the group. Those who accept these patients usually follow the guidelines provided by the literature: patients must fulfill the same inclusion criteria as the other patients with end-stage liver diseases, present low or undetectable HIV viral load, and a CD4 count above 250/mm3. They reported that there are 10 HIV-infected patients in waiting list and that only one patient has received a liver transplant in the country. Most centers do not accept in waiting lists for liver transplantation patients with HIV infection, even asymptomatic ones. However, advances in the management of HIV-infected patients suggest that this policy must be reevaluated. In Brazil, there is practically no experience in liver transplantation in HIV-positive patients.

  5. NORWEGIAN SCABIES IN AIDS PATIENT: A CASE REPORT

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    Meita Ardini Pratamasari

    2016-05-01

    Full Text Available Scabies is a skin infection caused by Sarcoptes scabiei var. hominis. This disease may present severe clinical manifestations in immune-compromised patient, well-known as Norwegian scabies or crusted scabies.A 36-year old man with AIDS had chief complaint thick crust almost all over his body in this case. History of household member infected by scabies before was present. Clinical findings show hyperpigmented macules unsharply marginated, covered with thick scales and accompanied by papules, fissures, and erotion. T cell CD4 level was 12 cell/μL. Scraping examination showed scabies infection and so did the histopathology examination. This patient was treated by topical Permethrin 5% combined with 2-4 ointment application in between permethrin usage. Before topical scabicide was given, thick crust was previously treated by topical urea 10% and wet dressing by normal saline. On day 14 after the patient first came there was lesion improvement.

  6. Cerebral toxoplasmosis in a patient leads to diagnosis of AIDS

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    Alireza Soleimani

    2015-08-01

    Full Text Available Toxoplasmosis is an infection caused by the intracellular protozoan parasite, with a worldwide distribution from 30%–75% seroprevalence in different countries. In patient with immunosuppression such as AIDS, the parasite can be reactivated and causes the disease. We report on the case of a 36–year–old man admitted to MadaniHospital with Imbalance and loss of consciousness. He has been suffering headache, impaired speech and inability to walk since two weeks ago. In magnetic resonance imaging multiple space occupying lesions in bilateral cerebral hemispheres with ring enhancement after contrast injection were seen. HIV test for HIV-1 was reactive, Toxoplasma serology was revealed raised immunoglobulin G antibody levels of 650 IU/mL. Cerebral toxoplasmosis in this patient leads to diagnosis of HIV infection at advanced stage. The patient treated successfully with alternative drug but we need more activity in education of high risk people to get tested for HIV in our country, Iran.

  7. Lymphangiectatic Kaposi's sarcoma in a patient with AIDS*

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    Santos, Mônica; Vilasboas, Virginia; Mendes, Luciana; Talhari, Carolina; Talhari, Sinésio

    2013-01-01

    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. PMID:23739700

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

    International Nuclear Information System (INIS)

    Palestro, C.J.; Goldsmith, S.J.

    1995-01-01

    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

  9. Allergen Microarray Indicates Pooideae Sensitization in Brazilian Grass Pollen Allergic Patients.

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    Priscila Ferreira de Sousa Moreira

    Full Text Available Grass pollen, in particular from Lolium multiflorum is a major allergen source in temperate climate zones of Southern Brazil. The IgE sensitization profile of Brazilian grass pollen allergic patients to individual allergen molecules has not been analyzed yet.To analyze the IgE sensitization profile of a Brazilian grass pollen allergic population using individual allergen molecules.We analyzed sera from 78 grass pollen allergic patients for the presence of IgE antibodies specific for 103 purified micro-arrayed natural and recombinant allergens by chip technology. IgE-ELISA inhibition experiments with Lolium multiflorum, Phleum pratense extracts and a recombinant fusion protein consisting of Phl p 1, Phl p 2, Phl p 5 and Phl p 6 were performed to investigate cross-reactivities.Within the Brazilian grass pollen allergic patients, the most frequently recognized allergens were Phl p 1 (95%, Phl p 5 (82%, Phl p 2 (76% followed by Phl p 4 (64%, Phl p 6 (45%, Phl p 11 (18% and Phl p 12 (18%. Most patients were sensitized only to grass pollen allergens but not to allergens from other sources. A high degree of IgE cross-reactivity between Phleum pratense, Lolium multiflorum and the recombinant timothy grass fusion protein was found.Component-resolved analysis of sera from Brazilian grass pollen allergic patients reveals an IgE recognition profile compatible with a typical Pooideae sensitization. The high degree of cross-reactivity between Phleum pratense and Lolium multiflorum allergens suggests that diagnosis and immunotherapy can be achieved with timothy grass pollen allergens in the studied population.

  10. Results of a randomized controlled trial to assess the effects of a mobile SMS-based intervention on treatment adherence in HIV/AIDS-infected Brazilian women and impressions and satisfaction with respect to incoming messages.

    Science.gov (United States)

    da Costa, Thiago Martini; Barbosa, Bárbara Jaqueline Peres; Gomes e Costa, Durval Alex; Sigulem, Daniel; de Fátima Marin, Heimar; Filho, Adauto Castelo; Pisa, Ivan Torres

    2012-04-01

    To assess whether a warning system based on mobile SMS messages increases the adherence of HIV-infected Brazilian women to antiretroviral drug-based treatment regimens and their impressions and satisfaction with respect to incoming messages. A randomized controlled trial was conducted from May 2009 to April 2010 with HIV-infected Brazilian women. All participants (n=21) had a monthly multidisciplinary attendance; each participant was followed over a 4-month period, when adherence measures were obtained. Participants in the intervention group (n=8) received SMS messages 30 min before their last scheduled time for a dose of medicine during the day. The messages were sent every Saturday and Sunday and on alternate days during the working week. Participants in the control group (n=13) did not receive messages. Self-reported adherence, pill counting, microelectronic monitors (MEMS) and an interview about the impressions and satisfaction with respect to incoming messages. The HIV Alert System (HIVAS) was developed over 7 months during 2008 and 2009. After the study period, self-reported adherence indicated that 11 participants (84.62%) remained compliant in the control group (adherence exceeding 95%), whereas all 8 participants in the intervention group (100.00%) remained compliant. In contrast, the counting pills method indicated that the number of compliant participants was 5 (38.46%) for the control group and 4 (50.00%) for the intervention group. Microelectronic monitoring indicated that 6 participants in the control group (46.15%) were adherent during the entire 4-month period compared to 6 participants in the intervention group (75.00%). According to the feedback of the 8 participants who completed the research in the intervention group, along with the feedback of 3 patients who received SMS for less than 4 months, that is, did not complete the study, 9 (81.81%) believed that the SMS messages aided them in treatment adherence, and 10 (90.90%) responded that they

  11. Adaptation and validation of the Hospital Survey on Patient Safety Culture in an electronic Brazilian version.

    Science.gov (United States)

    Andrade, Luiz Eduardo Lima de; Melo, Laiza Oliveira Mendes de; Silva, Ivanise Gomes da; Souza, Roselma Marinho de; Lima, André Luiz Barbosa de; Freitas, Marise Reis de; Batista, Almária Mariz; Gama, Zenewton André da Silva

    2017-01-01

    to adapt the Hospital Survey on Patient Safety Culture (HSOPSC) to the Brazilian context and validate a computer program that facilitates the collection and analysis of data in hospitals with different types of management. methodological study developed in six hospitals in Natal-RN, Brazil; a software which allows data collection via e-mail, cloud storage and automatic data report was developed; validity was verified through confirmatory factor analysis and reliability, through consistency analysis with Cronbach's alpha. 863 professionals participated in the study; the adapted version presented total Cronbach's alpha of 0.92 and median of 0.69 in the 12 dimensions (90% confidence interval: 0.53;0.87); the model was fitted and showed good indexes in the confirmatory factor analysis. the results confirmed the validity and reliability of the instrument with adequate psychometric properties for the assessment of patient's safety culture in Brazilian hospitals.

  12. AIDS in Brazilian Journalism: A study of the sources of information in the newspapers Folha de S. Paulo and O Globo

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    Marcia Benetti

    2006-06-01

    Full Text Available Journalism, understood as a meaning builder of reality, is a discourse that should represent the diversity of thoughts in a society. This article shows part of the results of a research in which we sought to answer whether Brazilian reference newspapers O Globo and Folha de S. Paulo treat the plurality of social voices talking about Aids in a balanced way. Through Content and Discourse Analysis, we mapped out the themes addressed and the sources of information by analyzing 310 journalistic texts, which represented the total published in both newspapers in 2004. The enunciator concept allowed us to verify that the dominant voices, even though they reflected official sources, demanded governmental actions in the fight against Aids. We recorded the comparison of enunciators in the texts, which characterized a polyphonic discourse. However, the voices of those living with HIV/Aids were hardly present; thus showing that the field of journalism failed to accomplish its function of representing the plurality of social voices.

  13. [Cryptococcal meningitis in patients with diabetes and AIDS].

    Science.gov (United States)

    Messina, Fernando Antonio; Negroni, Ricardo; Maiolo, Elena Isabel; Arechavala, Alicia; Villafañe, Maria Florencia; Santiso, Gabriela; Bianchi, Mario; Walker, Laura; Corti, Marcelo

    2014-12-01

    Cryptococcal meningitis is a severe AIDS-related infectious disease, with a high mortality rate. Diabetes mellitus (DM) is a metabolic disorder very common worldwide. Infectious diseases in diabetic patients are always more severe than in non-diabetic ones. The aim of this study was to compare the outcome of a group of HIV-positive patients with DM and cryptococcal meningitis with a similar group HIV-positive patients with cryptococcal meningitis, but without DM. A total of 182 clinical records of HIV-positive patients suffering cryptococcal meningitis were reviewed, and 28 of them with similar clinical and epidemiological characteristics, were chosen. They included 14 patients with DM (group A) and the remaining 14 who did not suffer this metabolic disorder (group B). Only 21.4% (3/14 cases) of group A patients had negative CSF cultures after 10 weeks of treatment. In group B patients, 78.5% (11/14 cases) achieved negative CSF cultures before 10 weeks. A higher overall mortality rate was observed in the diabetic patients (85.7%, 12/14 cases) than in the non-diabetic group (21.4%, 3/14 cases). All CSF isolates were identified as Cryptococcus neoformans, and all strains were susceptible in vitro to amphotericin B and fluconazole. Cryptococcal meningitis in diabetic patients was associated with a poor clinical outcome and a high mortality rate. A longer treatment induction period is suggested in order to improve the outcome of cryptococcal meningitis in diabetic patients. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  14. Sunitinib treatment in patients with advanced renal cell cancer: the Brazilian National Cancer Institute (INCA) experience.

    Science.gov (United States)

    Coelho, Rafael Corrêa; Reinert, Tomás; Campos, Franz; Peixoto, Fábio Affonso; de Andrade, Carlos Augusto; Castro, Thalita; Herchenhorn, Daniel

    2016-01-01

    The aim of this study was to assess the impact of sunitinib treatment in a non-screened group of patients with metastatic renal cell cancer (mRCC) treated by the Brazilian Unified Health System (SUS) at a single reference institution. Retrospective cohort study, which evaluated patients with mRCC who received sunitinib between May 2010 and December 2013. Fifty-eight patients were eligible. Most patients were male 41 (71%), with a median age of 58 years. Nephrectomy was performed in 41 (71%) patients with a median interval of 16 months between the surgery and initiation of sunitinib. The most prevalent histological subtype was clear cell carcinoma, present in 52 (91.2%) patients. In 50 patients (86%), sunitinib was the first line of systemic treatment. The main adverse effects were fatigue (57%), hypothyroidism (43%), mucositis (33%) and diarrhea (29%). Grade 3 and 4 adverse effects were infrequent: fatigue (12%), hypertension (12%), thrombocytopenia (7%), neutropenia (5%) and hand-foot syndrome (5%). Forty percent of patients achieved a partial response and 35% stable disease, with a disease control rate of 75%. Median progression free survival was 7.6 months and median overall survival was 14.1 months. Sunitinib treatment was active in the majority of patients, especially those with low and intermediate risk by MSKCC score, with manageable toxicity. Survival rates were inferior in this non-screened population with mRCC treated in the SUS. Copyright© by the International Brazilian Journal of Urology.

  15. The effect of multiple sclerosis on the professional life of a group of Brazilian patients

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    Yára Dadalti Fragoso

    2010-12-01

    Full Text Available OBJECTIVE: To assess the impact of multiple sclerosis (MS on the professional life of Brazilian patients. METHOD: One hundred MS patients were randomly selected from the database of the Brazilian Multiple Sclerosis Association (ABEM. An individual interview was carried out by telephone by a member of ABEM, who collected data on the patients' clinical status, educational level and professional lives. RESULTS: Complete data were obtained from 96 patients (27 males and 69 females aged 55.0±14.1 years, with average disease duration of 4.6±4.0 years. Eighty percent had eleven or more years of schooling. Among the whole group, 66% did not present limitations on walking. The longer the disease duration and the older the patient were, the higher the chances were that the patient was retired or receiving workers' compensation benefits. However, even among patients with MS for less than five years, the rate of non-participation in the workforce was 47.7%. Fatigue, paresthesia, cognitive dysfunction and pain were often cited as the motives for not working. CONCLUSION: MS patients presented high levels of unemployment, retirement and receipt of workers' compensation benefits, despite their high schooling levels. Age, disease duration and disability influenced these results for the whole group. However, even among younger patients with shorter disease duration and low disability, this finding remained.

  16. [Tropical pyomyositis simulating septic arthritis in AIDS patients. Two cases].

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    Abouzahir, A; Bouchama, R; Azennag, M; Garcin, J M

    2004-01-01

    Tropical pyomyositis (TP) is an acute bacterial infection of skeletal muscles characterized by rapid formation of abscesses. Since the beginning of the AIDS epidemic, interest in TP has increased because of its rising incidence in association with HIV infection and of the problems that it poses for differential diagnosis. Occurrence of TP is a criterion for classification of HIV infected patients in WHO disease stage III. The purpose of this report is to describe two HIV-infected patients who presented TP simulating septic arthritis of the hip and knee respectively. Medical imaging was particularly useful in establishing accurate topographic diagnosis and needle drainage in decreasing the duration of hospitalization and avoiding the need for surgical debridement. Needle puncture must be guided by ultrasound or scan imaging.

  17. Unusual cause of cholestatic jaundice in a patient with AIDS.

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    Kim, Su Bin; Shrivastava, Makardhwaj Sarvadaman; Anampa, Jesus M; Strakhan, Marianna

    2013-08-23

    A 61-year-old man with AIDS on chronic highly active antiretroviral treatment (HAART) presented with lethargy and jaundice and was found to have abnormal liver function tests (LFTs). Investigations including viral/autoimmune markers and imaging were unrevealing, except for positive Epstein-Barr virus. HAART was held, however, transaminases and total bilirubin continued to rise. The liver biopsy revealed classical Hodgkin's lymphoma (HL). HL presenting only with liver findings without lymphadenopathy is rare. Extreme cases can lead to fulminant liver failure. The bone marrow biopsy and dramatic elevation in serum ferritin were consistent with haemophagocytic lymphohistiocytosis. Finding a chemotherapy regimen was challenging given abnormal LFTs and HAART interactions. Initial chemotherapy regimen has successfully decreased LFTs; however, it was limited by pancytopenia. The patient's regimen was changed, however second regimen was complicated by neuropathy. LFTs improved and the patient was able to receive the standard care chemotherapy for HL with significant clinical, laboratory and radiological improvement.

  18. Quality of life of patients with advanced HIV/AIDS: measuring the impact of both AIDS-defining events and non-AIDS serious adverse events.

    Science.gov (United States)

    Anis, Aslam H; Nosyk, Bohdan; Sun, Huiying; Guh, Daphne P; Bansback, Nick; Li, Xin; Barnett, Paul G; Joyce, Vilija; Swanson, Kathleen M; Kyriakides, Tassos C; Holodniy, Mark; Cameron, D William; Brown, Sheldon T

    2009-08-15

    To investigate the relative magnitude and duration of impact of AIDS-defining events (ADEs) and non-AIDS serious adverse events (SAEs) on health-related quality of life (HRQoL) among patients with advanced HIV/AIDS. We use data from OPTIMA (OPTions In Management with Antiretrovirals), a multinational, randomized, open, control, clinical management trial of treatment strategies for patients with multidrug-resistant HIV and advanced immune disease. Longitudinal models were used to determine the effects of ADEs and SAEs on HRQoL across periods before, during, and after event onset. The Medical Outcomes Study HIV Health Survey (MOS-HIV) physical and mental health summary scores (MOS-PHS and MOS-MHS), EQ-5D, and the Health Utilities Index Mark 3 HRQoL measures were all assessed at regular follow-up intervals during the trial. ADEs occurred much less frequently than SAEs (n = 147 vs. n = 821) in the study sample population of 368 patients, during median follow-up of 3.96 years. Although both ADEs and SAEs had significant negative impacts on HRQoL, SAEs had at least as large an impact upon HRQoL as ADEs when both were included in a multivariate linear regression model, controlling for other covariates. However, the effect of ADEs on HRQoL was more persistent, with larger magnitude of effect across all instruments in time intervals further from the onset of the event. Non-AIDS SAEs occurring in patients with late-stage HIV/AIDS seem to have at least as important an immediate impact on patient HRQoL as ADEs; however, the impact of ADEs seems to be more persistent. Our findings call for a greater emphasis on the detection and active prevention of non-AIDS SAEs in patients with late-stage HIV/AIDS.

  19. Effects of Brazilian Cardioprotective Diet Program on risk factors in patients with coronary heart disease: a Brazilian Cardioprotective Diet randomized pilot trial

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    Bernardete Weber

    2012-12-01

    Full Text Available OBJECTIVE: To evaluate the effectiveness of the Brazilian Cardioprotective Diet Program in reducing blood pressures, fasting glucose levels and body mass indices in patients with established atherothrombotic disease. METHOD: This randomized controlled pilot trial included outpatients who were over 45 years of age with atherothrombotic cardiovascular disease. Group A, who received the Brazilian Cardioprotective Diet Program, had weekly sessions with dietitians. Groups B and C received the usual dietary therapy that is given to patients with cardiovascular diseases as proposed by the Brazilian guidelines. This diet had the same nutrient profile as that given to Group A, but it was customized by the integration of typical Mediterranean foods. The difference between Groups B and C was the number of sessions with the dietitian. Group B received weekly sessions, while group C only had monthly sessions. ClinicalTrials.gov: NCT 01453166. RESULTS: There was a greater reduction in systolic (7.8% and diastolic (10.8% blood pressures in Group A compared with Group B (2.3% and 7.3%, and Group C (3.9% and 4.9%, respectively. Fasting glucose decreased by 5.3% and 2% in Groups A and B, respectively. Fasting glucose increased by 3.7% in Group C. The BMIs decreased by 3.5% and 3.3% in Groups A and B, respectively. Group C did not present with any changes in BMI. However, none of these data showed statistical differences between the groups, which is methodologically acceptable in pilot trials. CONCLUSIONS: The Brazilian Cardioprotective Diet Program seems to be more effective in reducing blood pressures, fasting glucose levels, weights and BMIs in patients with previous cardiovascular disease compared with the diet that has been proposed by the Brazilian guidelines.

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

    OpenAIRE

    Hamed Mirjalali; Mehdi Mohebali; Hossein Mirhendi; Rashid Gholami; Hossein Keshavarz; Ahmad Reza Meamar; Mostafa Rezaeian

    2014-01-01

    Background 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. Methods Stool samples were collected from HIV+/AIDS patients during 12 months. All of the stool specimens washed with...

  1. Spirituality and Religion in Patients with HIV/AIDS

    Science.gov (United States)

    Cotton, Sian; Puchalski, Christina M; Sherman, Susan N; Mrus, Joseph M; Peterman, Amy H; Feinberg, Judith; Pargament, Kenneth I; Justice, Amy C; Leonard, Anthony C; Tsevat, Joel

    2006-01-01

    BACKGROUND Spirituality and religion are often central issues for patients dealing with chronic illness. The purpose of this study is to characterize spirituality/religion in a large and diverse sample of patients with HIV/AIDS by using several measures of spirituality/religion, to examine associations between spirituality/religion and a number of demographic, clinical, and psychosocial variables, and to assess changes in levels of spirituality over 12 to 18 months. METHODS We interviewed 450 patients from 4 clinical sites. Spirituality/religion was assessed by using 8 measures: the Functional Assessment of Chronic Illness Therapy—Spirituality-Expanded scale (meaning/peace, faith, and overall spirituality); the Duke Religion Index (organized and nonorganized religious activities, and intrinsic religiosity); and the Brief RCOPE scale (positive and negative religious coping). Covariates included demographics and clinical characteristics, HIV symptoms, health status, social support, self-esteem, optimism, and depressive symptoms. RESULTS The patients’ mean (SD) age was 43.3 (8.4) years; 387 (86%) were male; 246 (55%) were minorities; and 358 (80%) indicated a specific religious preference. Ninety-five (23%) participants attended religious services weekly, and 143 (32%) engaged in prayer or meditation at least daily. Three hundred thirty-nine (75%) patients said that their illness had strengthened their faith at least a little, and patients used positive religious coping strategies (e.g., sought God’s love and care) more often than negative ones (e.g., wondered whether God has abandoned me; Pspirituality/religion included ethnic and racial minority status, greater optimism, less alcohol use, having a religion, greater self-esteem, greater life satisfaction, and lower overall functioning (R2=.16 to .74). Mean levels of spirituality did not change significantly over 12 to 18 months. CONCLUSIONS Most patients with HIV/AIDS belonged to an organized religion and use

  2. Thyroid disorders in Brazilian patients with celiac disease.

    Science.gov (United States)

    da Silva Kotze, Lorete Maria; Nisihara, Renato Mitsunori; da Rosa Utiyama, Shirley Ramos; Piovezan, Gislaine Custodio; Kotze, Luiz Roberto

    2006-01-01

    Patients with celiac disease (CD) can develop a gluten related autoimmune disorder that affects not only the small intestine but other tissues as well. An increased prevalence of autoimmune diseases has been reported, particularly autoimmune thyroiditis. The aim of this study was to characterize thyroid disorders in patients with CD. Fifty-two patients with CD (43 female, 9 male; mean age, 41.1 years) were studied. Nine were on a gluten-free diet (GFD). They were divided into four groups: Group 1, without thyroid involvement (n=30); Groups 2A-C, with thyroid involvement (n=22); Group 2A, subclinical hypothyroidism (n=11); Group 2B, clinical hypothyroidism (n=10); and Group 2C, other thyroid disorders (n=1). CD was confirmed by serologic and histologic criteria. Thyroid involvement was detected by measurement of thyroid stimulating hormone (TSH) and anti-thyroperoxidase antibodies (anti-TPO). Increased levels of TSH and/or anti-TPO levels were detected in Groups 2A (21.1%) and 2B (19.2%). The patients of Group 2B presented clinical symptoms of hypothyroidism before the diagnosis of CD, and 5 of these patients were receiving levothyroxine. One woman (Group 2C; 1.92%) had a medullary carcinoma. There was statistical significance between the age when thyroid disease was diagnosed (current age) and the age of CD diagnosis between Groups 1 and 2B. Patients with thyroid involvement presented associated diseases such as diabetes mellitus (2), Down's syndrome (2), ulcerative colitis (1), and dermatitis herpetiformis (2). Our findings demonstrated an increased prevalence of thyroid disorders (hypothyroidism, 19.2%; and subclinical hypothyroidism, 21.2%), and other associated diseases in celiac patients, even on a GFD, increasing with the age of the patients. Screening for associated diseases is recommended for patients with CD, independent of age at diagnosis or treatment duration.

  3. 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.

  4. Molecular evidence of Borrelia burgdorferi sensu lato in patients in Brazilian central-western region

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    Fernando Aguilar Lopes

    Full Text Available Abstract We aimed to detect DNA of Borrelia burgdorferi in whole blood and serum samples of patients with clinical symptoms and epidemiology compatible with Brazilian Lyme-like disease. Four patients with positive epidemiological histories were recruited for the study. Blood samples were collected, screened by serologic testing by ELISA and Western blotting and molecular identification of B. burgdorferi by amplifying a fragment of the conserved gene that synthesizes the hook flagellar flgE. The results showed positive serology and for the first time, the presence of B. burgdorferi sensu lato in humans in the Midwest region of Brazil. The resulting sequences were similar to GenBank corresponding sequences of B. burgdorferi flgE gene. By neighbor-joining the phylogenetic analysis, the flgE sequence of the Brazilian strain clustered in a monophyletic group with the sequence of B. burgdorferi sensu lato under 100% bootstrap support. This study opens up promising perspectives and reinforces the need for additional studies to determine the epidemiological characteristics of the disease, as well as the impact of the prevalence of Brazilian borreliosis in Mato Grosso do Sul State, Brazil.

  5. Prostatic disorders in acromegalic patients experience of a Brazilian center

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    Livia L. Correa

    2013-06-01

    Full Text Available Introduction Published data suggest that patients with acromegaly have an increased prevalence of prostate disorders. Objective To evaluate prostatic disorders in acromegalic patients comparing these results after one year of treatment of acromegaly and with a group of healthy men. Materials and Methods This study was composed of two parts: sectional study comparing patients with healthy controls (baseline and prospective, longitudinal study (at baseline and after one year of treatment. Forty acromegalic patients were enrolled and evaluated at baseline and after one year with the application of international prostatic symptoms score (IPSS, digital rectal examination, measurements of growth hormone (GH, insulin-like growth factor-I (IGF-I, insulin-like growth factor-binding protein-3 (IGFBP-3, sex hormone-binding globulin (SHBG, prolactin, luteinizing hormone (LH, follicle-stimulating hormone (FSH, total testosterone, total and free prostate-specific antigen (PSA levels and prostate ultrasonography (US. Thirty healthy men were selected as control group. Results We stratified patients and controls according to age, considering 40 years-old as cut off. Healthy controls under 40 had IPSS values lower than acromegalic patients. When considering only older patients and controls prostate hyperplasia and structural abnormalities were more frequent in acromegalics. After one year of treatment there was significant decrease in GH, IGF-I and prostate volume in acromegalics over 40 years-old. Conclusions Acromegalics under 40 have more urinary symptoms according to IPSS and above 40 years-old higher frequency of structural changes and increased prostate volume than healthy men. Significant reduction of GH and IGF-I levels during treatment of acromegaly leads to decrease in the prostate volume.

  6. II Brazilian Consensus on the use of human immunoglobulin in patients with primary immunodeficiencies

    Science.gov (United States)

    Goudouris, Ekaterini Simões; Silva, Almerinda Maria do Rego; Ouricuri, Aluce Loureiro; Grumach, Anete Sevciovic; Condino, Antonio; Costa-Carvalho, Beatriz Tavares; Prando, Carolina Cardoso de Mello; Kokron, Cristina Maria; Vasconcelos, Dewton de Moraes; Tavares, Fabíola Scancetti; Segundo, Gesmar Rodrigues Silva; Barreto, Irma Cecília Douglas Paes; Dorna, Mayra de Barros; Barros, Myrthes Anna Maragna Toledo; Forte, Wilma Carvalho Neves

    2017-01-01

    ABSTRACT In the last few years, new primary immunodeficiencies and genetic defects have been described. Recently, immunoglobulin products with improved compositions and for subcutaneous use have become available in Brazil. In order to guide physicians on the use of human immunoglobulin to treat primary immunodeficiencies, based on a narrative literature review and their professional experience, the members of the Primary Immunodeficiency Group of the Brazilian Society of Allergy and Immunology prepared an updated document of the 1st Brazilian Consensus, published in 2010. The document presents new knowledge about the indications and efficacy of immunoglobulin therapy in primary immunodeficiencies, relevant production-related aspects, mode of use (routes of administration, pharmacokinetics, doses and intervals), adverse events (major, prevention, treatment and reporting), patient monitoring, presentations available and how to have access to this therapeutic resource in Brazil. PMID:28444082

  7. 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

  8. [Medical care costs for HIV-positive and AIDS patients in four hospitals in Santiago, Chile].

    Science.gov (United States)

    Toro, L; Jara, C; Adauy, A; Henríquez, A; Trujillo, F; Child, R; Ortiz, E

    1998-02-01

    Medical care of HIV infected and AIDS patients may represent an important economical burden for public hospitals. To assess direct and indirect costs of medical care for HIV infected and AIDS patients in public hospitals of the Metropolitan Region of Chile. Between August 1994 and February 1995, information about outpatient and hospitalized medical care of 417 HIV infected patients was gathered (representing approximately 16% of the seropositive population). Patients were divided as having or not having AIDS. The latter were those included in groups I, II, III and category C2 of group C (group 4). The cost of medications, procedures and examinations of these patients was calculated. Thirty six percent of studied patients had AIDS. The annual cost of care for AIDS patients was US$3760 compared to US$1450 for HIV infected patients without AIDS. Medications represented 75% and 65% of total costs in patients with and without AIDS respectively. The figures for examinations and procedures were 17% and 22% and for medical attentions were 7.5% and 8.8% respectively. Medical care of patients with AIDS has higher costs than that of HIV infected patients without AIDS. Thus, the retardation of the progression of the disease would have social, humanitarian and economical benefits. Our costs are similar to those of other countries with a similar level of economic development.

  9. Idiopathic dystonia. Clinical profile of 76 Brazilian patients.

    Science.gov (United States)

    Andrade, L A; Ferraz, H B

    1992-12-01

    Dystonia may be classified by age of onset (childhood, adolescence, adult onset), body distribution of the abnormal movements (focal, segmental, unilateral, multifocal and generalized) and etiology (idiopathic and symptomatic). We studied 76 patients with idiopathic dystonia among 122 cases of dystonic syndrome (62.3% of the total). There were 48 female and 28 male patients. Adult-onset focal dystonia was the most frequent feature (37 patients). The onset of generalized dystonia was more frequently seen under the age of 20, whereas focal and segmental dystonia usually started over this age. Postural tremor of the hands was observed in 19.7% of the patients. Spasmodic torticollis was the most prevalent form of dystonia overall. Except for writer's cramp, which occurred more frequently in males, and generalized dystonia, which was equally divided between sexes, all other forms were more frequent in females. Our data suggest that differences in racial origin, social and economical status and environmental factors do not account for a different manifestation in dystonia pattern.

  10. Idiopathic dystonia clinical, profile of 76 brazilian patients

    Directory of Open Access Journals (Sweden)

    Luiz A. F. Andrade

    1992-12-01

    Full Text Available Dystonia may be classified by age of onset (childhood, adolescence, adult onset, body distribution of the abnormal movements (focal, segmental, unilateral, multifocal and generalized and etiology (idiopathic and symptomatic. We studied 76 patients with idiopathic dystonia among 122; cases of dystonic syndrome (62.3% of the total. There were 48 female and 28 male patients. Adult-onset focal dystonia was the most frequent feature (37 patients. The onset of generalized dystonia was more frequently seen under the age of 20, whereas focal and segmental dystonia usually started over this age. Postural tremor of the hands was observed in 19.7% of the patients. Spasmodic torticollis was the most prevalent form of dystonia overall. Except for writer's cramp, which occurred more frequently in males, and generalized dystonia, which was equally divided between sexes, all other forms were more frequent in females. Our data suggest that differences in racial origin, social and economical status and environmental factors do not account for a different manifestation in dystonia pattern.

  11. Oral paracoccidioidomycosis: Retrospective analysis of 55 Brazilian patients.

    Science.gov (United States)

    Trindade, Aline Heloísa; Meira, Henrique Côrtes; Pereira, Igor Figueiredo; de Lacerda, Julio César Tanos; de Mesquita, Ricardo Alves; Santos, Vagner Rodrigues

    2017-08-01

    Paracoccidioidomycosis (PCM) is a rare fungal infection in the world, but endemic and acquired exclusively in Latin America, with the highest prevalence in South America and Brazil, particularly. Changes in oral cavity are common and constitute the first clinical manifestation in many patients. The aim of this study was to describe the prevalence of oral PCM and analyse the profile of the disease and patients. Retrospective research, consisting of information present in the medical records in the period 1998-2015, whose histopathological diagnosis was oral PCM. Fifty-five oral PCM cases were confirmed. Of these patients, 90.9% were males and 9.1% were females. The average age was 49.66 years and the most reported occupation was rural workers. The painful symptomatology was present in 61.82% of patients. Erythematous lesions were predominant in 73% of them. In single lesions (22 cases), the most common locations were jugal mucosa and tongue. In multiple involvement (30 cases), the most affected regions were lips, jugal mucosa and alveolar ridge. Epidemiology of PCM, was similar to several other studies, especially in Brazil. This is the most important fungal infection in Latin America and the recognition of oral lesions is extremely important, as is often the first and in many cases the only manifestation of the disease. © 2017 Blackwell Verlag GmbH.

  12. Hepatitis B and C co-infections in HIV/AIDS patients attending ARV ...

    African Journals Online (AJOL)

    Background: Co-infections of HIV/AIDS with HBV and HCV are emerging as an added burden to the already chaotic protocols of managing HIV/AIDS mono- infection. Objectives: To determine the prevalence of Hepatitis B and C co infections among HIV/AIDS patients in Zaria. Methods: A cross sectional study by which ...

  13. Misdiagnosed crusted scabies in an AIDS patient leads to hyperinfestation.

    Science.gov (United States)

    Yari, Niloofar; Malone, C Helen; Rivas, Antonio

    2017-03-01

    Crusted scabies is a severe, highly contagious form of classic scabies caused by the mite Sarcoptes scabiei var hominis . Crusted scabies is more common in immunosuppressed populations and overcrowded environments. In this condition, the host's immune system is overwhelmed and unable to defend against the mites on the skin, resulting in hyperinfestation of the host. Diagnosis can be challenging because the condition resembles other common skin conditions, such as plaque psoriasis. Furthermore, delayed diagnosis and inappropriate treatment can lead to worsening of the condition. We report a case of crusted scabies that was initially misdiagnosed in a 34-year-old incarcerated man with multidrug-resistant human immunodeficiency virus/AIDS. The patient had a complicated but complete recovery after treatment with permethrin and ivermectin was instituted.

  14. Reiki for Cancer Patients Undergoing Chemotherapy in a Brazilian Hospital: A Pilot Study.

    Science.gov (United States)

    Siegel, Pamela; da Motta, Pedro Mourão Roxo; da Silva, Luis G; Stephan, Celso; Lima, Carmen Silvia Passos; de Barros, Nelson Filice

    2016-01-01

    The purpose of this pilot study was to explore whether individualized Reiki given to cancer patients at a Brazilian hospital improved symptoms and well-being. Data from 36 patients who received 5 Reiki sessions were collected using the MYMOP and were compared before and after their treatment and also with 14 patients who did not receive Reiki and who acted as a comparison group. Twenty-one patients reported feeling better, 12 felt worse, and 3 reported no change. Of the comparison group, 6 patients reported feeling better and 8 felt worse. The Reiki practice delivered as part of the integrative care in oncology did produce clinically significant effects, although not statistically significant results, for more than half of the patients undergoing cancer treatment.

  15. 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

    demographic and clinical data from the Epidemiological Surveillance Center (TB database, Brazilian Case Registry Database, and Brazilian National Mortality Database, as well as the Brazilian National CD4+/CD8+ T Lymphocyte Count and Viral Load Network Laboratory Test Control System and the Logistic Medication Monitoring System (HIV/AIDS databases. All of the compiled data were cross-referenced. RESULTS: During the study period, we identified 9,543 TB patients > 15 years of age, 437 of whom (4.6% had AIDS. The median age did not differ between TB/AIDS and TB-only patients (35 years vs. 38 years. Of the 437 TB/AIDS patients, 298 (68.2% were male, and 156 (35.8% were in the 30-39 age bracket. In terms of TB treatment outcome, 79.0% were cured, 9.7% were referred to other facilities, 6.0% died, 5.2% abandoned treatment, and 0.2% developed multidrug-resistant TB. Death was 4.75 times more common in patients with TB/AIDS than in those with TB only. Pulmonary TB accounted for 82.4% of the cases. The combination of pulmonary and extrapulmonary TB was 8.2 times more common in the TB/AIDS patients than in the TB-only patients (95% CI: 6.2-10.8. CONCLUSIONS: Our results emphasize the significance of AIDS among TB patients in Brazil, as well as the importance of evaluating secondary data in order to improve their quality and develop public health interventions

  16. Plasma lactoferrin levels are decreased in end-stage AIDS patients

    NARCIS (Netherlands)

    Van der Strate, BWA; Harmsen, MC; The, TH; Sprenger, HG; de Vries, H; Eikelboom, MC; Kuipers, ME; Meijer, DKF; Swart, PJ

    1999-01-01

    The antimicrobial protein lactoferrin (Lf) is present in plasma and in mucosal secretions. Using ELISA we analysed plasma and saliva of HIV-infected patients, patients with AIDS, and healthy controls for the presence of secreted Lf. The plasma Lf levels of AIDS patients (classification C3) were

  17. 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.

  18. A strategy for molecular diagnostics of Fanconi anemia in Brazilian patients.

    Science.gov (United States)

    Pilonetto, Daniela V; Pereira, Noemi F; Bonfim, Carmem M S; Ribeiro, Lisandro L; Bitencourt, Marco A; Kerkhoven, Lianne; Floor, Karijn; Ameziane, Najim; Joenje, Hans; Gille, Johan J P; Pasquini, Ricardo

    2017-07-01

    Fanconi anemia (FA) is a predominantly autosomal recessive disease with wide genetic heterogeneity resulting from mutations in several DNA repair pathway genes. To date, 21 genetic subtypes have been identified. We aimed to identify the FA genetic subtypes in the Brazilian population and to develop a strategy for molecular diagnosis applicable to routine clinical use. We screened 255 patients from Hospital de Clínicas, Universidade Federal do Paraná for 11 common FA gene mutations. Further analysis by multiplex ligation-dependent probe amplification (MLPA) for FANCA and Sanger sequencing of all coding exons of FANCA , -C , and - G was performed in cases who harbored a single gene mutation. We identified biallelic mutations in 128/255 patients (50.2%): 89, 11, and 28 carried FANCA , FANCC , and FANCG mutations, respectively. Of these, 71 harbored homozygous mutations, whereas 57 had compound heterozygous mutations. In 4/57 heterozygous patients, both mutations were identified by the initial screening, in 51/57 additional analyses was required for classification, and in 2/57 the second mutation remained unidentified. We found 52 different mutations of which 22 were novel. The proposed method allowed genetic subtyping of 126/255 (49.4%) patients at a significantly reduced time and cost, which makes molecular diagnosis of FA Brazilian patients feasible.

  19. Immunologic thrombocytopenic purpura in patients at risk for AIDS.

    Science.gov (United States)

    Karpatkin, S

    1987-06-01

    HIV-seropositive homosexuals, narcotic addicts and hemophiliacs develop a new syndrome of immunologic thrombocytopenic purpura (ITP) which is clinically indistinguishable from classic autoimmune thrombocytopenic purpura (ATP) with respect to increased megakaryocytes in the bone marrow, peripheral destruction of antibody-coated platelets, negative serology for SLE, response to treatment with prednisone and/or splenectomy. Eleven of 79 homosexual patients have developed AIDS 2 to 43 months after the diagnosis of ITP (mean, 22 months). The mechanism of the ITP appears to be different in homosexuals and narcotic addicts when compared to classic ATP. Homosexuals and narcotic addicts have markedly elevated platelet-bound IgG and C3C4 (2.5-4-fold ATP levels), PEG-precipitable circulating immune complexes and anti-F(ab')2 antibodies (absent in ATP). There is no inverse relationship between platelet-bound IgG and platelet count and platelet antibody is usually not elutable from washed platelets as is the case with classic ATP. Homosexual patients do not have 7S platelet antibody in their sera as do classic ATP patients, but appear to have immune complex deposition on their platelets, possibly due to the presence of anti-F(ab')2 antibodies. Narcotic addict patients do have detectable 7S platelet antibody but also appear to have immune complex deposition on their platelets, possibly due to anti-F(ab')2 antibodies. The anti-F(ab')2 antibodies are of the IgG class. They react with autologous, homologous patient and healthy control F(ab')2 fragments. Some anti-F(ab')2 antibodies have broad reactivity, others are more limited. It is postulated that some of the anti-F(ab')2 antibodies may be responsible for the thrombocytopenia.

  20. [Detection of cryptosporidium infection among AIDS patients in Guangdong and Yunnan].

    Science.gov (United States)

    Le, Xiao-hua; Wang, Hui; Gou, Ji-zhou; Chen, Xin-chun; Yang, Gui-lin; Yang, Qian-ting; Li, Xiao-he; Zhou, Bo-ping; Li, Hui-qin; Cai, Wei-ping

    2008-10-01

    To investigate the infection of Cryptosporidium and its epidemiological characteristics in AIDS patients of Southern China. Stool samples colleted from AIDS confirmed patients. The samples were detected for oocyst of Cryptosporidium by acid fast bacteria stain and indirect fluorescent antibody stain respectively, CD4 count was detected by Flow Cytometry. 212 samples of fresh stool obtained from the AIDS patients who live in Guangdong and Yunnan province. The total infection rate of Cryptosporidium in AIDS patients was 4.25% (9/212), the infectious rate of oocyst in the group of 50- 59-years-old was significantly higher than those in 30-39 (P stool shape. AIDS patients infected by Cryptosporidium are not rare in southern China, and the infectious rate was lower than western country. Patients received ART could decrease the infectious rate of Cryptosporidium, Cryptosporidium always happen in patient whose CD4 count was very low (< 100 cells/microl).

  1. Age and gender changes in children and adolescent patients of a Brazilian eating disorder program

    Directory of Open Access Journals (Sweden)

    Felipe Alckmin-Carvalho

    Full Text Available ABSTRACT Background International studies have demonstrated an increase in the prevalence of boys and a decrease of patients’ age at the beginning of outpatient treatment for eating disorders (ED. Objective To evaluate if these changes are also present in the Brazilian population participating in the PROTAD, a Brazilian ED program, and to discuss its clinical implication for treatment. Methods Cross-sectional study. We evaluated 150 medical records of patients under 18 years diagnosed with ED (DSM IV-TR. Patients were divided into two groups: G1 (2001-2007 (n = 77 and G2 (2008-2014 (n = 73. The girl/boy proportion and the mean age of patients were compared. Results In G1, six boys (7.8% were admitted (girl/boy proportion: 11.8:1, while in G2, 16 (22% boys were admitted (girl/boy proportion: 3.5:1 (p 0.05. Discussion The increase in the number of boys treated for EDs reported in international studies was also found at the PROTAD. Contrary to what has been reported in international studies, the mean age of patients at the PROTAD did not decrease significantly. Gender and sexual orientation issues, clinical presentation, prior overweight history and culture/media impact on boys should be addressed by the healthcare team to increase the therapeutic efficacy.

  2. Varicella-zoster virus encephalitis in an AIDS patient

    Directory of Open Access Journals (Sweden)

    P.V. Toledo

    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.

  3. Can people find patient decision aids on the Internet?

    Science.gov (United States)

    Morris, Debra; Drake, Elizabeth; Saarimaki, Anton; Bennett, Carol; O'Connor, Annette

    2008-12-01

    To determine if people could find patient decision aids (PtDAs) on the Internet using the most popular general search engines. We chose five medical conditions for which English language PtDAs were available from at least three different developers. The search engines used were: Google (www.google.com), Yahoo! (www.yahoo.com), and MSN (www.msn.com). For each condition and search engine we ran six searches using a combination of search terms. We coded all non-sponsored Web pages that were linked from the first page of the search results. Most first page results linked to informational Web pages about the condition, only 16% linked to PtDAs. PtDAs were more readily found for the breast cancer surgery decision (our searches found seven of the nine developers). The searches using Yahoo and Google search engines were more likely to find PtDAs. The following combination of search terms: condition, treatment, decision (e.g. breast cancer surgery decision) was most successful across all search engines (29%). While some terms and search engines were more successful, few resulted in direct links to PtDAs. Finding PtDAs would be improved with use of standardized labelling, providing patients with specific Web site addresses or access to an independent PtDA clearinghouse.

  4. Genetic diversity of mycobacterium leprae isolates from Brazilian leprosy patients.

    Science.gov (United States)

    Fontes, Amanda Nogueira Brum; Sakamuri, Rama Murthy; Baptista, Ida Maria Foschiani Dias; Ura, Somei; Moraes, Milton Ozório; Martínez, Alejandra Nóbrega; Sarno, Euzenir Nunes; Brennan, Patrick J; Vissa, Varalakshmi D; Suffys, Philip Noel

    2009-09-01

    Leprosy is a chronic disease caused by infection with Mycobacterium leprae, an obligate intracellular parasite. A problem in studying the transmission of leprosy is the small amount of variation in bacterial genomic DNA. The discovery of variable number of tandem repeats (VNTRs) allowed the detection of strain variation in areas with a high prevalence of leprosy. Four genotypes of M. leprae based on three single-nucleotide polymorphism (SNPs) were also discovered to be useful for analysis of the global spread of leprosy. In this present study, we examined the allelic diversity of M. leprae at 16 select VNTR and three SNP loci using 89 clinical isolates obtained from patients mainly from the neighbouring states of São Paulo and Rio de Janeiro Brazil. By use of a PCR-RFLP-based procedure that allows the recognition of SNP types 3 and 4 without the need for the more expensive DNA sequencing steps, characterisation of the main M. leprae genotypes was easy. When applied on the study population, it was found that the SNP type 3 is most frequent in these two states of Brazil, and that VNTRs provided further discrimination of the isolates. Two Short Tandem Repeats (STRs) were monomorphic, with the remaining 14 STRs represented by two to 18 alleles. Epidemiological associations with township or state were not evident in this random collection and require further investigations. In phylogenetic trees, branches formed by all 16 STRs clearly separated SNP type 3 organisms from the other types while the allelic patterns of two minisatellite loci 27-5 and 12-5 were highly correlated with SNP type 3. This strain typing study provide the basis for comparison of M. leprae strain types within Brazil and with those from other countries, and informed selection of genomic markers and methods for future studies.

  5. Development of a Decision Aid for Patients with Atrial Fibrillation Who Are Considering Antithrombotic Therapy

    Science.gov (United States)

    Man-Son-Hing, Malcolm; Laupacis, Andreas; O'Connor, Annette M; Hart, Robert G; Feldman, George; Blackshear, Joseph L; Anderson, David C

    2000-01-01

    With patients demanding a greater role in the clinical decision-making process, many researchers are developing and disseminating decision aids for various medical conditions. In this article, we outline the essential elements in the development and evaluation of a decision aid to help patients with atrial fibrillation choose, in consultation with their physicians, appropriate antithrombotic therapy (warfarin, aspirin, or no therapy) to prevent stroke. We also outline possible future directions regarding the implementation and evaluation of this decision aid. This information should enable clinicians to better understand the role that decision aids may have in their interactions with patients. PMID:11089716

  6. 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

    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......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...

  7. Evaluating ECG-aided tip localization of peripherally inserted central catheter in patients with cancer

    OpenAIRE

    Liu, Yan-Jin; Dong, Lei; Lou, Xiao-Ping; Miao, Jin-Hong; Li, Xiu-Xia; Li, Xiao-Jing; Li, Jing; Liu, Qian-Qian; Chang, Zhi-Wei

    2015-01-01

    Objective: To evaluate ECG-aided tip localization of peripherally inserted central catheter (PICC) in the patients with cancer. Methods: Between September and December 2014, 170 patients undergoing PICC were divided into observation group and control group (each group with 85 patients). In observation group, patients received ECG-aided tip localization of PICC. In control group, PICC was performed with conventional method. After PICC was performed, all patients took orthophoria chest radiogra...

  8. Patients with HIV/AIDS: physicians' knowledge, attitudes, and referral practices.

    Science.gov (United States)

    Fournier, P O; Baldor, R A; Warfield, M E; Frazier, B

    1997-01-01

    This study investigated Massachusetts family physicians' current care and referral practices with respect to HIV/AIDS patients and examined actors that might influence family physicians in referring these patients to specialists. Educational opportunities for physicians with regard to HIV were also examined. In 1994, a 2-page survey was mailed to the 468 members of the Massachusetts Academy of Family Physicians. The survey questionnaire examined such factors as whether the respondents were teaching or nonteaching, rural or urban; number of years since medical school or residency training; and knowledge and attitudes with regard to HIV/AIDS patients. The data were analyzed using Student's t test, chi-square, and correlation analysis. Usable responses were returned by 281 (60%) of the physicians surveyed. Of these, 65% reported having HIV patients in their practice, and 46% reported having AIDS patients was being managed alone by 53% of these physicians, and 11% managed their patients with AIDS. Physicians providing care for HIV/AIDS patients were more likely to be practicing in urban locations, have three or more HIV/AIDS patients in their practice, or recently graduated from residency. Additionally, they were more likely to be involved in residency teaching programs. Those who did not care for HIV/AIDS patients felt less knowledgeable about HIV/AIDS care, and felt that they had no time in their practice to care for this population of patients. Physicians with HIV patients learn more about HIV care from their colleagues than those without HIV patients. Family physicians are increasingly seeing HIV/AIDS patients in their offices. The majority are continually caring for these patients, either by themselves or co-managing their care with a specialist. Local CME programs relying on colleagues and community resources to discuss management of these patients may be one of the best ways of ensuring that increasing numbers of family physicians obtain the appropriate

  9. Implementation of a trauma registry in a brazilian public hospital: the first 1,000 patients

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    Paulo Roberto Lima Carreiro

    Full Text Available OBJECTIVE: Show the steps of a Trauma Registry (TR implementation in a Brazilian public hospital and evaluate the initial data from the database.METHODS: Descriptive study of the a TR implementation in João XXIII Hospital (Hospital Foundation of the state of Minas Gerais and analysis of the initial results of the first 1,000 patients.RESULTS: The project was initiated in 2011 and from January 2013 we began collecting data for the TR. In January 2014 the registration of the first 1000 patients was completed. The greatest difficulties in the TR implementation were obtaining funds to finance the project and the lack of information within the medical records. The variables with the lowest completion percentage on the physiological conditions were: pulse, blood pressure, respiratory rate and Glasgow coma scale. Consequently, the Revised Trauma Score (RTS could be calculated in only 31% of cases and the TRISS methodology applied to 30.3% of patients. The main epidemiological characteristics showed a predominance of young male victims (84.7% and the importance of aggression as a cause of injuries in our environment (47.5%, surpassing traffic accidents. The average length of stay was 6 days, and mortality 13.7%.CONCLUSION: Trauma registries are invaluable tools in improving the care of trauma victims. It is necessary to improve the quality of data recorded in medical records. The involvement of public authorities is critical for the successful implementation and maintenance of trauma registries in Brazilian hospitals.

  10. Implementation of a trauma registry in a Brazilian public hospital: the first 1,000 patients.

    Science.gov (United States)

    Carreiro, Paulo Roberto Lima; Drumond, Domingos André Fernandes; Starling, Sizenando Vieira; Moritz, Mônica; Ladeira, Roberto Marini

    2014-01-01

    Show the steps of a Trauma Registry (TR) implementation in a Brazilian public hospital and evaluate the initial data from the database. Descriptive study of the a TR implementation in João XXIII Hospital (Hospital Foundation of the state of Minas Gerais) and analysis of the initial results of the first 1,000 patients. The project was initiated in 2011 and from January 2013 we began collecting data for the TR. In January 2014 the registration of the first 1000 patients was completed. The greatest difficulties in the TR implementation were obtaining funds to finance the project and the lack of information within the medical records. The variables with the lowest completion percentage on the physiological conditions were: pulse, blood pressure, respiratory rate and Glasgow coma scale. Consequently, the Revised Trauma Score (RTS) could be calculated in only 31% of cases and the TRISS methodology applied to 30.3% of patients. The main epidemiological characteristics showed a predominance of young male victims (84.7%) and the importance of aggression as a cause of injuries in our environment (47.5%), surpassing traffic accidents. The average length of stay was 6 days, and mortality 13.7%. Trauma registries are invaluable tools in improving the care of trauma victims. It is necessary to improve the quality of data recorded in medical records. The involvement of public authorities is critical for the successful implementation and maintenance of trauma registries in Brazilian hospitals.

  11. Genetic variability of Candida albicans in HIV/AIDS patient with and without ARV therapy and non HIV/AIDS

    OpenAIRE

    Rahayu, Retno Puji; P, Widiyanti; M, Arfijanto

    2012-01-01

    Background: Oral candidiasis is the mostly found oral manifestation in HIV/AIDS infected patient caused by immunocompromised especially immunodeficiency. Clinical symptoms is severe pain in oral cavity and dry mouth because of xerostomia which cause the loss of appetite. Candida albicans (C. albicans) is normal flora in oral cavity which plays as opportunistic pathogen and also the cause of oral candidiasis. Almost 90% of HIV–infected patient have oral candidiasis. This condition is clinical ...

  12. Trustworthy patient decision aids: a qualitative analysis addressing the risk of competing interests

    NARCIS (Netherlands)

    Elwyn, G.; Dannenberg, M.; Blaine, A.; Poddar, U.; Durand, M.A.

    2016-01-01

    OBJECTIVE: Our aim in this study was to examine the competing interest policies and procedures of organisations who develop and maintain patient decision aids. DESIGN: Descriptive and thematic analysis of data collected from a cross-sectional survey of patient decision aid developer's competing

  13. Hepatitis B and C virus infections and liver function in AIDS patients ...

    African Journals Online (AJOL)

    Background: Impaired liver function tests and co-infection with hepatitis viruses in AIDS patients are common in western countries. Objective: To assess liver function and prevalence of co-infection with hepatitis B and hepatitis C viruses in AIDS patients at Chris Hani Baragwanath Hospital. Design: A prospective study.

  14. Protein carbonyl content: a novel biomarker for aging in HIV/AIDS patients

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    Vaishali Kolgiri

    2017-01-01

    Conclusions: Carbonyl content may has a role as a biomarker for detecting oxidative DNA damage induced ART toxicity and/or accelerated aging in HIV/AIDS patients. Larger studies are warranted to elucidate the role of carbonyl content as a biomarker for premature aging in HIV/AIDS patients.

  15. Characteristics and Outcome of Patients With AIDS in Dutch ICUs Between 1997 and 2014

    NARCIS (Netherlands)

    Huson, Michaëla A.; Bakhshi-Raiez, Ferishta; Grobusch, Martin P.; de Jonge, Evert; de Keizer, Nicolette F.; van der Poll, Tom

    2016-01-01

    Knowledge on characteristics and outcome of ICU patients with AIDS is highly limited. We aimed to determine the main reasons for admission and outcome in ICU patients with AIDS and trends over time therein. A retrospective study within the Dutch National Intensive Care Evaluation registry. Dutch

  16. HIV/AIDS patient satisfaction with a food assistance programme in ...

    African Journals Online (AJOL)

    We measured the satisfaction of HIV/AIDS patients with a food assistance programme in Sofala province in Mozambique. This was an observational study that used a combination of qualitative and quantitative methods. HIV/AIDS patients receiving food assistance took part in focus group discussions (FDGs) and completed ...

  17. Pattern of First-Aid Measures Used by Snake-bite Patients and ...

    African Journals Online (AJOL)

    The use of first aid measures in the management of snake bite by patients in rural communities in Africa is a popular practice. Records of 103 snake bite patients admitted at Zamko Comprehensive Health Centre, were retrieved and reviewed. 84 (81.6%) of the 103 cases with snake bite used first aid measures. Common first ...

  18. The bone-anchored hearing aid in patients with a unilateral air-bone gap.

    NARCIS (Netherlands)

    Snik, A.F.M.; Mylanus, E.A.M.; Cremers, C.W.R.J.

    2002-01-01

    OBJECTIVES: To study the benefit of the application of a bone-anchored hearing aid in patients with a unilateral air-bone gap. STUDY DESIGN: Prospective evaluation in eight patients. METHODS: Binaural hearing was assessed in the sound field by comparing aided and unaided scores obtained with a sound

  19. Septata intestinalis frequently isolated from stool of AIDS patients with a new cultivation method

    NARCIS (Netherlands)

    van Gool, T.; Canning, E. U.; Gilis, H.; van den Bergh Weerman, M. A.; Eeftinck Schattenkerk, J. K.; Dankert, J.

    1994-01-01

    Two species of microsporidia, Enterocytozoon bieneusi and Septata intestinalis have been reported as intestinal parasites of AIDS patients. In attempts to establish E. bieneusi in vitro, spores were concentrated from stool samples from 4 AIDS patients with biopsy-proven E. bieneusi infections. After

  20. FANCD2 Western blot as a diagnostic tool for Brazilian patients with Fanconi anemia

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    D.V. Pilonetto

    2009-03-01

    Full Text Available Fanconi anemia is a rare hereditary disease showing genetic heterogeneity due to a variety of mutations in genes involved in DNA repair pathways, which may lead to different clinical manifestations. Phenotypic variability makes diagnosis difficult based only on clinical manifestations, therefore laboratory tests are necessary. New advances in molecular pathogenesis of this disease led researchers to develop a diagnostic test based on Western blot for FANCD2. The objective of the present study was to determine the efficacy of this method for the diagnosis of 84 Brazilian patients with Fanconi anemia, all of whom tested positive for the diepoxybutane test, and 98 healthy controls. The FANCD2 monoubiquitinated isoform (FANCDS+/FANCD2L- was not detected in 77 patients (91.7%. In 2 patients (2.4%, there was an absence of both the monoubiquitinated and the non-ubiquitinated proteins (FANCD2S-/FANCD2L- and 5 patients (5.9% had both isoforms (FANCD2S+/FANCD2L+. This last phenotype suggests downstream subtypes or mosaicism. All controls were diepoxybutane negative and were also negative on the FANCD2 Western blot. The Western blot for FANCD2 presented a sensitivity of 94% (79/84 and specificity of 100% (98/98. This method was confirmed as an efficient approach to screen Brazilian patients with deleterious mutations on FANCD2 (FANCD2S-/FANCD2L- or other upstream genes of the FA/BRCA pathway (FANCDS+/FANCD2L-, to confirm the chromosome breakage test and to classify patients according to the level of FA/BRCA pathway defects. However, patients showing both FANCD2 isoforms (FANCD2S+/FANCD2L+ require additional studies to confirm mutations on downstream Fanconi anemia genes or the presence of mosaicism.

  1. THE AIDS PATIENT SUFFERING FROM GENERALIZED MYCOBACTERIOSIS

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    T. F. Otten

    2015-01-01

    Full Text Available The clinical case of mycobacteriosis caused by drug resistant strains of M. avium (subspecies of hominissuis, was observed in the patient su}ering from HIV at the stage of AIDS. The severity of immune deficiency and the absence of opportunity for antibacterial and antiviral therapy promoted the rapid progression of mycobacteriosis, early lymphogeneous generalization and the lethal outcome in 16 months from the start of the disease. Mycobacteriosis in this clinical case was specifically characterized by the massive bacterial semination, the absence of specific granulomatous changes in parenchymal organs, massive lesion of lymph nodes with extensive necrosis and the presence of para-specific changes. It highlights the similarity of mycobacteriosis pathogenesis with pathogenesis of primary tuberculosis.

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

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    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.

  3. Mycobacterium avium complex-associated cholecystitis in AIDS patient: a case description and review of literature.

    Science.gov (United States)

    El Chaer, Firas; Harris, Nadine; El Sahly, Hana; Hemmige, Vagish; Martinez Blanco, Elvia; Woc-Colburn, Laila

    2016-11-01

    AIDS-related cholangiopathy was common in patients with AIDS prior to the advent of highly active antiretroviral therapy. Mycobacterium avium complex (MAC) is the most common opportunistic bacterial infection seen in AIDS patients and one of many opportunistic pathogens implicated in AIDS cholangiopathy. We describe a case of acute cholecystitis secondary to MAC in a patient with likely AIDS cholangiopathy. The patient, a 37-year-old Hispanic woman with CD4 + cell count of 10 cells/mm 3 who was previously diagnosed with disseminated MAC, presented with a eight days of diffuse abdominal pain and anorexia. Radiologic imaging suggested acute cholecystitis, so the patient underwent open cholecystectomy. Pathology staining of the gall bladder wall revealed acid-fast bacilli consistent with MAC. The patient had been receiving appropriate therapy as an outpatient for MAC with presumed reliable adherence, but we suggest her burden of disease was high due to her severe immunosuppressive state. A thorough review of the literature showed that there are many infectious and non-infectious aetiologies for AIDS-associated cholangiopathy. Acute cholecystitis can develop in the setting of AIDS cholangiopathy, potentially secondary to the opportunistic infection that initially caused the cholangiopathy. MAC-related gallbladder disease needs to be considered in patients with advanced AIDS who present with evidence of acute cholecystitis. © The Author(s) 2015.

  4. Health-related quality of life of patients of Brazilian primary health care.

    Science.gov (United States)

    Ascef, Bruna de Oliveira; Haddad, João Paulo Amaral; Álvares, Juliana; Guerra, Augusto Afonso; Costa, Ediná Alves; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mario; Leite, Silvana Nair; Silveira, Micheline Rosa

    2017-11-13

    To analyze the Health-Related Quality of Life (HRQoL) of patients of the primary health care of the Brazilian Unified Health System (SUS) and its associated factors. This is a cross-sectional study with data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos - Serviços, 2015 (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services, 2015). Data were collected with a questionnaire that included the EuroQol 5 Dimensions (EQ-5D) instrument. Patients from the five regions of Brazil were interviewed. Multiple linear regression was used to analyze their Health-Related Quality of Life and its associated factors. Of the total of 8,590 patients, the most frequent dimensions were pain/discomfort (50.7%) and anxiety/depression (38.8%). About 10% of the patients reported extreme problems in these dimensions. The following factors were significantly associated with a worse quality of life: being female; having arthritis, osteoarthritis, or rheumatism; cerebrovascular accident; heart disease; depression; health self-assessment as poor or very poor; drinking alcoholic beverages once or more per month; dieting to lose weight, avoiding salt consumption, and reducing fat intake. Significant association was observed between a better quality of life and: living in the North and Southeast regions of Brazil; practicing physical activities; and having a higher educational level. No association was observed with factors related to the health services. The Health-Related Quality of Life of patients was influenced by demographic and socioeconomic factors that were related to health conditions and lifestyle, being useful to guide specific actions for promoting health and the integral care to patients of the Brazilian Unified Health System.

  5. Health-related quality of life of patients of Brazilian primary health care

    Directory of Open Access Journals (Sweden)

    Bruna de Oliveira Ascef

    2017-11-01

    Full Text Available ABSTRACT OBJECTIVE To analyze the Health-Related Quality of Life (HRQoL of patients of the primary health care of the Brazilian Unified Health System (SUS and its associated factors. METHODS This is a cross-sectional study with data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015. Data were collected with a questionnaire that included the EuroQol 5 Dimensions (EQ-5D instrument. Patients from the five regions of Brazil were interviewed. Multiple linear regression was used to analyze their Health-Related Quality of Life and its associated factors. RESULTS Of the total of 8,590 patients, the most frequent dimensions were pain/discomfort (50.7% and anxiety/depression (38.8%. About 10% of the patients reported extreme problems in these dimensions. The following factors were significantly associated with a worse quality of life: being female; having arthritis, osteoarthritis, or rheumatism; cerebrovascular accident; heart disease; depression; health self-assessment as poor or very poor; drinking alcoholic beverages once or more per month; dieting to lose weight, avoiding salt consumption, and reducing fat intake. Significant association was observed between a better quality of life and: living in the North and Southeast regions of Brazil; practicing physical activities; and having a higher educational level. No association was observed with factors related to the health services. CONCLUSIONS The Health-Related Quality of Life of patients was influenced by demographic and socioeconomic factors that were related to health conditions and lifestyle, being useful to guide specific actions for promoting health and the integral care to patients of the Brazilian Unified Health System.

  6. Os significados atribuídos ao cuidar de pacientes com aids Caring for patients with aids

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    Maria Lúcia Araújo Sadala

    2000-03-01

    Full Text Available Este estudo apresenta o resultado de pesquisa envolvendo 27 profissionais da saúde, que atendem pacientes com aidsem enfermarias de isolamento, em Centro de Referência Regional para aids. Os dados do estudo, analisados e interpretados segundo a Fenomenologia Existencial, mostram a visão dos profissionais a respeito desse cuidado: trabalha-se com um paciente difícil, exigente, discriminado, embora deva ser visto como igual aos outros pacientes; o medo do contágio e o preconceito interferem na assistência e no relacionamento com este paciente; prejudicando a postura profissional; há a percepção a respeito dos efeitos deletérios do isolamento para os pacientes com aids, porém não se visualizam perspectivas para oferecer apoio efetivo. Os resultados sugerem a necessidade de implementar programas educativos e de apoio aos profissionais da área.This study presents the results of a research conducted with 27 health professionals caring for patients with aids on the isolation ward of a Regional Reference Center of aids. Data were analyzed and interpreted according to the Existential Phenomenology and demonstrate the view of professionals regarding to this type of caring for. This is a tough, demanding and discriminated patient who shoud be seen just like any other patient; the fear of contagion and prejudice interfere in the deliver of care and in the relationship with this patient, damaging the professional attitude. Although the deleterious effects of the isolation ward on patients are perceived, there are no signs of any perspectives of offering effective support to these patients. The results of the research suggest the need of introducing educational and supporting programas to professionals of this area.

  7. 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.

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

    International Nuclear Information System (INIS)

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

    1986-01-01

    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 [fr

  9. Sunitinib treatment in patients with advanced renal cell cancer: the Brazilian National Cancer Institute (INCA experience

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    Rafael Corrêa Coelho

    Full Text Available ABSTRACT Purpose: The aim of this study was to assess the impact of sunitinib treatment in a non-screened group of patients with metastatic renal cell cancer (mRCC treated by the Brazilian Unified Health System (SUS at a single reference institution. Material and Methods: Retrospective cohort study, which evaluated patients with mRCC who received sunitinib between May 2010 and December 2013. Results: Fifty-eight patients were eligible. Most patients were male 41 (71%, with a median age of 58 years. Nephrectomy was performed in 41 (71% patients with a median interval of 16 months between the surgery and initiation of sunitinib. The most prevalent histological subtype was clear cell carcinoma, present in 52 (91.2% patients. In 50 patients (86%, sunitinib was the first line of systemic treatment. The main adverse effects were fatigue (57%, hypothyroidism (43%, mucositis (33% and diarrhea (29%. Grade 3 and 4 adverse effects were infrequent: fatigue (12%, hypertension (12%, thrombocytopenia (7%, neutropenia (5% and hand-foot syndrome (5%. Forty percent of patients achieved a partial response and 35% stable disease, with a disease control rate of 75%. Median progression free survival was 7.6 months and median overall survival was 14.1 months. Conclusion: Sunitinib treatment was active in the majority of patients, especially those with low and intermediate risk by MSKCC score, with manageable toxicity. Survival rates were inferior in this non-screened population with mRCC treated in the SUS.

  10. KNOWLEDGE MANAGEMENT AND COLLABORATION EFFECTS: SOUTH-SOUTH NGO COLLABORATION: A CASE STUDY ON THE BRAZILIAN INTERDISCIPLINARY AIDS ASSOCIATION DOI:10.7444/fsrj.v4i1.107

    OpenAIRE

    Keeney, Grace

    2012-01-01

    In June 2008, the Brazilian Interdisciplinary AIDS Association (ABIA) and the Indian NGO SAHARA submitted a joint pre-grant opposition to the patent application of Tenofovir Disoproxil Fumarate in India. This joint action provides a pertinent case model of the potential effects of South-South cooperation between civil society groups. In this study, the aim sought to determine the practicality of the methodology and propositions developed in Resources, Knowledge and Influence: the Organizati...

  11. Indirect and direct costs of treating patients with ankylosing spondylitis in the Brazilian public health system.

    Science.gov (United States)

    Azevedo, Valderilio Feijó; Rossetto, Chayanne N; Lorencetti, Pedro G; Tramontin, Mariana Y; Fornazari, Bruna; Araújo, Denizar V

    2016-01-01

    Patients with ankylosing spondylitis require a team approach from multiple professionals, various treatment modalities for continuous periods of time, and can lead to the loss of labour capacity in a young population. So, it is necessary to measure its socio-economic impact. To describe the use of public resources to treat AS in a tertiary hospital after the use of biological medications was approved for treating spondyloarthritis in the Health Public System, establishing approximate values for the direct and indirect costs of treating this illness in Brazil. 93 patients selected from the ambulatory spondyloarthritis clinic at the Hospital de Clínicas of the Federal University of Paraná between September 2011 and September 2012 had their direct costs indirect treatment costs estimation. 70 patients (75.28%) were male and 23 (24.72%) female. The mean age was 43.95 years. The disease duration was calculated based on the age of diagnosis and the mean was 8.92 years (standard deviation: 7.32); 63.44% were using anti-tumour necrotic factor drugs. Comparing male and female patients the mean Bath Ankylosing Spondylitis Disease Activity Index was 4.64 and 5.49 while the mean Bath Ankylosing Spondylitis Functional Index was 5.03 and 6.35 respectively. The Brazilian public health system's spending related to ankylosing spondylitis has increased in recent years. An important part of these costs is due to the introduction of new, more expensive health technologies, as in the case of nuclear magnetic resonance and, mainly, the incorporation of anti-tumour necrotic factor therapy into the therapeutic arsenal. The mean annual direct and indirect cost to the Brazilian public health system to treat a patient with ankylosing spondylitis, according to our findings, is US$ 23,183.56. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  12. Common N-acetylgalactosamine-6-sulfate sulfatase (GALNS exon mutations in Brazilian patients with mucopolysaccharidosis IVA (MPS IVA

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    Tatiana Dieter

    2007-01-01

    Full Text Available Morquio A Syndrome (mucopolysaccharidosis IVA - MPS IVA, OMIM# 253000 is an autosomal recessive inborn error of metabolism caused by the deficiency of N-acetylgalactosamine-6-sulfate sulfatase (GALNS. We investigated five unrelated Brazilian MPS IVA families for mutations in exons 4, 5, 9 and 10 of the GALNS gene. Six out of the 10 mutant alleles were identified. Taken together with a previous study, which included six unrelated families, common mutations among Brazilian patients were p.N164T, p.G116S and p.G301C. Among one hundred control subjects three novel silent mutations were found (p.A107A; GCC -> GCT, p.Y108Y; TAC -> TAT, p.P357P; CCG -> CCA. Screening starting with exons 4, 5, 9, 10 and 11 may be a good strategy for genotyping of Brazilian patients since these exons include 73% of all mutations identified in the current and previous studies.

  13. Food insecurity of HIV/AIDS patients at a unit of outpatient healthcare system in Brasilia, Federal District, Brazil.

    Science.gov (United States)

    Charão, Ana Paula Sarmento; Batista, Meyre Hellen Ribeiro E Silva; Ferreira, Luzitano Brandão

    2012-12-01

    Food security remains to be one of the world's biggest problems and is found to be related to HIV/AIDS. The objective was to examine food insecurity in HIV/AIDS patients from Brasilia, Brazil. Short version of the Food Security Scale was applied to patients with HIV/AIDS. A total of 103 patients participated (65 HIV+ and 38 with AIDS). Food insecurity was found in 33.8% of HIV+ patients and 36.8% of patients with AIDS. A relation between food insecurity and low educational and social levels was established. Food security should be an important component in HIV/AIDS treatment programs.

  14. Poder inteligente: a questão do HIV/AIDS na política externa Brasileira Smart power: the issue of HIV/AIDS in Brazilian foreign policy

    Directory of Open Access Journals (Sweden)

    Alex Giacomelli da Silva

    2005-06-01

    Full Text Available O autor discute a faceta internacional da política brasileira sobre HIV/AIDS e sua relação com outras áreas da política externa, como propriedade intelectual e direitos humanos. Para isso, utiliza-se dos conceitos de Joseph Nye Jr. de soft power e hard power. Este reflete a capacidade de um ator fazer com que outros sigam sua posição, mesmo contra a vontade. Aquele consiste na capacidade de um ator atrair outros livremente para sua posição. O ensaio analisa a importância, nas relações internacionais, dos meios de comunicação, das ONGs, da opinião pública e das instituições interestatais, que não somente possuem soft power próprio, mas também desempenham papel relevante no fortalecimento do soft power dos países. O autor avalia a influência desse tipo de poder nas relações entre o Brasil e os Estados Unidos, bem como em foros multilaterais como as Nações Unidas e a Organização Mundial do Comércio. O artigo analisa, igualmente, o papel do hard power nas relações internacionais e avalia por que os países não podem dispensá-lo. Embora o soft power venha de fato tornando-se cada vez mais importante nos últimos anos, a combinação dos dois tipos de poder continua sendo a política mais correta a ser seguida. A política externa brasileira de HIV/AIDS constitui exemplo ilustrativo.The paper discusses the international facet of the Brazilian policy on HIV/AIDS and its connection to other areas of foreign relations, such as intellectual property rights and human rights. In so doing, it takes into account Joseph Nye Jr. concepts of soft and hard power. The latter reflects the capacity of making others follow one's position, albeit against their will. The former consists in the capacity of freely attracting others to one's position. The author analyses the importance of the media, the nongovernmental organizations, the public opinion, and the international institutions in foreign affairs. Not only do they possess soft

  15. Mutations of Bruton's tyrosine kinase gene in Brazilian patients with X-linked agammaglobulinemia

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    V.D. Ramalho

    2010-09-01

    Full Text Available Mutations in Bruton's tyrosine kinase (BTK gene are responsible for X-linked agammaglobulinemia (XLA, which is characterized by recurrent bacterial infections, profound hypogammaglobulinemia, and decreased numbers of mature B cells in peripheral blood. We evaluated 5 male Brazilian patients, ranging from 3 to 10 years of age, from unrelated families, whose diagnosis was based on recurrent infections, markedly reduced levels of IgM, IgG and IgA, and circulating B cell numbers <2%. BTK gene analysis was carried out using PCR-SSCP followed by sequencing. We detected three novel (Ala347fsX55, I355T, and Thr324fsX24 and two previously reported mutations (Q196X and E441X. Flow cytometry revealed a reduced expression of BTK protein in patients and a mosaic pattern of BTK expression was obtained from mothers, indicating that they were XLA carriers.

  16. Mutations of Bruton's tyrosine kinase gene in Brazilian patients with X-linked agammaglobulinemia.

    Science.gov (United States)

    Ramalho, V D; Oliveira Júnior, E B; Tani, S M; Roxo Júnior, P; Vilela, M M S

    2010-09-01

    Mutations in Bruton's tyrosine kinase (BTK) gene are responsible for X-linked agammaglobulinemia (XLA), which is characterized by recurrent bacterial infections, profound hypogammaglobulinemia, and decreased numbers of mature B cells in peripheral blood. We evaluated 5 male Brazilian patients, ranging from 3 to 10 years of age, from unrelated families, whose diagnosis was based on recurrent infections, markedly reduced levels of IgM, IgG and IgA, and circulating B cell numbers <2%. BTK gene analysis was carried out using PCR-SSCP followed by sequencing. We detected three novel (Ala347fsX55, I355T, and Thr324fsX24) and two previously reported mutations (Q196X and E441X). Flow cytometry revealed a reduced expression of BTK protein in patients and a mosaic pattern of BTK expression was obtained from mothers, indicating that they were XLA carriers.

  17. The Brazilian Registry of Adult Patient Undergoing Cardiovascular Surgery, the BYPASS Project: Results of the First 1,722 Patients.

    Science.gov (United States)

    Gomes, Walter J; Moreira, Rita Simone; Zilli, Alexandre Cabral; Bettiati, Luiz Carlos; Figueira, Fernando Augusto Marinho Dos Santos; D' Azevedo, Stephanie Steremberg Pires; Soares, Marcelo José Ferreira; Fernandes, Marcio Pimentel; Ardito, Roberto Vito; Bogdan, Renata Andrea Barberio; Campagnucci, Valquíria Pelisser; Nakasako, Diana; Kalil, Renato Abdala Karam; Rodrigues, Clarissa Garcia; Rodrigues, Anilton Bezerra; Cascudo, Marcelo Matos; Atik, Fernando Antibas; Lima, Elson Borges; Nina, Vinicius José da Silva; Heluy, Renato Albuquerque; Azeredo, Lisandro Gonçalves; Henrique, Odilon Silva; Mendonça, José Teles de; Silva, Katharina Kelly de Oliveira Gama; Pandolfo, Marcelo; Lima, José Dantas de; Faria, Renato Max; Santos, Jonas Pereira Dos; Paez, Rodrigo Pereira; Coelho, Guilherme Henrique Biachi; Pereira, Sergio Nunes; Senger, Roberta; Buffolo, Enio; Caputi, Guido Marco; Santo, José Amalth do Espírito; Oliveira, Juliana Aparecida Borges de; Berwanger, Otavio; Cavalcanti, Alexandre Biasi; Jatene, Fabio B

    2017-01-01

    To report the early results of the BYPASS project - the Brazilian registrY of adult Patient undergoing cArdiovaScular Surgery - a national, observational, prospective, and longitudinal follow-up registry, aiming to chart a profile of patients undergoing cardiovascular surgery in Brazil, assessing the data harvested from the initial 1,722 patients. Data collection involved institutions throughout the whole country, comprising 17 centers in 4 regions: Southeast (8), Northeast (5), South (3), and Center-West (1). The study population consists of patients over 18 years of age, and the types of operations recorded were: coronary artery bypass graft (CABG), mitral valve, aortic valve (either conventional or transcatheter), surgical correction of atrial fibrillation, cardiac transplantation, mechanical circulatory support and congenital heart diseases in adults. 83.1% of patients came from the public health system (SUS), 9.6% from the supplemental (private insurance) healthcare systems; and 7.3% from private (out-of -pocket) clinic. Male patients comprised 66%, 30% were diabetics, 46% had dyslipidemia, 28% previously sustained a myocardial infarction, and 9.4% underwent prior cardiovascular surgery. Patients underwent coronary artery bypass surgery were 54.1% and 31.5% to valve surgery, either isolated or combined. The overall postoperative mortality up to the 7th postoperative day was 4%; for CABG was 2.6%, and for valve operations, 4.4%. This first report outlines the consecution of the Brazilian surgical cardiac database, intended to serve primarily as a tool for providing information for clinical improvement and patient safety and constitute a basis for production of research protocols.

  18. Root caries prevalence in a group of Brazilian adult dental patients

    Directory of Open Access Journals (Sweden)

    Watanabe Marlívia G.C.

    2003-01-01

    Full Text Available The aim of this study was to measure the caries prevalence in the root surface in a group of Brazilian adults. The prevalence and their intraoral distribution of caries lesions of root surface were assessed in dental patients ranging in age from 35 to 44 and from 50 to 59 years of age of both sexes (n=360. A total of 98.9% had root surfaces with gingival recession and 78.1% had at least one root caries lesion. The prevalence of the disease was analyzed using the Root Caries Index (RCI. The average value was greater for women (18.6% than for men (13.4% (p0.01. The maxillary canines and first premolars and the mandibular molars presented the greatest RCI values. The RCI was greater in the proximal surface of the maxilla and buccal surface of the mandible. We conclude that caries of the root surface are present in the Brazilian population and deserve attention concerning their actual role in the epidemiology of principal oral diseases of the adult population.

  19. Nursing research on a first aid model of double personnel for major burn patients.

    Science.gov (United States)

    Wu, Weiwei; Shi, Kai; Jin, Zhenghua; Liu, Shuang; Cai, Duo; Zhao, Jingchun; Chi, Cheng; Yu, Jiaao

    2015-03-01

    This study explored the effect of a first aid model employing two nurses on the efficient rescue operation time and the efficient resuscitation time for major burn patients. A two-nurse model of first aid was designed for major burn patients. The model includes a division of labor between the first aid nurses and the re-organization of emergency carts. The clinical effectiveness of the process was examined in a retrospective chart review of 156 cases of major burn patients, experiencing shock and low blood volume, who were admitted to the intensive care unit of the department of burn surgery between November 2009 and June 2013. Of the 156 major burn cases, 87 patients who received first aid using the double personnel model were assigned to the test group and the 69 patients who received first aid using the standard first aid model were assigned to the control group. The efficient rescue operation time and the efficient resuscitation time for the patients were compared between the two groups. Student's t tests were used to the compare the mean difference between the groups. Statistically significant differences between the two groups were found on both measures (P's first aid model based on scientifically validated procedures and a reasonable division of labor can shorten the efficient rescue operation time and the efficient resuscitation time for major burn patients. Given these findings, the model appears to be worthy of clinical application.

  20. Nature of depression in patients with HIV/AIDS.

    Science.gov (United States)

    Judd, Fiona; Komiti, Angela; Chua, Phyllis; Mijch, Anne; Hoy, Jennifer; Grech, Paul; Street, Alan; Lloyd, John; Williams, Ben

    2005-09-01

    Existing research suggests that the rate of depressive illness and depressive symptoms are high in people living with HIV/AIDS, but investigations on the causes of depression provide conflicting results. Social, psychological and biological factors have all been suggested as possible causes of depression in people living with HIV/AIDS. The suggestion that depression may be the result of the neurotropic effects of the virus on the central nervous system leading to an 'organic' or secondary depression has major implications in the treatment of HIV/AIDS. The aim of the current study was to further investigate the nature and underlying aetiology of depression in people living with HIV/AIDS. One hundred and twenty-nine people living with HIV/AIDS recruited for the study from outpatients clinics and primary care settings completed a range of self-report symptom measures including the Beck Depression Inventory (BDI), SF-36, SPHERE and a personality measure, the NEO Personality Inventory (NEO-PI). They also completed a battery of neuropsychological tests (CANTAB) and a structured clinical interview (SCID-DSM-IV). Medical and sociodemographic data were also recorded. Approximately one-third scored > or = 14 on the BDI and 27% met criteria for a current 'mood disorder' on the SCID. Depressive symptoms were strongly related to personality style, having a past psychiatric history and current stressful psychosocial situation. There was no association between depression and HIV disease status. There was no evidence in this study cohort of a distinct subtype of 'organic' or secondary depression. These results suggest that at least for 'well' people living with HIV/AIDS, there is no distinct subtype of depression and early treatment approaches can be modelled on those used for other non-HIV groups. Further longitudinal studies will be required to dissect out the multiple factors underlying depression in HIV/AIDS.

  1. Retinocoroidite toxoplásmica em pacientes com AIDS e neurotoxoplasmose Toxoplasmic retinochoroiditis in patients with AIDS and neurotoxoplasmosis

    Directory of Open Access Journals (Sweden)

    Jane Mary Alves

    2010-04-01

    Full Text Available OBJETIVO: A neurotoxoplasmose é a alteração do sistema nervoso central mais frequente observada em pacientes com AIDS. A ocorrência de toxoplasmose ocular em neurotoxoplasmose ainda é pouco estudada. O objetivo deste estudo foi de investigar a ocorrência de retinocoroidite toxoplásmica, típica ou provável, em pacientes com AIDS e neurotoxoplasmose. MÉTODOS: Foi desenvolvido estudo prospectivo, tipo série de casos incluindo 70 pacientes, de ambos os sexos, com idade variando de 20 a 63 anos, internados nas enfermarias de três hospitais públicos da cidade do Recife, Pernambuco, com tais diagnósticos firmados segundo os critérios do CDC (1992, no período de janeiro a outubro de 2008. Os pacientes caracterizavam-se por: primeiro episódio de neurotoxoplasmose (65; 92,9% ou recidiva (5; 7,1%; desconhecimento de ter AIDS (23; 32,9%, contagem média de linfócitos T CD4 de 139,8 ± 3,04 células/mm³ e carga viral média igual a 137.080 ± 39.380 cópias/mL. Todos os pacientes foram submetidos a exame oftalmológico, consistindo de: inspeção ocular; aferição da acuidade visual; investigação da função muscular extrínseca ocular e fundoscopia, empregando oftalmoscópio indireto binocular (modelo OHN 3.5 (Eyetec® e lente externa de 20 dioptrias (Volk®. RESULTADOS: Foram diagnosticados 4 (5,7% pacientes com lesões cicatriciais de retinocoroidite, características de toxoplasmose ocular, sendo típica em 3 (75% pacientes e bilateral em 1. Não houve qualquer caso de retinocoroidite ativa, típica ou provável. As lesões oculares ativas foram raras comparadas às lesões cicatriciais, as quais se associam à presença de cistos na retina. CONCLUSÃO: Recomenda-se que mesmo lesões cicatriciais sejam valorizadas em pacientes com AIDS.PURPOSE: Neurotoxoplasmosis is the most common central nervous system disorder in patients with AIDS. The occurrence of ocular toxoplasmosis in neurotoxoplasmosis is not well studied. The objective of

  2. Proportion of Brazilian diabetes patients that achieve treatment goals: implications for better quality of care.

    Science.gov (United States)

    Baptista, Deise Regina; Thieme, Rubia Daniela; Reis, Walleri Christini Torelli; Pontarolo, Roberto; Correr, Cassyano Januário

    2015-01-01

    Diabetes and its complications are substantial causes of morbidity and mortality, and caused approximately 5.1 million deaths worldwide in 2013. Early detection and treatment of diabetes complications can prevent their progression. This study compared the proportions of patients with type 1 and 2 diabetes mellitus (T1DM and T2DM, respectively) who achieved the goals of good clinical control. Adults and elderly patients with T1DM and T2DM at a public outpatient endocrinology service in Brazil were retrospectively evaluated between 2012 and 2013. Clinical and socio demographic data were obtained from medical records and evaluated in accordance with the Brazilian Diabetes Society Guidelines. Care process measures, outcomes indicators, and supporting process measures were evaluated. A total of 1031 records were analyzed: 29 and 71 % of patients had T1DM and T2DM, respectively. T2DM patients had significantly higher BMI than T1DM patients (overweight and obesity in 85.1 vs. 47.5 %, p achieved all targets, and 1.1 % did not achieve any. The achievement of goals of good clinical practice varies among the parameters evaluated. Almost no patients achieved all targets. Many patients are overweight and do not achieve targets for HbA1c, lipid profile, or blood pressure control.

  3. [Evaluation of promoting the oral cavity health measures of rural AIDS patients/HIV-carriers].

    Science.gov (United States)

    Tao, Wei; Jiang, Yong

    2011-05-01

    To survey the status of oral cavity hygiene knowledge, attitude and practice (KAP) of rural acquired immunodeficiency syndrome (AIDS) patients and human immunodeficiency virus (HIV) carriers and take corresponding intervention measures to improve the oral health of these patients. From May to August in 2009, the methods of anonymous face to face structured interview and oral examination at the scene were carried out at the baseline in rural AIDS patients/HIV-carriers. According to the results of the survey, intervention measures were taken. The results of the intervention and the oral hygiene status were compared before and after the intervention. The oral health status of 82 AIDS patients and HIV-carriers were in poor before the intervention, and the knowledge of AIDS-related oral health of 76 AIDS patients and HIV-carriers was promoted after interventions, "scaling can spread AIDS" were 22 cases (27%), and after the intervention 41 patients (54%) think that can spread (χ(2) = 20.066, P oral diseases of related AIDS were decreased dramatically, 68 patients (83%) had gingivitis before intervention and 47 cases (62%) after the intervention (χ(2) = 8.852, P = 0.003). The personal oral cavity hygiene and related oral KAP of AIDS caused by subjective factors had improved to different extent, "brushing teeth over 3 min at every turn", there were over 36 cases (44%) before intervention and 45 patients after intervention (59%) (χ(2) = 4.017, P = 0.045). The oral hygiene and KAP of AIDS patients and HIV-carriers in rural areas were poor and improved after intervention.

  4. Validation of the Perceived Stigmatization Questionnaire for Brazilian adult burn patients

    Science.gov (United States)

    Forero, Carlos García; Caltran, Marina Paes; Alonso, Jordi; Dantas, Rosana A. Spadoti; Piccolo, Monica Sarto; Farina, Jayme Adriano; Lawrence, John W.; Rossi, Lidia A.

    2018-01-01

    Currently, there is no questionnaire to assess perceived stigmatization among people with visible differences in Brazil. The Perceived Stigmatization Questionnaire (PSQ), developed in the United States, is a valid instrument to assess the perception of stigmatizing behaviours among burn survivors. The objective of this cross-sectional and multicentre study was to assess the factor structure, reliability and validity of the Brazilian Portuguese version of the PSQ in burn patients. A Brazilian version of the 21-item PSQ was answered by 240 adult burn patients, undergoing rehabilitation in two burns units in Brazil. We tested its construct validity by correlating PSQ scores with depression (Beck Depression Index-BDI) and self-esteem (Rosenberg Self-Esteem Scale-RSE), as well as with two domains of the Revised Burn Specific Health Scale—BSHS-R: affect and body image, and interpersonal relationships. We used Confirmatory Item Factor Analysis (CIFA) to test whether the data fit a measurement model involving a three-factor structure (absence of friendly behaviour; confusing/staring behaviour; and hostile behaviour). We conducted Exploratory Factor Analyses (EFA) of the subscale in a 50% random sample of individuals (training split), treating items as ordinal categorical using unweighted least squares estimation. To assess discriminant validity of the Brazilian version of the PSQ we correlated PSQ scores with known groups (sex, total body surface area burned, and visibility of the scars) and assessed its reliability by means of Cronbach's alpha and using test-retest. Goodness-of-fit indices for confirmatory factor analysis were satisfactory for the PSQ, but not for the hostile behaviour subscale, which was modified to improve fit by eliminating 3 items. Cronbach’s alphas for the PSQ refined version (PSQ-R) ranged from 0.65 to 0.88, with test-retest reliability 0.87 for the total score. The PSQ-R scores correlated strongly with depression (0.63; p self-esteem (-0.57; p

  5. 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.

  6. [Identification of Cryptosporidium hominis in a patient with sclerosing cholangitis and AIDS].

    Science.gov (United States)

    Carnevale, Silvana; Néstor Velásquez, Jorge; Marta, Edgardo; Germán Astudillo, Osvaldo; Etchart, Cristina; Víctor Chertcoff, Agustín; Di Risio, Cecilia

    2010-09-01

    Cryptosporidium hominis (C hominis) is the most common protozoan parasite recognized in human patients with AIDS. We report the clinical features of a patient with chronic diarrhea and AIDS-related sclerosing cholangitis. The imaging studies with ultrasonography and endoscopic retrograde cholangiopancreatography disclosed intrahepatic and extrahepatic bile duct changes identical to those seen in sclerosing cholangitis. C hominis was detected in the duodenum and peri-papillary duodenum by means of light microscopy and confirmed by nested polymerase chain reaction (PCR) amplification from fresh biopsy specimens followed by restriction length polymorphism analysis. Chominis infection should be suspected in our country in patients with advanced immunodeficiency and AIDS-related sclerosing cholangitis.

  7. Clinical and genetic analysis of 29 Brazilian patients with Huntington's disease-like phenotype

    Directory of Open Access Journals (Sweden)

    Guilherme Riccioppo Rodrigues

    2011-06-01

    Full Text Available Huntington's disease (HD is a neurodegenerative disorder characterized by chorea, behavioral disturbances and dementia, caused by a pathological expansion of the CAG trinucleotide in the HTT gene. Several patients have been recognized with the typical HD phenotype without the expected mutation. The objective of this study was to assess the occurrence of diseases such as Huntington's disease-like 2 (HDL2, spinocerebellar ataxia (SCA 1, SCA2, SCA3, SCA7, dentatorubral-pallidoluysian atrophy (DRPLA and chorea-acanthocytosis (ChAc among 29 Brazilian patients with a HD-like phenotype. In the group analyzed, we found 3 patients with HDL2 and 2 patients with ChAc. The diagnosis was not reached in 79.3% of the patients. HDL2 was the main cause of the HD-like phenotype in the group analyzed, and is attributable to the African ancestry of this population. However, the etiology of the disease remains undetermined in the majority of the HD negative patients with HD-like phenotype.

  8. Antiendomysium antibodies in brazilian patients with celiac disease and their first-degree relatives

    Directory of Open Access Journals (Sweden)

    KOTZE Lorete Maria da Silva

    2001-01-01

    Full Text Available Background - Literature data have shown high specificity of antiendomysial antibodies (EmA IgA in celiac disease. The scarcity of Brazilian reports concerning this subject motivated the present study. Objectives - To determine the sensitivity and specificity of antiendomysial IgA antibodies in Brazilian celiac patients at diagnosis and after treatment, to confirm patient adherence to a gluten-free diet and to screen first-degree relatives. Methods - An extensive clinical and serological study was performed by investigating the presence of these antibodies in 392 individuals from Southern Brazil. Indirect immunofluorescence using human umbilical cord as substrate was employed and the total levels of IgA were determined by turbidimetry in all groups. The study was conducted on 57 celiac patients (18 at diagnosis, 24 who adhered to a gluten-free diet and 15 with marked or slight transgression of the diet, 115 relatives of celiac patients (39 families, 94 patients with other gastrointestinal diseases, and 126 healthy individuals from the general population. Results - The results demonstrated 100% positivity for the recently diagnosed patients and for those consuming gluten, in contrast to the patients who complied with the diet (0%. In the control group one individual was positive, but refused to undergo a biopsy. In the group of other gastrointestinal diseases, one positive patient presented ulcerative colitis, Down's syndrome and epilepsy, and the intestinal biopsy was diagnostic for celiac disease. These data showed 99.3% specificity for the test. Eighteen relatives were positive for antiendomysial antibodies IgA (15.65%, and comparison with the healthy population revealed a significant difference. An intestinal biopsy was obtained from seven subjects (one with total villous atrophy and six withouth alterations in the mucosal architecture, but all with a high number of intra-epithelial lymphocytes. Conclusions - The method revealed 100

  9. [Crusted scabies in HIV/AIDS infected patients. Report of 15 cases].

    Science.gov (United States)

    Tirado-Sánchez, Andrés; Bonifaz, Alexandro; Montes de Oca-Sánchez, Griselda; Araiza-Santibañez, Javier; Ponce-Olivera, Rosa María

    2016-01-01

    Crusted (Norwegian) scabies is a rare disease that occurs in patients with compromised immune system like patients with HIV/AIDS. We report 15 cases of crusted scabies in patients with HIV/AIDS successfully treated with oral ivermectin. The mean age of the patients was 43.7±8.06 and the diagnosis was made at a median of 5 months. All patients were diagnosed with HIV/AIDS treatment with antiretroviral therapy. Patients were treated with repeated doses of oral ivermectin with different schemes with good tolerance and efficacy with full resolution and without recurrence. Ivermectin is the treatment of choice for crusted scabies; it is tolerable and accessible to the patient. Immunosuppressed patients are those with the highest risk of acquiring that disease; we highlight the importance of lesion scraping to perform a correct and early diagnosis.

  10. Genetic variability of Candida albicans in HIV/AIDS patient with and without ARV therapy and non HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Retno Puji Rahayu

    2012-03-01

    Full Text Available Background: Oral candidiasis is the mostly found oral manifestation in HIV/AIDS infected patient caused by immunocompromised especially immunodeficiency. Clinical symptoms is severe pain in oral cavity and dry mouth because of xerostomia which cause the loss of appetite. Candida albicans (C. albicans is normal flora in oral cavity which plays as opportunistic pathogen and also the cause of oral candidiasis. Almost 90% of HIV–infected patient have oral candidiasis. This condition is clinical problem which has not been well-managed yet. C. albicans colonized oral mucous cavity has different genetic variability for each strain. Phenotype of C. albicans has been determined by genetic factor and environtment. This condition stimulate differences of genotype among various strain of C. albicans in the world. Purpose: The purpose of this research is to analyze the genetic variability of C.albicans which colonized in the mucous oral cavity of HIV/AIDS patient in Surabaya in the treatment with and without ARV therapy and non HIV/AIDS. Methods: This research has been identify and characterize the prevalent strain of C. albicans isolat in Surabaya (East Java in HIV/AIDS infected patient with oral candidiasis by method of Iatron candidal check. The highlight of this research including cytology examination by Papanicoloau staining, C. albicans culture, spheroplast making, DNA isolation and genetic variability checking by randomly amplyfied polymorphism DNA (RAPD. Results: C. albicans colonizing oral mucosa of non-HIV patients had a predisposition of farther genetic relationship (genetic distance of 0.452 with C. albicans colonizing oral mucosa of HIV ARV and HIV non-ARV patients. The genetic distance was ranging between 0 and 1, where 9 was long genetic distance and 1 was short genetic distance. In contrast, C. albicans colonizing oral mucosa of HIV ARV have predisposition of closer genetic relationship (genetic distance of 0.762 with C. albicans colonizing

  11. Validation of the Perceived Stigmatization Questionnaire for Brazilian adult burn patients.

    Science.gov (United States)

    Freitas, Noélle de Oliveira; Forero, Carlos García; Caltran, Marina Paes; Alonso, Jordi; Dantas, Rosana A Spadoti; Piccolo, Monica Sarto; Farina, Jayme Adriano; Lawrence, John W; Rossi, Lidia A

    2018-01-01

    Currently, there is no questionnaire to assess perceived stigmatization among people with visible differences in Brazil. The Perceived Stigmatization Questionnaire (PSQ), developed in the United States, is a valid instrument to assess the perception of stigmatizing behaviours among burn survivors. The objective of this cross-sectional and multicentre study was to assess the factor structure, reliability and validity of the Brazilian Portuguese version of the PSQ in burn patients. A Brazilian version of the 21-item PSQ was answered by 240 adult burn patients, undergoing rehabilitation in two burns units in Brazil. We tested its construct validity by correlating PSQ scores with depression (Beck Depression Index-BDI) and self-esteem (Rosenberg Self-Esteem Scale-RSE), as well as with two domains of the Revised Burn Specific Health Scale-BSHS-R: affect and body image, and interpersonal relationships. We used Confirmatory Item Factor Analysis (CIFA) to test whether the data fit a measurement model involving a three-factor structure (absence of friendly behaviour; confusing/staring behaviour; and hostile behaviour). We conducted Exploratory Factor Analyses (EFA) of the subscale in a 50% random sample of individuals (training split), treating items as ordinal categorical using unweighted least squares estimation. To assess discriminant validity of the Brazilian version of the PSQ we correlated PSQ scores with known groups (sex, total body surface area burned, and visibility of the scars) and assessed its reliability by means of Cronbach's alpha and using test-retest. Goodness-of-fit indices for confirmatory factor analysis were satisfactory for the PSQ, but not for the hostile behaviour subscale, which was modified to improve fit by eliminating 3 items. Cronbach's alphas for the PSQ refined version (PSQ-R) ranged from 0.65 to 0.88, with test-retest reliability 0.87 for the total score. The PSQ-R scores correlated strongly with depression (0.63; p validity comparable to the

  12. 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...

  13. SIMULTANEOUS INFECTION WITH DENGUE 1 AND 2 IN A BRAZILIAN PATIENT

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    ROCCO Iray Maria

    1998-01-01

    Full Text Available Dengue outbreaks have occurred in several Brazilian States since 1986 involving serotypes 1 (DEN-1 and 2 (DEN-2. In view of the few cases of double infection documented in the literature, we report here a case of simultaneous infection with DEN-1 and DEN-2 in a patient residing in the municipality of Miranda, State of Mato Grosso do Sul, Western region of Brazil. DEN-1 was introduced in this State in 1989 and DEN-2 in 1996, both of them circulating in some municipalities. This double infection was identified by virus isolation and by indirect immunofluorescence using monoclonal antibodies and confirmed by the polymerase chain reaction (PCR. This is the first documented case of simultaneous infection with serotypes DEN-1 and DEN-2 in Brazil.

  14. Community Based Organizations in HIV/AIDS Prevention, Patient ...

    African Journals Online (AJOL)

    The main objective of this review is to provide a preliminary evaluation of the suitability of community-based organizations (CBOs) to contribute to HIV/AIDS prevention, care/support and control programs in Ethiopia. In order to put CBOs and programs in the context of HIV transmission and spread, the role of the Multisectoral ...

  15. Kaposi's sarcoma involving the thyroid in a patient with AIDS

    International Nuclear Information System (INIS)

    Krauth, P.H.; Katz, J.F.

    1987-01-01

    A 30-year-old man with acquired immune deficiency syndrome (AIDS) and Kaposi's sarcoma had a palpable thyroid mass and cervical lymphadenopathy. Nuclear medicine and ultrasound scans revealed multiple thyroid nodules. Results of biopsy showed Kaposi's sarcoma metastatic to the thyroid

  16. Perceptions of HIV, AIDS and tuberculosis among patients on ...

    African Journals Online (AJOL)

    The objectives of the research were to explore perceptions of HIV, AIDS and tuberculosis (TB) among individuals enrolled in antiretroviral therapy (ART) at two ... The freelist data were analysed using multidimensional scaling and hierarchical clustering, and the interview data were analysed using the grounded theory ...

  17. Perceptions of HIV, AIDS and tuberculosis among patients on ...

    African Journals Online (AJOL)

    The objectives of the research were to explore perceptions of HIV, AIDS and tuberculosis (TB) among individuals enrolled in antiretroviral therapy (ART) at two municipal clinics in Bulawayo, Zimbabwe, and to assess the implications of these perceptions on the provision of HIV and TB care services. Data were collected ...

  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. Prevalence of factor VII deficiency and molecular characterization of the F7 gene in Brazilian patients.

    Science.gov (United States)

    Rodrigues, Dalva N; Siqueira, Lucia H; Galizoni, Andréa M; Arruda, Valder R; Annichino-Bizzacchi, Joyce M

    2003-04-01

    The prevalence of factor VII (FVII) deficiency in 267 Brazilian patients was estimated to be 4.1%, including one patient with significant bleeding, five with minor bleeding and five patients asymptomatic. Only one novel mutation 8926G F7 polymorphisms and FVII activity were found in these patients, as those with higher levels of FVII activity presented the genotype described in the literature as related to reduced FVII activity. As the R304Q mutation was the most frequent in these patients, and may be associated with an asymptomatic form of the disease, particularly in Blacks, we examined this mutation and FVII activity in 49 Blacks and 49 Caucasian blood donors with no clinical bleeding. None of the individuals showed the R304Q mutation, and FVII activity was normal in all of them, thus indicating that FVII deficiency is not common in normal individuals of these two ethnic groups in Brazil. This is the first study in South America to examine the prevalence and molecular basis of FVII deficiency, including the description of a novel mutation.

  20. Niemann-Pick disease type C: a case series of Brazilian patients

    Directory of Open Access Journals (Sweden)

    Paulo José Lorenzoni

    2014-03-01

    Full Text Available The aim of the study was to analyze a series of Brazilian patients with Niemann-Pick disease type C (NP-C. Method Correlations between clinical findings, laboratory data, molecular findings and treatment response are presented. Result The sample consisted of 5 patients aged 8 to 26 years. Vertical supranuclear gaze palsy, cerebellar ataxia, dementia, dystonia and dysarthria were present in all cases. Filipin staining showed the “classical” pattern in two patients and a “variant” pattern in three patients. Molecular analysis found mutations in the NPC1 gene in all alleles. Miglustat treatment was administered to 4 patients. Conclusion Although filipin staining should be used to confirm the diagnosis, bone marrow sea-blue histiocytes often help to diagnosis of NP-C. The p.P1007A mutation seems to be correlated with the “variant” pattern in filipin staining. Miglustat treatment response seems to be correlated with the age at disease onset and disability scale score at diagnosis.

  1. Mineral inadequacy of oral diets offered to patients in a Brazilian hospital.

    Science.gov (United States)

    Moreira, D C F; de Sá, J S M; Cerqueira, I B; Oliveira, A P F; Morgano, M A; Amaya-Farfan, J; Quintaes, K D

    2012-01-01

    While enteral diets for hospitalized patients normally follow nutrient composition guidelines, more than 90% of hospitalized patients receive oral diets with unknown mineral composition. To evaluate the mineral contents and adequacy of three types of oral diets (regular, blend and soft) and complementary snacks offered to patients of a Brazilian hospital. The amount of minerals was determined in two non-consecutive days in duplicate samples of breakfast, collation, lunch, snack, dinner, supper and a complementary snack meal. Dietary Reference Intakes (DRIs) were used to determine the adequacy of the daily amounts served to patients. The regular diet met the RDA (Recommended Dietary Allowances) requirements only for Mn, P and Se, while the blend diet was deficient in Ca, K and Mg, and the soft diet met RDA requirements only for P and Zn. Iron was below the RDA requirement in all diets for women in fertile age, and Na was above the safe limit of intake (UL) in all the diets. The use of complementary snack was effective in meeting RDA requirements for Cu in the regular diet, and Mn and Se in the soft diet, but promoted overconsumption of Na. Evident nutritional imbalances have been detected at a key interphase between nutrition and public health services, but a solution does not appear to be insurmountable. A permanent nutritional evaluation of hospital oral diets should be an integral part of routine health care in order to speed the recovery of the hospitalized patient and dispel eventual risks due to critical mineral imbalances.

  2. A recent increase in AIDS at Lyon University Hospitals: patient characteristics and comparisons with previous years.

    Science.gov (United States)

    Baratin, D; Marceillac, E; Trepo, C; Cotte, L; Peyramond, D; Chidiac, C; Touraine, J L; Livrozet, J M; Fabry, J; Vanhems, P

    2006-01-01

    A 36% increase in the incidence of AIDS was observed in 2002/2003 compared with 2000/2001 at Lyon University Hospitals. We compared the characteristics of these patients with the characteristics of those diagnosed previously with AIDS. Data for all patients with AIDS diagnosed at Lyon University Hospitals were analyzed. The data were collected prospectively. Multiple logistic regression was used for analysis. The variables independently associated with an AIDS diagnosis in 2002/2003 compared with the 1985-1989 period were: homosexual exposure [odds ratio (OR) 0.4; 95% confidence interval (CI) 0.2-0.8]; heterosexual exposure in an endemic area (OR 22.5; 95% CI 6.8-74.8), compared with other exposure to HIV; lymphoma as initial AIDS event (OR 10.3; 95% CI 2.7-39.1) compared with Pneumocystis carinii pneumonia; and age at first AIDS event aged 34-38 years (OR 2.5; 95% CI 1.0-6.4), aged 39-46 years (OR 5.1; 95% CI 2.2-11.8), and aged 47-84 years (OR 10.6; 95% CI 4.5-25.1) compared with aged <30 years. The variables independently associated with an AIDS diagnosis in 2002/2003 compared with the 1997/2001 period were age at first AIDS event aged 34-38 years (OR 0.4; 95% CI 0.2-0.9) compared with aged <30 years. Recently diagnosed AIDS patients differed from those diagnosed previously, showing an epidemic switch in different populations. The characteristics of the AIDS population in 2002/2003 might reflect public health messages disseminated around 10 years ago or more for the prevention of HIV transmission. Anticipation of populations affected by the AIDS epidemic is difficult.

  3. 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.

  4. Therapy for cytomegalovirus polyradiculomyelitis in patients with AIDS: treatment with ganciclovir

    NARCIS (Netherlands)

    de Gans, J.; Portegies, P.; Tiessens, G.; Troost, D.; Danner, S. A.; Lange, J. M.

    1990-01-01

    Six AIDS patients with progressive cytomegalovirus (CMV) polyradiculomyelitis were treated with ganciclovir in an open study. The diagnosis was based on the presence of a distinct clinical syndrome with progressive flaccid paraparesis, preserved proprioception and urinary retention with specific

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

    Directory of Open Access Journals (Sweden)

    Dominique Maes

    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.

  6. Self-care and HIV/aids patients: nursing care systematization

    OpenAIRE

    Caetano,Joselany Áfio; Pagliuca,Lorita Marlena Freitag

    2006-01-01

    This research aimed at systematizing nursing care to HIV/aids patients in view of Orem's Self-care Deficit Nursing Theory, using the convergent-care method and the Self-Care Nursing Process. Subjects were thirteen HIV/AIDS patients attended at a non-governmental organization in Fortaleza/CE, Brazil. We used interview techniques, physical examination, observation and information records, with a structured instrument, addressing requisites related to universal self-care, development and health ...

  7. Development of a Decision Aid for Patients with Atrial Fibrillation Who Are Considering Antithrombotic Therapy

    OpenAIRE

    Man-Son-Hing, Malcolm; Laupacis, Andreas; O'Connor, Annette M; Hart, Robert G; Feldman, George; Blackshear, Joseph L; Anderson, David C

    2000-01-01

    With patients demanding a greater role in the clinical decision-making process, many researchers are developing and disseminating decision aids for various medical conditions. In this article, we outline the essential elements in the development and evaluation of a decision aid to help patients with atrial fibrillation choose, in consultation with their physicians, appropriate antithrombotic therapy (warfarin, aspirin, or no therapy) to prevent stroke. We also outline possible future directio...

  8. COMPARATIVE ANALYSIS OF THE PATIENTS' SATISFACTION LEVEL BY MEDICAL AID QUALITY IN PRIMARY HEALTHCARE AND PLASTIC SURGERY SERVICE

    Directory of Open Access Journals (Sweden)

    Ganshin Igor Borisovich

    2013-03-01

    Full Text Available Satisfaction of patient is one of main parts of medical aid quality declared by WHO. Questionnaire of patients can elucidate mechanism of satisfaction from medical aid quality formed during treatment communication. Estimation of received information permits to compare different hospital activities and know image of medical aid created by patient's mention. Science results can be used to support management decision for choice of activities providing the higher quality signs of medical aid.

  9. Patient quality of life with bone-anchored hearing aid: 10-year experience in Glasgow, Scotland.

    Science.gov (United States)

    Mace, A T M; Isa, A; Cooke, L D

    2009-09-01

    This study aimed to ascertain the usefulness of the bone-anchored hearing aid and its impact on the quality of life of patients fitted in Glasgow between 1996 and 2006. The Entific Medical Systems questionnaire and the Glasgow Benefit Inventory were posted to patients in order to assess their satisfaction and quality of life changes. Sixty adult patients were identified, with a questionnaire response rate of 63 per cent. Thirty-two respondents (85 per cent) reported using their bone-anchored hearing aid for more than eight hours per day. Twenty-nine respondents (75 per cent) found their bone-anchored hearing aid to be generally better than their previous, conventional aid. Twenty-seven respondents (71 per cent) reported that their bone-anchored hearing aid improved their quality of life. The median total Glasgow Benefit Inventory score was +33.3. Bone-anchored hearing aid usage rates and satisfaction levels were high amongst patients in Glasgow. Glasgow Benefit Inventory indices were comparable to published findings from other centres. Despite this, bone-anchored hearing aid funding is still not universally available within the National Health Service in Scotland.

  10. [Clinical feature of cryptosporidium infection in HIV/AIDS patients with chronic diarrhea].

    Science.gov (United States)

    Jiao, Bing-xin; Wang, Hui-zhu; Liu, Ying; Li, Juan; Guo, Jie; Li, Min; Wan, Gang; Hua, Wen-hao

    2011-10-11

    To investigate the clinical feature of cryptosporidium infection in HIV/AIDS patients with chronic diarrhea. 253 Stool samples were collected from HIV/AIDS patients with chronic diarrhea during Nov.2009 to Dec.2010. The samples were concentrated by Formalin-Ethyl Acetate Sedimentation technique and stained by Modified acid-fast stain (AFS) for the identification of oocysts by microscopy. Divided the cases into three groups according to their CD4 cell counts (AIDS patients was 12.6% in 253 cases. CD4(+) T-lymphocyte counts was related to the infection rates of cryptosporidium, the difference was statistically significant (χ(2) = 10.33, P 0.05). HIV/AIDS patients with chronic diarrhea who progressed during asymptomatic period, pre-AIDS period, AIDS period, had the infection rate of 0(0/7), 21.3% (19/89), 8.3% (13/157) respectively, the difference was statistically significant (χ(2) = 9.822, P 0.05). The infection rate of cryptosporidium and clinical severity of cryptosporidium infection are statistically correlated with CD4(+) T-lymphocyte counts, with AIDS stage, with HIV associated proctitis.

  11. [Survival analysis of dialysis patients in the Brazilian Unified National Health System].

    Science.gov (United States)

    Szuster, Daniele Araújo Campos; Caiaffa, Waleska Teixeira; Andrade, Eli Iola Gurgel; Acurcio, Francisco de Assis; Cherchiglia, Mariangela Leal

    2012-03-01

    The aim of this study was to analyze the survival of patients who initiated renal replacement therapy (RRT) with hemodialysis or peritoneal dialysis in the Brazilian Unified National Health System from 2002 to 2004. This was an observational, prospective, non-concurrent study. The study used the National Database for Renal Replacement Therapies resulting from probabilistic matching of Authorization of High-Complexity Procedures/Outpatient Information System and the Mortality Information System. The study included patients admitted in 2002 and 2003, with 3 months of treatment, and 18 years or older. Of the 31,298 patients, the majority: began RRT with hemodialysis, were male, with mean age 54 years, and living in the Southeast region and in municipalities with a mean HDI of 0.78. Increased risk of death was associated with: female gender, age greater than 55 years, diagnosis of diabetes mellitus, peritoneal dialysis, and not residing in the Southeast region. Residing in cities with higher HDI was associated with lower risk. Adjusted risk was HR = 1.17 in favor of hemodialysis. The results suggest shorter survival for peritoneal dialysis and older patients. It is thus necessary to support policies to better evaluate the RRT modality with studies that further elucidate the findings.

  12. Clinical and molecuar characterization of Brazilian patients with growth hormone gene deletions

    Directory of Open Access Journals (Sweden)

    I.J.P. Arnhold

    1998-04-01

    Full Text Available Genomic DNA from 23 patients with isolated growth hormone (GH deficiency (12 males and 11 females: heights -4.9 ± 1.4 SDS was screened for GH gene deletions by restriction endonuclease analysis of polymerase chain reaction amplification products. Three unrelated patients had typical features of severe GH deficiency and deletions (6.7 kb in two and 7.6 kb in one of the GH gene. The two patients with 6.7-kb deletions developed growth-attenuating anti-GH antibodies whereas the patient with the 7.6-kb deletion continued to grow with GH replacement therapy. Our finding that 3/23 (~13% Brazilian subjects had GH gene deletions agrees with previous studies of severe isolated GH deficiency subjects in other populations. Two of three subjects (67% with deletions developed blocking antibodies despite administration of exogenous GH at low doses. Interestingly, only 1/10 of cases with affected relatives or parental consanguinity had GH-1 gene deletions

  13. [Patient safety culture in three Brazilian hospitals with different types of management].

    Science.gov (United States)

    Andrade, Luiz Eduardo Lima; Lopes, Johnnatas Mikael; Souza, Marlon César Melo; Vieira, Romero Fonseca; Farias, Luiz Paulo Costa; Santos, Carla Caroline Medeiros Dos; Gama, Zenewton André da Silva

    2018-01-01

    The scope of the study was to evaluate patient safety culture and associated factors in Brazilian hospitals with different types of management, namely federal, state and private hospitals. The design was cross-sectional and observational. A survey of 1576 professionals at three hospitals of Rio Grande do Norte state was performed using the Hospital Survey on Patient Safety Culture adapted for Brazil, which measures 12 dimensions of safety culture. Perceptions are described by attributing a general result (Range 0-10) and the percentage of positive responses to estimate their strengths and weaknesses. The response rate was 13.6% (n= 215). The patient safety coefficient was between 7 and 10 for 78.1% of the respondents, whereby the highest average grade was attributed to the private hospital (8.32). It has been estimated that the type of hospital management, unit service, position and number of adverse event notifications are associated with the overall patient safety grade (p <0.001). Only the private hospital had strengths in the dimensions analyzed, while the weaknesses appeared in all the hospitals.

  14. [Variables associated with underreporting of AIDS patients in Rio de Janeiro, Brazil, 1996].

    Science.gov (United States)

    Ferreira, V M; Portela, M C; Vasconcellos, M T

    2000-04-01

    The underreporting of AIDS cases in the municipality of Rio de Janeiro, Brazil, is significant. The study intends to analyze the factors associated to this event. Using data provided by the Hospital Information System for the year of 1996, in Rio de Janeiro city, and by the National Surveillance System, patients were randomly selected and their medical records reviewed to verify an AIDS diagnosis. A multinomial model was used to perform an analysis of the variations on the chances of underreporting of AIDS cases versus reporting and on the chances of underreporting without evidences to fulfill the case definition of AIDS versus reporting. No significant associations were found between the variables such as "age", "marital status", "level of education", "occupation", and "severity of illness" and the underreporting of AIDS cases. The variable "female gender" showed a strong association with hospitalization without evidence of an AIDS diagnosis. A strong association was found between two or more admissions in an inpatient unit care and reporting. The existence of a epidemiological surveillance department in the hospital is inversely associated with the underreporting of AIDS cases. The significant association between organizational variables and underreporting of AIDS cases found in the study point out to the need of standardization of the surveillance procedures, the especial need for the creation and maintenance of surveillance departments in hospitals to improve the quality of the health information system and, therefore, AIDS prevention and care.

  15. Dietary patterns in Brazilian patients with nonalcoholic fatty liver disease: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Silvia Marinho Ferolla

    2013-01-01

    Full Text Available OBJECTIVE: Recent evidence suggests that non-alcoholic fatty liver disease is associated with diet. Our aim was to investigate the dietary patterns of a Brazilian population with this condition and compare them with the recommended diet. METHODS: A cross-sectional study was conducted on 96 non-alcoholic fatty liver disease patients before any dietetic counseling. All patients underwent abdominal ultrasound, biochemical tests, dietary evaluations, and anthropometric evaluations. Their food intake was assessed by a semi-quantitative food-frequency questionnaire and 24-hour food recall. RESULTS: The median patient age was 53 years, and 77% of the individuals were women. Most (67.7% participants were obese, and a large waist circumference was observed in 80.2% subjects. Almost 70% of the participants had metabolic syndrome, and 62.3% presented evidence of either insulin resistance or overt diabetes. Most patients (51.5, 58.5, and 61.7%, respectively exceeded the recommendations for energy intake, as well as total and saturated fat. All patients consumed less than the amount of recommended monounsaturated fatty acids, and 52.1 and 76.6% of them consumed less polyunsaturated fatty acids and fiber, respectively, than recommended. In most patients, the calcium, sodium, potassium, pyridoxine, and vitamin C intake did not meet the recommendations, and in 10.5-15.5% of individuals, the tolerable upper limit intake for sodium was exceeded. The patients presented a significantly high intake of meats, fats, sugars, legumes (beans, and vegetables and a low consumption of cereals, fruits, and dairy products compared with the recommendations. CONCLUSIONS: Although patients with non-alcoholic fatty liver disease exhibited high energy and lipid consumption, most of them had inadequate intake of some micronutrients. The possible role of nutrient-deficient intake in the development of non-alcoholic fatty liver disease warrants investigation.

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

    Science.gov (United States)

    Madumo, M M; Peu, M D

    2006-08-01

    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.

  17. Evaluation of a decision aid for patients considering autologous blood donation before open-heart surgery

    Science.gov (United States)

    Grant, F. Curry; Laupacis, Andreas; O'Connor, Annette M.; Rubens, Fraser; Robblee, James

    2001-01-01

    Background Patients undergoing open-heart surgery frequently require one or more blood transfusions. Because of the risks of receiving blood from volunteer donors, some patients choose to donate their own blood before surgery. This reduces their risk of exposure to volunteer-donated blood, but it increases their chance of receiving any transfusion, either of self-donated or volunteer-donated blood. Also, preoperative hemoglobin levels tend to be lower in patients who donate their own blood, and surgeons may be more likely to give transfusions to patients with self-donated blood. To help patients decide whether to donate their blood before surgery, we designed a decision aid comprising a booklet and audiotape and assessed its effectiveness. Methods The 59 study subjects were a sample of consecutive patients referred to the Ottawa Heart Institute between Oct. 1, 1998, and Jan. 5, 1999, for future coronary artery bypass grafting, valve surgery or combined surgery. All were eligible to donate blood. Initial questionnaires were administered in the clinic by a physician or study nurse, and follow-up questionnaires were completed at home and mailed in after use of the decision aid. Outcome measures included patients' knowledge, values (importance ratings), preferences for transfusion methods, decisional conflict (the amount of uncertainty about the course of action to take), risk perception and acceptability of the decision aid. Results Mean knowledge scores on a 15-item test increased from 67% correct responses before the decision aid to 85% correct responses after use of the aid (p decision aid was acceptable to the majority of patients, and 95% indicated that they would recommend it to others. Interpretation The decision aid improved knowledge and risk perceptions of blood donation and transfusion, and it helped uncertain patients to make choices. PMID:11338799

  18. 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.

  19. 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.

  20. A framework for evaluating the cost-effectiveness of patient decision aids: A case study using colorectal cancer screening.

    Science.gov (United States)

    Cantor, Scott B; Rajan, Tanya; Linder, Suzanne K; Volk, Robert J

    2015-08-01

    Patient decision aids are important tools for facilitating balanced, evidence-based decision making. However, the potential of decision aids to lower health care utilization and costs is uncertain; few studies have investigated the cost-effectiveness of decision aids that change patient behavior. Using an example of a decision aid for colorectal cancer screening, we provide a framework for analyzing the cost-effectiveness of decision aids. A decision-analytic model with two strategies (decision aid or no decision aid) was used to calculate expected costs in U.S. dollars and benefits measured in life-years saved (LYS). Data from a systematic review of ten studies about decision aid effectiveness was used to calculate the percentage increase in the number of people choosing screening instead of no screening. We then calculated the incremental cost per LYS with the use of the decision aid. The no decision aid strategy had an expected cost of $3023 and yielded 18.19 LYS. The decision aid strategy cost $3249 and yielded 18.20 LYS. The incremental cost-effectiveness ratio for the decision aid strategy was $36,126 per LYS. Results were sensitive to the cost of the decision aid and the percentage change in behavior caused by the decision aid. This study provides proof-of-concept evidence for future studies examining the cost-effectiveness of decision aids. The results suggest that decision aids can be beneficial and cost-effective. Published by Elsevier Inc.

  1. Estigma, discriminação e HIV/Aids no contexto brasileiro, 1998 e 2005 Stigma, discrimination and HIV/AIDS in the Brazilian context, 1998 and 2005

    Directory of Open Access Journals (Sweden)

    Sandra Garcia

    2008-06-01

    Full Text Available OBJETIVO: Identificar a prevalência de atitudes discriminatórias em dois momentos da epidemia brasileira de HIV/Aids e possíveis mudanças ocorridas. MÉTODOS: O Índice de Intenção de Discriminação foi obtido por pontuação, somando 1 para situações de discriminação ou 0, para o caso contrário. As faixas de intenção de discriminação foram estabelecidas por meio da técnica de cluster, compatibilizadas entre os estudos de 1998 e 2005. Para verificar associação entre o índice e as variáveis sociodemográficas, utilizou-se comparações de médias, teste qui-quadrado, e modelos ajustados de regressão logito ordenado. RESULTADOS: Houve redução estatisticamente significante na proporção de pessoas entre as pesquisas de 1998 e 2005 que responderam sim à obrigatoriedade do teste anti-HIV para: a admissão no emprego, antes do casamento, ingresso nas forças armadas, usuários de drogas, entrada de estrangeiros no país, profissionais do sexo e para todas as pessoas. Possuir menor escolaridade, ser do sexo feminino, ter acima de 45 anos e residir na região Norte/Nordeste são fatores associados ao maior nível de intenção de discriminação. CONCLUSÕES: O crescimento da intenção de discriminação mostra que as informações sobre formas de transmissão e não transmissão da Aids ainda necessitam de melhor elaboração e divulgação, principalmente entre as populações de menor escolaridade, residentes nos estados do Norte/Nordeste, do sexo feminino e pertencentes à faixa etária acima de 45 anos.OBJECTIVE: To identify discriminatory attitudes in two moments of the Brazilian HIV/AIDS epidemic, as well as the occurrence of possible changes. METHODS: The Intention of Discrimination Index was obtained by scoring 1 for discriminatory situations or 0, when the opposite was the case. Intention of discrimination ranges were established by means of the clustering technique, and made compatible between the 1998 and 2005

  2. Clinical features of ocular manifestations of 93 AIDS patients in Urumqi

    Directory of Open Access Journals (Sweden)

    Gang Liu

    2014-10-01

    Full Text Available AIM: To investigate the clinical features of acquired immune deficiency syndrome(AIDSpatients associated ocular diseases in Urumqi and the relationship between ocular fundus manifestations and CD4+T cell count.METHODS: The fundus of 93 AIDS patients were examined by indirect ophthalmoscopy. The clinical symptoms and CD4+T cell count of those patients with fundus changes were analyzed.RESULTS: Thirteen patients were found having fundus changes which occurred in one eye of 4 patients and two eyes of 9 patients, respectively, and the total detection rate was 14.0%. Seven patients had vision changes, and the main clinical features of retinal lesion were cotton wool spot and hemorrhage of retina. Four patients were diagnosed as retinitis with cytomegalovirus(CMVinfection and 9 patients were diagnosed as HIV related retinopathy diseases. Seven patients among 37 patients with CD4+T cell count ≤100cell/μL had fundus changes related AIDS, and the detection rate was 18.9%; while 6 patients among 56 patients with CD4+T cell count >100cell/μL had fundus changes related AIDS, and the detection rate was 10.7%. There was statistical difference between the two detection rates(PCONCLUSION: No specificity was found of those patients with the clinical manifestation of HIV-related retinopathy, and those patients are easy to be missed diagnosis. A number of AIDS patients have fundus changes without any vision changes. Therefore, it is very useful for AIDS patients to be carried out the routine fundus examination for the early diagnosis and treatment.

  3. [Diagnosis and treatment of opportunistic infections in HIV/AIDS adult patients].

    Science.gov (United States)

    Lasso B, Martín

    2011-10-01

    The following guidelines for the diagnosis and treatment of opportunistic infections (OI) in adult HIV/AIDS patients represent the first approach to standardize the management of this patient group in Chile. The guidelines are based on scientific evidence. They intend to serve as a practical and easy-to-use tool for physicians during the process of selecting appropriate diagnostic tests and effective treatments for their patients. They also include the local experience in Chile related to OI in HIV/AIDS patients. Regular up-dates to include new scientific knowledge are proposed.

  4. Oral health of pediatric AIDS patients: a hospital-based study.

    Science.gov (United States)

    Valdez, I H; Pizzo, P A; Atkinson, J C

    1994-01-01

    The prevalence of acquired immunodeficiency syndrome (AIDS) is steadily increasing among American children. The dental needs of these patients are significant. This study evaluated the oral health of forty children being treated for HIV-infection at the National Institutes of Health (NIH). Eight of twenty-two patients in primary dentition (36 percent) had baby bottle tooth decay (BBTD). These cases required extensive dental restoration usually under general anesthesia. Tooth development was delayed in 31 percent of patients. Candidiasis was the most common soft tissue abnormality, found in 35 percent of children. Preventive and therapeutic dental programs should be instituted to meet the special needs of pediatric AIDS patients.

  5. Bone-anchored hearing aid implantation in a patient with Goldenhar syndrome.

    Science.gov (United States)

    Santarelli, Griffin; Redfern, Roberta E; Benson, Aaron G

    2015-12-01

    Patients with Goldenhar syndrome exhibit a number of characteristic symptoms, including middle and internal ear malformations that may cause profound hearing loss. Bone-anchored hearing aids have been used to treat these patients in the past, although complications may arise due to the nature of the disease. Herein we present the case of a pediatric patient with Goldenhar syndrome whose hearing aid abutment extruded spontaneously because of poor bone quality, despite adequate thickness. We provide a brief review of the literature and suggest a flexible surgical plan for any syndromic pediatric patient.

  6. Reliability and validity of the Brazilian version of the Hospital Survey on Patient Safety Culture (HSOPSC): a pilot study.

    Science.gov (United States)

    Reis, Cláudia Tartaglia; Laguardia, Josué; Vasconcelos, Ana Glória Godoi; Martins, Mônica

    2016-12-01

    The evaluation of the culture of patient safety in hospitals is nowadays considered as a management too, since it helps to identify problem areas and provide valuable information for planning improvements. This study explored the reliability and validity of the Brazilian version of the Hospital Survey on Patient Safety Culture, an instrument that evaluates characteristics of patient safety culture among hospital staff. The reliability of the instrument was evaluated by analyzing the internal consistency of each dimension. The validity of the tool was carried out by means of exploratory and confirmatory factor analysis. The sample was made up of 322 questionnaires that were collected in two Brazilian hospitals in 2012. Cronbach's alpha ranged from 0.52 to 0.91 for the different dimensions, with the exception of two, for which it was much lower. After excluding four items, the exploratory factor analysis presented adjusted indices that were appropriate for a 10 factor model.

  7. Patient decision aids in routine maternity care: Benefits, barriers, and new opportunities.

    Science.gov (United States)

    Stevens, Gabrielle; Thompson, Rachel; Watson, Bernadette; Miller, Yvette D

    2016-02-01

    Participation in decision-making, supported by comprehensive and quality information provision, is increasingly emphasised as a priority for women in maternity care. Patient decision aids are tools that can offer women greater access to information and guidance to participate in maternity care decision-making. Relative to their evaluation in controlled settings, the implementation of patient decision aids in routine maternity care has received little attention and our understanding of which approaches may be effective is limited. This paper critically discusses the application of patient decision aids in routine maternity care and explores viable solutions for promoting their successful uptake. A range of patient decision aids have been developed for use within maternity care, and controlled trials have highlighted their positive impact on the decision-making process for women. Nevertheless, evidence of successful patient decision aid implementation in real world health care settings is lacking due to practical and ideological barriers that exist. Patient-directed social marketing campaigns are a relatively novel approach to patient decision aid delivery that may facilitate their adoption in maternity care, at least in the short-term, by overcoming common implementation barriers. Social marketing may also be particularly well suited to maternity care, given the unique characteristics of this health context. The potential of social marketing campaigns to facilitate patient decision aid adoption in maternity care highlights the need for pragmatic trials to evaluate their effectiveness. Identifying which sub-groups of women are more or less likely to respond to these strategies will further direct implementation. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  8. Nosocomial bloodstream infections in Brazilian pediatric patients: microbiology, epidemiology, and clinical features.

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    Carlos Alberto Pires Pereira

    Full Text Available BACKGROUND: Nosocomial bloodstream infections (nBSIs are an important cause of morbidity and mortality and are the most frequent type of nosocomial infection in pediatric patients. METHODS: We identified the predominant pathogens and antimicrobial susceptibilities of nosocomial bloodstream isolates in pediatric patients (≤16 years of age in the Brazilian Prospective Surveillance for nBSIs at 16 hospitals from 12 June 2007 to 31 March 2010 (Br SCOPE project. RESULTS: In our study a total of 2,563 cases of nBSI were reported by hospitals participating in the Br SCOPE project. Among these, 342 clinically significant episodes of BSI were identified in pediatric patients (≤16 years of age. Ninety-six percent of BSIs were monomicrobial. Gram-negative organisms caused 49.0% of these BSIs, Gram-positive organisms caused 42.6%, and fungi caused 8.4%. The most common pathogens were Coagulase-negative staphylococci (CoNS (21.3%, Klebsiella spp. (15.7%, Staphylococcus aureus (10.6%, and Acinetobacter spp. (9.2%. The crude mortality was 21.6% (74 of 342. Forty-five percent of nBSIs occurred in a pediatric or neonatal intensive-care unit (ICU. The most frequent underlying conditions were malignancy, in 95 patients (27.8%. Among the potential factors predisposing patients to BSI, central venous catheters were the most frequent (66.4%. Methicillin resistance was detected in 37 S. aureus isolates (27.1%. Of the Klebsiella spp. isolates, 43.2% were resistant to ceftriaxone. Of the Acinetobacter spp. and Pseudomonas aeruginosa isolates, 42.9% and 21.4%, respectively, were resistant to imipenem. CONCLUSIONS: In our multicenter study, we found a high mortality and a large proportion of gram-negative bacilli with elevated levels of resistance in pediatric patients.

  9. Influence of catechol-O-methyltransferase (COMT) gene polymorphisms in pain sensibility of Brazilian fibromialgia patients.

    Science.gov (United States)

    Barbosa, Flávia Regina; Matsuda, Josie Budag; Mazucato, Mendelson; de Castro França, Suzelei; Zingaretti, Sônia Marli; da Silva, Lucienir Maria; Martinez-Rossi, Nilce Maria; Júnior, Milton Faria; Marins, Mozart; Fachin, Ana Lúcia

    2012-02-01

    Fibromyalgia syndrome (FS) is a rheumatic syndrome affecting to 2-3% of individuals of productive age, mainly women. Neuroendocrine and genetic factors may play a significant role in development of the disease which is characterized by diffuse chronic pain and presence of tender points. Several studies have suggested an association between FS, especially pain sensitivity, and polymorphism of the catechol-O-methyltransferase (COMT) gene. The aim of the present study was to characterize the SNPs rs4680 and rs4818 of the COMT gene and assess its influence in pain sensitivity of patients with fibromyalgia screened by the Fibromyalgia Impact Questionnaire (FIQ). DNA was extracted from peripheral blood of 112 patients with fibromyalgia and 110 healthy individuals and was used as template in PCR for amplification of a 185-bp fragment of the COMT gene. The amplified fragment was sequenced for analyses of the SNPs rs4680 and rs4818. The frequency of mutant genotype AA of SNP rs6860 was 77.67% in patients with FS and 28.18% for the control group. For the SNP rs4818, the frequency of mutant genotype CC was 73.21 and 39.09% for patients with FS and controls, respectively. Moreover, the FIQ score was higher in patients with the homozygous mutant genotype for SNPs rs4680 (87.92 points) and rs4818 (86.14 points). These results suggest that SNPs rs4680 and rs4818 of the COMT gene may be associated with fibromyalgia and pain sensitivity in FS Brazilian patients.

  10. Prevalence of substance use among trauma patients treated in a Brazilian emergency room

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    Reis Alessandra Diehl

    2006-01-01

    Full Text Available OBJECTIVE: Although there is a considerable amount of data in the literature regarding the association between alcohol consumption and injuries treated in emergency rooms, little is known about the relationship between such injury and the use of other substances. The objective of this study was to estimate the prevalence of substance use in patients admitted to the emergency room for non-fatal injuries. METHOD: A prospective cross-sectional study assessing all patients admitted to the emergency room within 6 hours after a non-fatal injury was conducted over a three-month period. The following were used as measures of alcohol and drug use: a standardized World Health Organization questionnaire; a self-administered questionnaire related to drug consumption within the 24 hours preceding contact; the Drug Abuse Screening Test; urine screens for cannabis, cocaine and benzodiazepines; and determination of blood alcohol concentration. Descriptive analyses were performed and the confidence interval used was 95%. RESULTS: A total of 353 patients were included. Cannabis and cocaine screens were conducted for 242 patients and benzodiazepine screens were conducted for 166. Blood alcohol concentrations reached the level of positivity in 11% (n = 39, and 10% (n = 33 presented some degree of intoxication. Among the 242 patients screened, 13.6% (n = 33 tested positive for cannabis, and 3.3% (n = 8 tested positive for cocaine, whereas 4.2% (n = 7 of the 166 patients screened tested positive for benzodiazepines. CONCLUSIONS: Substance use was highly prevalent among these individuals. In this sample, the frequency for the use of cannabis (an illicit drug was comparable to that of alcohol. More studies are needed in order to characterize such use among Brazilians and to develop proper approaches to such cases, with the aim of reducing substance use and its consequences.

  11. Niacin metabolite excretion in alcoholic pellagra and AIDS patients with and without diarrhea.

    Science.gov (United States)

    Monteiro, Jacqueline Pontes; da Cunha, Daniel Ferreira; Filho, Dalmo Correia; Silva-Vergara, Mario León; dos Santos, Vitorino Modesto; da Costa, José Carlos; Etchebehere, Renata Margarida; Gonçalves, Jussara; de Carvalho da Cunha, Selma Freire; Jordão, Alceu A; Chiarello, Paula Garcia; Vannucchi, Helio

    2004-09-01

    Malnourished patients with the acquired immunodeficiency syndrome (AIDS) can develop pellagra-like manifestations such as dermatitis, diarrhea, and dementia; therefore, we tested the hypothesis that patients with AIDS and diarrhea would have niacin depletion. This study compared 24-h urine excretion of N1-methyl-nicotinamide (N1MN) among patients with pellagra and patients with AIDS who did and did not have diarrhea. Three groups were studied: G1 (patients with AIDS and diarrhea, n = 5); G2 (patients with AIDS and no diarrhea, n = 7), and G3 (patients with alcoholic pellagra and without the human immunodeficiency virus, n = 8). Diarrhea was defined as the production of at least three liquid stools per day over 3 to 5 d. Studies included mucosal intestinal biopsy, malabsorption tests, detection of parasites in stool, and serum albumin measurements. Semiquantitative food-frequency questionnaire, anthropometry, and daily urinary N1MN excretion were also determined. Groups were matched in relation to age, sex, presence of parasites in stool, and intestinal absorption results. G1 had normal intestinal examination by light microscopy and no parasites in stools. G2 group showed lower levels of serum albumin (2.6 +/- 0.3 g/dL) when compared with G1 (3.4 +/- 0.3 g/dL) and G3 (3.1 +/- 0.7 g/dL). Except for patients with pellagra, groups met their energy requirements. Patients in G3 (0.013, 0.01-0.081 mg/dL) and G1 (0.062, 0.001-0.33 mg/dL) excreted smaller amounts of N1MN in urine than did those in G2 (0.63, 0.02-2.9 mg/dL). Patients with AIDS and diarrhea excreted less N1MN in urine than did those without diarrhea. These patients may have an impaired niacin nutritional status, possibly associated with increased metabolic needs.

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

    NARCIS (Netherlands)

    Zoufaly, A.; Cozzi-Lepri, A.; Reekie, J.; Kirk, O.; Lundgren, J.; Reiss, P.; Jevtovic, D.; Machala, L.; Zangerle, R.; Mocroft, A.; Lunzen, J. van; Burger, D.M.; et al.,

    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 with

  13. 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

    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...

  14. 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.

  15. Health self-assessment by hemodialysis patients in the Brazilian Unified Health System

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    Tiago Ricardo Moreira

    2016-01-01

    Full Text Available ABSTRACT OBJECTIVE To examine whether the level of complexity of the services structure and sociodemographic and clinical characteristics of patients in hemodialysis are associated with the prevalence of poor health self-assessment. METHODS In this cross-sectional study, we evaluated 1,621 patients with chronic terminal kidney disease on hemodialysis accompanied in 81 dialysis services in the Brazilian Unified Health System in 2007. Sampling was performed by conglomerate in two stages and a structured questionnaire was applied to participants. Multilevel multiple logistic regression was used for data analysis. RESULTS The prevalence of poor health self-assessment was of 54.5%, and in multivariable analysis it was associated with the following variables: increasing age (OR = 1.02; 95%CI 1.01–1.02, separated or divorced marital status (OR = 0.62; 95%CI 0.34–0.88, having 12 years or more of study (OR = 0.51; 95%CI 0.37–0.71, spending more than 60 minutes in commuting between home and the dialysis service (OR = 1.80; 95%CI 1.29–2.51, having three or more self-referred diseases (OR = 2.20; 95%CI 1.33–3.62, and reporting some (OR = 2.17; 95%CI 1.66–2.84 or a lot of (OR = 2.74; 95%CI 2.04–3.68 trouble falling asleep. Individuals in treatment in dialysis services with the highest level of complexity in the structure presented less chance of performing a self-assessment of their health as bad (OR = 0.59; 95%CI 0.42–0.84. CONCLUSIONS We showed poor health self-assessment is associated with age, years of formal education, marital status, home commuting time to the dialysis service, number of self-referred diseases, report of trouble sleeping, and also with the level of complexity of the structure of health services. Acknowledging these factors can contribute to the development of strategies to improve the health of patients in hemodialysis in the Brazilian Unified Health System.

  16. Health self-assessment by hemodialysis patients in the Brazilian Unified Health System

    Science.gov (United States)

    Moreira, Tiago Ricardo; Giatti, Luana; Cesar, Cibele Comini; Andrade, Eli Iola Gurgel; Acurcio, Francisco de Assis; Cherchiglia, Mariângela Leal

    2016-01-01

    ABSTRACT OBJECTIVE To examine whether the level of complexity of the services structure and sociodemographic and clinical characteristics of patients in hemodialysis are associated with the prevalence of poor health self-assessment. METHODS In this cross-sectional study, we evaluated 1,621 patients with chronic terminal kidney disease on hemodialysis accompanied in 81 dialysis services in the Brazilian Unified Health System in 2007. Sampling was performed by conglomerate in two stages and a structured questionnaire was applied to participants. Multilevel multiple logistic regression was used for data analysis. RESULTS The prevalence of poor health self-assessment was of 54.5%, and in multivariable analysis it was associated with the following variables: increasing age (OR = 1.02; 95%CI 1.01–1.02), separated or divorced marital status (OR = 0.62; 95%CI 0.34–0.88), having 12 years or more of study (OR = 0.51; 95%CI 0.37–0.71), spending more than 60 minutes in commuting between home and the dialysis service (OR = 1.80; 95%CI 1.29–2.51), having three or more self-referred diseases (OR = 2.20; 95%CI 1.33–3.62), and reporting some (OR = 2.17; 95%CI 1.66–2.84) or a lot of (OR = 2.74; 95%CI 2.04–3.68) trouble falling asleep. Individuals in treatment in dialysis services with the highest level of complexity in the structure presented less chance of performing a self-assessment of their health as bad (OR = 0.59; 95%CI 0.42–0.84). CONCLUSIONS We showed poor health self-assessment is associated with age, years of formal education, marital status, home commuting time to the dialysis service, number of self-referred diseases, report of trouble sleeping, and also with the level of complexity of the structure of health services. Acknowledging these factors can contribute to the development of strategies to improve the health of patients in hemodialysis in the Brazilian Unified Health System. PMID:27143610

  17. Isolation of human immune deficiency virus from African AIDS patients and from persons without AIDS or IgG antibody to human immune deficiency virus.

    Science.gov (United States)

    McCormick, J B; Krebs, J W; Mitchell, S W; Feorino, P M; Getchell, J P; Odio, W; Kapita, B; Quinn, T C; Piot, P

    1987-01-01

    We previously reported a high incidence of acquired immune deficiency syndrome (AIDS) in Kinshasa, Zaire, as well as a high frequency of antibody to human immunodeficiency virus (HIV), which includes HTLV-III and LAV viruses, in persons without AIDS. In this report we assessed the frequency of HIV virus infection in persons with and without clinical AIDS and the association of virus isolation to presence of antibody. We isolated HIV from 27 (77%) of 35 patients with AIDS, and 5 of 9 patients with AIDS-related complex (ARC). Virus was also isolated from plasma and cerebrospinal fluid of patients in the study. The presence of antibody was a reliable marker for virus infection in African patients with AIDS. HIV was isolated from 5 of 27 control patients without AIDS, 3 of whom had normal T helper to T suppressor ratios and normal numbers of T helper cells. Two of these patients had no detectable antibody to HIV by ELISA or Western blot methods. In a population, such as the general heterosexual population of Kinshasa, with frequent infection by HIV and with few clearly definable risk groups, screening for antibodies to HIV may not be sufficient to identify some virus infected persons.

  18. Tradução e validação de um questionário de avaliação de qualidade de vida em AIDS no Brasil Brazilian-Portuguese translation and validation of the HIV/AIDS-Targeted Quality of Life Instrument

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    Patrícia Coelho De Soárez

    2009-01-01

    Full Text Available OBJETIVO: Traduzir para português brasileiro, adaptar culturalmente e avaliar as propriedades psicométricas (validade e confiabilidade de um questionário de qualidade de vida (HIV/AIDS-Targeted Quality of Life Instrument, HAT-QoL específico para pacientes infectados pelo HIV. MÉTODO: Estudo transversal realizado no ambulatório de infectologia da Escola Paulista de Medicina da Universidade Federal de São Paulo. Coletaram-se características sociodemográficas e clínicas de 106 indivíduos infectados pelo HIV, que responderam os questionários de qualidade de vida HAT-QoL e SF-36. O coeficiente de correlação de Pearson aferiu a validade de construto. Para avaliar a confiabilidade foram calculados o alfa de Cronbach e o coeficiente de correlação intraclasse. RESULTADOS: A proporção de homens na amostra foi de 70,8%. A média de idade foi 39,9 anos. Dos participantes, 40,5% eram homo ou bissexuais. Onze (10,4% pacientes tinham contagem de células CD4 OBJECTIVES: To translate the HIV/AIDS-Targeted Quality of Life Instrument (HAT-QoL into Brazilian Portuguese, culturally adapt it, and evaluate its psychometric properties (validity and reliability as a Brazilian version. METHODS: This cross-sectional study was carried out at the laboratory of infectious diseases at Escola Paulista de Medicina (Universidade Federal de São Paulo. Data were collected on clinical and sociodemographic characteristics of 106 HIV-infected individuals who answered the HAT-QoL and the SF-36®. Pearson's correlation coefficient was used to measure construct validity. Reliability was assessed using Cronbach's alpha and intraclass correlation coefficients. RESULTS: The sample was 70.8% male. The mean age was 39.9 years, with 40.5% of the participants being homosexual or bisexual. Eleven (10.4% patients had a CD4 cell count < 200 cells/mm3. A substantial ceiling effect was observed in 7 of 9 HAT-QoL domains (overall function, life satisfaction, health worries

  19. Perception of Patients With HIV/AIDS From Stigma and Discrimination

    Science.gov (United States)

    Saki, Mandana; Mohammad Khan Kermanshahi, Sima; Mohammadi, Eesa; Mohraz, Minoo

    2015-01-01

    Background: Stigma and discrimination among patients with HIV/AIDS cause various problems for the patients and their health systems. Objectives: The purpose of this study was to explain the perceived experiences of the patients from stigma and discrimination and their roles on health-seeking services among patients. Patients and Methods: This was a qualitative research using content analysis approach and semi-structured interviews, conducted on patients living with HIV/ADS, during 2013 - 2014 in Iran. Sampling started purposefully and continued in a snowball. Results: The experiences of patients with HIV/AIDS from stigma and discrimination led to exploring three main themes and nine subthemes. The main themes were multidimensional stigma, rejection, and insult and discrimination in receiving health services. Conclusions: Stigma and discrimination play an important role in patients' lives and hinder them from accessing the treatment. The patients' responses to this event by secrecy strategy can be an important factor in the disease prevalence. PMID:26290751

  20. Use of liver-spleen scintigraphy to detect immune status and Kaposi sarcoma in AIDS patients

    International Nuclear Information System (INIS)

    Ganz, W.I.; Heiba, S.; Ganz, S.S.; Serafini, A.N.

    1987-01-01

    Fifty-one patients seropositive for human immunodeficiency virus (HIV) underwent liver-spleen scintigraphy. In 43 clinically immunocompromised patients splenic activity was decreased or absent. Eight of these patients had enlarged spleens with decreased uptake. Autopsy results are available on three, all of whom had Kaposi sarcoma of the spleen. Splenic uptake was initially demonstrated in six HTV-positive patients. In three of these subsequently symptomatic patients, follow-up scans showed decreased splenic uptake. Two non-AIDS, HIV-positive patients had normal splenic uptake. These preliminary data suggest that AIDS patients initially have increased uptake, which progresses to decreased splenic uptake as the patients become immunocompromised. Azidothymidine reversed this pattern in one patient. In addition, splenic enlargement with decreased uptake suggests the presence of Kaposi sarcoma

  1. Normal limits of the electrocardiogram derived from a large database of Brazilian primary care patients.

    Science.gov (United States)

    Palhares, Daniel M F; Marcolino, Milena S; Santos, Thales M M; da Silva, José L P; Gomes, Paulo R; Ribeiro, Leonardo B; Macfarlane, Peter W; Ribeiro, Antonio L P

    2017-06-13

    Knowledge of the normal limits of the electrocardiogram (ECG) is mandatory for establishing which patients have abnormal ECGs. No studies have assessed the reference standards for a Latin American population. Our aim was to establish the normal ranges of the ECG for pediatric and adult Brazilian primary care patients. This retrospective observational study assessed all the consecutive 12-lead digital electrocardiograms of primary care patients at least 1 year old in Minas Gerais state, Brazil, recorded between 2010 and 2015. ECGs were excluded if there were technical problems, selected abnormalities were present or patients with selected self-declared comorbidities or on drug therapy. Only the first ECG from patients with multiple ECGs was accepted. The University of Glasgow ECG analysis program was used to automatically interpret the ECGs. For each variable, the 1st, 2nd, 50th, 98th and 99th percentiles were determined and results were compared to selected studies. A total of 1,493,905 ECGs were recorded. 1,007,891 were excluded and 486.014 were analyzed. This large study provided normal values for heart rate, P, QRS and T frontal axis, P and QRS overall duration, PR and QT overall intervals and QTc corrected by Hodges, Bazett, Fridericia and Framingham formulae. Overall, the results were similar to those from other studies performed in different populations but there were differences in extreme ages and specific measurements. This study has provided reference values for Latinos of both sexes older than 1 year. Our results are comparable to studies performed in different populations.

  2. Quality of life and adherence to treatment in early-treated Brazilian phenylketonuria pediatric patients.

    Science.gov (United States)

    Vieira, E; Maia, H S; Monteiro, C B; Carvalho, L M; Tonon, T; Vanz, A P; Schwartz, I V D; Ribeiro, M G

    2017-12-11

    Early dietary treatment of phenylketonuria (PKU), an inborn error of phenylalanine (Phe) metabolism, results in normal cognitive development. Although health-related quality of life (HRQoL) of PKU patients has been reported as unaffected in high-income countries, there are scarce data concerning HRQoL and adherence to treatment of PKU children and adolescents from Brazil. The present study compared HRQoL scores in core dimensions of Brazilian early-treated PKU pediatric patients with those of a reference population, and explored possible relationships between adherence to treatment and HRQoL. Early-treated PKU pediatric patient HRQoL was evaluated by self- and parent-proxy reports of the Pediatric Quality of Life Inventory (PedsQL) core scales. Adherence to treatment was evaluated by median Phe levels and percentage of results within the therapeutic target range in two periods. Means for total and core scales scores of PedsQL self- and parent proxy-reports of PKU patients were significantly lower than their respective means for controls. Adequacy of median Phe concentrations and the mean percentage of values in the target range fell substantially from the first year of life to the last year of this study. There was no significant difference in mean total and core scale scores for self- and parent proxy-reports between patients with adequate and those with inadequate median Phe concentrations. The harmful consequences for intellectual capacity caused by poor adherence to dietary treatment could explain the observed decrease in all HRQoL scales, especially in school functioning. Healthcare system and financial difficulties may also have influenced negatively all HRQoL dimensions.

  3. Clinical characteristics and frequency of TLR4 polymorphisms in Brazilian patients with ankylosing spondylitis

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    Natalia Pereira Machado

    Full Text Available ABSTRACT Objectives: Innate immunity is involved in the physiopathology of ankylosing spondylitis (AS, with the participation of Gram-negative bacteria, modulation of human leukocyte antigen (HLA B27 and the involvement of pattern recognition receptors, such as Toll-like receptors (TLRs. The aim of this study was to investigate the clinical characteristics and frequency of TLR4 polymorphisms (Asp299Gly and Thr 399Ile in a cohort of Brazilian patients with AS. Methods: A cross-sectional study was carried out involving 200 patients with a diagnosis of AS and a healthy control group of 200 individuals. Disease activity, severity and functional capacity were measured. The study of TLR4 polymorphisms was performed using the restriction fragment length polymorphism method. HLA-B27 was analyzed by conventional polymerase chain reaction. The IBM SPSS Statistics 20 program was used for the statistical analysis, with p-values less than 0.05 considered significant. Results: Mean age and disease duration were 43.1 ± 12.7 and 16.6 ± 9.2 years, respectively. The sample was predominantly male (71% and non-Caucasian (52%. A total of 66% of the group of patients were positive for HLA-B27. The sample of patients was characterized by moderate functional impairment and a high degree of disease activity. No significant association was found between the two TLR4 polymorphisms and susceptibility to AS. Conclusions: TLR4 polymorphisms 399 and 299 were not more frequent in patients with AS in comparison to the health controls and none of the clinical variables were associated with these polymorphisms.

  4. Quality of life and adherence to treatment in early-treated Brazilian phenylketonuria pediatric patients

    Directory of Open Access Journals (Sweden)

    E. Vieira Neto

    2017-12-01

    Full Text Available Early dietary treatment of phenylketonuria (PKU, an inborn error of phenylalanine (Phe metabolism, results in normal cognitive development. Although health-related quality of life (HRQoL of PKU patients has been reported as unaffected in high-income countries, there are scarce data concerning HRQoL and adherence to treatment of PKU children and adolescents from Brazil. The present study compared HRQoL scores in core dimensions of Brazilian early-treated PKU pediatric patients with those of a reference population, and explored possible relationships between adherence to treatment and HRQoL. Early-treated PKU pediatric patient HRQoL was evaluated by self- and parent-proxy reports of the Pediatric Quality of Life Inventory (PedsQL core scales. Adherence to treatment was evaluated by median Phe levels and percentage of results within the therapeutic target range in two periods. Means for total and core scales scores of PedsQL self- and parent proxy-reports of PKU patients were significantly lower than their respective means for controls. Adequacy of median Phe concentrations and the mean percentage of values in the target range fell substantially from the first year of life to the last year of this study. There was no significant difference in mean total and core scale scores for self- and parent proxy-reports between patients with adequate and those with inadequate median Phe concentrations. The harmful consequences for intellectual capacity caused by poor adherence to dietary treatment could explain the observed decrease in all HRQoL scales, especially in school functioning. Healthcare system and financial difficulties may also have influenced negatively all HRQoL dimensions.

  5. Development of a patient decision aid for the treatment of localised prostate cancer: a participatory design approach.

    Science.gov (United States)

    Al-Itejawi, Hoda H M; van Uden-Kraan, Cornelia F; Vis, André N; Nieuwenhuijzen, Jakko A; Hofstee, Myrna J A; van Moorselaar, Reindert Jeroen A; Verdonck-de Leeuw, Irma M

    2016-04-01

    To develop a patient decision aid and to prepare an overview of requirements for implementation. We developed a decision aid that fits the preferences of patients and health care professionals to ensure adequate uptake in clinical practice. A participatory design approach was used to acquire insight into preferences regarding the content and design of a decision aid and into barriers and aspects of the decision aid that facilitate implementation in clinical practice. Three focus group interviews with patients, their partners and health care professionals were conducted. A prototype of the decision aid was developed and presented to patients (n = 14) and health care professionals (n = 13) in semi-structured interviews. Patients (n = 5) participated in a usability study. Data were analysed by two independent coders. Health care professionals considered medical information on treatments and side effects as the most important aspect to be included in the decision aid. Patients also focused on nonmedical considerations, such as location. Both expected the decision aid to support patients in making a treatment choice. According to health care professionals, the oncology nurse was the most suitable to discuss the decision aid with patients, while some patients preferred to discuss the patient decision aid with the urologist. The main barrier to implementation of the decision aid was said to be the expectation that it is time and money consuming, while the incorporation of the decision aid into clinical guidelines and basing the content on these guidelines, would promote implementation. By using a participatory design approach a patient decision aid was designed to meet patients' and health care professionals' needs. Insight was also gained on requirements for implementation. Wide-scale implementation of decision aids is desirable. An overview is provided of requirements for implementation to successfully incorporate a decision aid into clinical practice. © 2016 John

  6. Magnetic resonance imaging findings of the brain in adult HIV and AIDS patients

    International Nuclear Information System (INIS)

    Kloska, S.P.; Schlegel, P.M.; Fischbach, R.; Heindel, W.; Husstedt, I.W.; Anneken, K.; Evers, S.

    2008-01-01

    The spectrum of pathology affecting the central nervous system (CNS) in patients suffering from acquired immunodeficiency syndrome (AIDS) includes not only the human immunodeficiency virus (HIV) infection itself but also opportunistic infections and tumors secondary to AIDS. Despite progress in antiretroviral therapy and the subsequent decrease in the incidence of associated diseases, opportunistic infections and tumors secondary to the HIV infection continue to be the limiting factor in terms of survival with AIDS. Therefore, the therapeutic aim is permanent antiretroviral therapy as well as early diagnosis and treatment of opportunistic infections. Magnetic resonance imaging is often the diagnostic method of choice in suspected CNS pathology of HIV patients. In the following, the typical clinical and radiological features of several AIDS-related pathologies are presented and discussed. (orig.)

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

    Science.gov (United States)

    Thejus, Tj; Jeeja, Mc; Jayakrishnan, T

    2009-01-01

    To assess the functional status of patients with Acquired immunodeficiency syndrome (AIDS) registered in the Anti-Retroviral Treatment (ART) center. Descriptive study. ART center in Calicut Medical College, Kerala, India. Cohorts of AIDS patients attending the ART center during the year 2007. Done prospectively from the secondary data available from the center. 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. 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. 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.

  8. Prevalence of Intestinal Parasites in HIV+ and AIDS Patients Khorramabad 2006

    Directory of Open Access Journals (Sweden)

    shirzad Fallahi

    2007-09-01

    Full Text Available Fallahi Sh1, Badparva E1, Nahrovanian H2, Chegeni Sharafi A3, Ebrahimzadeh F4 1. Instructor, Department of parasitology, Faculty of medicine, Lorestan University of medical sciences 2. PhD, Pasteur institute of Iran. 3. Master of science, parasitology 4. Instructor, Department of statistic, Faculty of health, Lorestan University of medical sciences Abstract Background: Intestinal parasites are the most common enteric pathogens in patients with HIV infection. These intestinal pathogens are the main cause of morbidity and mortality in HIV positive patients. There have been very few reports on the prevalence of intestinal parasites in HIV positive and AIDS patients in Iran. To investigate the prevalence of opportunistic intestinal parasites in this population, a cross-sectional study was carried out on 306 HIV positive and AIDS patients in Khorramabad city. Materials and methods: Demographic data were collected by a questionnaire. Three stool samples were collected from every patient. Direct smear, Formalin-ether concentration techniques and Modified acid fast (Kinione and modified trichorome staining method carried out on all samples. Data was analyzed by T-test and Chi square method. Results: After examination’s it detect that, Prevalence of the intestinal parasite in HIV positive and AIDS patients in Khorramabad city was 22.5% and This rate was higher in AIDS patients. Moreover, we demonstrated that there is a significant relationship between age group, level of education, occupation, type of intestinal signs, variants and infection to intestinal parasites. It’s noticeable that between status of HIV/AIDS variant and infection to intestinal parasite there was a significant relationship Conclusion: High prevalence of intestinal parasites in HIV positive and AIDS patients in Khorramabad city reflects the necessity of prevention, screening, diagnosis and treatment programs for these patients.

  9. 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.

  10. Cardiac 123I-MIBG uptake in de novo Brazilian patients with Parkinson's disease without clinically defined dysautonomia

    Directory of Open Access Journals (Sweden)

    Marco Antonio Araujo Leite

    2014-06-01

    Full Text Available Myocardial scintigraphy with meta-iodo-benzyl-guanidine (123I cMIBG has been studied in Parkinson's disease (PD, especially in Asian countries, but not in Latin America. Most of these studies include individuals with PD associated to a defined dysautonomia. Our goal is to report the cardiac sympathetic neurotransmission in de novo Brazilian patients with sporadic PD, without clinically defined dysautonomia. We evaluated retrospectively a series of 21 consecutive cases with PD without symptoms or signs of dysautonomia assessed by the standard bedside tests. This number was reduced to 14 with the application of exclusion criteria. 123I cMIBG SPECT up-take was low or absent in all of them and the heart/mediastinum ratio was low in 12 of 14. We concluded that 123I cMIBG has been able to identify cardiac sympathetic neurotransmission disorder in Brazilian de novo PD patients without clinically defined dysautonomia.

  11. [Translation and cross-cultural adaptation of the Brazilian version of the Hospital Survey on Patient Safety Culture: initial stage].

    Science.gov (United States)

    Reis, Claudia Tartaglia; Laguardia, Josué; Martins, Mônica

    2012-11-01

    Patient safety culture assessment allows hospitals to identify and prospectively manage safety issues in work routines. This article aimed to describe the cross-cultural adaptation of the Hospital Survey on Patient Safety Culture (HSOPSC) into Brazilian Portuguese. A universalist approach was adopted to assess conceptual, item, and semantic equivalence. The methodology involved the following stages: (1) translation of the questionnaire into Portuguese; (2) back-translation into English; (3) an expert panel to prepare a draft version; and (4) assessment of verbal understanding of the draft by a sample of the target population. The questionnaire was translated into Portuguese, and the scale's final version included 42 items. The target population sample assessed all the items as easy to understand. The questionnaire has been translated into Portuguese and adapted to the Brazilian hospital context, but it is necessary to assess its measurement equivalence, external validity, and reproducibility.

  12. 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....

  13. 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/m2...... doses for extended periods was not associated with serious toxicity. Trimetrexate alone had dramatic but transient activity in sulfonamide-intolerant patients and thus is not adequate as single-agent therapy for AIDS-associated toxoplasmosis....

  14. UCSD Performance-Based Skills Assessment (UPSA: validation of a Brazilian version in patients with schizophrenia

    Directory of Open Access Journals (Sweden)

    Lucas M. Mantovani

    2015-03-01

    Full Text Available The UCSD Performance-based Skills Assessment (UPSA is a measure of Functional Capacity and assesses skills involved in community tasks. It has good psychometrics properties, and is currently recommended as a co-primary assessment of cognition in the MATRICS Project. To our knowledge so far, there are no studies in western developing countries concerning Functional Capacity in Schizophrenia. The aims of this study were to translate, culturally adapt and validate the UPSA to assess Functional Capacity in community-dwelling patients with Schizophrenia living in Brazil. Eighty-two subjects (52 patients, 30 controls were evaluated using: the Brazilian version of the UPSA (UPSA-1-BR, PANSS, Personal and Social Performance (PSP and Global Assessment of Functioning (GAF. In the reliability test, UPSA-1-BR showed good Internal Consistency (Cronbach’s alpha of 0.88 and strong correlation between test and retest (4-month gap; r = 0.91; p < 0.01. Spearman’s rho values showed a moderate correlation between UPSA-1-BR and both PSP (0.50; p < 0.01 and GAF (0.46; p < 0.01 scores. UPSA-1-BR is capable of differentiating people with and without Schizophrenia. Patients scored lower than controls (58.9 versus 79.1, with an AUC of 0.79 (95%IC: 0.69–0.89. Sensitivity and specificity values of 0.71 and 0.70, respectively, were found in the cut-off point of 73.5, for separation of patients and controls, with predictive values of 80% (positive and 58% (negative. UPSA-B-BR was also evaluated. UPSA-1-BR and its brief version presented adequate psychometric properties and proved to be valid and reliable instruments in the assessment of Functional Capacity in subjects with Schizophrenia.

  15. Relevance of apolipoprotein E4 for the lipid profile of Brazilian patients with coronary artery disease

    Directory of Open Access Journals (Sweden)

    D.R.S. Souza

    2007-02-01

    Full Text Available Apolipoprotein E (apoE - e2, e3, e4 alleles plays a role in the regulation of lipid metabolism, with the e4 considered to be a risk factor for coronary artery disease (CAD. We aimed to evaluate the apoE polymorphisms in Brazilians with CAD and their influence on the lipid profile and other risk factors (hypertension, diabetes mellitus, smoking. Two hundred individuals were examined: 100 patients with atherosclerosis confirmed by coronary angiography and 100 controls. Blood samples were drawn to determine apoE polymorphisms and lipid profile. As expected, the e3 allele was prevalent in the CAD (0.87 and non-CAD groups (0.81; P = 0.099, followed by the e4 allele (0.09 and 0.14, respectively; P = 0.158. The e3/3 (76 and 78% and e3/4 (16 and 23% were the most common genotypes for patients and controls, respectively. The lipid profile was altered in patients compared to controls (P < 0.05, independently of the e4 allele. However, in the controls this allele was prevalent in individuals with elevated LDL-cholesterol levels only (odds ratio = 2.531; 95% CI = 1.028-6.232. The frequency of risk factors was higher in the CAD group (P < 0.05, but their association with the lipid profile was not demonstrable in e4 carriers. In conclusion, the e4 allele is not associated with CAD or lipid profile in patients with atherosclerosis. However, its frequency in the non-CAD group is associated with increased levels of LDL-cholesterol, suggesting an independent effect of the e4 allele on lipid profile when the low frequency of other risk factors in this group is taken into account.

  16. A Qualitative Case Study of Smartphone-Connected Hearing Aids: Influences on Patients, Clinicians, and Patient-Clinician Interactions.

    Science.gov (United States)

    Ng, Stella L; Phelan, Shanon; Leonard, MaryAnn; Galster, Jason

    2017-06-01

    Innovations in hearing aid technology influence clinicians and individuals who use hearing aids. Little research, to date, explains the innovation adoption experiences and perspectives of clinicians and patients, which matter to a field like audiology, wherein technology innovation is constant. By understanding clinician and patient experiences with such innovations, the field of audiology may develop technologies and ways of practicing in a manner more responsive to patients' needs, and attentive to society's influence. The authors aimed to understand how new innovations influence clinician and patient experiences, through a study focusing on connected hearing aids. "Connected" refers to the wireless functional connection of hearing aids with everyday technologies like mobile phones and tablets. The authors used a qualitative collective case study methodology, borrowing from constructivist grounded theory for data collection and analysis methods. Specifically, the authors designed a collective case study of a connected hearing aid and smartphone application, composed of two cases of experience with the innovation: the case of clinician experiences, and the case of patient experiences. The qualitative sampling methods employed were case sampling, purposive within-case sampling, and theoretical sampling, and culminated in a total collective case n = 19 (clinician case n = 8; patient case n = 11). These data were triangulated with a supplementary sample of ten documents: relevant news and popular media collected during the study time frame. The authors conducted interviews with the patients and clinicians, and analyzed the interview and document data using the constant comparative method. The authors compared their two cases by looking at trends within, between, and across cases. The clinician case highlighted clinicians' heuristic-based candidacy judgments in response to the adoption of the connected hearing aids into their practice. The patient case revealed

  17. Decision Aids: The Effect of Labeling Options on Patient Choices and Decision Making.

    Science.gov (United States)

    Dolan, James G; Cherkasky, Olena A; Chin, Nancy; Veazie, Peter J

    2015-11-01

    Conscious and unconscious biases can influence how people interpret new information and make decisions. Current standards for creating decision aids, however, do not address this issue. Using a 2×2 factorial design, we developed surveys that contained a decision scenario (involving a choice between aspirin or a statin drug to lower risk of heart attack) and a decision aid. Each aid presented identical information about reduction in heart attack risk and likelihood of a major side effect. They differed in whether the options were labeled and the amount of decisional guidance: information only (a balance sheet) versus information plus values clarification (a multicriteria decision analysis). We sent the surveys to members of 2 Internet survey panels. After using the decision aid, participants indicated their preferred medication. Those using a multicriteria decision aid also judged differences in the comparative outcome data provided for the 2 options and the relative importance of achieving benefits versus avoiding risks in making the decision. The study sample size was 536. Participants using decision aids with unlabeled options were more likely to choose a statin: 56% versus 25% (P < 0.001). The type of decision aid made no difference. This effect persisted after adjustment for differences in survey company, age, gender, education level, health literacy, and numeracy. Participants using unlabeled decision aids were also more likely to interpret the data presented as favoring a statin with regard to both treatment benefits and risk of side effects (P ≤ 0.01). There were no significant differences in decision priorities (P = 0.21). Identifying the options in patient decision aids can influence patient preferences and change how they interpret comparative outcome data. © The Author(s) 2015.

  18. Correlation of depression and quality of life in HIV/AIDS patients

    Science.gov (United States)

    Siregar, M. L.; Abdullah, V.; Mamfaluti, T.

    2018-03-01

    Depression in HIV/AIDS patients will influence the quality of life (QoL) demographically or by its own HIV disease. QoL-affected factors could be helpful in making important policy decisions and health care interventions, especially in Banda Aceh. The study aims to find the relationship between depression and quality of life in HIV/AIDS patients. A cross sectional design and the sample recruitment technique was done by total sampling that all outpatient and inpatient HIV/AIDS patients who had received antiretroviral therapy or not and were willing to be interviewed in Zainoel Abidin Hospital, Aceh Province, Indonesia. QoLwas assessed using WHOQoL and depression data werecollectedusing the BDI questionnaires. The study resulted in 29 HIV/AIDS patients which the most were men (62.1%), and the mean age was 33.14 ± 6.13 years old. The most transmitted type was by IVDU, and the CD4+ count was less than 350 cells. There is a strong relationship between sex and QoL (p = 0.005) and depression is strongly negative correlation with QoL (r = -0.619, p HIV/AIDS patients.

  19. 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

  20. Participação social como elemento de análise da sustentabilidade: estudo do Programa Brasileiro de DST/AIDS Social participation as element of sustainability analysis: study on the Brazilian STD/AIDS Program

    Directory of Open Access Journals (Sweden)

    Maria Matilde Zraik Baracat

    2013-03-01

    in the construction of public policies for HIV/AIDS control in Brazil and it contributes by characterizing social participation as a measure for qualitative analysis of social sustainability. One begins by contextualizing the globalization and population growth processes which led to economic, social, and environmental problems particularly evidenced from the second half of the 20th century and the early 21st century, culminating in a greater need for discussion and definition of a sustainable development in society. One presents a historical overview of the AIDS epidemic and, according to the proposal, one seeks to include social participation in the sustainability context, taking into account the Brazilian experiences of collective construction of public policies which succeed from the promulgation of the 1988 Constitution, with a special attention to the creation of the HIV/AIDS National Policy. The field research, with a qualitative approach, was conducted through semi-structured interviews, non-participant observation, and documentary analysis. Data were examined through the content analysis technique, taking into account the triangulation between the various data sources. One concludes that social participation is included in the sustainable development perspective, since it's through this mechanism that civil society, especially poorer groups, becomes able to obtain representativeness in the government and effectively contribute to the building of democracy. However, one finds out some specific weaknesses related to the socioeconomic, cultural, and political context in Brazil, something which may compromise the democratization of the various listening spaces of society and the implementation of the public policies related to the case under study.

  1. Low Sensitivity of the Mini-Mental State Examination for Cognitive Assessment of Brazilian Patients With Parkinson Disease.

    Science.gov (United States)

    Breder, Raphael; Leite, Marco Antonio Araujo; Pinto, Jony Arrais; Cavalcante, Igor Pinto; Pessoa, Bruno Lima; Neves, Marco Antônio Orsini

    2017-11-01

    Recent publications have highlighted the low sensitivity of the Mini-Mental State Examination (MMSE) for the cognitive assessment of patients with Parkinson disease (PD). The Montreal Cognitive Assessment (MoCA), otherwise, has shown greater sensitivity when compared to the MMSE. Based on this, we have searched for the cognitive impairment measurable by the MoCA and the functional performance on activities of daily living in a sample of Brazilian patients with PD and normal MMSE. We hypothesized that the low sensitivity of the MMSE, already shown by other authors, could be replicated in a low-income country. To describe the performance on the MoCA and the dependence on third parties for activities of daily living in a sample of Brazilian patients with PD and normal MMSE. We evaluated 43 volunteers with PD and normal MMSE considering the Brazilian cutoffs. Cognitive performance was assessed through the MoCA and functional performance through a modified version of the Disability Assessment for Dementia Scale. Despite normal score on the MMSE, considering the Brazilian cutoffs, 62.7% of the volunteers performed below the literature cutoff for the MoCA (26 points). Furthermore, 30.2% had dependence on third party for activities of daily living. By using a strict cutoff for the MMSE (26 points), 56.7% performed below the MoCA cutoff and 24.3% had dependence for activities of daily living. Our findings confirm the limitations of the MMSE for the cognitive screening of patients with PD in a low-income country.

  2. Patchy uptake of gallium in the lungs of AIDS patients with atypical mycobacterial infection

    International Nuclear Information System (INIS)

    Skarzynski, J.J.; Sherman, W.; Lee, H.K.; Berger, H.

    1987-01-01

    The gallium scans of seven AIDS patients who cultured positive for atypical mycobacterium were reviewed. Six cultured positive for Mycobacterium avium intracellulare, while one for Mycobacterium xenopi. A patchy uptake pattern of gallium in the lungs of these patients was identified

  3. Case Series of Mania Secondary to HIV/AIDS in Patients at two ...

    African Journals Online (AJOL)

    Objective: The objective of the study was to gain the greater knowledge of the mania secondary to HIV/AIDS while specific objectives were to determine whether the specific clinical characteristics of mania secondary to HIV identified in previous studies are also found in Zambian patients and to determine whether patients ...

  4. Characteristics of HIV/AIDS Patients Presenting Late at a Teaching ...

    African Journals Online (AJOL)

    Background: The introduction of highly active antiretroviral therapy (HAART) has significantly reduced the morbidity and mortality associated with HIV/AIDS. This benefit that HAART confers can only be maximized if patients present early. This study was embarked upon to describe the characteristics of patients presenting ...

  5. Demographic characteristics of HIV/AIDS patients at the University of ...

    African Journals Online (AJOL)

    Aim: To determine the demographic characteristics of people living with HIV/AIDs attending the UNTH treatment center. Patients and Methods: All patients who assess Antiretroviral treatment at the University of Nigeria Teaching Hospital between February 2002 and July 2004 were included. Demographic characteristics ...

  6. Morphine use in the last six days of life of patients with HIV/AIDS at ...

    African Journals Online (AJOL)

    Care provision is shared between professional nurses and non-professional community-based caregivers, who are trained by Hospice. For challenging symptoms, respite or terminal care, the hospice has a six-bed IPU to which patients can be admitted for short periods. The AIDS patients admitted to the IPU of the study ...

  7. Medicine use among HIV/Aids patients in public hospitals, Kwara State

    African Journals Online (AJOL)

    Method: This study was conducted in seven public hospitals in six local government areas, Kwara State. Exit interviews of 780 eligible HIV/AIDS patients were conducted through use of structured questionnaire. Additionally, there were exit observational checks of medicines dispensed to these patients. Descriptive statistics ...

  8. Prevalence of human cytomegalovirus (HCMV antibodies among patients HIV/AIDS in Kurdistan province, 2015

    Directory of Open Access Journals (Sweden)

    Arezo Omati

    2016-12-01

    Full Text Available Background : Cytomegalovirus (CMV infection is one of the most common causes of death in people with immune deficiency diseases such as: organ or tissue recipients, patients with HIV/AIDS and newborn infants. The aim of this study was to determine the prevalence of anti-CMV antibodies in patients with HIV/AIDS in the Kurdistan province. Materials and Methods: This cross-sectional study carried out on 151 patients with HIV/AIDS covered by behavioral health counseling centers in Kurdistan province, 2015. For all patients the values of CMV antibodies, include IgG and IgM, were determined by ELISA technique and Diagnostic Kits (EIA WELL, Rome, Italy. Data analyses were done by use of t-test and multiple linear regression tests in stata software, version 13. Results: 116 (76.8% and 35 (23.2% of the patients were male and female, respectively. Mean (SD age of the patients were 39.3 (9.1 years. All studied patients were found positive for CMV-IgG (prevalence=100%, whereas only one case (0.7% was found positive for CMV-IgM. The relationship between age and CMV-IgG levels was statistically significant. Conclusion: The results showed that high prevalence of CMV in patients with HIV/AIDS, so in addition to paying more attention to the issue of HIV and CMV co-infection, about value of early antiretroviral treatment conducting further studies seems necessary.

  9. A non-specific biomarker of disease activity in HIV/AIDS patients ...

    African Journals Online (AJOL)

    Objective: To investigate the potential of neopterin as non-specific biomarker in patients with advanced HIV/AIDS. Methods: Cross-sectional study in 105 HIV positive patients (75 on highly active antiretroviral treatment (HAART). Neop- terin was assessed by enzyme linked immune-absorbent assay and cytokines by flow ...

  10. Combined zidovudine and interferon-alpha treatment in patients with AIDS-associated Kaposi's sarcoma

    NARCIS (Netherlands)

    de Wit, R.; Danner, S. A.; Bakker, P. J.; Lange, J. M.; Eeftinck Schattenkerk, J. K.; Veenhof, C. H.

    1991-01-01

    The effectiveness of addition of interferon-alpha (IFN-alpha) to zidovudine in patients with AIDS-associated Kaposi's sarcoma was assessed in a non-randomized, phase II clinical trial. Twenty-one patients were treated with oral zidovudine (600 mg daily) and IFN-alpha was increased to 18 MU daily for

  11. 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...

  12. Cost to patients of obtaining treatment for HIV/AIDS in South Africa ...

    African Journals Online (AJOL)

    Background. South Africa is providing antiretroviral (ARV) drugs for HIV I AIDS free of charge in order to increase access for poorer patients and promote adherence. However, non-drug costs of obtaining treatment may limit access. We estimated the costs that South African patients incur in obtaining antiretroviral therapy ...

  13. Toxoplasma encephalitis: an HIV/AIDS patient with cerebral mass

    Directory of Open Access Journals (Sweden)

    Seza Ayse inal

    2017-03-01

    Full Text Available Toxoplasmic encephalitis is an opportunistic infection, which develops as a result of reactivation of the latent tissue cysts of Toxoplasma gondii in patients with reduced CD4+ T lymphocytes. Amongst patients with human immunodeficiency virus or acquired immunodeficiency syndrome, toxoplasmic encephalitis is one of the leading causes of the intracerebral involvement. In this report, we present a toxoplasmic encephalitis case, who has admitted with neurological symptoms and fever. The patient was identified human immunodeficiency virus positive while he was under investigation for cerebral mass lesion, The patient has fully recovered by antiprotozoal and antiretroviral therapy. [Cukurova Med J 2017; 42(1.000: 184-188

  14. 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.

  15. Access to medicines by patients of the primary health care in the Brazilian Unified Health System.

    Science.gov (United States)

    Álvares, Juliana; Guerra, Augusto Afonso; Araújo, Vânia Eloisa de; Almeida, Alessandra Maciel; Dias, Carolina Zampirolli; Ascef, Bruna de Oliveira; Costa, Ediná Alves; Guibu, Ione Aquemi; Soeiro, Orlando Mario; Leite, Silvana Nair; Karnikowski, Margô Gomes de Oliveira; Costa, Karen Sarmento; Acurcio, Francisco de Assis

    2017-11-13

    To evaluate the access to medicines in primary health care of the Brazilian Unified Health System (SUS), from the patients' perspective. This is a cross-sectional study that used data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos - Services, 2015 (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines), conducted by interviews with 8,591 patients in cities of the five regions of Brazil. Evaluation of access to medicines used concepts proposed by Penshansky and Thomas (1981), according to the dimensions: availability, accessibility, accommodation, acceptability, and affordability. Each dimension was evaluated by its own indicators. For the "availability" dimension, 59.8% of patients reported having full access to medicines, without significant difference between regions. For "accessibility," 60% of patients declared that the basic health unit (UBS) was not far from their house, 83% said it was very easy/easy to get to the UBS, and most patients reported that they go walking (64.5%). For "accommodation," UBS was evaluated as very good/good for the items "comfort" (74.2%) and "cleanliness" (90.9%), and 70.8% of patients reported that they do not wait to receive their medicines, although the average waiting time was 32.9 minutes. For "acceptability," 93.1% of patients reported to be served with respect and courtesy by the staff of the dispensing units and 90.5% declared that the units' service was very good/good. For "affordability," 13% of patients reported not being able to buy something important to cover expenses with health problems, and 41.8% of participants pointed out the expense with medicines. Results show 70%-90% compliance, which is compatible with developed countries. However, access to medicines remains a challenge, because it is still heavily compromised by the low availability of essential medicines in public health units, showing that it does not occur universally, equally

  16. Patient preferences for direct hearing aid provision by a private dispenser. A discrete choice experiment.

    Science.gov (United States)

    Grutters, Janneke P C; Joore, Manuela A; Kessels, Alfons G H; Davis, Adrian C; Anteunis, Lucien J C

    2008-08-01

    Our objective was to elicit patient preferences for transferring elements of hearing aid provision from the medical sector [Ear Nose and Throat (ENT) specialists and audiological centers] to private hearing aid dispensers, and to understand the trade-offs between different elements of hearing aid provision. A discrete choice experiment was administered from 150 hearing-impaired persons in the Netherlands. Mean age was 71 (range 18-95) and 57% were male. Participants preferred the initial assessment at the dispenser, higher accuracy in identifying persons in need of medical care, shorter duration of the total hearing aid provision, and a follow-up at the ENT specialist. They required compensation of at least euro 17 per 2 mo extra duration, euro 54 for an initial assessment at the ENT specialist, euro 119 per 10% decrease in accuracy, and euro 227 to forgo the follow-up at the ENT specialist. Preferences were influenced by sex, age, educational level, and experience with hearing aid provision. Hearing-impaired persons are receptive to transferring elements of hearing aid provision from the medical sector to private dispensers. Although safety and efficiency issues should also be considered, from the present study we can conclude that in the organization of hearing aid provision hearing-impaired persons prefer an initial assessment at a private dispenser when the dispenser is at least 95% as accurate as the ENT specialist, and prefer a follow-up visit at the ENT specialist.

  17. Caring for terminal AIDS patients: The experiences of caregivers in ...

    African Journals Online (AJOL)

    This research focused on the lived experiences of caregivers working with Acquired Immune Defi ciency Syndrome 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 ...

  18. Comparative study of dental cephalometric patterns of Japanese-Brazilian, Caucasian and Mongoloid patients

    Directory of Open Access Journals (Sweden)

    Renata Sathler

    2014-08-01

    Full Text Available INTRODUCTION: The objective of this study was to identify the patterns of dental variables of adolescent Japanese-Brazilian descents with normal occlusion, and also to compare them with a similar Caucasian and Mongoloid sample. METHODS: Lateral cephalometric radiographs were used to compare the groups: Caucasian (n = 40, Japanese-Brazilian (n = 32 and Mongoloid (n = 33. The statistical tests used were one-way ANOVA and ANCOVA. The cephalometric measurements used followed the analyses of Steiner, Tweed and McNamara Jr. RESULTS: Statistical differences (P < 0.05 indicated a smaller interincisal angle and overbite for the Japanese-Brazilian sample, when compared to the Caucasian sample, although with similar values to the Mongoloid group. CONCLUSION: The dental patterns found for the Japanese-Brazilian descents were, in general, more similar to those of the Mongoloid sample.

  19. Comparative study of dental cephalometric patterns of Japanese-Brazilian, Caucasian and Mongoloid patients

    Science.gov (United States)

    Sathler, Renata; Pinzan, Arnaldo; Fernandes, Thais Maria Freire; de Almeida, Renato Rodrigues; Henriques, José Fernando Castanha

    2014-01-01

    Introduction The objective of this study was to identify the patterns of dental variables of adolescent Japanese-Brazilian descents with normal occlusion, and also to compare them with a similar Caucasian and Mongoloid sample. Methods Lateral cephalometric radiographs were used to compare the groups: Caucasian (n = 40), Japanese-Brazilian (n = 32) and Mongoloid (n = 33). The statistical tests used were one-way ANOVA and ANCOVA. The cephalometric measurements used followed the analyses of Steiner, Tweed and McNamara Jr. Results Statistical differences (P overbite for the Japanese-Brazilian sample, when compared to the Caucasian sample, although with similar values to the Mongoloid group. Conclusion The dental patterns found for the Japanese-Brazilian descents were, in general, more similar to those of the Mongoloid sample. PMID:25279521

  20. Development of a quantitative food frequency questionnaire for Brazilian patients with type 2 diabetes.

    Science.gov (United States)

    Sarmento, Roberta Aguiar; Riboldi, Bárbara Pelicioli; da Costa Rodrigues, Ticiana; de Azevedo, Mirela Jobim; de Almeida, Jussara Carnevale

    2013-08-09

    To investigate the association between dietary components and development of chronic diabetic complications, the dietary evaluation should include a long period, months or years. The present manuscript aims to develop a quantitative food frequency questionnaire (FFQ) and a portfolio with food photos to assess the usual intake pattern of Brazilian patients with type 2 diabetes to be used in future studies. Dietary data using 3-day weighed diet records (WDR) from 188 outpatients with type 2 diabetes were used to construct the list of usually consumed foods. Foods were initially clustered into eight groups: "cereals, tubers, roots, and derivatives"; "vegetables and legumes"; "fruits"; "beans"; "meat and eggs"; "milk and dairy products"; "oils and fats", and "sugars and sweets". The frequency of food intake and the relative contribution of each food item to the total energy and nutrient intakes were calculated. Portion sizes were determined according to the 25th, 50th, 75th, and 95th percentiles of intake for each food item. A total of 62 food items were selected based on the 3-day WDR and another 27 foods or how they are prepared and nine beverages were included after the expert examination. Also, a portfolio with food photos of each included food item and portion sizes was made to assist the patients in identifying the consumed portion. We developed a practical quantitative FFQ and portfolio with photos of 98 food items covering those most commonly consumed in the past 12 months, to assess the usual diet pattern of patients with type 2 diabetes in Southern Brazil.

  1. Brazilian Dental Students' Attitudes About Provision of Care for Patients Living in Poverty.

    Science.gov (United States)

    Dos Santos, Beatriz Ferraz; Madathil, Sreenath; Zuanon, Angela Cristina Cilense; Bedos, Christophe; Nicolau, Belinda

    2017-11-01

    The aims of this study were to investigate dental students' attitudes toward people living in poverty and the extent to which their perceptions were associated with their willingness to treat those patients in their future practice. All 910 dental students enrolled in three Brazilian public universities in 2010 were invited to take part in a cross-sectional survey. A total of 766 students (83.7% response rate) completed the self-administered questionnaire on their perceptions of and attitudes about poverty and their intention to provide dental care to poor people. The responding students showed slightly positive attitudes about people living in poverty; however, a high percentage (35%) reported thinking they were different from the rest of the population. Nevertheless, most of these students expressed willingness to provide care to underserved populations in their future practice; this willingness was found to be associated with their beliefs about poverty (OR 1.65; 95% CI=1.41-1.94). Overall, the study found that these dental students had altruistic views toward people living in poverty. However, they seemed to lack a deep understanding of poverty that may prevent them from acting on their good intentions.

  2. II Brazilian Consensus on the use of human immunoglobulin in patients with primary immunodeficiencies.

    Science.gov (United States)

    Goudouris, Ekaterini Simões; Rego Silva, Almerinda Maria do; Ouricuri, Aluce Loureiro; Grumach, Anete Sevciovic; Condino-Neto, Antonio; Costa-Carvalho, Beatriz Tavares; Prando, Carolina Cardoso; Kokron, Cristina Maria; Vasconcelos, Dewton de Moraes; Tavares, Fabíola Scancetti; Silva Segundo, Gesmar Rodrigues; Barreto, Irma Cecília; Dorna, Mayra de Barros; Barros, Myrthes Anna; Forte, Wilma Carvalho Neves

    2017-01-01

    In the last few years, new primary immunodeficiencies and genetic defects have been described. Recently, immunoglobulin products with improved compositions and for subcutaneous use have become available in Brazil. In order to guide physicians on the use of human immunoglobulin to treat primary immunodeficiencies, based on a narrative literature review and their professional experience, the members of the Primary Immunodeficiency Group of the Brazilian Society of Allergy and Immunology prepared an updated document of the 1st Brazilian Consensus, published in 2010. The document presents new knowledge about the indications and efficacy of immunoglobulin therapy in primary immunodeficiencies, relevant production-related aspects, mode of use (routes of administration, pharmacokinetics, doses and intervals), adverse events (major, prevention, treatment and reporting), patient monitoring, presentations available and how to have access to this therapeutic resource in Brazil. RESUMO Nos últimos anos, novas imunodeficiências primárias e defeitos genéticos têm sido descritos. Recentemente, produtos de imunoglobulina, com aprimoramento em sua composição e para uso por via subcutânea, tornaram-se disponíveis em nosso meio. Com o objetivo de orientar o médico no uso da imunoglobulina humana para o tratamento das imunodeficiências primárias, os membros do Grupo de Assessoria em Imunodeficiências da Associação Brasileira de Alergia e Imunologia produziram um documento que teve por base uma revisão narrativa da literatura e sua experiência profissional, atualizando o I Consenso Brasileiro publicado em 2010. Apresentam-se novos conhecimentos sobre indicações e eficácia do tratamento com imunoglobulina nas imunodeficiências primárias, aspectos relevantes sobre a produção, forma de utilização (vias de administração, farmacocinética, doses e intervalos), efeitos adversos (principais efeitos, prevenção, tratamento e notificação), monitorização do

  3. Bone-anchored hearing aids and unilateral sensorineural hearing loss: why do patients reject them?

    Science.gov (United States)

    Siau, D; Dhillon, B; Andrews, R; Green, K M J

    2015-04-01

    This study aimed to report the bone-anchored hearing aid uptake and the reasons for their rejection by unilateral sensorineural deafness patients. A retrospective review of 90 consecutive unilateral sensorineural deafness patients referred to the Greater Manchester Bone-Anchored Hearing Aid Programme between September 2008 and August 2011 was performed. In all, 79 (87.8 per cent) were deemed audiologically suitable: 24 (30.3 per cent) eventually had a bone-anchored hearing aid implanted and 55 (69.6 per cent) patients declined. Of those who declined, 26 (47.3 per cent) cited perceived limited benefits, 18 (32.7 per cent) cited reservations regarding surgery, 13 (23.6 per cent) preferred a wireless contralateral routing of sound device and 12 (21.8 per cent) cited cosmetic reasons. In all, 32 (40.5 per cent) suitable patients eventually chose the wireless contralateral routing of sound device. The uptake rate was 30 per cent for audiologically suitable patients. Almost half of suitable patients did not perceive a sufficient benefit to proceed to device implantation and a significant proportion rejected it. It is therefore important that clinicians do not to rush to implant all unilateral sensorineural hearing loss patients with a bone-anchored hearing aid.

  4. Diagnosis by computer-aided tomography in patients with carcinomas in the rectum-sigma area

    International Nuclear Information System (INIS)

    Gnann, H.; Huebener, K.H.; Ahlemann, L.M.; Harms, S.

    1984-01-01

    In a retrospective study on the patients at Tuebingen between 1977 and 1980, the diagnostic value of computer-aided tomography was investigated in 232 cases of carcinomas in the rectum-sigma area. 192 examinations were post-operative. Whether computer-aided tomography will catch on as a staging measure in the pre-operative phase must for now remain unanswered until prospective studies on a large number of patients have been carried through. However, it is useful as a decision-taking aid as regards the choice of the operation method and to clarify whether the carcinoma is operable. Far more important in view of the known high rate of recurvency and metastatic spread seems to be the role of computer-aided tomography in the aftercare especially of those patients who had their rectum removed: the diagnosis of the recidivation permits direct therapeutic action (a second operation, radiation therapy) at an early date. The search for clinically not previously known recidivations revealed that computer-aided tomography had in 124 patients with operated rectal carcinoma a high sensitivity of 98 per cent, a specificity of 87 per cent and an accuracy of 91.9 percent. How long after the operation CAT checks should be carried through is quite as uncertain at present as the role of CAT in the staging of those tumors. The authors recommend intervals of 2-3 months within the first two post-operative years. (orig.) [de

  5. 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.

  6. Diffuse small bowel thickening in AIDS patient--a case report.

    Science.gov (United States)

    Singla, Rohit; Hari, Samriti; Sharma, Surendra K

    2010-10-28

    Diarrhea is common in HIV/AIDS patients, caused by both classic enteric pathogens and different opportunistic agents. Infection with these different pathogens may lead to similar radiological findings, thus causing diagnostic confusion. A 30-yr-old female with AIDS presented with chronic diarrhea of 4 months duration. She had diffuse small bowel thickening present on CT scan of her abdomen, with stool examination showing no parasites. She was erroneously diagnosed as abdominal tuberculosis and given antituberculosis drugs with which she showed no improvement. Repeat stool examination later at a specialized laboratory revealed Cryptosporidium parvum infection.The patient was given an extended course of nitazoxanide treatment, as her stool examination was positive for Cryptosporidium parvum even after 2 weeks of drug consumption. Parasite clearance was documented after 10 weeks of treatment. Interestingly, the bowel thickening reversed with parasitological clearance. Cryptosporidium parvum may lead to small bowel thickening in AIDS patients. This small bowel thickening may reverse following parasitological clearance.

  7. burden of intestinal parasites amongst hiv/aids patients attending

    African Journals Online (AJOL)

    boaz

    use of questionnaires and laboratory tests of stool and blood samples respectively. Results: A total of 200 volunteer patients participated in this ... rassemblées par l'utilisation de questionnaires et les tests de laboratoire effectués sur des prélèvements de selles et de sang respectivement. Résultats: Un total de 200 patients ...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Bone-anchored hearing aids in conductive and mixed hearing losses: why do patients reject them?

    Science.gov (United States)

    Siau, Richard T K; Dhillon, Baljeet; Siau, Derrick; Green, Kevin M J

    2016-10-01

    This study aimed to report the bone-anchored hearing aid uptake rate and the reasons for their rejection by patients with conductive and mixed hearing losses. A retrospective review was performed of 113 consecutive patients with unilateral or bilateral conductive or mixed hearing loss referred to the Greater Manchester bone-anchored hearing aid (BAHA) programme between September 2008 and August 2011. 98 (86.7 %) patients were deemed audiologically suitable for BAHA implantation. Of these, 38 (38.8 %) had BAHA implanted; 60 (61.2 %) patients declined. Of those who declined, 27 (45 %) cited anxiety over surgery, 18 (30 %) cited cosmetic reasons, 16 (26.7 %) perceived limited benefit from the device and six (10 %) preferred conventional hearing aids. Our study highlights a 38.8 % BAHA uptake rate in audiologically suitable patients. The main reasons cited for rejection of BAHA were anxiety over surgery and cosmetic concerns. It is important that clinicians address these early during consultation with prospective BAHA recipients and avoid rushing to implant these patients with a bone-anchored hearing aid.

  11. Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas

    Science.gov (United States)

    2013-01-01

    Background In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension—the delivery of patient decision aids on the Internet—is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. Methods An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. Results The updated definition distinguishes Internet-delivery of patient decision aids from online health information and clinical practice guidelines. Theories in cognitive psychology, decision psychology, communication, and education support the value of Internet features for providing interactive information and deliberative support. Dissemination and implementation theories support Internet-delivery for providing the right information (rapidly updated), to the right person (tailored), at the right time (the appropriate point in the decision making process). Additional efforts are needed to integrate the theoretical rationale and empirical evidence from health technology perspectives, such as consumer health informatics, user experience design, and human-computer interaction. Despite Internet usage ranging from 74% to 85% in developed countries and 80% of users searching for health information, it is unknown how many individuals specifically seek patient decision aids on the Internet. Among the 86 randomized controlled trials in the 2011 Cochrane Collaboration’s review of patient decision aids, only four studies focused on Internet-delivery. Given the limited number of published studies, this paper particularly focused on identifying gaps in the empirical evidence base and

  12. Disseminated acanthamoeba infection in patients with AIDS: case reports and review.

    Science.gov (United States)

    Sison, J P; Kemper, C A; Loveless, M; McShane, D; Visvesvara, G S; Deresinski, S C

    1995-05-01

    Acanthamoeba infection has been described as an opportunistic infection in persons with AIDS. We report two cases of patients with AIDS and acanthamoeba infection and review the manifestations of this protozoan infection in patients infected with human immunodeficiency virus. The diagnosis of this infection requires a high index of suspicion because the clinical and histologic manifestations may be confused with those of disseminated fungal or algal disease. Clinicians and laboratory personnel should be aware of this potentially fatal condition so that appropriate diagnostic studies can be performed and treatment can be urgently administered. Early initiation of therapy may alter the clinical outcome of the disease.

  13. Fulminant gastrointestinal hemorrhage due to Strongyloides stercoralis hyperinfection in an AIDS patient

    Directory of Open Access Journals (Sweden)

    Valdes Roberto Bollela

    2013-01-01

    Full Text Available Strongyloides stercoralis is an endemic nematode to tropical and subtropical regions of the globe. The parasite is capable of autoinfection, which is limited by an intact immune response. In immunocompromised hosts, hyperinfection and dissemination can occur and have a high index of mortality. A hyperinfection syndrome with dissemination is frequently associated with corticosteroid administration and other conditions (malignancies and organ transplantation. Interestingly, although strongyloidiasis is common among AIDS patients in endemic areas, the hyperinfection syndrome is rarely noted. We report here on a rare manifestation of fulminant gastrointestinal hemorrhage due to hyperinfection of strongyloidiasis in a female drug-abusing, alcoholic HIV/AIDS patient.

  14. Diversity of breakpoints of variant Philadelphia chromosomes in chronic myeloid leukemia in Brazilian patients

    Directory of Open Access Journals (Sweden)

    Maria de Lourdes Lopes Ferrari Chauffaille

    2015-02-01

    Full Text Available Background: Chronic myeloid leukemia is a myeloproliferative disorder characterized by the Philadelphia chromosome or t(9;22(q34.1;q11.2, resulting in the break-point cluster regionAbelson tyrosine kinase fusion gene, which encodes a constitutively active tyrosine kinase protein. The Philadelphia chromosome is detected by karyotyping in around 90% of chronic myeloid leukemia patients, but 5-10% may have variant types. Variant Philadelphia chromosomes are characterized by the involvement of another chromosome in addition to chromosome 9 or 22. It can be a simple type of variant when one other chromosome is involved, or complex, in which two or more chromosomes take part in the translocation. Few studies have reported the incidence of variant Philadelphia chromosomes or the breakpoints involved among Brazilian chronic myeloid leukemia patients. Objective: The aim of this report is to describe the diversity of the variant Philadelphia chromosomes found and highlight some interesting breakpoint candidates for further studies. Methods: the Cytogenetics Section Database was searched for all cases with diagnoses of chronic myeloid leukemia during a 12-year period and all the variant Philadelphia chromosomes were listed. Results: Fifty (5.17% cases out of 1071 Philadelphia-positive chronic myeloid leukemia were variants. The most frequently involved chromosome was 17, followed by chromosomes: 1, 20, 6, 11, 2, 10, 12 and 15. Conclusion: Among all the breakpoints seen in this survey, six had previously been described: 11p15, 14q32, 15q11.2, 16p13.1, 17p13 and 17q21. The fact that some regions get more fre- quently involved in such rare rearrangements calls attention to possible predisposition that should be further studied. Nevertheless, the pathological implication of these variants remains unclear.

  15. Workforce participation and activities in Parkinson's disease patients receiving device-aided therapy.

    Science.gov (United States)

    Sahlström, T; Eklund, M; Timpka, J; Henriksen, T; Nyholm, D; Odin, P

    2018-03-22

    Many countries have an aging population, and it is thus likely that Parkinson's disease (PD) will become an increasing health problem. It is important to ensure this group can use their resources in the best way possible, including remaining in the work market. This study aimed to investigate workforce participation and daily activities among patients with PD receiving device-aided therapy to provide new knowledge that may be used to inform decisions about these therapy options. This was a retrospective, descriptive quantitative pilot study, including 67 patients with PD from 3 centers in Sweden and Denmark. Included patients were younger than 67 years at the time of introduction of device-aided therapy. Eligible patients were identified by the Swedish national Parkinson patient registry or by the treating neurologist. Quantitative interviews were made by telephone. A majority of the patients could perform the same, or more, amount of activities approximately 5 years after the introduction of device-aided therapy. A small number of patients receiving deep brain stimulation (DBS) and levodopa-carbidopa intestinal gel (LCIG) were able to increase their work capacity within 1 year of initiating device-aided therapy and a remarkably high share could still work at the end-point of this study, approximately 15 years since the diagnosis of PD. Device-aided therapy may sustain or increase daily activities and workforce participation in patients with PD who have not yet reached retirement age. There is need for prospective studies, both quantitative and qualitative, to confirm these results. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Factors associated with caregiver burden: comparative study between Brazilian and Spanish caregivers of patients with Alzheimer's disease (AD).

    Science.gov (United States)

    Sousa, Maria Fernanda B; Santos, Raquel L; Turró-Garriga, Oriol; Dias, Rachel; Dourado, Marcia C N; Conde-Sala, Josep L

    2016-08-01

    Transcultural studies regarding the comparison of levels of burden in caregivers of patients with Alzheimer's disease (AD) from Europe and Latin America are rare. We designed this study to investigate the differentiating factors associated with burden in Brazilian and Spanish caregivers of patients with AD. This is a cross-sectional study composed by samples of outpatients with AD and their caregivers from Brazil (n = 128) and Spain (n = 146). Caregivers answered the Zarit Burden Interview (ZBI) and a Sociodemographic Questionnaire. Patients were assessed with the Mini-Mental State Examination (MMSE), Functional Activities Questionnaire (FAQ), Disability Assessment for Dementia (DAD), Neuropsychiatric Inventory (NPI), and Clinical Dementia Rating (CDR) Scale. In the multivariate regression analysis, high burden levels were reported in Brazil, when caregivers were female (p = 0.025) and when patients did not attend Day Care Center (p = 0.025). In Spain, high burden levels were associated with living with the patient (p = 0.014), younger caregivers (p = 0.003), and participation of patients at Day Care Center (p = 0.046). Also, different neuropsychiatric symptoms explained high burden levels: in Brazil, depression (p Caregivers' gender, patients who attended Day Care Center and neuropsychiatric symptoms were differentiating factors in the burden of Brazilian and Spanish caregivers.

  17. Use of medicines by patients of the primary health care of the Brazilian Unified Health System.

    Science.gov (United States)

    Costa, Clarisse Melo Franco Neves; Silveira, Micheline Rosa; Acurcio, Francisco de Assis; Guerra, Augusto Afonso; Guibu, Ione Aquemi; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mario; Leite, Silvana Nair; Costa, Ediná Alves; Nascimento, Renata Cristina Rezende Macedo do; Araújo, Vânia Eloísa de; Álvares, Juliana

    2017-11-13

    To characterize the use of medicines by patients of the primary health care of the Brazilian Unified Health System (SUS). This is a cross-sectional, exploratory, and descriptive study, part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos - Serviços, 2015 (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services, 2015). Interviews were carried out with patients present in the services by semi-structured questionnaires. Sociodemographic, clinical, and use of medicines variables were assessed and the use of medicines in the 30 days prior to the interview was also verified. The population was stratified into three age groups: 18 to 44, 45 to 64, and 65 years or more. The differences between the age groups were verified using the Student's t-test for continuous variables and chi-square test for the categorical ones. The complex samples analysis plan was employed. The medicines were classified according to the Anatomical Therapeutic Chemical Classification System. Of the 8,803 patients interviewed, 6,511 (76.2%) reported to have used medicines in the 30 days prior to the interview. On average, each patient used 2.32 medicines, without difference between the sexes. Among medicine users, 18.2% were aged 65 years or more. Compared to the other age groups, older adults presented more comorbidities, used more medicines, and self-reported worse health conditions. They were also less educated, reported worse economic situation, and lived alone. The medicines that were mostly used were "other analgesics and antipyretics" (3rd ATC level) and Losartan (5th ATC level). Most medicine users had lower education level and presented comorbidities. The most used medicines were the antihypertensive ones. Self-medication was higher among young people. Most patients reported to use generic medicines. The average number of medicines and the prevalence of use increased with age. Due to the characteristics

  18. Isosporiasis in HIV/AIDS Patients in Edo State, Nigeria.

    Science.gov (United States)

    Olusegun, Akinbo Frederick; Okaka, Christopher Ehis; Luiz Dantas Machado, Ricardo

    2009-07-01

    The role of opportunistic infections in accelerating disease progression in HIV-positive individuals, leading to quick death, is still receiving serious attention. The objective of this study was to determine the prevalence of Isospora belli infections in HIV-positive patients in Edo State, Nigeria between August 2007 and March 2008. A total of 268 samples from HIV-positive patients and 20 samples from HIV-negative patients were processed using the modified Ziehl-Neelsen staining technique to microscopically identify the presence of I. belli oocysts. The overall prevalence of the coccidian was 3.1%. Gender and age had no correlation with the prevalence of the parasite (P > 0.05). There was a significant relationship between isosporiasis and CD4+ T cell counts in HIV-positive patients (OR=11.388, 95% CI= 2.797-46.371, P=0.0004). Routine investigation of I. belli in HIV-positive subjects is advocated in tertiary health institutions.

  19. Clinical Profile and HIV/AIDS Prevalence of Patients with ...

    African Journals Online (AJOL)

    Data was analyzed using Epi info software package. Test of significance was done using the Chi-square and Fisher's exact probability test with the statistical significance set at p <0.05. Results: A total of 100 patients were studied, 6% had both malignancies and HIV sero-positivity, 94% had only malignancies without HIV ...

  20. Comparative Analysis of Patient Satisfaction Levels in HIV/AIDS ...

    African Journals Online (AJOL)

    Background: Continuous quality improvement is linked to the use of timely and useful feedback from clients in HIV care. HIV experts and care professionals agree that consumer involvement, such as patient satisfaction survey, is an essential part of HIV care and policy making today. The introduction of Antiretroviral Drugs ...

  1. User-centered design and the development of patient decision aids: protocol for a systematic review.

    Science.gov (United States)

    Witteman, Holly O; Dansokho, Selma Chipenda; Colquhoun, Heather; Coulter, Angela; Dugas, Michèle; Fagerlin, Angela; Giguere, Anik Mc; Glouberman, Sholom; Haslett, Lynne; Hoffman, Aubri; Ivers, Noah; Légaré, France; Légaré, Jean; Levin, Carrie; Lopez, Karli; Montori, Victor M; Provencher, Thierry; Renaud, Jean-Sébastien; Sparling, Kerri; Stacey, Dawn; Vaisson, Gratianne; Volk, Robert J; Witteman, William

    2015-01-26

    Providing patient-centered care requires that patients partner in their personal health-care decisions to the full extent desired. Patient decision aids facilitate processes of shared decision-making between patients and their clinicians by presenting relevant scientific information in balanced, understandable ways, helping clarify patients' goals, and guiding decision-making processes. Although international standards stipulate that patients and clinicians should be involved in decision aid development, little is known about how such involvement currently occurs, let alone best practices. This systematic review consisting of three interlinked subreviews seeks to describe current practices of user involvement in the development of patient decision aids, compare these to practices of user-centered design, and identify promising strategies. A research team that includes patient and clinician representatives, decision aid developers, and systematic review method experts will guide this review according to the Cochrane Handbook and PRISMA reporting guidelines. A medical librarian will hand search key references and use a peer-reviewed search strategy to search MEDLINE, EMBASE, PubMed, Web of Science, the Cochrane Library, the ACM library, IEEE Xplore, and Google Scholar. We will identify articles across all languages and years describing the development or evaluation of a patient decision aid, or the application of user-centered design or human-centered design to tools intended for patient use. Two independent reviewers will assess article eligibility and extract data into a matrix using a structured pilot-tested form based on a conceptual framework of user-centered design. We will synthesize evidence to describe how research teams have included users in their development process and compare these practices to user-centered design methods. If data permit, we will develop a measure of the user-centeredness of development processes and identify practices that are likely

  2. Lipoatrophy in patients with AIDS: treatment with polymethylmethacrylate in Amazonas, Brazil.

    Science.gov (United States)

    Orsi, Ana Tereza; Miranda, Angélica Espinosa; Souza, Andrea Cavalcante; Silva, Leila Cristina; Dias, Gisele Reis; Talhari, Carolina; Talhari, Sinesio; Santos, Monica

    2011-10-01

    The use of antiretroviral therapy (ART) in AIDS has been associated with lipodystrophic syndrome, which is characterized by metabolic alterations and abnormal corporal fat distribution. Our goal was to describe and evaluate the use of polymethylmethacrylate (PMMA) to treat lipoatrophy in patients with AIDS from Amazonas, Brazil. Patients with AIDS undergoing ART and presenting with facial lipoatrophy were invited to participate in the study. A face-to-face interview was conducted, and patients were treated with applications of PMMA 30%. A total of 49 cases were included. The mean age was 45 (SD 6.1) years old, and the mean educational level (measured in schooling years) was 10.5 (SD 3.2) years of schooling. The median of CD4 cell count was 482.5 (interquartile range: 338-574.5) cells/mm(3) . Stavudine and zidovudine were the most frequently prescribed ART drugs. The total number of PMMA injections ranged from one to five times, and side effects were not frequent. A total of 42 (85.7%) patients reported satisfaction after a follow-up of more than 12 months, presenting good fullness of the deformity. Our data showed that patients with AIDS with lipoatrophy related to ART could safely benefit from PMMA-based treatment. © 2011 The International Society of Dermatology.

  3. Strongyloides stercoralis hyper-infection syndrome in HIV+/AIDS patients in Iran.

    Science.gov (United States)

    Meamar, A R; Rezaian, M; Mohraz, M; Hadighi, R; Kia, E B

    2007-08-01

    Strongyloides stercoralis is an intestinal nematode in humans, distributed through tropical and subtropical regions of the world. In most individuals, the infection has a chronic nature due to auto-infection at the low level. Accelerated auto-infection, mainly after an alteration in immune status, can cause a syndrome of severe hyper-infection or potentially fatal disseminated strongyloidiasis. Due to the increasing numbers of immunocompromised patients in Iran, strongyloidiasis is an emerging public health concern in the country. In the current study, which was carried out between 2003 and 2005, for the investigation on strongyloidiasis in HIV(+)/AIDS patients, a total of 781 patients were examined by agar plate culture, formalin ether concentration, and direct smear preparation of stool samples. According to the results, 2 out of 781 HIV( + )/AIDS patients were found infected with S. stercoralis, but both patients were at the progressive stage of AIDS and showing severe hyper-infection syndrome. In both cases, numerous rhabditiform and filariform larvae were found in fresh stool direct smears, and rapid and intensive development of parasite in agar plate cultures. In conclusion, in the progressive stages of AIDS, as a result of immunosuppression conditions or in the context of chemotherapy, S. stercoralis is capable of inducing overwhelming infection.

  4. Successful bone-anchored hearing aid implantation in a patient with osteogenesis imperfecta.

    Science.gov (United States)

    Coutinho, M B; Marques, C; Mendes, G J; Gonçalves, C

    2015-11-01

    To report a case of successful bone-anchored hearing aid implantation in an adult patient with type III osteogenesis imperfecta, which is commonly regarded as a contraindication to this procedure. A 45-year-old man with type III osteogenesis imperfecta presented with mixed hearing loss. There was a mild sensorineural component in both ears, with an air-bone gap between 45 and 50 dB HL. He was implanted with a bone-anchored hearing aid. The audiological outcome was good, with no complications and good implant stability (as measured by resonance frequency analysis). To our knowledge, this is the first recorded case of bone-anchored hearing aid implantation in a patient with osteogenesis imperfecta.

  5. Productive human immunodeficiency virus infection levels correlate with AIDS-related manifestations in the patient

    International Nuclear Information System (INIS)

    Mathez, D.; Paul, D.; de Belilovsky, C.; Sultan, Y.; Deleuze, J.; Gorin, I.; Saurin, W.; Decker, R.; Leibowitch, J.

    1990-01-01

    Mononuclear cells were obtained from 71 human immunodeficiency virus type 1 (HIV-1) seropositive subjects presenting and first visit either as asymptomatic or with minor symptoms and with CD4 lymphocytes greater than 550 per mm3 (group A, 35 patients) or as patients with AIDS, AIDS-related illnesses, or CD4 lymphocytes less than 400 per mm3 (group B, 36 patients). After 1-5 years of follow-up, 13 patients of group A had essentially retained their initial status (asymptomatics); the 22 others had suffered clinical or immunological deterioration (progressors). Frozen cells were thawed and submitted to lethal gamma-irradiation in vitro (4500 rads; 1 rad = 0.01 Gy) before they were cultured with normal phytohemagglutinin-stimulated lymphocytes to determine radiation-resistant HIV expression ex vivo (R-HEV). HIV antigenemia correlated with R-HEV values in 142 samples (r = 0.92, P less than 0.001) but was a less sensitive predictor of disease than R-HEV. R-HEV was detected in all specimens from patients with major AIDS-related illnesses or HIV-associated CD4 lymphopenia. In 77% of the progressors from group A, R-HEV detection preceded the onset of AIDS-associated disease or CD4 lymphopenia by 1 year (average). Conversely, R-HEV was low or was not detected in 36 sequential specimens from the 13 patients who remained asymptomatic over the following 2-5 years. Thus, persistently low HIV expression in vivo predicted a nondiseased state, whereas higher HIV expression levels seemed necessary for disease to occur. These data indicate that R-HEV is related to productive HIV infection in vivo, the latter acting as a determinant of AIDS-related illnesses. In view of this, measurement of HIV expression levels in the patient should be useful in antiviral efficacy trials

  6. [Self-rated efficacy in bilateral aural atresia patients using bone-anchored hearing aid].

    Science.gov (United States)

    Yue, Fan; Yibei, Wang; Zhen, Wang; Pu, Wang; Xiaowei, Chen

    2015-03-01

    Using questionnaires to evaluate the audiological benefit and satisfaction of bilateral aural atresia patients with bone-anchored hearing aid (Baha). Implanted Baha user questionnaire was applied to 19 patients suffering bilateral aural atresia, and 15 of the patients were evaluated with abbreviated profile of hearing aid benefit (APHAB). Glasgow children's benefit inventory (GCBI) was used to measure subjective benefit of patients under the age of 18. The Baha user questionnaire demonstrated great satisfaction. The mean Baha scores for the subdomains of ease of communication (EC), backgroud noise (BN) and revereration (RV) were decreased by 54.6 ± 10.2 (t = 20.6, P hearing ability and quality of life of patients with bilateral aural atresia.

  7. [Erosive gastritis associated with cryptosporidium in 2 patients with AIDS].

    Science.gov (United States)

    Besasso, H R; Macías, J; Trombetta, L A; di Risio, C A; Argento, R; Besuschio, S C

    1994-01-01

    Occurrence of vomiting and diarrhea in patients with acquired immunodeficiency syndrome was most frequently attributed to enteropathogens organism that invade the gastrointestinal tract because of the immunologic unbalance of the host... Among several causes the cryptosporidium has been detected quite often and its predominant localization was the gastrointestinal tract, although other extraintestinal sites has also been reported. In both cases, erosive congestive gastritis was found, while histological examination showed cryptosporidium in gastric biopsy specimens.

  8. Impact of Hearing Aid Technology on Outcomes in Daily Life I: The Patients' Perspective.

    Science.gov (United States)

    Cox, Robyn M; Johnson, Jani A; Xu, Jingjing

    2016-01-01

    difference in outcomes between premium- and basic-feature devices. Participants did not report better outcomes with premium processing with any measure. It could reasonably be asserted that the patient's perspective is the gold standard for hearing aid effectiveness. While the acoustical processing provided by premium features can potentially improve scores on tests conducted in contrived conditions in a laboratory, or on specific items in a questionnaire, this does not ensure that the processing will be of noteworthy benefit when the hearing aid is used in the real world challenges faced by the patient. If evidence suggests the patient cannot detect that premium features yield improvements over basic features in daily life, what is the responsibility of the provider in recommending hearing aid technology level? In the present research, there was no evidence to suggest that premium-feature devices yielded better outcomes than basic-feature devices from the patient's point of view. All of the research hearing aids were substantially, but equally, helpful. Further research is needed on this topic with other hearing aids and other manufacturers. In the meantime, providers should insist on scientifically credible independent evidence to support effectiveness claims for any hearing help devices.

  9. Infectious diarrhoea in antiretroviral therapy-naïve HIV/AIDS patients in Kenya

    Science.gov (United States)

    Wanyiri, Jane W.; Kanyi, Henry; Maina, Samuel; Wang, David E.; Ngugi, Paul; O'Connor, Roberta; Kamau, Timothy; Waithera, Tabitha; Kimani, Gachuhi; Wamae, Claire N.; Mwamburi, Mkaya; Ward, Honorine D.

    2013-01-01

    Background Diarrhoea is a significant cause of morbidity and mortality in immunocompromised patients. The objectives of this study were to investigate the aetiological agents, risk factors and clinical features associated with diarrhoea in HIV/AIDS patients in Kenya. Methods Sociodemographic, epidemiological and clinical data were obtained for 164 HIV/AIDS patients (70 with and 94 without diarrhoea) recruited from Kenyatta National Hospital, Kenya. Stool samples were examined for enteric pathogens by microscopy and bacteriology. Results Intestinal protozoa and fungi were identified in 70% of patients, more frequently in those with diarrhoea (p<0.001). Helminths were detected in 25.6% of patients overall, and bacterial pathogens were identified in 51% of patients with diarrhoea. Polyparasitism was more common in patients with diarrhoea than those without (p<0.0001). Higher CD4+ T-cell count (OR = 0.995, 95% CI 0.992–0.998) and water treatment (OR = 0.231, 95% CI 0.126–0.830) were associated with a lower risk of diarrhoea, while close contact with cows (OR = 3.200, 95% CI 1.26–8.13) or pigs (OR = 11.176, 95% CI 3.76–43.56) were associated with a higher risk of diarrhoea. Conclusions Multiple enteric pathogens that are causative agents of diarrhoea were isolated from stools of antiretroviral therapy-naïve HIV/AIDS patients, indicating a need for surveillance, treatment and promotion of hygienic practices. PMID:24026463

  10. Infectious diarrhoea in antiretroviral therapy-naive HIV/AIDS patients in Kenya.

    Science.gov (United States)

    Wanyiri, Jane W; Kanyi, Henry; Maina, Samuel; Wang, David E; Ngugi, Paul; O'Connor, Roberta; Kamau, Timothy; Waithera, Tabitha; Kimani, Gachuhi; Wamae, Claire N; Mwamburi, Mkaya; Ward, Honorine D

    2013-10-01

    Diarrhoea is a significant cause of morbidity and mortality in immunocompromised patients. The objectives of this study were to investigate the aetiological agents, risk factors and clinical features associated with diarrhoea in HIV/AIDS patients in Kenya. Sociodemographic, epidemiological and clinical data were obtained for 164 HIV/AIDS patients (70 with and 94 without diarrhoea) recruited from Kenyatta National Hospital, Kenya. Stool samples were examined for enteric pathogens by microscopy and bacteriology. Intestinal protozoa and fungi were identified in 70% of patients, more frequently in those with diarrhoea (p<0.001). Helminths were detected in 25.6% of patients overall, and bacterial pathogens were identified in 51% of patients with diarrhoea. Polyparasitism was more common in patients with diarrhoea than those without (p<0.0001). Higher CD4(+) T-cell count (OR = 0.995, 95% CI 0.992-0.998) and water treatment (OR = 0.231, 95% CI 0.126-0.830) were associated with a lower risk of diarrhoea, while close contact with cows (OR = 3.200, 95% CI 1.26-8.13) or pigs (OR = 11.176, 95% CI 3.76-43.56) were associated with a higher risk of diarrhoea. Multiple enteric pathogens that are causative agents of diarrhoea were isolated from stools of antiretroviral therapy-naïve HIV/AIDS patients, indicating a need for surveillance, treatment and promotion of hygienic practices.

  11. Reliability and validity of the Treatment Satisfaction Questionnaire for Medication among Portuguese-speaking Brazilian patients with hypertension.

    Science.gov (United States)

    Sauer Liberato, Ana Carolina; Cunha Matheus Rodrigues, Roberta; Kim, MyoungJin; Mallory, Caroline

    2016-07-01

    This study examined the reliability and validity of the Brazilian Portuguese version of the Treatment Satisfaction Questionnaire for Medication (version 1.4) among patients with hypertension. Understanding the patient experience with treatment satisfaction will contribute to improved medication adherence and control of hypertension. Hypertension is a serious problem in Brazil that is associated with chronic illness controlled, in part, by consistent adherence to medications. Patient satisfaction with medication treatment is associated with adherence to medication. The Treatment Satisfaction Questionnaire for Medication (version 1.4) is a promising instrument for measuring medication; however, to date there has been no report of the reliability and validity of the instrument with Portuguese-speaking adults with hypertension in Brazil. Cross-sectional descriptive exploratory study. A convenience sample of 300 patients with hypertension in an outpatient setting in the southeast region of São Paulo state in Brazil completed the Treatment Satisfaction Questionnaire for Medication (version 1.4). The instrument, comprised of four subscales, was evaluated for reliability using correlation analyses and internal consistency. Confirmatory factor analysis was used to determine factorial validity. Correlational analyses, internal consistency (Cronbach's alpha) and hierarchical confirmatory factor analysis demonstrate adequate support for the four-factor dimensionality, reliability and factorial validity of the Treatment Satisfaction Questionnaire for Medication (version 1.4). This study provides modest evidence for internal consistency and factorial validity of the Treatment Satisfaction Questionnaire for Medication (version 1.4) in Portuguese-speaking adult Brazilians with hypertension. Future testing should focus on extending reliability testing, discriminant validity and potential translation and literacy issues in this population. Within known limitations, clinicians will

  12. Impact of a patient decision aid on care among patients with nonvalvular atrial fibrillation: a cluster randomized trial

    Science.gov (United States)

    McAlister, Finlay A.; Man-Son-Hing, Malcolm; Straus, Sharon E.; Ghali, William A.; Anderson, David; Majumdar, Sumit R.; Gibson, Paul; Cox, Jafna L.; Fradette, Miriam

    2005-01-01

    Background Too few patients with nonvalvular atrial fibrillation (NVAF) receive appropriate antithrombotic therapy. We tested the short-term (primary outcome) and long-term (secondary outcome) effect of a patient decision aid on the appropriateness of antithrombotic therapy among patients with NVAF. Methods We conducted a cluster randomized trial with blinded outcome assessment involving 434 NVAF patients from 102 community-based primary care practices. Patients in the intervention group received a self-administered booklet and audiotape decision aid tailored to their personal stroke risk profile. Patients in the control group received usual care. The primary outcome measure was change in antithrombotic therapy at 3 months. Appropriateness of therapy was defined using the American College of Chest Physicians (ACCP) recommendations. Results The mean patient age was 72 years, and the median duration of NVAF was 5 years. In the control group, there was a 3% decrease over 3 months in the number of patients receiving therapy appropriate to their risk of stroke (40% [85/215] at baseline v. 37% [79/215] at 3 months). In the intervention group, the number of patients receiving therapy appropriate to their stroke risk increased by 9% (32% [69/219] at baseline v. 41% [89/219] at 3 months). Although the proportion of patients whose therapy met the ACCP treatment recommendations did not differ between study arms at baseline (p = 0.11) or 3 months (p = 0.44), there was a 12% absolute improvement in the number of patients receiving appropriate care in the intervention group compared with the control group at 3 months (p = 0.03). The beneficial effect of the decision aid did not persist (p = 0.44 for differences between study arms after 12 months). Interpretation There was short-term improvement in the appropriateness of antithrombotic care among patients with NVAF who were exposed to a decision aid, but the improvement did not persist. PMID:16129870

  13. Mitochondrial and genomic ancestry are associated with etiology of heart failure in Brazilian patients.

    Science.gov (United States)

    Cardena, M M S G; Ribeiro-Dos-Santos, A K; Santos, S E B; Mansur, A J; Bernardez-Pereira, S; Santos, P C J L; Pereira, A C; Fridman, C

    2016-02-01

    There is a high prevalence of heart failure (HF) in the general population, but it is more common in black people. We evaluated the association between genomic ancestry and mitochondrial haplogroups (mt-haplogroups) with HF etiology in 503 Brazilian patients. We elicited Mt-haplogroups by analyzing the control region of mitochondrial DNA, and genomic ancestry, by using 48 autosomal insertion-deletion ancestry informative markers. Hypertensive (28.6%, n=144) and ischemic (28.4%, n=143) etiologies of HF were the most prevalent herein. Our results showed that 233 individuals (46.3%) presented African mitochondrial (mt)-haplogroups, and the major contribution in the genomic ancestry analysis was the European ancestry (57.5% (±22.1%)). African mt-haplogroups were positively associated with a diagnosis of hypertensive cardiomyopathy (odds ratio, OR 1.55, confidence interval, CI 95% 1.04-2.44, P=0.04) when compared with European mt-haplogroups. Regarding the genomic ancestry, the African ancestry variant had higher risks (OR 7.84, 95% CI 2.81-21.91, Pancestry variant had lower risks (OR 0.14, 95% CI 0.04-5.00, Pancestry showed an OR of 4.05 (CI 95% 1.53-10.74, P=0.005), whereas African ancestry showed an OR of 0.17 (CI 95% 0.06-0.48, P=0.001) for developing ischemic etiology. In conclusion, this study supports the importance of using ancestry informative markers and mitochondrial DNA to study the genetics of complex diseases in admixed populations to improve the management, treatment and prevention of these illnesses. Therefore, the ancestry informative markers and mt-haplogroups could provide new biomarkers to be associated with HF etiologies and be used as a premise for more specific management.

  14. In vivo HIV-1 hypermutation and viral loads among antiretroviral-naive Brazilian patients.

    Science.gov (United States)

    de Lima-Stein, Mariana Leão; Alkmim, Wagner Tadeu; Bizinoto, Maria Clara de Souza; Lopez, Luis Fernandez; Burattini, Marcelo Nascimento; Maricato, Juliana Terzi; Giron, Leila; Sucupira, Maria Cecília Araripe; Diaz, Ricardo Sobhie; Janini, Luiz Mario

    2014-09-01

    Hypermutation alludes to an excessive number of specific guanine-to-adenine (G- >A) substitutions in proviral DNA and this phenomenon is attributed to the catalytic activity of cellular APOBECs. Population studies relating hypermutation and the progression of infection by human immunodeficiency virus type 1 (HIV-1) have been performed to elucidate the effect of hypermutation on the natural course of HIV-1 infection. However, the many different approaches employed to assess hypermutation in nucleotide sequences render the comparison of results difficult. This study selected 157 treatment-naive patients and sought to correlate the hypermutation level of the proviral sequences in clinical samples with demographic variables, HIV-1 RNA viral load, and the level of CD4(+) T cells. Nested touchdown polymerase chain reaction (PCR) was performed with specific primers to detect hypermutation in the region of HIV-1 integrase, and the amplified sequences were run in agarose gels with HA-Yellow. The analysis of gel migration patterns using the k-means clustering method was validated by its agreement with the results obtained with the software Hypermut. Hypermutation was found in 31.2% of the investigated samples, and a correlation was observed between higher hypermutation levels and higher viral load levels. These findings suggest a high frequency of hypermutation detection in a Brazilian cohort, which can reflect a particular characteristic of this population, but also can result from the method approach by aiming at hypermutation-sensitive sites. Furthermore, we found that hypermutation events are pervasive during HIV-1 infection as a consequence of high viral replication, reflecting its role during disease progression.

  15. Measuring fatigue with multiple instruments in a Brazilian cohort of early rheumatoid arthritis patients

    Directory of Open Access Journals (Sweden)

    Leonardo Rios Diniz

    Full Text Available Abstract Objective: To assess the prevalence of fatigue in a Brazilian population with early rheumatoid arthritis using multiple instruments, and the predictors of these instruments by differents independent variables. Methods: Cross-sectional study with direct interview and medical records review. Fatigue, dependent variable, was assessed using eight instruments: Profile of Mood States (POMS, Multidimensional Assessment of Fatigue scale (MAF, Fatigue Severity Scale (FSS, Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire (BRAF-MDQ, Numerical Rating Scales (BRAF-NRS, Short-form Survey 36 (SF-36, Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACIT-F and Visual Analogic Scale for Fatigue (VASf. Independent variables: sociodemographic, clinical and serological, were measured using medical records and direct interview. Disability and disease activity were assessed using the Health Assessment Questionnaire (HAQ and disease activity assessed using the Disease Activity Score 28 joints (DAS28. The scores of scales demonstrated the level of fatigue and multiple linear regression method used in statistical analysis to demonstrate prediction models. Results: A total of 80 patients was assessed, and 57 reported clinically relevant fatigue (VASf > 2, representing 71.25% prevalence point (51 women [89.5%], mean age 48.35 ± 15 years, and mean disease duration of 4.92 ± 3.8 years. Eight predictive models showed statistical significance, one for each fatigue instrument. The highest coefficient of determination (R 2 was 56% for SF-36 and the lowest (R 2 = 21% for FSS. The HAQ was the only independent variable to predict fatigue on all instruments. Conclusion: Clinically relevant fatigue is a highly prevalent symptom and is mostly predicted by disability and age in the population assessed.

  16. Measuring fatigue with multiple instruments in a Brazilian cohort of early rheumatoid arthritis patients.

    Science.gov (United States)

    Diniz, Leonardo Rios; Balsamo, Sandor; Souza, Talita Yokoy de; Muniz, Luciana Feitosa; Martins, Wagner Rodrigues; Mota, Licia Maria Henrique da

    To assess the prevalence of fatigue in a Brazilian population with early rheumatoid arthritis using multiple instruments, and the predictors of these instruments by differents independent variables. Cross-sectional study with direct interview and medical records review. Fatigue, dependent variable, was assessed using eight instruments: Profile of Mood States (POMS), Multidimensional Assessment of Fatigue scale (MAF), Fatigue Severity Scale (FSS), Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire (BRAF-MDQ), Numerical Rating Scales (BRAF-NRS), Short-form Survey 36 (SF-36), Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACIT-F) and Visual Analogic Scale for Fatigue (VASf). sociodemographic, clinical and serological, were measured using medical records and direct interview. Disability and disease activity were assessed using the Health Assessment Questionnaire (HAQ) and disease activity assessed using the Disease Activity Score 28 joints (DAS28). The scores of scales demonstrated the level of fatigue and multiple linear regression method used in statistical analysis to demonstrate prediction models. A total of 80 patients was assessed, and 57 reported clinically relevant fatigue (VASf>2), representing 71.25% prevalence point (51 women [89.5%], mean age 48.35±15 years, and mean disease duration of 4.92±3.8 years). Eight predictive models showed statistical significance, one for each fatigue instrument. The highest coefficient of determination (R 2 ) was 56% for SF-36 and the lowest (R 2 =21%) for FSS. The HAQ was the only independent variable to predict fatigue on all instruments. Clinically relevant fatigue is a highly prevalent symptom and is mostly predicted by disability and age in the population assessed. Copyright © 2017 Elsevier Editora Ltda. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Frequency of Mycobacterium Tuberculosis Infection among Iranian Patients with HIV/AIDS by PPD Test

    Directory of Open Access Journals (Sweden)

    Fatemeh Fattahi

    2010-02-01

    Full Text Available Persons infected with the Human Immunodeficiency Virus (HIV are particularly susceptible to tuberculosis, either by latent infection reactivation or by a primary infection with rapid progression to active disease. This study was done to determine the frequency of tuberculosis infection among Iranian patients with HIV/AIDS. A total of 262 HIV/AIDS patients attending all three HIV/AIDS health care centers of Tehran, Iran were enrolled in this study. A detailed history and physical examination were obtained from all HIV patients suspected of having pulmonary M. tuberculosis. A positive PPD skin test was used as a diagnostic parameter for probability of TB infection. Out of 262 HIV/AIDS patients, a total of 63 (24% were shown to have the tuberculosis infection based on a positive PPD skin test. Of the patients with positive PPD skin test, 22 (35% had pulmonary Tuberculosis, 2 (3.2% had extrapulmonary tuberculosis, and 39 (53% had no evidence of M. tuberculosis infection (latent infection. Also 8 (12.7% had history of long term residence in a foreign country, 32 (50.8% were exposed to an index case, and 9 (14.3% had past history of pulmonary tuberculosis, while only 33.3% had clinical manifestations of TB (active disease. There was no resistant case of tuberculosis. Our study showed that near 24% of Iranian patients with HIV/AIDS were infected with M. tuberculosis. This finding denotes the need to improve the diagnostic and preventive measures, and also prompt treatment of this type of infection in the HIV infected individuals.

  19. Association of progressive outer retinal necrosis and varicella zoster encephalitis in a patient with AIDS

    NARCIS (Netherlands)

    van den Horn, G. J.; Meenken, C.; Troost, D.

    1996-01-01

    A patient with AIDS who developed the clinical picture of bilateral progressive outer retinal necrosis (PORN) in combination with varicella zoster encephalitis is described. The picture developed more than 2 years after an episode of ophthalmic zoster infection, and following intermittent exposure

  20. Myelodysplasia in Ugandan Patients with HIV/AIDS: An Autopsy Study

    African Journals Online (AJOL)

    Background: Myelodysplasia has been reported to occur quite frequently in the spectrum of HIV/AIDS disease and is thought to be partly responsible for bone marrow failure in these patients. However, the frequency and type of myelodysplasia appear to differ at different stages of the disease in different populations with ...

  1. [Prevalence and related factors of HIV/HBV coinfection among HIV/AIDS patients].

    Science.gov (United States)

    Feng, D; Yao, T; Cheng, Y P; Pan, M H; Li, C X; Wang, J; Feng, Y L; Shi, J; Huang, H L; Lu, H Y; Lan, G H; Wang, S P; Zhang, Y W

    2017-12-10

    Objective: To reveal the prevalence and the related factors of hepatitis B (HepB) virus infection among HIV/AIDS patients. Methods: We conducted a cross-sectional study in two HIV clinics, affiliated to local Centers of Disease Control and Prevention in Guangxi Zhuang Autonomous Regional. A face-to-face interview, with questionnaire was conducted to collect information on socio-demographic characteristics, drug use, and sexual behavior. Blood samples were used to test HBsAg. χ (2) test or Fisher's exact test and unconditional logistic regression models were used to identify the influencing factors. Results: The prevalence of HBV and HIV co-infection was 13.85% (113/816). Results from multivariate logistic regression analyses showed that age (25-45), family history of HBV and history of HepB vaccination were independent influencing factors for HBV and HIV coinfection, with OR (95% CI ) as 1.738 (1.031-2.931), 2.898 (1.678-5.005) and 1.744 (1.052-2.892), respectively. Conclusion: The prevalence of HBV among HIV/AIDS patients was significantly higher than that in general population. HIV/AIDS patients aged between 25 and 45 and with family history of HBV were more likely to be infected with HBV, while HepB vaccination was associated with the reduction of HIV/HBV coinfection. Specific comprehensive prevention and treatment programs on HIV/AIDS patients need to be set up.

  2. Itraconazole compared with amphotericin B plus flucytosine in AIDS patients with cryptococcal meningitis

    NARCIS (Netherlands)

    de Gans, J.; Portegies, P.; Tiessens, G.; Eeftinck Schattenkerk, J. K.; van Boxtel, C. J.; van Ketel, R. J.; Stam, J.

    1992-01-01

    We conducted a comparison of itraconazole versus amphotericin B plus flucytosine in the initial treatment of cryptococcal meningitis in patients with AIDS and established the efficacy of itraconazole as maintenance treatment. The trial was a prospective, randomized, and non-blinded study. The study

  3. Plasmid Profile of Bacteria Isolated from tears of HIV/AIDS Patients ...

    African Journals Online (AJOL)

    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 ... staphylococcus aureus strains showed 100% resistance to Ampiclox and erythromycin, 66.6% to Perfloxacin, amoxicillin and septrin, 33.33% to ciprofloxacin.

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

    Directory of Open Access Journals (Sweden)

    Fábio Tadeu Rodrigues REINA

    2016-01-01

    Full Text Available 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.

  5. audit of referral of aids patients from hospital to an integrated ...

    African Journals Online (AJOL)

    Laura Campbell, .I."IB GliB, MFamMed, Dip PalllvIed, Dip MH. HQnorary ucturer, Department of Family Medicine, U"iversity ofNatal, Durban. AUDIT OF REFERRAL OF AIDS PATIENTS. FROM HOSPITAL TO AN INTEGRATED. COMMUNITY-BASED HOME CARE. PROGRAMME IN KWAZULU-NATAL,. SOUTH AFRICA.

  6. 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...

  7. Myelodysplasia in Ugandan patients with hiV/aids: an aUtopsy stUdy

    African Journals Online (AJOL)

    East African Medical Journal Vol. 88 No. 1 January 2011. Myelodysplasia in Ugandan patients with hiV/aids: an aUtopsy stUdy. S. Nabadda, MBChB, MMed, Medical Officer Special Grade, Mulago Hospital, Department of Pathology P. O. Box. 7072 Kampala, Uganda, M. Odida, MBChB, MMed, Senior Lecturer and H.

  8. The effect of walking aids on muscle activation patterns during walking in stroke patients

    NARCIS (Netherlands)

    Buurke, Jaap; Hermens, Hermanus J.; Erren-Wolters, C.V.; Nene, A.V.

    2005-01-01

    The purpose of this study was to investigate changes in muscle activation patterns with respect to timing and amplitude that occur when subjects with stroke walk with and without a walking aid. This knowledge could help therapists in deciding whether or not patients should use a cane or quad stick

  9. Toxoplasma gondii IgG antibodies in HIV/AIDS patients attending ...

    African Journals Online (AJOL)

    Background: Toxoplasmosis is caused by Toxoplasma gondii, a parasite that gradually evolved to be the most opportunistic parasite that complicates the course of HIV/AIDS in developing countries. Aim: This study was undertaken to investigate the presence of Toxoplasma gondii IgG antibodies in HIVinfected patients ...

  10. Cytomegalovirus glycoprotein B genotyping in ocular fluids and blood of AIDS patients with cytomegalovirus retinitis

    NARCIS (Netherlands)

    Peek, R.; Verbraak, F.; Bruinenberg, M.; van der Lelij, A.; van den Horn, G.; Kijlstra, A.

    1998-01-01

    To determine the frequency of cytomegalovirus glycoprotein B (gB) genotypes in clinical samples of ocular fluids of patients with acquired immune deficiency syndrome (AIDS) who have cytomegalovirus retinitis and to compare these with the cytomegalovirus gB genotype in paired peripheral blood

  11. Estimating the cost to rural ambulating HIV/AIDS patients on Highly ...

    African Journals Online (AJOL)

    Results: The median total, indirect and direct annual costs to rural ambulating HIV/AIDS patients on HAART were estimated to be $US71.18 (115.16 Ghana cedis), $US2.740 (3.92 Ghana cedis) and $US53.04 (75.00 Ghana cedis) respectively. Conclusion: Although the cost of antiretroviral drugs has been subsidized by ...

  12. Radiotherapy of epidemic Kaposi's sarcoma in patients with AIDS

    International Nuclear Information System (INIS)

    Westermann, V.A.; Mueller, R.P.; Adler, M.; Bendick, C.; Rasokat, H.

    1990-01-01

    From August 1986 to May 1989, 15 patients suffering from Kaposi's sarcoma and serologically proven HIV infections were treated in the Department of Radiotherapy, University of Cologne, Medical Hospital. All patients were male and homosexual. Therapeutic objectives were palliation of pain and functional impairment as well as elimination of the cosmetically disturbing Kaposi's sarcoma. 68 localizations (facial skin, torso, extremities, sole of the foot, penis, oral mucosa and oropharynx) were irradiated. Depending on the individual therapy regimen, photons or high-energy electrons up to a total dose of 26 to 40 Gy, with single doses of 1.8 to 2.5 Gy were applied four to five times a week. In 66% of the cases, complete remission was achieved within the area of irradiation at the dermal or mucosal level, with at most a discrete residual pigmentation of the cluster remaining. Partial remission with at least 50% regression or a distinctive residual pigmentation was achieved in 31%. In 3% of the cases, a less than 50% regression of the Kaposi's lesions were achieved after radiotherapy. There were five local recurrences. Treatment with radiation is an effective local therapy in epidemic Kaposi's sarcoma and yields good functional and cosmetic results and also provides relief from pain. (orig.) [de

  13. 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

  14. Usefulness of recombinant human TSH aided radioiodine doses administered in patients with differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Pitoia, Fabian; El Tamer, Elias; Schere, Daniel B.; Passerieu, Mariano; Bruno, Oscar D.; Niepominiszcze, Hugo

    2006-01-01

    The published studies confirming the safety and efficacy of rh TSH for diagnostic purposes have led to an increased interest in its use for preparation for radioiodine (RI) dose administration in patients with recurrent or persistent differentiated thyroid carcinoma (DTC). In order to establish the efficacy of RI therapy after rh TSH, we have reviewed 39 rh TSH-aided radioiodine treatments in a series of 28 DTC patients. Patients were divided into two groups: GI (n=17), with previous thyroid bed uptake and undetectable thyroglobulin (Tg) levels under levothyroxine treatment and GII (n=11), with proven metastatic local or distant disease. Median follow-up after the first rh TSH-aided radioiodine treatment was 32 ± 13 months (range 8 to 54 months). Sixteen patients (94%) in GI were rendered disease free and one patient was shown to have persistent disease. In GII, the post therapy whole body scan showed pathological uptakes in all cases: in four patients in lungs, in four in mediastinum and in three in lateral neck. In two patients with mediastinum uptake, Tg levels were undetectable after rh TSH. In the follow-up, two patients with lateral neck uptake were rendered disease free, four patients died (three due to thyroid cancer) and five out of the remaining patients have persistent disease. In conclusion, rh TSH aided therapy was helpful to eliminate normal thyroid bed remnants in 16/17 (94%) patients (GI). rh TSH stimulated Tg was undetectable in two patients with mediastinal metastasis. We believe that rh TSH is a good alternative to levothyroxine withdrawal for the treatment of DTC with radioactive iodine, increasing the quality of life in these patients. Caution should be recommended in the follow-up of unselected DTC patients only with stimulated Tg levels. (author) [es

  15. Enteric parasites in HIV-1/AIDS-infected patients from a Northwestern São Paulo reference unit in the highly active antiretroviral therapy era

    Directory of Open Access Journals (Sweden)

    Luciana Ventura Cardoso

    2011-12-01

    Full Text Available INTRODUCTION: We describe the epidemiology of intestinal parasites in patients from an AIDS reference service in Northeastern São Paulo, Brazil. METHODS: Retrospective evaluation was done for all HIV-1/AIDS-positive patients whose Hospital de Base/São José do Rio Preto laboratorial analysis was positive for enteroparasites after diagnosis of HIV-1 infection, from January 1998 to December 2008. Statistical analysis was performed using the R statistical software version 2.4.1. The level of significance adopted was 5%. RESULTS: The most frequent protozoan was Isospora belli (4.2%, followed by Giardia lamblia (3.5%, Entamoeba coli (2.8%, and Cryptosporidium parvum (0.3%. Ancylostoma duodenale (1.4% was the most frequently detected helminth, while Taenia saginata and Strongiloides stercoralis were found in 0.7% of the samples. The results showed that diarrhea was significantly associated with giardiasis and isosporiasis. However, no association was observed between CD4+ cell counts, viral load, and the characteristics of any particular parasite. CONCLUSIONS: Our data may be useful for further comparisons with other Brazilian regions and other developing countries. The data may also provide important clues toward improving the understanding, prevention, and control of enteric parasites around the world.

  16. Prevalence and clinical management of cytomegalovirus retinitis in AIDS patients in shanghai, china

    Directory of Open Access Journals (Sweden)

    Shi Ying

    2011-11-01

    Full Text Available Abstract Background Cytomegalovirus retinitis is a common AIDS-associated illness, leading to blindness in up to 30% of patients. This study was to investigate the prevalence and clinical management of the cytomegalovirus retinitis associated with AIDS in a large municipality of China. Methods Clinical and laboratory data from 23 cytomegalovirus retinitis patients (35 eyes out of 303 hospitalized AIDS individuals in a single medical center were analyzed retrospectively. Two of 23 patients were diagnosed cytomegalovirus retinitis just before hospitalization without anti-CMV therapy. Ganciclovir combined with the high active anti-retroviral therapy was installed for treatment of cytomegalovirus retinitis after diagnosis was confirmed. The data were analyzed by specialists and statistics was also applied. Results The prevalence of cytomegalovirus retinitis in hospitalized AIDS patients was 7.6% in this study. The level of CD4+ T lymphocytes was correlated well with the occurrence of cytomegalovirus retinitis, showing 16.8% (19/113 (95% confidence interval: 10.4,25.0, 5.4% (3/56 (95% confidence interval: 1.1,14.9, and 1.4% (1/69 (95% confidence interval: 0.0,7.8 occurrence in the patients with CD4+ T lymphocyte counts 4+ T lymphocyte counts was 31.7 ± 38.6 cells/μl in 23 AIDS patients with cytomegalovirus retinitis. Median CD4+ T lymphocyte count is 20 cells/μl with inter-quartile range as (5, 36. Seven patients died (11 eyes and 16 patients (24 eyes survived. The proportion of blindness and low vision in eyes infected with cytomegalovirus retinitis respectively was 20.8% (5/24 and 29.2% (7/24 when they were diagnosed in survivors. The ganciclovir therapy was effective in 16 patients (24 eyes. Clinical recovery of cytomegalovirus retinitis was 41.7% (10/24 and clinical improvement 58.3% (14/24. After anti-CMV treatment, the proportion of blindness or low vision was 16.7% (4/24. Conclusions The AIDS patients with CD4+ T lymphocyte 4+ T lymphocyte

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

    International Nuclear Information System (INIS)

    Thurnher, M.M.; Post, M.J.D.; Jinkins, J.R.

    2000-01-01

    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.)

  18. 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.)

  19. Oral candidiasis as clinical manifestation of HIV/AIDS infection in Airlangga University hospital patients

    Science.gov (United States)

    Putranti, A.; Asmarawati, T. P.; Rachman, B. E.; Hadi, U.; Nasronudin

    2018-03-01

    The purpose of this study was to determine the characteristics of HIV/AIDS patients with oral candidiasis as its clinical manifestation at Airlangga University Hospital Surabaya. This is a descriptive analytic research with cross-sectional design using Chi-Square statistic test. Samples of this study consist of 34 patients using total sampling methods. Those patients were all HIV/AIDS infected patients with oral candidiasis clinical manifestations, who were admitted to Airlangga University Hospital Surabaya from January 2016 to September 2017. Results showed that mostly HIV/AIDS patients with oral candidiasis are male (79.4%), old age (40-75years) total amounted to 58.8%, heterosexual as main risk factor (70%), clinical stadium mostly in stage IV (61.8%), 26% of patients with chronic diarrhea and 56% with pulmonary TB, clinical stages of patients have a significant relation to the incidence of oral candidiasis infection (p=0.024). The most common oral lesions found in people with HIV are Candidiasis. The best management is through routine dental examination and dental precautions to maintain health and achieve a better quality of life.

  20. Patients' Attitudes Regarding Lung Cancer Screening and Decision Aids. A Survey and Focus Group Study.

    Science.gov (United States)

    Crothers, Kristina; Kross, Erin K; Reisch, Lisa M; Shahrir, Shahida; Slatore, Christopher; Zeliadt, Steven B; Triplette, Matthew; Meza, Rafael; Elmore, Joann G

    2016-11-01

    Little is known about vulnerable patients' perceptions and understanding of, and preferences for, lung cancer screening decision aids. To determine, in a low-income, racially diverse population, (1) participants' experience, preferences, and reactions to web-based and paper decision aids, and (2) their understanding of harms and benefits of lung cancer screening. We enrolled outpatients at an urban county hospital in six focus group discussions that included review of a web-based and a paper-based lung-cancer screening decision aid. Participants completed surveys before and after the focus groups. Forty-five patients participated (mean age, 61 yr; 76% current smokers; 24% former smokers); 27% had not completed high school; 50% had an annual income not exceeding $15,000; 42% were nonwhite; and 96% reported chronic illness requiring at least three health care visits yearly. Comparing the proportion with correct answers on pre- and postsurveys, participants' understanding of lung cancer screening increased, particularly of the harms of screening including the potential for false positives, extra testing, and complications. However, after conclusion of the focus groups, more than 50% believed that screening lowered the chance of getting lung cancer. Five major themes emerged from qualitative analyses. Participants (1) were not aware of the purpose of lung cancer screening; (2) wanted to know about the benefits and harms; (3) believed physicians need to communicate more effectively; (4) found decision aids helpful and influential for decision-making about screening; and (5) wanted the discussion to be personalized and tailored. Participants expressed surprise that the magnitude of their lung cancer risk and benefits of screening were lower than anticipated. Vulnerable patients find lung cancer screening decision aids helpful and generally show increased knowledge after reviewing decision aids, particularly of harms. Our results can inform future implementation efforts.

  1. Prevalence of Leishmania infection in adult HIV/AIDS patients treated in a tertiary-level care center in Brasilia, Federal District, Brazil.

    Science.gov (United States)

    Carranza-Tamayo, César O; de Assis, Tália Santana Machado; Neri, Ana Teresa Basílio; Cupolillo, Elisa; Rabello, Ana; Romero, Gustavo Adolfo Sierra

    2009-07-01

    In order to estimate the magnitude of Leishmania/HIV co-infection, patients with HIV/AIDS at the Brasilia University Hospital, DF, Brazil were used as subjects in a cross-sectional study. One hundred and sixty-three patients were enrolled, seven of whom had visceral leishmaniasis (VL). One hundred and twelve patients (68.7%) were men; 155 (95.1%) had been exposed to HIV infection through unprotected sex. The median age was 37 years (range: 20-74) and the median CD4+ lymphocyte count was 314 cells/microl (range: 2-1600). Symptomatic patients underwent bone marrow evaluations through direct examination of Giemsa-stained films, parasite culture and PCR assay. Blood samples were evaluated by means of an indirect immunofluorescent antibody test (IFAT), an ELISA using a soluble antigen of L. chagasi (ELISA), an ELISA with the rK39 antigen (ELISA-rK39) and a PCR targeted to the kDNA region and to the internal transcribed spacer 1 of the rDNA gene. The proportion of positive results was 2.4% for the IFAT, 12.3% for the ELISA and 4.9% for the rK39 tests. The estimated prevalence was 16%. The PCR in the blood was positive in three patients (1.8%). The prevalence of Leishmania spp. infection is high among HIV patients attending this Brazilian center suggesting that they should be routinely investigated for VL infection.

  2. Agreement between premortem and postmortem diagnoses in patients with acquired immunodeficiency syndrome observed at a brazilian teaching hospital

    Directory of Open Access Journals (Sweden)

    BORGES Aércio Sebastião

    1997-01-01

    Full Text Available Acquired immunodeficiency syndrome (AIDS is one of the main causes of death in adults worldwide. More commonly than in the general population, in patients with AIDS there is substantial disagreement between causes of death which are clinically suspected and those established by postmortem examination. The findings of 52 postmortem examinations were compared to the premortem (clinical diagnoses, and there was 46% agreement between them. Fifty two percent of the patients had more than one postmortem diagnosis, and 48% had at least one AIDS-related disease not suspected clinically. Cytomegalovirus infection was the commonest (30.7% autopsy finding, but not a single case had been suspected premortem. Bacterial infection, tuberculosis, and histoplasmosis were also common, sometimes not previously suspected, postmortem findings. This study shows that multiple infections occur simultaneously in AIDS patients, and that many among them are never suspected before the postmortem examination. These findings suggest that an aggressive investigation of infections and cancers should be done in patients with AIDS, particularly in those who do not respond to therapy of an already recognized condition

  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. Lipodystrophy induced by combination antiretroviral therapy in HIV/AIDS patients: A Belgrade cohort study

    Directory of Open Access Journals (Sweden)

    Dragović Gordana

    2014-01-01

    Full Text Available Background/Aim. Highly active antiretroviral therapy (HAART has led to dramatic reductions in mortality and morbidity of HIV/AIDS-patients. Lipodystrophy, a syndrome including peripheral fat wasting and central obesity, is well-documented side effect of HAART. The aim of this study was to evaluate the incidence of lipodystrophy, and to determine its risk ratios in a HIV/AIDS cohort. Methods. This cross-sectional study included all antiretroviral-naive HIV/AIDS patients commencing HAART from October 1, 2001 to October 1, 2010, in the HIV/AIDS Center, Institute of Infectious and Tropical Diseases, Belgrade, Serbia. Univariate and stepwise multivariate logistic regression analyses were used to determine the odds ratios (OR with the confidence interval (CI of 95%, in order to establish the relative risk for lipodystrophy. The Kaplan-Meier-method was used to determine the probability of development lipodystrophy over time. All statistical analyses were performed using SPSS software version using 0.05 as a p-treshold for the significance. Results. This study included 840 HIV/AIDS patients, 608 women and 232 men, followed for 5.6 ± 2.8 years. The prevalence of lipodystrophy was 69.2%. Univariate and stepwise multivariate regression analysis identified that the female gender, hepatitis C coinfection, AIDS diagnosis prior to HAART initiation, nucleoside-reverse-transcriptase-inhibitors and proteaseinhibitors based regimens had a high risk for developing lipodystrophy in HIV/AIDS-patients (OR = 1.6, 95% CI = 1.1-3.49, p = 0.04; OR = 3.31, 95% CI = 1.4 - 3.8, p < 0.01; OR = 3.7, 95% CI = 1.7 - 6.1, p < 0.01; OR = 2.1, 95% CI = 1.7 - 3.3, p < 0.01; OR = 6.1, 95% CI = 4.1 - 9.7, p < 0.01, respectively. Conclusion. Despite much greater life expectancy of HIV/AIDSpatients, treatment-related toxicities still remain a major concern. Monitoring of lipodystrophy, as side effect of HAART, is particularly important. [Projekat Ministarstva nauke Republike Srbije, br

  5. 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.

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

    International Nuclear Information System (INIS)

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

    1988-01-01

    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

  7. Firstly diagnosed HIV/AIDS-associated tuberculosis: clinical peculiarities and causes of patients` deaths

    Directory of Open Access Journals (Sweden)

    A. S. Shalmin

    2013-06-01

    Full Text Available Introduction. According to the literature, HIV infection increases the risk of tuberculosis, and tuberculosis causes an adverse effect on the course of HIV infection. Tuberculosis is the direct cause of death of patients up to 30.0% with HIV infection and in 90.0% of cases at AIDS. That’s why studying the clinical course of HIV/AIDS-associated tuberculosis and analysis of causes of death in these patients is highly actual today. The aim of the study. To determine the clinical course and causes of death in patients with primarily diagnosed HIV/AIDS-associated tuberculosis. Materials and methods. 22 patients cards who died of primarily diagnosed HIV/AIDS-associated tuberculosis were analyzed in this article. The results of research. Among patients with primarily diagnosed HIV/AIDS-associated tuberculosis there were 12 men (54.6%, and 10 (45.4% women. The average age was 39.5 ± 1.5 years. There were 90.9% of unemployed patients (20 patients, 4 patients (18.2% were former prisoners, 1(4.5% – shelterless person, 5 patients (22.7% suffered from drug addiction and alcoholism. 9 (40.9% patients lived antisocial life. HIV-infection had started after tuberculosis in 1 patient (4.5%, before tuberculosis - in 15 (68.2%, the simultaneous detection of co-infection was found in 6 cases (27.3%. Prevailed disseminated (60 % and infiltrative forms of lung tuberculosis (33,3 % were significantly (P <0.05 more often registered among patients with co-infection of primarily diagnosed HIV/AIDS-associated tuberculosis. 5 (33.3% patients had pulmonary tuberculosis combined with extrapulmonary, that significantly complicated the course of co-infection. There were 3 patients (13.6%, who interrupted treatment, 1 patient refused treatment completely. 6 patients had received antiretroviral therapy (27.3%, 5 patients (22.7% renounced, in 11 (50.0% - antiretroviral therapy was not intended. The autopsy determined that 14 (63.6% patients died from progressive worsening of

  8. 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.

  9. Metabolic dysfunctions in non-antiretroviral treated HIV/AIDS patients

    African Journals Online (AJOL)

    ... higher plasma triglyceride concentration (166.5 ± 20.7mg/dL versus 148.9 ± 13.5mg/dL; p = 0.04). The proportion of patients with hypertriglyceridaemia was also significantly higher among patients than controls (56.3%versus 17.5%; p = 0.04). Metabolic dysfunctions occur inHIV/AIDS independent of antiretroviral therapy.

  10. Mismatch between health-care professionals' and patients' views on a diabetes patient decision aid: a qualitative study.

    Science.gov (United States)

    Lee, Ping Yein; Khoo, Ee Ming; Low, Wah Yun; Lee, Yew Kong; Abdullah, Khatijah Lim; Azmi, Syahidatul Akmal; Ng, Chirk Jenn

    2016-04-01

    Malaysia is an Asian country with population of diverse culture and health perceptions. Patient decision aid (PDA) is a new tool in Malaysia. Patients' and health-care professionals' (HCPs) expectation of a PDA is unknown. We aimed to explore patients' and health-care professionals'(HCPs) views on the information needed in a patient decision aid (PDA) on insulin initiation developed for patients with type 2 diabetes mellitus (T2DM). We used a qualitative design and thematic approach. Three main primary health-care settings in Malaysia: public university-based primary care clinics, public health-care clinics and private general practices. We conducted focus groups and one-to-one interviews with a purposive sample of health professionals and patients with type 2 diabetes. We interviewed 18 patients and 13 HCPs. Patients viewed the content of the PDA as simple and clear. However, HCPs felt the PDA might be difficult for patients with low literacy to understand. HCPs thought the PDA was too lengthy. Nevertheless, patients would prefer more information. HCPs tended to focus on benefits of insulin, while patients wanted to know the impact of insulin on their quality of life and practical issues regarding insulin and its side-effects. Patients preferred numbers to weigh the risks and benefits of treatment options. HCPs' views that presenting numbers in a PDA would be too complex for patients to understand. It is important to consider including issues related to psycho-social impact of treatment to patients when developing a patient decision aid. © 2015 John Wiley & Sons Ltd.

  11. Cytomegalovirus pneumonia: high-resolution CT findings in ten non-AIDS immunocompromised patients

    International Nuclear Information System (INIS)

    Moon, Jeung Hee; Kim, Eun A; Lee, Kyung Soo; Kim, Tae Sung; Jung, Kyung Jae; Song, Jae Hoon

    2000-01-01

    To describe the HRCT findings of cytomegalovirus (CMV) pneumonia in non-AIDS immunocompromised patients. This retrospective study involved the ten all non-AIDS immunocompromised patients with biopsy-proven CMV pneumonia and without other pulmonary infection encountered at our Medical Center between January 1997 and May 1999. HRCT scans were retrospectively analysed by two chest radiologists and decisions regarding the findings were reached by consensus. The most frequent CT pattern was ground-glass opacity, seen in all patients, with bilateral patchy (n = 8) and diffuse (n = 2) distribution. Other findings included poorly-defined small nodules (n = 9) and consolidation (n = 7). There was no zonal predominance. The small nodules, bilateral in eight cases and unilateral in one, were all located in the centrilobular region. Consolidation (n = 7), with patchy distribution, was bilateral in five of seven patients (71%). Pleural effusion and bilateral areas of thickened interlobular septa were seen in six patients (60%). CMV pneumonia in non-AIDS immunocompromised patients appears on HRCT scans as bilateral mixed areas of ground-glass opacity, poorlydefined centrilobular small nodules, and consolidation. Interlobular septal thickening and pleural effusion are frequently associated

  12. Spectrum of opportunistic and other parasites among HIV/AIDS patients attending a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Sonali Jain

    2014-12-01

    Full Text Available Objective: To determine the spectrum of opportunistic as well as non-opportunistic parasitic infections in HIV/AIDS patients. Methods: A total of 250 HIV sero-positive individuals are included in study. Among them, 76 clinical cases of diarrhea and 8 clinically suspected cases of toxoplasmosis were identified. Fresh stool samples were collected in a suitable container on three consecutive days and processed immediately for identification of oocysts of Cryptosporidium parvum, Isospora belli and Cyclospora. Blood sample was collected from suspected cases of toxoplasmosis and tested for antitoxoplasma immunoglobulin M antibodies using immunoComb Toxo IgM test. Estimation of CD4 counts was also done by flow cytometry from these patients. Results: The opportunistic parasites identified in total HIV sero-positive patients were Cryptosporidium spp. (20.8% and Isospora belli (0.8%. While the non-opportunistic parasite identified were Entamoeba histolytica (4%, Giardia intestinalis (1.6% and Hymenolepis nana (0.8%. Toxoplasmosis was identified in 2.4% HIV sero-positive patients. Conclusions: Increasing prevalence of parasitic infections in HIV/AIDS patients suggests that simple steps such as drinking safe water, maintaining high level o=f environmental and personal hygiene and avoiding contact with contaminated soil are necessary to prevent the occurrence of these diseases in AIDS patients

  13. Stroke subtypes and comorbidity among ischemic stroke patients in Brasilia and Cuenca: a Brazilian-Spanish cross-cultural study.

    Science.gov (United States)

    Carod-Artal, Francisco Javier; Casanova Lanchipa, Jardiel Omar; Cruz Ramírez, Luis Miguel; Pérez, Noelia Sánchez; Siacara Aguayo, Fátima M; Moreno, Isabel Gómez; Romero, Lourdes Gómez; Coral, Luciene Ferreira; Trizotto, Daniele Stieven; Moreira, Clarissa Menezes

    2014-01-01

    With the increase in life expectancy worldwide, changes in stroke subtypes and burden of stroke population are expected in both developing and developed countries. Prevalence of stroke subtypes and comorbidity in ischemic stroke patients was assessed in Brasilia, Brazil, and Cuenca, Spain. This was an international (Brazilian-Spanish) cross-sectional study. Stroke subtypes were assessed by means of Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification. Modified Rankin scale was used to measure functional recovery and the Cumulative Illness Rating Scale for Geriatrics (CIRS-G) was used to assess comorbidity. A total of 500 patients (mean age 66.2 ± 16.4 years; 48% female; 48.2% Spanish) were included in the study. Spanish patients were significantly older than Brazilian ones (76.4 ± 11.2 versus 56.7 ± 14.6 years; P < .0001). Prevalence of ischemic cardiopathy (20.3% versus 6.2%) and atrial fibrillation (25.7% versus 6.6%) was significantly higher in Spanish stroke patients, whereas they less frequently used tobacco (28.3% versus 52.9%); P less than .0001. Prevalence of stroke subtypes in Spanish and Brazilian stroke patients was: stroke of undetermined etiology (58.1% versus 32.4%), cardioembolism (24.5% versus 11.6%), lacunar infarct (11.6% versus 25.5%), atherothrombotic (3.7% versus 19.7%), and other causes (2.1% versus 10.8%); P less than .0001. The Spanish sample had a significantly higher frequency of comorbidities. The CIRS-G total score and CIRS-G mean number of affected organs significantly increased with age, and correlated with the level of functional dependence as measured by Rankin scale (rS = 0.50; P = .0005). Spanish stroke people had a higher frequency of comorbid conditions, atrial fibrillation, and cardioembolism and these facts were associated with age. Atherothrombotic and lacunar strokes were more common in the younger Brazilian stroke population. Copyright © 2014 National Stroke Association. Published by Elsevier

  14. Serological and polymerase chain reaction-based analysis of aqueous humour samples in patients with AIDS and necrotizing retinitis

    NARCIS (Netherlands)

    Verbraak, F. D.; Galema, M.; van den Horn, G. H.; Bruinenberg, M.; Luyendijk, L.; Danner, S. A.; Kijlstra, A.

    1996-01-01

    To evaluate the measurement of intraocular antibody production and detection of DNA by the polymerase chain reaction (PCR) for diagnosis of the causative microorganism in patients with AIDS and necrotizing retinitis. Paired serum and aqueous humour samples obtained from 28 patients with AIDS and

  15. Evaluation of disease patterns, treatment and prognosis of tuberculosis in AIDS patient

    Directory of Open Access Journals (Sweden)

    Atomiya Angela Naomi

    2002-01-01

    Full Text Available Patterns of disease, diagnosis, treatment and prognosis of tuberculosis in 100 patients co-infected with AIDS at Casa da AIDS clinic was studied. Demographic characteristics were as follows: 76 male patients, 24 female patients, 67 caucasian, average 35.8 years-old (SD ± 8.5. Sexual transmission of HIV was reported in 68 patients. Pulmonary tuberculosis was seen in 40 patients, extrapulmonary in 11, and combined in 49 patients. In 63 patients, TCD4+ counts were below 200/mm³ when tuberculosis was diagnosed. Fifty-five patients had their diagnoses confirmed by bacteriological identification of Mycobacterium; either through direct observation and/or culture. Tuberculosis was treated with rifampin, isoniazid and pyrazinamide in 60 patients, reinforced treatment in 14 and alternative treatment in the other 13 patients. Tuberculosis therapy lasted up to 9 months in 66% of the patients. Fifty-four patients were treated with a two-drug antiretroviral regimen and the remaining 46 patients received a triple regimen, which included a protease inhibitor. Among the latter, 35 patients were co-treated with rifampin. The occurrence of hepatic liver enzyme abnormalities was statistically related to alternative antiretroviral regimens (p = 0.01 and to the co-administration of rifampin and protease inhibitor (p = 0.019. Clinical resolution of tuberculosis was obtained in 74 patients. Twelve patients died during tuberculosis treatment. Resolution of tuberculosis was statistically significant related to antituberculosis treatment adherence (p = 0.001. The risk of no response to the treatment was 1.84 times more frequent among patients treated with alternative regimens regardless of the duration of the therapy. We conclude that the characteristics of tuberculosis in HIV infected patients requires that special attention be directed to the types and duration of both antiretroviral and anti-TB therapy in order to achieve the highest level of care.

  16. [Hospital-based psychological first aid provided to patients injured in the Lushan earthquake].

    Science.gov (United States)

    Yin, Min; Li, Xiao-Lin; Li, Jing; Huang, Xue-Hua; Tao, Qing-Lan; Luo, Xi

    2015-04-01

    In the aftermath of the 7.0 earthquake that struck Lushan in China's Sichuan Province on April 20, 2013, a psychological crisis intervention working group was established in a hospital that was treating earthquake victims. Patients at this hospital received psychological first aid that was delivered in accordance with scientific, systematic, and standardized principles. This first aid employed a "rooting mode" methodology and was designed as a supportive psychological intervention. Mental assessment results showed that the general mental health, acute stress reactions, and anxiety and depression status of all of the 131 injured who received the psychological intervention had significantly improved (p first aid, the approach used to organize the working groups, the main contents of the intervention, specific methods used, and intervention outcomes. This information is provided as a reference for providing localized psychological assistance in the aftermath of a disaster incident.

  17. Neutrophil chemotactic activity in bronchoalveolar lavage fluid of patients with AIDS-associated Pneumocystis carinii pneumonia

    DEFF Research Database (Denmark)

    Benfield, T L; Kharazmi, A; Larsen, C G

    1997-01-01

    been shown to confer a poor prognosis in PCP. We therefore investigated the potential of BAL fluid from 17 patients with PCP to induce neutrophil chemotaxis. BAL fluid from patients induced considerable neutrophil chemotactic activity compared to normal controls. Elevated levels of IL-8 were detected...... in patient samples as compared to controls. A specific anti-IL-8 antibody significantly reduced chemotactic activity of patient samples by more than 50%. In conclusion, IL-8 appears to be a significant participant of neutrophil chemotaxis in AIDS-associated PCP, and may participate in the recruitment...

  18. 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....... SUBJECTS: One hundred and ninety-seven HIV-infected patients (60 with AIDS and 137 with ARC or KS). MAIN OUTCOME MEASURES: Serum HIV p24-antigen levels measured using the Abbott HIV solid-phase enzyme immunoassay. RESULTS: Of 76 ARC/KS patients who were initially HIV p24-antigen-positive, one out of 25......-antigen levels. Change in antigen level in response to antiviral therapy needs further investigation before it is used as a surrogate marker for clinical efficacy of antiviral therapy....

  19. Tumors associated with HIV / AIDS monitoring 45 patients between 1/1998 and 6/2004

    International Nuclear Information System (INIS)

    Krygier, G.; Lombardo, K.; Sosa, A.; Ocampo; Suárez P, R.; Muse, I.

    2010-01-01

    Full text: This paper is intended to show 45 patients with cancer associated the human immunodeficiency virus (HIV) / AIDS, diagnosed, treated and followed over a period of 6.5 years in our country. The medical records were retrospectively analyzed of cancer patients diagnosed HIV positive on 5 institutions public and private in our midst, in the period between 1/98 and 6/04 (Institute of Health, National Institute of Oncology, Hospital of Clinics, Service Comprehensive Medical, Spanish Mutual Aid Association). They took into account different variables (origin, medical record number, sex, age, sexual habits, addiction to injecting drugs, HIV diagnosis positive diagnosis of AIDS, infectious prophylaxis, antiretroviral therapy, lymphocyte start and in the evolution population viral load start and evolutionary, tumor type, stage, treatment received, date of last control and status the close of the work). We compared data collected by us AIDS Ministry report of Public Health. 24 cases were Kaposi sarcomas (one nodal exclusive), 11 were non-Hodgkin lymphomas (two of SNC and other gastric), 1 Hodgkin's Disease 1 rectal cancer, tongue cancer 1 1 laryngeal cancer, thyroid cancer 1 1 Melanoma 1 parotid cancer, cancer 1 Lung and breast cancer 1. No cervical tumors or recorded anal canal in the study population. Treatments received varied for each disease depending on the stage of the disease and viral load / Towns lymphocyte start. This is the first study with longer follow-up in our country HIV patients / AIDS-associated cancer, he reflected the difficulty in collecting data, various types of cancer in the study population and demand the need to create an accurate and accessible system of monitoring these patients

  20. On the suitability of fast and frugal heuristics for designing values clarification methods in patient decision aids : A critical analysis

    NARCIS (Netherlands)

    Pieterse, A.H.; de Vries, M.

    2013-01-01

    Background  Increasingly, patient decision aids and values clarification methods (VCMs) are being developed to support patients in making preference-sensitive health-care decisions. Many VCMs encourage extensive deliberation about options, without solid theoretical or empirical evidence showing that

  1. The Relationship of Spirituality with the Pain and Quality of Life in Patients with HIV/AIDS

    Directory of Open Access Journals (Sweden)

    AK Pirasteh Motlagh

    2012-10-01

    Conclusion: Reinforcing the spiritual and religious attitude in patients with HIV/AIDS through spiritual and religion instruction may increase the social-mental health and reduce the feeling of suffering and improve quality of life of the patients.

  2. The effect of patient positioning aids on PET quantification in PET/MR imaging.

    Science.gov (United States)

    Mantlik, Frederic; Hofmann, Matthias; Werner, Matthias K; Sauter, Alexander; Kupferschläger, Jürgen; Schölkopf, Bernhard; Pichler, Bernd J; Beyer, Thomas

    2011-05-01

    Clinical PET/MR requires the use of patient positioning aids to immobilize and support patients for the duration of the combined examination. Ancillary immobilization devices contribute to overall attenuation of the PET signal, but are not detected with conventional MR sequences and, hence, are ignored in standard MR-based attenuation correction (MR-AC). We report on the quantitative effect of not accounting for the attenuation of patient positioning aids in combined PET/MR imaging. We used phantom and patient data acquired with positioning aids on a PET/CT scanner (Biograph 16, HI-REZ) to mimic PET/MR imaging conditions. Reference CT-based attenuation maps were generated from measured (original) CT transmission images (origCT-AC). We also created MR-like attenuation maps by following the same conversion procedure of the attenuation values except for the prior delineation and subtraction of the positioning aids from the CT images (modCT-AC). First, a uniform (68)Ge cylinder was positioned centrally in the PET/CT scanner and fixed with a vacuum mattress (10 cm thick) and, in a repeat examination, with MR positioning foam pads. Second, 16 patient datasets were selected for subsequent processing. All patients were regionally immobilized with positioning aids: a vacuum mattress for head/neck imaging (nine patients) and a foam mattress for imaging of the lower extremities (seven patients). PET images were reconstructed following CT-based attenuation and scatter correction using the original and modified (MR-like) CT images: PET(origCT-AC) and PET(modCT-AC), respectively. PET images following origCT-AC and modCT-AC were compared visually and in terms of mean differences of voxels with a standardized uptake value of at least 1.0. In addition, we report maximum activity concentration in lesions for selected patients. In the phantom study employing the vacuum mattress the average voxel activity in PET(modCT-AC) was underestimated by 6.4% compared to PET(origCT-AC), with 3

  3. Relational messages of control in nurse-patient interactions with terminally ill patients with AIDS and cancer.

    Science.gov (United States)

    Pepler, C J; Lynch, A

    1991-01-01

    When dying patients are young adults or have a contagious disease, nursing staff may feel acutely uncomfortable and the patients may become isolated and alone. Nurses who work in palliative care units (PCU) develop special interactive skills that are generally acknowledged but not clearly defined or understood. Admission of patients with Acquired Immune Deficiency Syndrome (AIDS) to the PCU was expected to provide a unique opportunity for study. The project was an analysis of nurse-patient verbal interactions during physical care for the purpose of understanding communication patterns during the longest usual block of uninterrupted time nurses spend with patients. Included were six terminally ill patients with AIDS in an acute medical unit and nine other patients of differing ages in the medical unit and PCU. Data were tape recordings of up to six hours with each patient, a total of 78 days of taping. These were transcribed and analyzed to examine the content of interactions and communication techniques for identification of themes. The major overall themes were control, well-being, humor, uncertainty, and routines. The process themes identified were validation, problem solving, and therapeutic interaction. A framework for analysis of the relational messages of control was developed and detailed analysis conducted. The most frequent behavior was that of nurses offering control. Nurses and patients took control with approximately the same frequency, and by far the least frequent situation was that of the patient offering control to the nurse. The complexities of dying with a disease such as AIDS have made the care of these patients extremely demanding for all concerned. This analysis will help to delineate the content and process of nurse-patient interaction which is basic to comprehensive care of all patients.

  4. Changing Mortality Profile among HIV-Infected Patients in Rio de Janeiro, Brazil: Shifting from AIDS to Non-AIDS Related Conditions in the HAART Era

    Science.gov (United States)

    Grinsztejn, Beatriz; Luz, Paula M.; Pacheco, Antonio G.; Santos, Desiree V. G.; Velasque, Luciane; Moreira, Ronaldo I.; Guimarães, Maria Regina C.; Nunes, Estevão P.; Lemos, Alberto S.; Ribeiro, Sayonara R.; Campos, Dayse P.; Vitoria, Marco A. A.; Veloso, Valdilea G.

    2013-01-01

    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. PMID:23577074

  5. Nearly one-half of Brazilian patients with multiple sclerosis using natalizumab are DNA-JC virus positive

    Directory of Open Access Journals (Sweden)

    Yara Dadalti Fragoso

    2013-10-01

    Full Text Available Objective Natalizumab is a new and efficient treatment for multiple sclerosis (MS. The risk of developing progressive multifocal leukoencephalopathy (PML during the use of this drug has created the need for better comprehension of JC virus (JCV infection. The objective of the present study was to assess the prevalence of JCV-DNA in Brazilian patients using natalizumab. Method Qualitative detection of the JCV in the serum was performed with real-time polymerase chain reaction (PCR. Results In a group of 168 patients with MS who were undergoing treatment with natalizumab, JCV-DNA was detectable in 86 (51.2% patients. Discussion Data on JCV-DNA in Brazil add to the worldwide assessment of the prevalence of the JCV in MS patients requiring treatment with natalizumab.

  6. Acute respiratory failure associated with cryptococcosis in patients with AIDS: analysis of predictive factors.

    Science.gov (United States)

    Visnegarwala, F; Graviss, E A; Lacke, C E; Dural, A T; Johnson, P C; Atmar, R L; Hamill, R J

    1998-11-01

    The incidence of acute respiratory failure (ARF) associated with cryptococcal disease in patients with AIDS is underestimated in the literature. We performed a retrospective, case-control (referent) study to determine the prevalence of ARF associated with cryptococcal disease and analyzed associated factors. Potential cases of ARF were identified at four university-affiliated teaching hospitals from a cohort of 210 patients with AIDS who had positive cryptococcal antigen tests and/or Cryptococcus neoformans isolated from any body site. Twenty-nine of the 210 (13.8%) had ARF associated with cryptococcal disease. Nineteen were thought to have respiratory failure due solely to C. neoformans. The demographic, clinical, laboratory, treatment, and outcome data of 19 cases of respiratory failure were compared with data for 20 patients without respiratory failure. In-hospital mortality was 100% and median survival was 2 days for cases, vs. 25% and > 365 days, respectively, for referents. The clinical presentation was identical to that of Pneumocystis carinii pneumonia. In multivariate analysis, variables independently predictive of ARF in patients with cryptococcal disease were black race, a lactate dehydrogenase level of > or = 500 IU/L, the presence of interstitial infiltrates, and the presence of cutaneous lesions. ARF with cryptococcosis in patients with AIDS is associated with disseminated disease and high mortality. The diagnosis frequently is not considered before death. Serum cryptococcal antigen testing is a sensitive and rapid screening method.

  7. 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.

  8. Detection of HTLV-III RNA in lungs of patients with AIDS and pulmonary involvement

    International Nuclear Information System (INIS)

    Chayt, K.J.; Harper, M.E.; Marselle, L.M.; Lewin, E.B.; Rose, R.M.; Oleske, J.M.; Epstein, L.G.; Wong-Staal, F.; Gallo, R.C.

    1986-01-01

    A majority of pediatric patients and rare adult patients with the acquired immunodeficiency syndrome (AIDS) develop a chronic respiratory disorder referred to as lymphocytic interstitial pneumonitis (LIP). Efforts to identify an infectious agent responsible for this process so far have failed. In this study, frozen sections of lungs from patients with AIDS and pulmonary disease were tested by in situ molecular hybridization for the presence of cells infected with human T-cell lymphotropic virus type III (HTLV-III) and expressing viral RNA. In the case of an infant with LIP, a relatively high frequency (0.1%) of cells in the lung were found to be positive for HTLV-III RNA. This number is the lower limit of total cells infected since the in situ hybridization technique as applied in this study depends on expression of HTLV-III genes, and previous evidence indicates that a proportion of cells infected with HTLV-III may not express viral RNA. Moreover, this degree of infection of the lung is likely limited to LIP, since in ten patients with AIDS and pulmonary diseases other than LIP, only 0% to 0.002% of cells in lung were positive for viral RNA expression. Thus, HTLV-III may play a direct causal role in the development of LIP in infected patients, implicating its involvement in yet another of the diverse clinical diseases associated with this virus

  9. The phenomenology of bodily care: caregivers' experiences with AIDS patients before antiretroviral therapies in Lesotho.

    Science.gov (United States)

    Makoae, Mokhantšo G

    2009-03-01

    This study provides an account of caregivers' experiences with the bodily care of AIDS patients before antiretroviral therapies were available in the public health sector in Lesotho. It describes the mechanisms through which the body may become a stressor in caregiving. The phenomenological method, guided by the notion of epoché, was used to understand caregiving experiences from the perspective of family caregivers. Data on caregivers' physical activities and what they saw and thought were collected through in-depth interviews with 21 caregivers (mostly females); the caregivers were identified with the help of HIV/AIDS counsellors at two hospitals where AIDS patients received medical treatment. The thematic analysis shows that a patient's body was central in caregiving experiences. Social interaction in caregiving was mediated through seeing and touching the bodies of the patients. The different aspects of caregiving and the close interaction with the body of an ill family member - especially seeing major changes in the patient's physical appearance, their declined capacity to perform the activities of daily living, and discovering the symptoms of their illness - contributed to the caregivers' experiences of sympathy and pain. The social meanings and boundaries that tended to persist regarding touching and accessing others' bodies and bodily matter also contributed to the caregivers' stress.

  10. [Innate immunity restoration in patients with HIV/AIDS infection associated with antiretroviral therapy].

    Science.gov (United States)

    Afani, Alejandro; Jiusán, Lorena; Raby, Pablo; Sitia, Giovanni; Puente, Javier; Sepúlveda, Cecilia; Miranda, Dante; Cabrera, Roy; Guidotti, Luca; Lanza, Paola

    2006-06-01

    Highly active antiretroviral therapy (HAART) in HIV/AIDS infection induces an important reduction of the viral load (VL) and an immune system reconstitution. CD4+ T lymphocyte count is the immunological measurement commonly used for the follow up of HIV/AIDS patients. To study prospectively the restoration of the innate immune system in patients with HIV/AIDS infection during their first year on HAART. 25 naive HIV/AIDS patients, from San José Hospital and University of Chile Clinical Hospital, Santiago, Chile, were studied between years 2002-2003. Every 4 months after HAART initiation, CD3+, CD4+, CD8+ T lymphocytes and CD16/56+ natural killer (NK) cells were quantified by flow cytometry. NK cell cytotoxicity was measured using radioactive chrome liberation (Cr51). Tumor necrosis factor alpha (TNF-alpha) and interleukin-10 (IL-10) were measured in peripheral blood mononuclear cells and viral load was determined using Amplicor HIV-1 from Roche Diagnostics Systems. Thirteen of the 25 patients continued in the study. They were all males, average age 35 years old (23-50). At baseline average CD4+ count was 146 cells/microL (31-362) and average viral load was 82.000 copies/mL (4.000-290.000). A raise in CD3+, CD4+, CD8+, and CD16/56 cells was noted at months 9-12 of therapy. Viral load became undetectable in the same period. NK cell function was decreased at the beginning of the therapy (1-4 months), reaching its highest values at months 9-12. There was no significant change in IL-10. TNF-alpha increased in six patients during the study. In this group of patients, innate immunity was restored during HAART. These results should be confirmed in studies with a longer follow up period and also measuring cytokines such as MIP-1a, MIP-1ss and RANTES.

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

    OpenAIRE

    Corti, Marcelo; Villafañe, Maria Florencia; Trione, Norberto; Mamanna, Lilia; Bouzas, Belén

    2011-01-01

    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 wa...

  12. Do personal stories make patient decision aids more effective? A critical review of theory and evidence.

    Science.gov (United States)

    Bekker, Hilary L; Winterbottom, Anna E; Butow, Phyllis; Dillard, Amanda J; Feldman-Stewart, Deb; Fowler, Floyd J; Jibaja-Weiss, Maria L; Shaffer, Victoria A; Volk, Robert J

    2013-01-01

    Patient decision aids support people to make informed decisions between healthcare options. Personal stories provide illustrative examples of others' experiences and are seen as a useful way to communicate information about health and illness. Evidence indicates that providing information within personal stories affects the judgments and values people have, and the choices they make, differentially from facts presented in non-narrative prose. It is unclear if including narrative communications within patient decision aids enhances their effectiveness to support people to make informed decisions. A survey of primary empirical research employing a systematic review method investigated the effect of patient decision aids with or without a personal story on people's healthcare judgements and decisions. Searches were carried out between 2005-2012 of electronic databases (Medline, PsycINFO), and reference lists of identified articles, review articles, and key authors. A narrative analysis described and synthesised findings. Of 734 citations identified, 11 were included describing 13 studies. All studies found participants' judgments and/or decisions differed depending on whether or not their decision aid included a patient story. Knowledge was equally facilitated when the decision aids with and without stories had similar information content. Story-enhanced aids may help people recall information over time and/or their motivation to engage with health information. Personal stories affected both "system 1" (e.g., less counterfactual reasoning, more emotional reactions and perceptions) and "system 2" (e.g., more perceived deliberative decision making, more stable evaluations over time) decision-making strategies. Findings exploring associations with narrative communications, decision quality measures, and different levels of literacy and numeracy were mixed. The pattern of findings was similar for both experimental and real-world studies. There is insufficient evidence

  13. Study of the association between human leukocyte antigens (HLA) and pemphigus vulgaris in Brazilian patients.

    Science.gov (United States)

    Gil, Julio M; Weber, Raimar; Rosales, Claudia B; Rodrigues, Helcio; Sennes, Luiz U; Kalil, Jorge; Chagury, Azis; Miziara, Ivan D

    2017-05-01

    Pemphigus vulgaris is a mucocutaneous blistering autoimmune disease that manifests as painful blisters or erosions on the skin and/or mucosal surfaces. IgG autoantibodies target desmoglein, playing a major role in disease pathogenesis. Genetic predisposal to pemphigus vulgaris, especially the HLA DR and DQ alleles, has been known since the 1980s. The unique constitution of the Brazilian population favors exploratory genetic studies. The study group included 51 patients with a confirmed diagnosis of pemphigus vulgaris from a tertiary hospital in Sao Paulo city, Sao Paulo, southeast Brazil. DNA was extracted from peripheral blood, and HLA A, B, C, DR, and DQ typing was performed. The control group was composed of a database of 297 deceased donors from the city of São Paulo typed with the same method. The statistical significance level was adjusted using the Bonferroni correction depending on the phenotypic frequencies evaluated for HLA A, HLA B, HLA C, HLA DRB1, DQA1, and HLA DQB1. The alleles HLA-B*57, HLA-C*15, HLA-DRB1*04:02, HLA-DRB1*08:04, HLA-DRB1*14:01, DQA1*03:01, DQB1*03:02, and DQB1*05:03 were associated with susceptibility. Alleles HLA DRB1*04:02 and HLA-DRB1*14:01 and their respective haplotypes DRB1*04-DQA1*03:01-DQB1*03:02, and DRB1*14-DQA1*01:01-DQB1*05:03 conferred a risk of the disease. The DRB1*04:02 and DQB1*05:03 alleles are associated with pemphigus vulgaris in our study as well as in various populations. The association with HLA-DRB1*08:04 in our study was confirmed to be specific to this allele and not to linkage disequilibrium to any adjacent gene. The association between HLA-B*57 and pemphigus vulgaris is reported for the first time in the present study. © 2017 The International Society of Dermatology.

  14. ABCB1 variation and treatment response in AIDS patients: initial results of the Henan cohort.

    Directory of Open Access Journals (Sweden)

    Peng Zhu

    Full Text Available HIV/AIDS has the highest mortality among infectious diseases in China. In ongoing efforts to alleviate this crisis, the national government has placed great emphasis on efforts in Henan province where HIV-infected former plasma donors in the 1990s contributed to AIDS becoming a public health crisis. Concomitant with a national initiative focusing the use of pharmacogenetics for the better prediction of treatment response, we studied genetic variants with known pharmacokinetic phenotypes in a set of 298 HAART-treated (highly active antiretroviral therapy patients infected with HIV from the Henan cohort. We measured the association of response to treatment, assessed as changes in CD4+ T cell counts after antiretroviral therapy, of five polymorphisms in four genes (CYP2B6, ABCB1/MDR1, ABCG2, and ABCC4 in which variation has been suggested to affect the pharmacokinetics of drugs commonly employed to treat HIV/AIDS. We show that genotyping for ABCB1 variations (rs1045642 and rs2032582 may help predict HIV treatment response. We found variations in this gene have a significant association with outcome as measured by CD4+ T cell counts in a discovery subset (N= 197; odds ratio (OR = 1.58; 95% CI 1.02-2.45, these results were confirmed in a validation subset of the cohort (N = 78; OR= 2.81; 95% CI 1.32-5.96. Exploratory analysis suggests that this effect may be specific to NVP (nevirapine or 3TC (lamivudine response. This publication represents the first genetic analysis in a continuing effort to study and assist the patients in a very large, unique, and historically significant HIV-AIDS cohort. Genotyping of AIDS patients for ABCB1 variation may help predict outcome and potentially could help guide treatment strategies.

  15. X-linked adrenoleukodystrophy: clinical and laboratory findings in 15 Brazilian patients

    Directory of Open Access Journals (Sweden)

    Carmen R. Vargas

    2000-06-01

    Full Text Available Adrenoleukodystrophy (X-ALD is an X-linked recessively inherited peroxisomal disorder, phenotypically heterogeneous, characterized by progressive white-matter demyelination of the central nervous system and adrenocortical insufficiency. We investigated 15 male X-ALD patients varying in age from 7 to 39, diagnosed among 108 suspected patients referred for investigation. Plasma levels of very long chain fatty acids (VLCFA were measured at our laboratory using gas chromatography (GC. Eleven cases of childhood X-ALD and four cases of adrenomyeloneuropathy (AMN were diagnosed. Adrenal leukodystrophy insufficiency and limb weakness were the most frequent symptoms, appearing in 12, 8 and 6 of the patients, respectively. Physician awareness of X-ALD seems inadequate to judge by age at diagnosis and lengthy interval between the start of symptoms and diagnosis. This is the first published series of Brazilian patients with X-ALD. We determined signs and symptoms relevant for diagnosis, as early identification seems important for treatment outcome. In addition, diagnosis identifies carriers, who could benefit from genetic counselling and prenatal diagnosis.Adrenoleucodistrofia (X-ALD é uma desordem peroxissomal com padrão de herança ligada ao X, fenotipicamente heterogênea, caracterizada por uma progressiva desmielinização da substância branca do sistema nervoso central e por insuficiência adrenal. Foram investigados por nós 15 pacientes do sexo masculino com sinais clínicos sugestivos de X-ALD, com idade entre 7 e 39 anos, diagnosticados entre 108 pacientes encaminhados para investigação por suspeita clínica. Os níveis plasmáticos dos ácidos graxos de cadeia muito longa (VLCFA foram dosados em nosso laboratório através de cromatografia gasosa (GC. Onze (73% casos da forma infantil de X-ALD (ALD e 4 (27% casos de adrenomieloneuropatia (AMN foram diagnosticados. Insuficiência leucodistrofia adrenal e fraqueza muscular foram os sinais mais

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

    Science.gov (United States)

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

    2017-01-01

    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. 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. 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. 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 groups. EMLA with AV aids was found to be a better topical

  17. [Characterization of the pain, sleep and alexithymia patterns of patients with fibromyalgia treated in a Brazilian tertiary center].

    Science.gov (United States)

    Avila, Lazslo A; de Araujo Filho, Gerardo M; Guimarães, Estefano F U; Gonçalves, Lauro C S; Paschoalin, Paola N; Aleixo, Fabia B

    2014-01-01

    Fibromyalgia (FM) is a complex syndrome that is characterized by lasting and diffuse chronic musculoskeletal pain, derived from non-inflammatory causes and classically associated with the presence of specific tender points. However, studies have highlighted other important symptoms associated with a lower quality of life (QOL) in FM, such as sleep disturbances and alexithymia. This study aimed to investigate the pain, sleep and alexithymia patterns of FM patients treated in a Brazilian tertiary center. 20 patients with FM who were followed-up in the Rheumatology outpatient clinic of a Brazilian tertiary center (Faculdade de Medicina de São José do Rio Preto - FAMERP, São Paulo, Brazil) and 20 patients without FM from other outpatient services of the FAMERP completed a clinical and socio-demographic questionnaire, the Fibromyalgia Impact Questionnaire (FIQ), the Pittsburgh Sleep Quality Index (PSQI), the Toronto Alexithymia Scale (TAS-20) and the SF-36 (WHOQOL). The patients with FM presented worse performances in all QOL dimensions of the SF-36 and higher scores on the PSQI (p=0.01), and the TAS-20 (p=0.02). Patients with FM also scored significantly higher in all specific domains of PSQI and TAS-20. The present data were in accordance with literature, disclosing a worse performance of patients with FM on pain impact, sleep complains and more presence of alexithymia. Studies have disclosed the presence of important and frequently underdiagnosed symptoms beyond pain complaints in FM, such as sleep complaints and alexithymia, and a better knowledge of such disturbances might improve FM patients' approach and treatment. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

  18. Nível de conhecimento e percepção de risco da população brasileira sobre o HIV/Aids, 1998 e 2005 Knowledge and risk perception on HIV/AIDS by Brazilian population, 1998 and 2005

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    Maria Paula Ferreira

    2008-06-01

    Full Text Available OBJETIVO: Descrever o nível de conhecimento e percepção de risco da população brasileira sobre o HIV/Aids. MÉTODOS: Foram utilizadas as bases de dados da Pesquisa sobre Comportamento Sexual e Percepções da População, nos anos 1998 e 2005. Utilizou-se um indicador sintético composto de nove questões sobre níveis de conhecimento e percepção de risco acerca de formas de transmissão do vírus e situações de risco, segundo subgrupos populacionais. RESULTADOS: Os homens aumentaram seu nível de conhecimento no período, atingindo o nível de informação das mulheres. Entre os jovens não houve crescimento significativo do conhecimento, e tornou-se praticamente inexistente a diferença entre os sexos em relação a essa dimensão. Quanto à percepção de risco, aumentou a proporção dos que declaram não apresentar risco de contrair HIV/Aids. CONCLUSÕES: Apesar do aumento no nível de conhecimento em geral, os resultados encontrados indicam a necessidade de ações e programas e de prevenção do HIV/Aids para a população em geral, em especial, aos jovens.OBJECTIVE: To describe the level of knowledge and risk perception on HIV/AIDS of the Brazilian Population. METHODS: Data base from a national survey on sexual behavior and HIV/AIDS risk perception in the Brazilian population, in 1998 and 2005, were used. A synthetic indicator was used, composed by nine questions on the level of knowledge and risk perception on the forms of transmission of the virus and risk situations, according to population subgroups. RESULTS: Men increased their level of knowledge in the period, reaching the same information level of women. Among youngsters, there was no significant increase in knowledge, and the difference between sexes was absent in this dimension. Regarding risk perception, there was an increase in the proportion of those that declared they were not under risk of HIV/AIDS contamination. CONCLUSIONS: Despite the increase in the level of

  19. Protein carbonyl content: a novel biomarker for aging in HIV/AIDS patients.

    Science.gov (United States)

    Kolgiri, Vaishali; Patil, Vinayak Wamanrao

    The major complications of "treated" Human Immunodeficiency Virus (HIV) infection are cardiovascular disease, malignancy, renal disease, liver disease, bone disease, and perhaps neurological complications, which are phenomena of the normal aging process occurring at an earlier age in the HIV-infected population. The present study is aimed to explore protein carbonyl content as a biomarker for detecting oxidative DNA damage induced ART toxicity and/or accelerated aging in HIV/AIDS patients. To investigate the potential of carbonyl content as a biomarker for detecting oxidative Deoxyribonucleic acid (DNA) damage induced Antiretroviral Theraphy (ART) toxicity and/or accelerated aging in HIV/AIDS patients. In this case-control study a total 600 subjects were included. All subjects were randomly selected and grouped as HIV-negative (control group) (n=300), HIV-infected ART naive (n=100), HIV-infected on first line ART (n=100), and HIV-infected on second line ART (n=100). Seronegative control subjects were age- and sex-matched with the ART naive patients and the two other groups. Carbonyl protein was determined by the method described in Levine et al. DNA damage marker 8-OH-dG was determined using 8-hydroxy-2-deoxy Guanosine StressXpress ELA Kit by StressMarq Biosciences. Protein carbonyl content levels and oxidative DNA damage were significantly higher (paging in HIV/AIDS patients. Larger studies are warranted to elucidate the role of carbonyl content as a biomarker for premature aging in HIV/AIDS patients. Copyright © 2016 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.

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

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    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

  1. 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.

  2. Applicability of the Spoken Knowledge in Low Literacy Patients with Diabetes in Brazilian elderly.

    Science.gov (United States)

    Souza, Jonas Gordilho; Apolinario, Daniel; Farfel, José Marcelo; Jaluul, Omar; Magaldi, Regina Miksian; Busse, Alexandre Leopold; Campora, Flávia; Jacob-Filho, Wilson

    2016-01-01

    To translate, adapt and evaluate the properties of a Brazilian Portuguese version of the Spoken Knowledge in Low Literacy Patients with Diabetes, which is a questionnaire that evaluate diabetes knowledge. A cross-sectional study with type 2 diabetes patients aged ≥60 years, seen at a public healthcare organization in the city of Sao Paulo (SP). After the development of the Portuguese version, we evaluated the psychometrics properties and the association with sociodemographic and clinical variables. The regression models were adjusted for sociodemographic data, functional health literacy, duration of disease, use of insulin, and glycemic control. We evaluated 129 type 2 diabetic patients, with mean age of 75.9 (±6.2) years, mean scholling of 5.2 (±4.4) years, mean glycosylated hemoglobin of 7.2% (±1.4), and mean score on Spoken Knowledge in Low Literacy Patients with Diabetes of 42.1% (±25.8). In the regression model, the variables independently associated to Spoken Knowledge in Low Literacy Patients with Diabetes were schooling (B=0.193; p=0.003), use of insulin (B=1.326; p=0.004), duration of diabetes (B=0.053; p=0.022) and health literacy (B=0.108; p=0.021). The determination coefficient was 0.273. The Cronbach a was 0.75, demonstrating appropriate internal consistency. This translated version of the Spoken Knowledge in Low Literacy Patients with Diabetes showed to be adequate to evaluate diabetes knowledge in elderly patients with low schooling levels. It presented normal distribution, adequate internal consistency, with no ceiling or floor effect. The tool is easy to be used, can be quickly applied and does not depend on reading skills. Traduzir, adaptar e avaliar as propriedades de uma versão, em português do Brasil, do Spoken Knowledge in Low Literacy Patients with Diabetes, um questionário que avalia conhecimento em diabetes. Estudo transversal, em diabéticos tipo 2, com idade ≥60 anos de uma instituição pública de saúde, em São Paulo (SP

  3. mHealth and memory aids: levels of smartphone ownership in patients.

    Science.gov (United States)

    Migo, Ellen M; Haynes, Becky I; Harris, Lara; Friedner, Kim; Humphreys, Kate; Kopelman, Michael D

    2015-01-01

    The use of mobile devices to deliver healthcare has not yet been exploited in neuropsychological rehabilitation. Smartphones have the potential to serve as multi-functional memory aids. To investigate whether patients attending a clinic for mixed memory problems own smartphones, to determine whether this could be a widely applicable medium to use as a memory aids device. A questionnaire on smartphone ownership was given to an opportunity sample of consecutive patients attending a neuropsychiatry and memory disorders outpatient clinic. Data were collected in 2012 and repeated 12 months later in 2013 to assess changes over time. Ownership of mobile phones was stable between 2012 (81%) and 2013 (85%), but ownership of smartphones showed a significant increase (from 26% to 40%). Age negatively predicted smartphone ownership. Despite cognitive or psychiatric problems, our patient group are as likely to own a mobile phone as a member of the general population. Ownership levels are at 40% and likely to increase in the future. Exploring how smartphones and their apps could function as memory aids is likely to be useful for a large enough number of patients to be clinically worthwhile.

  4. Intensive care management of patients with liver disease: proceedings of a single-topic conference sponsored by the Brazilian Society of Hepatology

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    Paulo Lisboa Bittencourt

    Full Text Available ABSTRACT Survival rates of critically ill patients with liver disease has sharply increased in recent years due to several improvements in the management of decompensated cirrhosis and acute liver failure. This is ascribed to the incorporation of evidence-based strategies from clinical trials aiming to reduce mortality. In order to discuss the cutting-edge evidence regarding critical care of patients with liver disease, a joint single topic conference was recently sponsored by the Brazilian Society of Hepatology in cooperation with the Brazilian Society of Intensive Care Medicine and the Brazilian Association for Organ Transplantation. This paper summarizes the proceedings of the aforementioned meeting and it is intended to guide intensive care physicians, gastroenterologists and hepatologists in the care management of patients with liver disease.

  5. Drug resistance mutation of HIV-1 in HIV/AIDS patients infected by blood transfusion

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    Xin-li LU

    2013-03-01

    Full Text Available Objective  To study the characteristic of HIV-1 gene mutation in HIV/AIDS patients infected by blood transfusion, and analyze the resistance to anti-HIV drugs. Methods  Plasma samples were collected from 37 HIV/AIDS patients infected by blood transfusion for extraction of HIV-1 RNA. The gene fragments of HIV pol domain were amplified by RT-PCR and nested-PCR , and the electrophoresis positive products were sequenced. The sequencing result was landed to the website http:// HIV-1db.stanford.edu to analyze the drug resistance mutations. Results  Drug resistance mutations were found in 20 patients, including 19 cases of virological or immunological failure. Mutation of gene locus V32AV of protease inhibitors (PIs occurred in 3 patients during the treatment, but it did not cause the drug resistance of PIs. Mutation of the coding regions of reverse transcriptase was found in 23 patients, including M184V, TAMs, Q151M complexus, K103N, Y181C and so on. Of the 23 patients mentioned above, the HIV-1 gene mutation induced the resistance to reverse transcriptase inhibitors (RTIs in 20 patients, and the mutation rate of RTIs was 54.05% (20/37. Conclusion  The drug resistance rate of HIV-1 in patients infected by blood transfusion may be high for antiviral therapy, so the drug resistance of HIV-1 should be monitored and treatment plan should be adjusted timely.

  6. 201Tl brain SPECT in differentiating central nervous system lymphoma from toxoplasmosis in AIDS patients

    International Nuclear Information System (INIS)

    Kamata, Noriko; Suzuki, Kenzo; Abe, Katsumi; Yokoyama, Yoshiaki; Ushimi, Hisashi; Terada, Kazushi

    1997-01-01

    In AIDS patients, toxoplasmosis and lymphoma are the leading causes of CNS mass lesions. It is important to make the correct diagnosis expeditiously, since the two diseases require markedly different treatments and have different prognoses. In general, CT and MR imaging have failed to provide specific distinguishing characteristics to differentiate CNS lymphoma from toxoplasmosis, and it is difficult to differentiate these entities clinically. We performed 201 Tl brain SPECT in order to differentiate two diseases. Counts ratio of a lesion to the normal brain (L/N ratio) was elevated in patients of lymphoma compared in patients of toxoplasmosis. 201 Tl brain SPECT is useful to differentiate CNS lymphoma from toxoplasmosis. (author)

  7. 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.

  8. Histopathologic identification of Trypanosoma cruzi (Chagas' encephalitis in an AIDS patient

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    Dimath Alyemni

    2017-03-01

    Full Text Available Trypanosoma cruzi (Chagas' encephalitis is an uncommon manifestation of T. cruzi infection, typically seen in immunocompromised patients. Encephalitis results from the reactivation of chronic infection predominately in individuals from endemic areas. Increased awareness of this complication is essential especially with increased migration of patients from endemic areas with concomitant HIV infection. Here we report a case of Chagas' encephalitis in an AIDS patient from Mexico in which there was no evidence of acute serologic, CSF, or blood infection by T. cruzi trypomastigotes.

  9. Hearing Aid Benefit in Patients with Mild Sensorineural Hearing Loss: A Systematic Review.

    Science.gov (United States)

    Johnson, Carole E; Danhauer, Jeffrey L; Ellis, Blakely B; Jilla, Anna Marie

    2016-04-01

    Untreated sensorineural hearing loss (SNHL) is associated with chronic health-care conditions, isolation, loneliness, and reduced quality of life. Although hearing aids can minimize the negative effects of SNHL, only about one in five persons with SNHL seeks help for communication problems. Many persons wait 10 yr or more from the time they first notice a problem before pursuing amplification. Further, little information about the benefits of amplification is available for persons with mild SNHL (MSNHL), who likely defer treatment even longer. To conduct a systematic review to weigh the evidence regarding benefits derived from the use of amplification by adults with MSNHL. Systematic review with meta-analysis. Adult hearing aid wearers with bilateral average pure-tone thresholds ≤45 dB HL at 500, 1000, 2000, and 4000 Hz. PubMed, Cumulative Index to Nursing and Allied-Health Literature, Cochrane Collaboration, and Google Scholar were searched independently by the authors during September 2013. The authors used a consensus approach to assess the quality and extract data for the meta-analysis. Of 106 articles recovered for full-text review, only 10 met inclusion criteria (at least Level IV of evidence and involved and reported separate pre-/postfitting hearing aid outcomes for patients with MSNHL). Included studies involved mainly middle-aged to elderly patients using hearing aids of various styles and circuitry. Results from all of the studies indicated positive benefits from amplification for patients with MSNHL. Data from five studies were suitable for a meta-analysis, which produced a small-to-medium effect size of 0.85 (95% confidence intervals = 0.44-1.25) after adjusting for a small publication bias. This evidence confirmed benefits from the use of amplification in adults with MSNHL. Evidence exists supporting the notion that adults with MSNHL benefit from hearing aids. This information is important and useful to audiologists, patients, and third-party payers

  10. Knowledge and attitudes of Jordanian nurses towards patients with HIV/AIDS: findings from a nationwide survey.

    Science.gov (United States)

    Hassan, Zeinab M; Wahsheh, Moayad A

    2011-01-01

    This study explored the knowledge and attitudes of Jordanian nurses toward patients with HIV/AIDS, particularly in regards to their sources of information and education. This survey utilized a cross-sectional design. A self-administered questionnaire developed by Eckstein was used in collecting the data. A total of 922 nurses completed the questionnaire. Overall, Jordanian nurses expressed negative attitudes toward patients with HIV/AIDS, and their level of HIV/AIDS knowledge was weak. Weak knowledge level was recorded among nurses in the following subsections: agent and immunology; course and manifestation; transmission and incidence; and precaution and prevention. Only in one subsection (risk group), did nurses show a good level of knowledge about HIV/AIDS. More than two-thirds of nurses (84%) refused to provide care to patients who tested positive for HIV/AIDS. Most of the nurse participants believed that currently provided HIV/AIDS information resources were inadequate (81.4 %). The majority of nurses were interested in support groups for staff nurses (96.5%). The major source of HIV/AIDS information obtained by Jordanian nurses was through Internet web sites (52.7%). The majority of nurses (96.2%) ranked their fear of getting AIDS from their nursing practice as overwhelming. The total attitude of participants towards patients with HIV/AIDS in all five subsections (i.e., fear of contagion, social stigma, fatal outcome of the disease, direct care, and education and counseling) was negative (84.3%). Accurate knowledge about HIV/AIDS along with an in-depth understanding of patients? needs can help alleviate much of the fear, anxiety, and stigma associated with caring for patients with HIV/AIDS.

  11. Clinical and molecular analysis of spinal muscular atrophy in Brazilian patients

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    C.A. Kim

    1999-12-01

    Full Text Available Spinal muscular atrophy (SMA, the second most common lethal autosomal recessive disorder, has an incidence of 1:10,000 newborns. SMA is divided into acute (Werdnig-Hoffmann disease, type I, intermediate (type II and juvenile forms (Kugelberg-Welander disease, type III. The gene of all three forms of SMA maps to chromosome 5q 11.2-13.3. Two candidate genes, the survival motor neuron (SMN gene and the neuronal apoptosis inhibitory protein (NAIP gene, have been identified; SMN is deleted in most SMA patients. We studied both genes in 87 Brazilian SMA patients (20 type I, 14 type II and 53 type III from 74 unrelated families, by using PCR and single strand conformation polymorphism (SSCP. Deletions of exons 7 and/or 8 of the SMN gene were found in 69% of the families: 16/20 in type I, 9/12 in type II and 26/42 in type III. Among 51 families with deletions, 44 had both exons deleted while seven had deletions only of exon 7. Deletions of exon 5 of the NAIP gene were found in 7/20 of type I, 2/12 of type II and 1/42 of type III patients. No deletion of SMN and NAIP genes was found in 112 parents, 26 unaffected sibs and 104 normal controls. No correlation between deletions of one or both genes and phenotype severity was found.As amiotrofias espinhais progressivas (SMAs constituem as doenças degenerativas de origem genética letais mais comuns do sistema nervoso central e mais freqüentes dentre as doenças autossômicas recessivas após a mucoviscidose. A incidência estimada das SMAs é de aproximadamente 1:10.000 nativivos. Clinicamente, as SMAs são classificadas em mais grave (doença de Werdnig-Hoffmann, tipo I, intermediária (tipo II e tardia e benigna (doença de Kugelberg-Welander, tipo III. O gene para os três tipos de SMAs foi mapeado no cromossomo 5 q11.2-13.3. Foram identificados dois genes candidatos na mesma região: SMN (sobrevida do neurônio motor e NAIP (proteína inibidora de apoptose neuronal. Estudamos ambos genes em 87 pacientes

  12. Intraoperative cardiac arrest and mortality in trauma patients. A 14-yr survey from a Brazilian tertiary teaching hospital.

    Science.gov (United States)

    Carlucci, Marcelo T O; Braz, José R C; do Nascimento, Paulo; de Carvalho, Lidia R; Castiglia, Yara M M; Braz, Leandro G

    2014-01-01

    Little information on the factors influencing intraoperative cardiac arrest and its outcomes in trauma patients is available. This survey evaluated the associated factors and outcomes of intraoperative cardiac arrest in trauma patients in a Brazilian teaching hospital between 1996 and 2009. Cardiac arrest during anesthesia in trauma patients was identified from an anesthesia database. The data collected included patient demographics, ASA physical status classification, anesthesia provider information, type of surgery, surgical areas and outcome. All intraoperative cardiac arrests and deaths in trauma patients were reviewed and grouped by associated factors and also analyzed as totally anesthesia-related, partially anesthesia-related, totally surgery-related or totally trauma patient condition-related. Fifty-one cardiac arrests and 42 deaths occurred during anesthesia in trauma patients. They were associated with male patients (Pundergoing gastroenterological or multiclinical surgeries (Ptrauma (Ptrauma patient condition. Intraoperative cardiac arrest and mortality incidence was highest in male trauma patients at a younger age with poor clinical condition, mainly related to uncontrolled hemorrhage and head injury, resulted from motor vehicle accidents and violence.

  13. Association of progressive outer retinal necrosis and varicella zoster encephalitis in a patient with AIDS.

    Science.gov (United States)

    van den Horn, G J; Meenken, C; Troost, D

    1996-01-01

    BACKGROUND: A patient with AIDS who developed the clinical picture of bilateral progressive outer retinal necrosis (PORN) in combination with varicella zoster encephalitis is described. The picture developed more than 2 years after an episode of ophthalmic zoster infection, and following intermittent exposure to oral acyclovir because of recurrent episodes of cutaneous herpes simplex infection. METHODS: Aqueous humour, obtained by paracentesis of the anterior chamber, was analysed using immunofluorescence and polymerase chain reaction (PCR). Postmortem analysis of eye and brain tissue was performed by using conventional techniques and in situ hybridisation. RESULTS: While conventional techniques all failed to detect a causative agent, analysis of the aqueous humour using PCR, and histological examination of necropsy specimens from eyes and brain using in situ hybridisation were conclusive for the diagnosis varicella zoster virus (VZV) infection. CONCLUSION: This case documents the presumed association of PORN and VZV encephalitis in a severely immunocompromised AIDS patient. Images PMID:8976726

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

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    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.

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

    International Nuclear Information System (INIS)

    Kim, Hae Won; Won, Kyung Sook; Choi, Byung Wook; Zeon, Seok Kil

    2010-01-01

    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.

  16. Behavioral and biological correlates of medicine use in type 2 diabetic patients attended by Brazilian public healthcare system

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    Jamile Sanches Codogno

    2013-01-01

    Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2013v15n1p82 The relationship between physical activity and the use of medicines is not clear. The purpose of this study was to investigate this relationship between the level of physical activity and the use of medications by type 2 diabetic patients who were attended in the Brazilian public healthcare system. The sample was composed of 121 Brazilian diabetic patients, of both genders, attended by the public healthcare system. Body fat (estimated by anthropometry and bioelectrical impedance, physical activity (measured by Baecke’s questionnaire, and the participant’s use of medicines (during the 15 days before evaluation were assessed. There was a relationship between the use of medicines and: gender (r = 0.18; p = 0.045, body mass index (BMI (r = 0.22; p = 0.012, waist circumference (r = 0.19; p = 0.029, body fat percentage (r = 0.21; p = 0.016, age (r = 0.23; p = 0.009, and level of physical activity (r = -0.22; p = 0.012. Linear regression included in the multivariate model only age (β = 0.718; p = 0.057, BMI (β= 0.057; p = 0.022, and level of physical activity (β = -0.176; p = 0.044. In conclusion, physical activity decreases medicinal use independent of age or obesity.

  17. Genetic Analysis of PARK2 and PINK1 Genes in Brazilian Patients with Early-Onset Parkinson's Disease

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    Karla Cristina Vasconcelos Moura

    2013-01-01

    Full Text Available Parkinson's disease is the second most frequent neurodegenerative disorder in the world, affecting 1-2% of individuals over the age of 65. The etiology of Parkinson's disease is complex, with the involvement of gene-environment interactions. Although it is considered a disease of late manifestation, early-onset forms of parkinsonism contribute to 5–10% of all cases. In the present study, we screened mutations in coding regions of PARK2 and PINK1 genes in 136 unrelated Brazilian patients with early-onset Parkinson's disease through automatic sequencing. We identified six missense variants in PARK2 gene: one known pathogenic mutation, two variants of uncertain role, and three nonpathogenic changes. No pathogenic mutation was identified in PINK1 gene, only benign polymorphisms. All putative pathogenic variants found in this study were in heterozygous state. Our data show that PARK2 point mutations are more common in Brazilian early-onset Parkinson's disease patients (2.9% than PINK1 missense variants (0%, corroborating other studies worldwide.

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

    Directory of Open Access Journals (Sweden)

    Graciela Augusto Xavier

    2013-02-01

    Full Text Available 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.

  19. Combination therapy with fluconazole and flucytosine for cryptococcal meningitis in Ugandan patients with AIDS.

    Science.gov (United States)

    Mayanja-Kizza, H; Oishi, K; Mitarai, S; Yamashita, H; Nalongo, K; Watanabe, K; Izumi, T; Ococi-Jungala; Augustine, K; Mugerwa, R; Nagatake, T; Matsumoto, K

    1998-06-01

    We performed a randomized trial in which combination therapy with fluconazole and short-term flucytosine was compared with fluconazole monotherapy in 58 patients with AIDS-associated cryptococcal meningitis (CM). Thirty of these patients were randomized to receive combination therapy with fluconazole, 200 mg once a day for 2 months, and flucytosine, 150 mg/(kg.d) for the first 2 weeks, and 28 were randomized to receive monotherapy with fluconazole at the same dose for 2 months. Patients in both groups who survived for 2 months received fluconazole as maintenance therapy at a dose of 200 mg three times per week for 4 months. The combination therapy prevented death within 2 weeks and significantly increased the survival rate among these patients (32%) at 6 months over that among patients receiving monotherapy (12%) (P = .022). The combination therapy also resulted in a significant decrease in the severity of headache after 1 month of treatment, compared with monotherapy (P = .005). No serious adverse reactions were observed in patients receiving either regimen. These data indicate that treatment with fluconazole and short-term flucytosine is a cost-effective and safe regimen that improves the quality of life for patients with AIDS-associated CM in developing countries where human immunodeficiency virus is endemic.

  20. [HIV/AIDS patients in a Critical Care Unit: The experience of a general hospital in a developing country].

    Science.gov (United States)

    Verdugo, Fernando; Pinto, Francisco; Charpentier, Paulo; Von Mühlenbrock, Christian; Soto, Andrés; Dabanch, Jeannette; Fica, Alberto

    2015-06-01

    Despite general availability of HAART in Chile, admissions of HIV/AIDS patients to Intensive-Intermediate Care Units (IICU) are still happening, and a characterization of patient's profile, mortality and potentially avoidable admissions is necessary. Observational retrospective study in one general hospital in Chile of HIV/AIDS patients admitted to IICU during 9 years. During 2005-2013, 32 patients were admitted to IICU, with 87,5% in AIDS stage, only 53,1% knew his/her condition, 43,8% were receiving HAART and 16.6% chemoprophylaxis for opportunistic infections, A CD4 count Chile, hospitalizations of patients with HIV/AIDS are still happening, affecting those that either are unaware of his/her condition, are not receiving HAART and/or chemoprophylaxis. These admissions generate premature deaths and happen even after discharge in severely ill patients.

  1. Brain computed tomography of patients with HIV/AIDS before the ...

    African Journals Online (AJOL)

    Brain computed tomography of patients with HIV/AIDS before the advent of subsidized treatment program in Nigeria. ... (36.1%), right hemiplegia 6 (16.7%), coma 7 (19.4%), memory loss/dementia complex 5 (13.9%), convulsion with coma 2 (5.6%), left hemi‑pariesis with memory loss 2 (5.6%), and staggering gait 1 (2.8%).

  2. 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. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

  3. Comparison of diagnostic methods to detect Histoplasma capsulatum in serum and blood samples from AIDS patients

    Science.gov (United States)

    da Silva, Marcos Vinicius; Criado, Paulo Ricardo; Luiz, Olinda do Carmo; Vicentini, Adriana Pardini

    2018-01-01

    Background Although early and rapid detection of histoplasmosis is essential to prevent morbidity and mortality, few diagnostic tools are available in resource-limited areas, especially where it is endemic and HIV/AIDS is also epidemic. Thus, we compared conventional and molecular methods to detect Histoplasma capsulatum in sera and blood from HIV/AIDS patients. Methodology We collected a total of 40 samples from control volunteers and patients suspected of histoplasmosis, some of whom were also infected with other pathogens. Samples were then analyzed by mycological, serological, and molecular methods, and stratified as histoplasmostic with (group I) or without AIDS (group II), uninfected (group III), and infected with HIV and other pathogens only (group IV). All patients were receiving treatment for histoplasmosis and other infections at the time of sample collection. Results Comparison of conventional methods with nested PCR using primers against H. capsulatum 18S rRNA (HC18S), 5.8S rRNA ITS (HC5.8S-ITS), and a 100 kDa protein (HC100) revealed that sensitivity against sera was highest for PCR with HC5.8S-ITS, followed by immunoblotting, double immunodiffusion, PCR with HC18S, and PCR with HC100. Specificity was equally high for double immunodiffusion, immunoblotting and PCR with HC100, followed for PCR with HC18S and HC5.8-ITS. Against blood, sensitivity was highest for PCR with HC5.8S-ITS, followed by PCR with HC18S, Giemsa staining, and PCR with HC100. Specificity was highest for Giemsa staining and PCR with HC100, followed by PCR with HC18S and HC5.8S-ITS. PCR was less efficient in patients with immunodeficiency due to HIV/AIDS and/or related diseases. Conclusion Molecular techniques may detect histoplasmosis even in cases with negative serology and mycology, potentially enabling early diagnosis. PMID:29342162

  4. Comparison of diagnostic methods to detect Histoplasma capsulatum in serum and blood samples from AIDS patients.

    Directory of Open Access Journals (Sweden)

    Katia Cristina Dantas

    Full Text Available Although early and rapid detection of histoplasmosis is essential to prevent morbidity and mortality, few diagnostic tools are available in resource-limited areas, especially where it is endemic and HIV/AIDS is also epidemic. Thus, we compared conventional and molecular methods to detect Histoplasma capsulatum in sera and blood from HIV/AIDS patients.We collected a total of 40 samples from control volunteers and patients suspected of histoplasmosis, some of whom were also infected with other pathogens. Samples were then analyzed by mycological, serological, and molecular methods, and stratified as histoplasmostic with (group I or without AIDS (group II, uninfected (group III, and infected with HIV and other pathogens only (group IV. All patients were receiving treatment for histoplasmosis and other infections at the time of sample collection.Comparison of conventional methods with nested PCR using primers against H. capsulatum 18S rRNA (HC18S, 5.8S rRNA ITS (HC5.8S-ITS, and a 100 kDa protein (HC100 revealed that sensitivity against sera was highest for PCR with HC5.8S-ITS, followed by immunoblotting, double immunodiffusion, PCR with HC18S, and PCR with HC100. Specificity was equally high for double immunodiffusion, immunoblotting and PCR with HC100, followed for PCR with HC18S and HC5.8-ITS. Against blood, sensitivity was highest for PCR with HC5.8S-ITS, followed by PCR with HC18S, Giemsa staining, and PCR with HC100. Specificity was highest for Giemsa staining and PCR with HC100, followed by PCR with HC18S and HC5.8S-ITS. PCR was less efficient in patients with immunodeficiency due to HIV/AIDS and/or related diseases.Molecular techniques may detect histoplasmosis even in cases with negative serology and mycology, potentially enabling early diagnosis.

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

    OpenAIRE

    MM Madumo; MD Peu

    2006-01-01

    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, partic...

  6. Macromodular splenic tuberculosis in a medically-treated AIDS patient: diagnosis and management by CT

    International Nuclear Information System (INIS)

    Galant, J., Marti-Bonmati, L.; Tornero, C.; Ferrer, M.D.

    1995-01-01

    We used computerized tomography (CT) in the study of eight patients with macronodular splenic tuberculosis prior to the microbiological diagnosis. These patients underwent additional CT controls during and after tuberculostatic therapy. All the patients studed presented the acquired immunodeficiency syndrome (AIDS). Splenomegaly and numerosous round, hypodense lesions that showed no contrast uptake were found in all the subjects. Only three patients presented evidence of tuberculosis in plain radiography and/or chest X-ray. Two patients presented abdominal lymph nodes. None of them showed evidence of hepatic lesions or ascites. follow-up CT scans revealed a progressive reduction of the lesions, which eventually disappeared completely, and splenomegaly was considerably reduced. Anthough it is uncommon, we should suspect splenic involvement in tuberculosis if the clinical and radiological contexts are appropriate. CT provides excellent monitoring of the efficacy of treatment in these patients. 17 refs

  7. Bone anchored hearing aid in single sided deafness: outcome in right-handed patients.

    Science.gov (United States)

    Saliba, Issam; Nader, Marc-Elie; El Fata, Fouad; Leroux, Tony

    2011-10-01

    To assess the benefits in terms of sound localization, to evaluate speech discrimination in noise, to appraise the prosthesis benefit and to identify outcome in right and left handed patients when BAHA are implanted on the right or on the left deaf side. Two years prospective study in a tertiary referral center. Tests consist on Hearing in Noise Test (HINT) and sound localization after 6 months of BAHA use. Quality of life was assessed by the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire. The paired T-test and the analysis of variance were used for the statistical measures. Twenty-one subjects participated in this study. HINT: patients score better when speech and noise are spatially separated and noise is not presented to the healthy ear. In the right-handed group (left dominant brain), unaided left-implanted patients performed better than right-implanted patient when speech is in front and noise to the good ear; when speech is presented to the good ear and noise to the front, aided right-implanted patients performed better than aided left-implanted patients. Sound localization: correct answers attain 35% at best. No statistical difference between the frequencies was found, neither between the left and right implanted patients. APHAB: the score improvement is statistically significant for the global score, the background noise subscale at 5 weeks and for the reverberation subscale at 6 months. It seems that left dominant hemisphere is able to filter crossed noise better than the right hemisphere. Results of uncrossed speech to the dominant left brain are better than the uncrossed speech to the non-dominant right brain. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  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. Distribution and clinical manifestations of Cryptosporidium species and subtypes in HIV/AIDS patients in Ethiopia.

    Science.gov (United States)

    Adamu, Haileeyesus; Petros, Beyene; Zhang, Guoqing; Kassa, Hailu; Amer, Said; Ye, Jianbin; Feng, Yaoyu; Xiao, Lihua

    2014-04-01

    Cryptosporidiosis is an important cause for chronic diarrhea and death in HIV/AIDS patients. Among common Cryptosporidium species in humans, C. parvum is responsible for most zoonotic infections in industrialized nations. Nevertheless, the clinical significance of C. parvum and role of zoonotic transmission in cryptosporidiosis epidemiology in developing countries remain unclear. In this cross-sectional study, 520 HIV/AIDS patients were examined for Cryptosporidium presence in stool samples using genotyping and subtyping techniques. Altogether, 140 (26.9%) patients were positive for Cryptosporidium spp. by PCR-RFLP analysis of the small subunit rRNA gene, belonging to C. parvum (92 patients), C. hominis (25 patients), C. viatorum (10 patients), C. felis (5 patients), C. meleagridis (3 patients), C. canis (2 patients), C. xiaoi (2 patients), and mixture of C. parvum and C. hominis (1 patient). Sequence analyses of the 60 kDa glycoprotein gene revealed a high genetic diversity within the 82 C. parvum and 19 C. hominis specimens subtyped, including C. parvum zoonotic subtype families IIa (71) and IId (5) and anthroponotic subtype families IIc (2), IIb (1), IIe (1) and If-like (2), and C. hominis subtype families Id (13), Ie (5), and Ib (1). Overall, Cryptosporidium infection was associated with the occurrence of diarrhea and vomiting. Diarrhea was attributable mostly to C. parvum subtype family IIa and C. hominis, whereas vomiting was largely attributable to C. hominis and rare Cryptosporidium species. Calf contact was identified as a significant risk factor for infection with Cryptosporidium spp., especially C. parvum subtype family IIa. Results of the study indicate that C. parvum is a major cause of cryptosporidiosis in HIV-positive patients and zoonotic transmission is important in cryptosporidiosis epidemiology in Ethiopia. In addition, they confirm that different Cryptosporidium species and subtypes are linked to different clinical manifestations.

  10. Distribution and clinical manifestations of Cryptosporidium species and subtypes in HIV/AIDS patients in Ethiopia.

    Directory of Open Access Journals (Sweden)

    Haileeyesus Adamu

    2014-04-01

    Full Text Available BACKGROUND: Cryptosporidiosis is an important cause for chronic diarrhea and death in HIV/AIDS patients. Among common Cryptosporidium species in humans, C. parvum is responsible for most zoonotic infections in industrialized nations. Nevertheless, the clinical significance of C. parvum and role of zoonotic transmission in cryptosporidiosis epidemiology in developing countries remain unclear. METHODOLOGY/PRINCIPAL FINDINGS: In this cross-sectional study, 520 HIV/AIDS patients were examined for Cryptosporidium presence in stool samples using genotyping and subtyping techniques. Altogether, 140 (26.9% patients were positive for Cryptosporidium spp. by PCR-RFLP analysis of the small subunit rRNA gene, belonging to C. parvum (92 patients, C. hominis (25 patients, C. viatorum (10 patients, C. felis (5 patients, C. meleagridis (3 patients, C. canis (2 patients, C. xiaoi (2 patients, and mixture of C. parvum and C. hominis (1 patient. Sequence analyses of the 60 kDa glycoprotein gene revealed a high genetic diversity within the 82 C. parvum and 19 C. hominis specimens subtyped, including C. parvum zoonotic subtype families IIa (71 and IId (5 and anthroponotic subtype families IIc (2, IIb (1, IIe (1 and If-like (2, and C. hominis subtype families Id (13, Ie (5, and Ib (1. Overall, Cryptosporidium infection was associated with the occurrence of diarrhea and vomiting. Diarrhea was attributable mostly to C. parvum subtype family IIa and C. hominis, whereas vomiting was largely attributable to C. hominis and rare Cryptosporidium species. Calf contact was identified as a significant risk factor for infection with Cryptosporidium spp., especially C. parvum subtype family IIa. CONCLUSIONS/SIGNIFICANCE: Results of the study indicate that C. parvum is a major cause of cryptosporidiosis in HIV-positive patients and zoonotic transmission is important in cryptosporidiosis epidemiology in Ethiopia. In addition, they confirm that different Cryptosporidium species and

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

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    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.

  12. Nutritional status and food intake of Brazilian patients at various stages of Alzheimer’s disease: A crosssectional study

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    Vanessa Fernanda Goes

    2014-04-01

    Full Text Available Alzheimer’s disease (AD is characterized by disorders that can impair the nutrition of the patient and lead to weight loss and nutritional deficits during the course of the disease. The aim of this study was to assess the nutritional status and food intake of Brazilian patients with Alzheimer’s disease at 3 different stages of the disease. The sample consisted of 30 subjects of both genders, mean age 77 years, with probable AD. Subjects were assessed by collecting anthropometric data, the Mini Nutritional Assessment (MNA, serum albumin content, Mini Mental State Examination and 24-hour records of food and drink. Although a steady decrease in average weight was observed as the disease progressed (CDR1: 70.8±15.9 kg; CDR2: 61.4±15.7 kg; CDR3: 56.1± 8.4 kg, the differences were not significant. MNA and serum albumin both fell during the progression of the disease (p = 0.042; p = 0.047, respectively and, at the severe stage, half the patients were found to be undernourished and the other half at risk of undernutrition. According to their body mass index, 23.3% of patients were overweight. The nutritional value of the food consumed was similar across the stages of AD. In conclusion, the majority of Brazilian patients with AD in this study exhibited cognitive decline and malnutrition. However, food intake was similar among the stages of the disease, thus having no direct association with the progression of AD.

  13. Better performance with bone-anchored hearing aid than acoustic devices in patients with severe air-bone gap

    NARCIS (Netherlands)

    Wolf, M.J. de; Hendrix, S.; Cremers, C.W.R.J.; Snik, A.F.M.

    2011-01-01

    OBJECTIVES/HYPOTHESIS: A study performed in the 1990s with analogue linear hearing aids showed that in patients with mixed hearing loss and an air-bone gap that exceeded 25 to 30 dB, speech perception was better with a bone-anchored hearing aid (Baha) than with a conventional behind-the-ear (BTE)

  14. [Demographic and clinical characterizations of newly diagnosed patients with HIV/AIDS above fifty years of age].

    Science.gov (United States)

    Asher, Ilan; Elbirt, Daniel; Mahlev-Guri, Keren; Rozenberg-Bezalet, Shira; Werner, Ben; Sthoeger, Zev

    2013-04-01

    Major changes happened in the last decade in the HIV/AIDS pandemic. The disease is no longer limited to young age. Due to the effectiveness of HAART (Highly Active Anti-Retroviral Therapy) as well as new diagnosis in older age groups, many patients in AIDS centers are above 50 years of age. To determine the prevalence, demographics and clinical characteristics of newly diagnosed HIV/AIDS patients older than 50 years compared to younger newly diagnosed patients. Retrospective single center analysis of the demographics and clinical characterizations of 62 newly diagnosed HIV/AIDS patients over 50 years of age. The average age at diagnosis of the whole cohort was 39+/-16 years. There was a gradual increase in the age at diagnosis over the years, as well as the percent of patients above the age of 50 diagnosed with the disease. In comparison to younger patients, in the older group there were more males compared to females and less patients who acquired the HIV/AIDS in unprotected homosexual sex. Furthermore, CD4 cells counts were lower and viral load leveLs were higher at diagnosis in the older group. Despite good adherence, patients above the age of 50 don't achieve adequate immunological response and many are left with significant immunodeficiency (CD4increasing number of patients over the age of 50 Living with HIV/AIDS.

  15. Metabolic effects associated to the highly active antiretroviral therapy (HAART in AIDS patients

    Directory of Open Access Journals (Sweden)

    Hamilton Domingos

    Full Text Available The aim of this study was to evaluate the metabolic abnormalities (dyslipidaemia and insulin resistance associated with highly active antiretroviral therapy (HAART in AIDS patients, treated in Campo Grande, Mato Grosso do Sul, Brazil. The patients were distributed in five different groups: Group 1, HIV-infected without antiretroviral therapy; Group 2, with Zidovudine, Lamivudine and Efavirenz or Nevirapine; Group 3, with Zidovudine, Lamivudine and Protease Inhibitor; Group 4, with Stavudine, Lamivudine and Efavirenz or Nevirapine; and Group 5, with Stavudine, Lamivudine and Protease Inhibitor. The lipid and glucose profile were determined and statistics comparison was made. The findings of this study showed significant statistics elevations of total cholesterol and triglycerides levels in patients of Groups 3, 4 and 5, when comparing to patients of Groups 1 and 2. Significant differences were not observed between the groups in the others parameters evaluated: Glucose, HDL cholesterol and LDL cholesterol. Comparing two drugs of same class (NNRTI through the subgroups II-efavirenz and II-nevirapine, significant differences in the serum levels of total cholesterol, triglycerides and glucose favorable to the subgroup II-NVP were observed. These findings suggest that combinations including Protease Inhibitors and/or Stavudine could cause more adverse metabolic effects, and if possible, should be avoided in patients with others cardiovascular risk factors to prevent the precocious atherosclerosis in AIDS patients receiving HAART.

  16. 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.

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

    Science.gov (United States)

    Wumba, R; Longo-Mbenza, B; Mandina, M; Odio, Wobin T; Biligui, S; Sala, J; Breton, J; Thellier, M

    2010-12-01

    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%), Ascoris lumbricoides 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.

  18. Disability Grant: a precarious lifeline for HIV/AIDS patients in South Africa.

    Science.gov (United States)

    Govender, Veloshnee; Fried, Jana; Birch, Stephen; Chimbindi, Natsayi; Cleary, Susan

    2015-06-09

    In South Africa, HIV/AIDS remains a major public health problem. In a context of chronic unemployment and deepening poverty, social assistance through a Disability Grant (DG) is extended to adults with HIV/AIDS who are unable to work because of a mental or physical disability. Using a mixed methods approach, we consider 1) inequalities in access to the DG for patients on ART and 2) implications of DG access for on-going access to healthcare. Data were collected in exit interviews with 1200 ART patients in two rural and two urban health sub-districts in four different South African provinces. Additionally, 17 and 18 in-depth interviews were completed with patients on ART treatment and ART providers, respectively, in three of the four sites included in the quantitative phase. Grant recipients were comparatively worse off than non-recipients in terms of employment (9.1 % vs. 29.9 %) and wealth (58.3 % in the poorest half vs. 45.8 %). After controlling for socioeconomic and demographic factors, site, treatment duration, adherence and concomitant TB treatment, the regression analyses showed that the employed were significantly less likely to receive the DG than the unemployed (p ART and tuberculosis care) were more likely to receive the DG (significant at the 5 % level). The qualitative analyses indicated that the DG alleviated the burden of healthcare related costs for ART patients. Both patients and healthcare providers spoke of the complexity of the grants process and eligibility criteria as a barrier to accessing the grant. This impacted adversely on patient-provider relationships. These findings highlight the appropriateness of the DG for people living with HIV/AIDS. However, improved collaboration between the Departments of Social Development and Health is essential for preparing healthcare providers who are at the interface between social security and potential recipients.

  19. 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.

  20. Effectiveness and Comparison of Various Audio Distraction Aids in Management of Anxious Dental Paediatric Patients.

    Science.gov (United States)

    Navit, Saumya; Johri, Nikita; Khan, Suleman Abbas; Singh, Rahul Kumar; Chadha, Dheera; Navit, Pragati; Sharma, Anshul; Bahuguna, Rachana

    2015-12-01

    Dental anxiety is a widespread phenomenon and a concern for paediatric dentistry. The inability of children to deal with threatening dental stimuli often manifests as behaviour management problems. Nowadays, the use of non-aversive behaviour management techniques is more advocated, which are more acceptable to parents, patients and practitioners. Therefore, this present study was conducted to find out which audio aid was the most effective in the managing anxious children. The aim of the present study was to compare the efficacy of audio-distraction aids in reducing the anxiety of paediatric patients while undergoing various stressful and invasive dental procedures. The objectives were to ascertain whether audio distraction is an effective means of anxiety management and which type of audio aid is the most effective. A total number of 150 children, aged between 6 to 12 years, randomly selected amongst the patients who came for their first dental check-up, were placed in five groups of 30 each. These groups were the control group, the instrumental music group, the musical nursery rhymes group, the movie songs group and the audio stories group. The control group was treated under normal set-up & audio group listened to various audio presentations during treatment. Each child had four visits. In each visit, after the procedures was completed, the anxiety levels of the children were measured by the Venham's Picture Test (VPT), Venham's Clinical Rating Scale (VCRS) and pulse rate measurement with the help of pulse oximeter. A significant difference was seen between all the groups for the mean pulse rate, with an increase in subsequent visit. However, no significant difference was seen in the VPT & VCRS scores between all the groups. Audio aids in general reduced anxiety in comparison to the control group, and the most significant reduction in anxiety level was observed in the audio stories group. The conclusion derived from the present study was that audio distraction

  1. Psychopathology and coping in recently diagnosed HIV/AIDS patients - the role of gender

    Directory of Open Access Journals (Sweden)

    Benjamin O Olley

    2004-04-01

    Full Text Available Background. Although there is growing literature on the psy- chological responses to and the psychopathology associated with HIV/AIDS, few investigations have focused on the role of gender. This study compared psychiatric morbidity, coping responses, and disability in male and female outpatients recently diagnosed with HIV/AIDS. Method. One hundred and forty-nine patients (44 male, 105 female with HIV/AIDS (mean ± standard deviation (SD months since diagnosis 5.8 ± 4.1 attending an infectious dis- eases clinic at Tygerberg Hospital, Cape Town, were evaluat- ed. Subjects were assessed using the MINI International Neuropsychiatric Interview (MINI, the Carver Brief COPE, and the Sheehan Disability Scale. In addition, negative life events and risk behaviours were evaluated. Results. Fifty-six per cent of patients were diagnosed with a psy- chiatric disorder, most commonly major depression (34.9%, dysthymic disorder (21.5%, post-traumatic stress disorder (14.8%, and alcohol dependence (10.1%. There were no significant gender differences in the prevalence of mood disor- ders in the sample. Men, however, were more likely than women to meet diagnostic criteria for alcohol abuse or depen- dence, and to engage in certain risky sexual behaviours. Women were more likely to suffer from post-traumatic stress dis- order, and to use coping strategies of planning and religion to deal with the illness. There were no significant gender differ- ences in disability. Conclusion. Psychiatric disorders are common in recently diag- nosed HIV/AIDS patients in South Africa. Clinicians should be aware of the high prevalence of mood disorders in both men and women, and of gender-different responses such as increased alcohol and substance use and more risky sexual behaviour in men.

  2. [Features and influencing factors of self-discrimination among HIV/AIDS patients according to sex].

    Science.gov (United States)

    Ju, L H; Lyu, P; Xu, P; Chen, W Y; He, H J; Ma, L P

    2016-10-06

    Objective: To investigate the features and influencing factors of self-discrimination among patients with HIV/AIDS according to sex. Methods: A total of 2 432 HIV/AIDS patients were recruited in Yunnan, Henan, Hubei, Jiangsu, Shanxi, Jilin, and Inner Mongolia provinces by a multistage stratified cluster sampling method, based on HIV epidemic and transmission modes, from May 2013 to October 2013. All participants were ≥18 years old, and we excluded those with mental disorders, hearing loss or other factors that prevented them from properly answering questions, and those who were unwilling to participate. A self-designed questionnaire was conducted to collect information about self-discrimination features and social behavior changes among HIV/AIDS patients. Differences in performance and self-discrimination features between participants of different sexes were compared using the chi-squared test. Factors influencing self-discrimination were analyzed by sex, using unconditional logistic regression. Results: Of the 2 432 cases, 78.9%(1 918 cases)were male and 21.1%(514 cases)female. The proportion of self-discrimination overall was 76.1%(1 850 cases); this proportion among female HIV/AIDS patients was 80.5%(414 cases), which was higher than that among men(74.9%, 1 436 cases)(χ 2 =7.17, P= 0.007). Of the 11 forms of self-discrimination performance, proportions of feeling guilt, shame, and self-abasement among participants were greater than 50%. Proportions of feeling shame, inferiority, and blaming others among females were 61.3%, 59.5%, and 45.3%, respectively, which were higher than these among males(49.8%, 50.0%, 28.4%, respectively)( Pdiscrimination among those with HIV confirmatory testing time ≥1 year was higher than those with HIV confirmatory testing time discrimination among male farm workers was higher( OR= 1.62, 95 % CI :1.03-2.54). The risks of self-discrimination in males who had been infected with HIV by transmission routes of blood transfusion or

  3. 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

    -embedded lung, spleen, lymph node, and liver tissue were further studied by in situ hybridization using a probe for EBV early RNA (EBER, Kreatech). The same method was applied to lymphoid tissues from eight other archival AIDS autopsy cases. Case patient tissues were also examined by electron microscopy......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...... and pneumocytes. Of the archival cases studied, only one spleen was found to have rare positive lymphocytes. CONCLUSION: Primary or reactivation EBV infection may represent a previously underreported cause of morbidity and mortality in AIDS patients. Autopsy tissues from AIDS patients do not routinely show...

  4. Use of a Novel Memory Aid to Educate Perioperative Team Members on Proper Patient Positioning Technique.

    Science.gov (United States)

    Woodfin, Kaitlen O; Johnson, Corey; Parker, Renee; Mikach, Caroline; Johnson, Molly; McMullan, Susan P

    2018-03-01

    Interdisciplinary collaboration is key to safe surgical positioning. Although the surgical procedure dictates the patient's position, surgeons, anesthesia care providers, intraoperative nurses, and ancillary staff members must work together to achieve the goal of safe positioning. Correct patient positioning includes the provision of adequate access to the surgical site for the surgeon and surgical assistants. Surgical positions may put the patient at risk of injury. Understanding human anatomy, including the nerves commonly affected by each surgical position, can help the surgical team prevent accidental and irreversible patient injury. A lack of knowledge of proper positioning practices can result in serious patient injury, such as permanent paralysis, blindness, tissue necrosis, burns, bone fracture, and even death. This article reviews surgical positioning and introduces a learning module that involves the use of mnemonics as memory aids for perioperative team members who are learning proper positioning techniques. © AORN, Inc, 2018.

  5. Tuberculoid leprosy and cytomegalovirus retinitis as immune restoration disease in a patient with AIDS.

    Science.gov (United States)

    Kumar, Shishir; Ghosh, Manab Kumar; Sarkar, Somenath; Mallik, Sudeshna; Biswas, Pradyot Narayan; Saha, Bibhuti

    2012-02-01

    Here we report a unique case of tuberculoid leprosy and cytomegalovirus retinitis in a 27-year-old female patient with AIDS, suggestive of highly active antiretroviral therapy (HAART)-induced immune restoration disease. After initiation of HAART, the patient presented with decreased visual acuity, hypoesthetic patch with local nerve thickening, and an increase in her CD4+ T cell count. On further investigations cytomegalovirus retinitis and tuberculoid leprosy were confirmed. To our knowledge no case with such a co-existence has previously been reported. Copyright © 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  6. 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.

  7. Evaluation of a Patient Decision Aid for Unicompartmental or Total Knee Arthroplasty for Medial Knee Osteoarthritis.

    Science.gov (United States)

    de Jesus, Christopher; Stacey, Dawn; Dervin, Geoffrey F

    2017-11-01

    Many patients with isolated medial compartment osteoarthritis are candidates for either unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA). A novel patient decision aid (PDA) was developed to educate patients on both interventions and prepare them for making the decision with their surgeon. The study objective was to evaluate the acceptability and usefulness of a PDA for informing and helping patients reach a surgical preference without increasing decisional conflict. A PDA was developed in accordance with the criteria listed by Ottawa Decision Support Framework and prospectively tested in UKA and TKA patients, who were mailed the PDAs to complete at home along with outcome measures before surgeon consultation. Of 50 patients who consented to participate, 45 patients (26 men, 19 women) used the PDA. Quantitative analysis of acceptability, decisional conflict, knowledge, and preferred surgical option was then performed. Mean patient age was 64.6 years (range, 50-80 years). Patients rated the PDA as acceptable: 84.4% indicated balanced presentation of information and 77.8% asserted that PDA helped them to make decisions between UKA and TKA. Mean knowledge score was 86.6% and total decisional conflict was 19.7 out of 100. Of 45, 33 stated a preferred option (24 UKA; 9 TKA; 12 unsure). Patients understood the majority of the benefits and risks for each surgical option without increasing decisional conflict. The decision aid for advanced medial compartment osteoarthritis is shown to be acceptable and useful for choosing between UKA and TKA. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Soft tissue overgrowth in bone-anchored hearing aid patients: use of 8.5 mm abutment.

    Science.gov (United States)

    Pelosi, S; Chandrasekhar, S S

    2011-06-01

    To review outcomes following implantation of an 8.5 mm bone-anchored hearing aid abutment, as regards post-operative management of scalp soft tissue overgrowth. Retrospective chart review of paediatric and adult patients implanted with bone-anchored hearing aids between 2003 and 2008 who subsequently underwent revision surgery for excessive soft tissue growth. A tertiary referral centre and a private otology and neurotology clinic. A total of 80 patients underwent bone-anchored hearing aid placement between 2003 and 2008. Of these patients, 14 had significant scalp soft tissue overgrowth unresponsive to first-line, nonsurgical local wound care. Fourteen patients underwent an average of 2.1 surgical procedures each for soft tissue overgrowth around their bone-anchored hearing aid abutment. The mean time between initial implantation and revision surgery was 13.6 months. Of these 14 patients, 11 were eventually fitted with an 8.5 mm abutment. Following placement of the longer abutment, only one patient required additional surgical reduction of soft tissue overgrowth (mean follow-up time 11.8 months). All patients were able to use their bone-anchored hearing aid. The 8.5 mm bone-anchored hearing aid abutment is successful in preventing the need for additional surgical intervention in the small but significant number of patients with post-implantation soft tissue overgrowth. Early consideration should be given to this option when first-line soft tissue care is inadequate.

  9. [Ocular manifestations in HIV/AIDS patients undergoing highly active antiretroviral treatment (HAART) in Togo].

    Science.gov (United States)

    Ayena, K D; Amedome, K M; Agbo, A R D; Kpetessou-Ayivon, A L; Dzidzinyo, B K; Djagnikpo, P A; Banla, M; Balo, K P

    2010-04-01

    The twofold purpose of this study in people living with human immunodeficiency virus (PLHIV/AIDS) and undergoing highly active antiretroviral treatment (HAART) was to determine the prevalence of ocular manifestations and its correlation with CD4 T-cell count. All patients who attended 2 NGO care centers that manage PLHIV/AIDS in Lomé, Togo between August and October 2005 were recruited. CD4 T-cell counts and use of antiretroviral treatment was noted. A thorough eye examination was performed in all cases. A total of 422 PLHIV/SIDA were recruited including 281 who were undergoing HAART. The sex-ratio was 2 female/1 male. Mean age was 34 +/- 2294 years. Involvement of the anterior segment was observed in 36.3% of patients and involvement of the posterior segment in 54.1%. The second most common ocular manifestation was ophthalmic herpes zoster of the anterior segment (19.6%) secondary to conjunctivitis (57.8%). One case of palpebral and conjunctival Kaposi's sarcoma was noted. The most common type of posterior segment involvement was cotton-wool nodules (35.5%). Five cases of CMV retinitis were observed. A longitudinal study in PLHIV/AIDS will be needed to better evaluate the correlation between ocular manifestations and CD4 T-cell count.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Histoplasmosis in Patients With Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS)

    Science.gov (United States)

    Anderson, Albert M.; Sanchez, Alejandro; Farabi, Alireza; Hage, Chadi; Baddley, John W.; Jhaveri, Malhar; Greenberg, Richard N.; Bamberger, David M.; Rodgers, Mark; Crawford, Timothy N.; Wheat, L. Joseph

    2014-01-01

    Abstract Although discontinuation of suppressive antifungal therapy for acquired immunodeficiency syndrome (AIDS)-associated histoplasmosis is accepted for patients with immunologic recovery, there have been no published studies of this approach in clinical practice, and minimal characterization of individuals who relapse with this disease. We performed a multicenter retrospective cohort study to determine the outcome in AIDS patients following discontinuation of suppressive antifungal therapy for histoplasmosis. Ninety-seven patients were divided into a physician-discontinued suppressive therapy group (PD) (38 patients) and a physician-continued suppressive therapy group (PC) (59 patients). The 2 groups were not statistically different at baseline, but at discontinuation of therapy and at the most recent follow-up there were significant differences in adherence to therapy, human immunodeficiency virus (HIV) RNA, and urinary Histoplasma antigen concentration. There was no relapse or death attributed to histoplasmosis in the PD group compared with 36% relapse (p 150 cells/mL, HIV RNA <400 c/mL, Histoplasma antigenuria <2 ng/mL (equivalent to <4.0 units in second-generation method), and no CNS histoplasmosis. PMID:24378739

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

    Directory of Open Access Journals (Sweden)

    Evanizio Roque de Arruda Junior

    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.

  13. Patient satisfaction and functional results with the bone-anchored hearing aid (BAHA).

    Science.gov (United States)

    Saroul, N; Gilain, L; Montalban, A; Giraudet, F; Avan, P; Mom, T

    2011-06-01

    To assess patient satisfaction with bone-anchored hearing aids (BAHA) and the role of preoperative audiometric testing. A telephone satisfaction survey was conducted on all patients implanted between June 1, 2005 and February 1, 2008. Patients with unilateral total deafness underwent preoperative audiometric tests in quiet and in noise and stereoaudiometry with and without BAHA. Patients with a conductive hearing loss underwent preoperative audiometric tests in quiet and in noise and real-life testing at home using a headband. A standardized satisfaction questionnaire derived from the Entific BAHA questionnaire was used. Twenty-two out of 26 patients responded to the questionnaire. Ten patients were implanted for conductive hearing loss (CHL) and 12 for unilateral total deafness (UTD). Mean follow-up was 19 months in the UTD group and 21 months in the CHL group. Sixty-seven percent of UTD and 80% of CHL patients reported improved quality of life. The BAHA was worn for more than 4hours per day by 83% of UTD and 100% of CHL patients, and at least 5 days per week by 67% of UTD and 80% of CHL patients. BAHAs provided real benefit in all situations for CHL patients. In UTD, its benefit basically related to noisy environments. In UTD, satisfaction on preoperative stereoaudiometric testing in noise with and without BAHA was predictive of postimplantation satisfaction. In response to the question "Would you do it again?", 81% of patients answered "Yes". Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  14. Idiopathic ulcers as an oral manifestation in pediatric patients with AIDS: multidisciplinary management.

    Science.gov (United States)

    Martinez-Sandoval, B; Ceballos-Hernández, H; Téllez-Rodríguez, J; Xochihua-Díaz, L; Durán-Ibarra, G; Pozos-Guillen, A J

    2012-01-01

    HIV infection is a major global health problem affecting developing and developed countries alike. HIV infection is associated with multiple oral lesions, some of which are of value in diagnosing the disease. The aim of this report is to describe the clinical manifestations and their multidisciplinary management, in a 6-year-old girl with AIDS. The findings of this case report indicate that, it is essential to be familiar with the early oral manifestations of AIDS in order to understand the patient's dental health needs, apply preventive methods, control caries, and understand the value of oral lesions as diagnostic markers of disease progression in children with HIV infection. A multidisciplinary management is fundamental.

  15. 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...... the feasibility of using the rollator as a standardized walking aid during the TUG in patients with hip fracture who were allowed full weight-bearing (FWB). DESIGN: Prospective methodological study. SETTING: An acute orthopedic hip fracture unit at a university hospital. PARTICIPANTS: Patients (N=126; 90 women......, 36 men) with hip fracture with a mean age +/- SD of 74.8+/-12.7 years performed the TUG the day before discharge from the orthopedic ward. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The TUG was performed with the walking aid the patient was to be discharged with: a walker (n=88) or elbow...

  16. Recombinant human granulocyte colony-stimulating factor increases circulating CD34-postive cells in patients with AIDS

    DEFF Research Database (Denmark)

    Nielsen, S D; Dam-Larsen, S; Nielsen, C

    1997-01-01

    In a gene therapy-based treatment of AIDS, it would be desirable to have as many transduced target cells as possible. A limiting factor is the number of target cells. In this study, we investigated whether it was possible to increase the absolute number of one possible target cell, i.......e., the circulating hematopoietic progenitor cells (CD34 cells) in patients with AIDS, using the recombinant human granulocyte colony-stimulating factor (G-CSF). Eight patients with AIDS were treated with G-CSF for neutropenia (... cells. The median increase in CD34 cells was from 0.8 to 2.2 x 10(6)/l. Finally, using a highly sensitive HIV-1 RNA PCR, we found that treatment of AIDS patients with G-CSF did not lead to enhanced HIV replication. These observations indicate that G-CSF may be used to mobilize CD34 cells in patients...

  17. Characterization of Encephalitozoon (Septata) intestinalis isolates cultured from nasal mucosa and bronchoalveolar lavage fluids of two AIDS patients

    NARCIS (Netherlands)

    Didier, E. S.; Rogers, L. B.; Orenstein, J. M.; Baker, M. D.; Vossbrinck, C. R.; van Gool, T.; Hartskeerl, R.; Soave, R.; Beaudet, L. M.

    1996-01-01

    Microsporidia are obligate intracellular protozoan parasites that can cause opportunistic infections in AIDS patients. Species from five genera of microsporidia are presently known to infect man. One species, Septata intestinalis originally was detected in stool specimens of individuals with chronic

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  19. 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

    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...... 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...

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

    International Nuclear Information System (INIS)

    Franquet, Tomas

    2006-01-01

    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.)