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Biomedical subjects

J D Rich

Publications and source records attributed to J D Rich.

At least 73 records · Page 4Linked to original sources
PubMed1996

Human immunodeficiency virus infection and acquired immunodeficiency syndrome among North American women.

Women constitute the fastest growing segment of adults with acquired immunodeficiency syndrome (AIDS), representing 18% of all cases in the United States in 1994. Heterosexual transmission is now the dominant route by which women are infected. Recent reports indicate that although certain manifestations may be different in women than in men, the rate of clinical progression is similar when they receive comparable medical treatment. Antiretroviral therapy is equally as effective in women as in men. As in men, Pneumocystis carinii pneumonia is the most frequent AIDS-defining diagnosis in women. Candida esophagitis and ulcers secondary to herpes simplex virus are more common in women. Kaposi's sarcoma is rare. The prevalence of humanpapilloma virus infection and cervical neoplasia is increased in HIV-seropositive women. Vaginitis due to candida, trichomonas, and bacterial vaginosis are common findings among human immunodeficiency virus seropositive women. The clinical course and response to therapy in certain sexually transmitted diseases (syphilis and herpes) may be altered. The use of zidovudine during pregnancy and delivery has been associated with a 67.5% reduction in vertical transmission.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Update of HIV and AIDS in North America.

The second wave of the HIV epidemic, which increasingly affects injection drug users, women, and minorities, necessitates the development of primary care HIV services so that these individuals may benefit from new therapies. The ability to dramatically decrease vertical transmission of HIV from mother to child with antiretroviral therapy is encouraging. Better understanding of HIV pathogenesis, disease progression, antiviral therapy, and opportunistic infection prophylaxis are leading to more effective therapy and prevention. Clinical trials are ongoing to assess the efficacy of protease inhibitors in combination with nucleoside analog antiretroviral therapy to provide long term viral suppression and alter the natural history of HIV. Prophylaxis of pneumocystis, toxoplasma, MAC, TB, and invasive fungal infections is cost effective and leads to improved quality of life.

AIDS-Related Opportunistic Infections↗
PubMed1996

Autopsy verification of Encephalitozoon intestinalis (microsporidiosis) eradication following albendazole therapy.

Microsporidian infections are increasingly recognized as an important cause of morbidity for persons infected with the human immunodeficiency virus. Encephalitozoon (formerly Septata) intestinalis is a recently described microsporidian that causes intestinal and disseminated infections in severely immunocompromised patients with acquired immunodeficiency syndrome. Several studies suggest that albendazole is an effective therapy for E intestinalis infection. However, relapses of symptoms and reappearance of microsporidian spores in diagnostic specimens have been reported following treatment in some cases. Because these results are based on examination of feces or cytologic specimens with an inherent sampling bias, it would be ideal to have autopsy data on the complete tissue evaluation of major organ systems of patients who had antemortem E intestinalis infection treated with albendazole. This report describes an acquired immunodeficiency syndrome patient with diarrhea and wasting syndrome associated with E intestinalis infection. Treatment with albendazole produced relief of his clinical symptoms and eliminated microsporidian spores in his feces. Following his death from other causes, an autopsy was performed. Comprehensive microscopic examination of all major organs revealed no evidence of residual microsporidian infection, suggesting parasitologic cure of E intestinalis with albendazole. The postmortem finding of complete clearance of microsporidia from body tissues is significant for future albendazole treatment of patients infected with E intestinalis and provides strong support for the value of the autopsy in evaluating the therapeutic efficacy of antimicrobials in emerging infections.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Transmission of human immunodeficiency virus infection presumed to have occurred via female homosexual contact.

We describe a 24-year-old woman infected with the human immunodeficiency virus (HIV) whose sole risk behavior was prior sexual contact with an HIV-infected woman. Our patient's clinical course suggests that viral transmission occurred during the beginning of their sexual relationship. Our case, combined with those previously reported, provides evidence that female homosexual activity can be a risk behavior for acquisition of HIV infection. Seroprevalence studies, however, have not provided evidence for transmission of HIV by this behavior. These studies, combined with the sparse number of individual case reports, suggest that female homosexual activity is an inefficient mechanism of HIV transmission.

Adult↗
PubMed1992

Discrete gastrointestinal mass lesions caused by cytomegalovirus in patients with AIDS: report of three cases and review.

We report the detailed clinical features of discrete mass lesions of the gastrointestinal tract caused by cytomegalovirus in three patients who had the acquired immunodeficiency virus syndrome. The disease occurred in the fundus of the stomach in one patient and in the cecum in the other two persons. The symptoms as well as radiographic and endoscopic findings in each case are described and are shown to be indistinguishable from those resulting from a neoplasm. The diagnosis was established by the presence of inflammation with cytomegalovirus-like inclusions and confirmed by immunoperoxidase staining. Cytomegalovirus infection should be considered, along with Kaposi's sarcoma and lymphoma, as a cause of focal mass lesions of the alimentary tract in persons infected with HIV.

AIDS-Related Opportunistic Infections↗
PubMed1984

Carcinoma in augmented breasts.

We report two cases of women in whom breast carcinoma was detected three and four years following breast augmentation. The implications of a mass in the augmented breast are discussed.

Adult↗
PubMed1984

Presternal ciliated cyst.

We report the case of a presternal ciliated cyst in a 39-year-old man. The location and histologic features of this lesion have led us to favor a primitive foregut origin for this cyst, probably via the process of embryonic sequestration and migration.

Adult↗