Search PubMed⌕ Search

Biomedical subjects

K Henry

Publications and source records attributed to K Henry.

207 records · Page 12Linked to original sources
PubMedDate not supplied

Intervention for hyperlipidemia associated with protease inhibitors.

In the past 3 years, treatment for HIV infection has significantly improved the prognosis for HIV-infected persons. The administration of protease inhibitors for the treatment of HIV infection has had a significant role in the reduction of AIDS-related complications. Recent findings have indicated that protease inhibitors may significantly increase lipids to levels that pose a health risk that may be greater than the illness itself. This article reviews the initial findings of a study that investigated the impact of interventions for the treatment of protease inhibitor-related hyperlipidemia. The purpose of the study was to determine if initiation of interventions based on the National Cholesterol Education Program Guidelines would be effective in lowering protease inhibitor-related hyperlipidemia without disrupting the effectiveness of the HIV therapy. A total of 45 HIV-infected individuals who were taking a protease inhibitor and had abnormally elevated lipids were enrolled into this study. Mean serum cholesterol level prior to initiation of a protease inhibitor regimen was 170 mg/dl as compared to a mean cholesterol at time of enrollment of 289 mg/dl and triglycerides of 879 mg/dl. Interventions included diet and exercise and the prescription of gemfibrozil alone or in combination with atorvatstatin. During the course of the study, overall intervention significantly reduced serum cholesterol level to 201 mg/dl (p. 01) over a study period of ten months. Case studies of five medical events related to hyperlipidemia are included. Currently, 26 participants continue in the study. Sixteen participants discontinued protease inhibitor therapy during the course of the study and thus ended their participation.

Adult↗
PubMedDate not supplied

Pituitary carcinoma: an ultrastructural study of eleven cases.

Pituitary carcinomas are very rare. Defined as adenohypophysial tumors that undergo craniospinal and/or systemic metastasis, most are PRL- or ACTH-producing. Their ultrastructural features, particularly relative to benign adenomas of similar functional type, have not been sufficiently explored. Eleven cases of immunohistochemically characterized pituitary carcinoma with documented cerebrospinal and/or systemic metastases were collected from various institutions and studied by transmission electron microscopy. The tumors were surgically removed from 7 women and 4 men ranging in age between 28 and 74 years (mean, 50 years). All were endocrinologically functioning. Six tumors secreted PRL; three were ACTH-producing; one each was GH/PRL- and TSH-producing. The patients with the ACTH-producing tumors had all presented with Cushing's disease and two of them had undergone adrenalectomy (Nelson syndrome). In most cases significant cellular atypia and mitotic activity were observed. In terms of morphologic features of functional differentiation, electron microscopy revealed that in 9 cases the tumor cells maintained at least some ultrastructural markers of their basic phenotype. A unique feature in 2 ACTH carcinomas was the variable admixture of smooth endoplasmic reticulum with intermediate (cytokeratin) filaments. In 2 cases, both PRL-producing carcinomas, the cell type comprising the tumor could not be identified on an ultrastructural basis alone. Ultrastructural investigation of pituitary carcinomas confirms their endocrine nature and, in most but not all cases, reveals their functional differentiation. Despite the diagnostic utility of electron microscopy in the assessment of these rare tumors, the distinction of pituitary carcinoma from pituitary adenoma cannot be firmly made on ultrastructural grounds alone.

Adenoma↗
PubMedDate not supplied

Nasal septal abscess due to Staphylococcus aureus in a patient with AIDS.

Nasal septal abscess is a potentially serious infection about which there has been little information in the infectious disease literature. A patient with acquired immunodeficiency syndrome who developed a nasal septal abscess was studied, and the literature about this infection was reviewed.

AIDS-Related Complex↗
PubMedDate not supplied

Thymidine-analog and multi-nucleoside resistance mutations are observed in both zidovudine-naive and zidovudine-experienced subjects with viremia after treatment with stavudine-containing regimens.

OBJECTIVE: The type and frequency of mutations in the human immunodeficiency virus type 1 (HIV-1) reverse transcriptase coding region observed in virus from antiretroviral therapy (ART)-experienced, zidovudine (ZDV)-naive subjects receiving stavudine (d4T)-based therapies were compared with mutations observed in virus from ART-experienced subjects with previous ZDV exposure. METHODS: Plasma HIV-1 RNA was isolated from 67 ART-experienced subjects. Reverse transcriptase mutations were assessed by sequencing polymerase chain reaction products. RESULTS: Thirty-four subjects (51%) were ZDV-experienced (Z(exp)) and 33 (49%) were ZDV-naive and d4T-experienced (d(exp)Z(naive)). Human immunodeficiency virus type 1 from 16 of 33 (48%) d(exp)Z(naive) subjects and from 16 of 34 (47%) Z(exp) subjects had thymidine analog mutations (TAMs). Multi-nucleoside resistance (MNR) mutations were observed in virus from 5 of 33 (15%) d(exp)Z(naive) subjects and 3 of 34 (9%) Z(exp) subjects. At least one TAM or MNR mutation was identified in 18 of 33 (55%) of the former and in 19 of 34 (56%) of the latter group. CONCLUSIONS: These results confirm recent reports that TAMs and MNR mutations can arise in subjects receiving d4T-based therapy who are naive with respect to ZDV.

Adult↗
PubMedDate not supplied

The potential efficiency of routine HIV testing of hospital patients--data from a CDC sentinel hospital.

St. Paul-Ramsey Medical Center is a member of the Centers for Disease Control (CDC) Sentinel Hospital Surveillance Group. The authors have modified the surveillance group's protocol in order to calculate what percentage of the human immunodeficiency virus (HIV)-infected samples identified came from persons known by them to be HIV infected. All identifiers are still unlinked from the sample before testing for HIV. After 24 months, the HIV seroprevalence was 0.96 percent and the estimated cost of identifying a "new" seropositive at this site is $4,530 to $9,060. This range is a cost estimate; a typical laboratory charge for the HIV ELISA screen, if applied to such a testing program, would considerably increase this estimate. Modifications to the protocol design that would target patients in certain demographic groups (for example, men ages 15 to 44 years) or HIV-associated diseases might improve efficiency but could miss a significant number of HIV-infected patients. The efficiency of hospital-based HIV testing would likely decline after several years of practice. Although there are significant ethical problems with programs attempting routine hospital-based HIV testing, pilot testing may merit consideration in areas where the HIV-1 seroprevalence is greater than 1 percent.

AIDS Serodiagnosis↗
PubMedDate not supplied

Pharmacokinetics and safety of concentration-controlled oral zidovudine therapy.

STUDY OBJECTIVE: To evaluate the pharmacokinetics, safety, and feasibility of concentration-controlled oral zidovudine therapy. DESIGN: Randomized, crossover, open-label study. SETTING: University-affiliated general clinical research center. PATIENTS: Eight individuals infected with the human immunodeficiency virus with CD4+ lymphocyte counts of 100 cells/microliter or greater. INTERVENTION: During the 24-week study, patients received oral zidovudine regimens that consisted of a standard fixed dose of 500 mg/day and a concentration-controlled regimen designed to maintain a steady-state plasma concentration (Css) of 0.187 +/- 0.04 mg/L (0.7 +/- 0.14 microM). MEASUREMENTS AND MAIN RESULTS: The mean Css during standard therapy was 0.170 +/- 0.024 mg/L versus 0.205 +/- 0.021 mg/L with the concentration-controlled regimen (p = 0.025). Respective mean changes in hemoglobin were -0.02 g/dl (range -0.9-0.9 g/dl) and -0.30 g/dl (range -1.5-0.4 g/dl, p = 0.67). The absolute neutrophil count decreased 0.90 x 10(9)/L during standard therapy and increased 0.40 x 10(9)/L during concentration-controlled therapy (p = 0.07). The regimens did not differ in toxicity. CONCLUSION: Concentration-controlled oral antiretroviral therapy with zidovudine is feasible and safe, and provides pharmacologic data to determine the regimen's virologic and immunologic benefits.

Administration, Oral↗