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Biomedical subjects

K Henry

Publications and source records attributed to K Henry.

At least 109 records · Page 6Linked to original sources

HIV infection in healthcare workers. How great is the risk? What can be done before and after exposure?

Healthcare workers know that there is a risk of HIV infection through exposure to AIDS patients. In both hospital and office settings, physicians have the opportunity to set standards and promote education about the degree of risk, effective precautions, and postexposure testing, prophylaxis, and treatment. Drs Henry and Thurn share the latest findings and offer policy recommendations based on their own experience.

Acquired Immunodeficiency Syndrome↗

Mac387: its non-specificity as a tumour marker or marker of histiocytes.

A commercially available monoclonal antibody which detects histiocytes in paraffin sections, Mac387, was reacted with 148 soft tissue sarcomas, 29 carcinomas and 10 malignant melanomas. The soft tissue sarcomas had been previously immunophenotyped. All categories of sarcomas, with the exception of angiosarcomas, were positive. Most showed staining in less than 50% of the tumour cells. Six of 10 adenocarcinomas and three of nine basal cell carcinomas were positive, while squamous carcinomas and malignant melanomas were negative. Normal squamous mucosa and epidermis were also positive. The results of this study suggest that Mac387 is of little value in the differential diagnosis of soft tissue tumours, nor is it a specific histiocytic marker.

Antibodies, Monoclonal↗

Cytomegalovirus gastritis with perforation and gastrocolic fistula formation.

A 76-year-old man with lymphoma involving cervical and mediastinal lymph nodes and abdomen was treated by radiotherapy and chemotherapy. He subsequently developed cytomegalovirus gastritis and gastric ulcers with a gastrocolic fistula and a jejuno-jejunal fistula, necessitating a partial gastrectomy. The pathogenesis of cytomegalovirus gastritis and its complications are discussed.

Aged↗

The impact of experience with AIDS on HIV testing and counseling practices: a study of U.S. infectious disease teaching hospitals and Minnesota hospitals.

A survey on HIV antibody testing practices was sent to the 200 hospitals in the United States that conduct infectious disease (ID) fellowship training and to all 171 short-term care Minnesota hospitals. Responses were obtained from 124 U.S. ID hospitals (62%) and from 133 (78%) Minnesota hospitals. The U.S. ID hospitals estimated that consent for HIV antibody testing is obtained 70.1% of the time, that consent is both obtained and documented 54.3% of the time, and that risk-reduction counseling in conjunction with such testing is provided 51.4% of the time. The Minnesota hospitals estimated that consent for HIV antibody testing is obtained 35.2% of the time, that consent is both obtained and documented 25.7% of the time, and that risk-reduction counseling in conjunction with such testing is provided 21.8% of the time. Wide variance was noted in both the U.S. and Minnesota responses. Those U.S. hospitals serving higher numbers of persons with AIDS gave higher estimates for each of the 3 items (p less than .05); similar findings were noted among the Minnesota hospitals. The data suggests that standard clinical use of HIV testing remains deficient.

AIDS Serodiagnosis↗

AIDS-related knowledge, attitudes, and behaviors among 629 registered nurses at a Minnesota hospital: a descriptive study.

Since nurses play a pivotal role in many aspects of healthcare delivery, their knowledge, attitudes, and behavior in relation to AIDS are crucial. A descriptive study was done to discover the AIDS-related knowledge, attitudes, and behavior among registered nurses who practice in a hospital setting, and to describe the relationship of these findings with other variables. A 67-item survey was sent to 704 registered nurses at a 455-bed acute care teaching hospital and its associated clinics. The results indicated there is a considerable level of misinformation, mistrust, and fear regarding AIDS among RNs practicing in the hospital setting.

Acquired Immunodeficiency Syndrome↗

Documented male-to-female transmission of HIV-1 after minimal vaginal exposure in the absence of other cofactors for infection.

AIDS cases attributable to heterosexual vaginal intercourse constitute a growing proportion of new AIDS cases in the United States. Major cofactors that possibly increase the efficiency of heterosexual transmission of HIV-1 include genital ulcer disease, multiple sexual exposures, lack of male circumcision, and primary and advanced stages of HIV-1 disease. I report the case of a 33-year-old woman who was recently infected with HIV-1 after one to three nontraumatic episodes of vaginal intercourse with a healthy-appearing, HIV-1-infected, bisexual man. An investigation of her exposure history revealed the precise time frame during which infection occurred. The patient developed a primary HIV-1-infection syndrome and became seropositive for HIV-1 within eight weeks of her last sexual contact with the infected man. An epidemiological and laboratory evaluation of the index patient and her sexual partner identified only one risk factor for enhanced HIV-1 transmission: the patient's use of oral contraceptives. Her partner was immunologically intact, HIV-1 antigen negative, and circumcised. Both of the individuals were from Minnesota, as were their recent sexual partners. This case illustrates that HIV-1 infection by vaginal intercourse can occur in the absence of the major risk factors believed to increase the efficiency of transmission. Even in a low HIV-1 prevalence area like Minnesota, efforts to promote awareness of HIV-1 status, abstinence, non-penetrative sex, or barrier protection need to be expanded and the behaviors adopted by sexually active persons if HIV-1 transmission is to be minimized.

Adult↗

HIV and AIDS resources.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗

The evolving challenge of Pneumocystis carinii. A deadly opportunist in AIDS.

Considerable progress has been made in the identification and treatment of Pneumocystis carinii pneumonia related to acquired immunodeficiency syndrome (AIDS). Prophylaxis, either primary or secondary, represents a major advance and should be used appropriately by physicians caring for patients infected with human immunodeficiency virus. Yet with success come new challenges. Centers for treatment of AIDS that aggressively use prophylaxis have seen a shift toward severe illness due to other pathogens and generalized wasting. The strategies employed in combating P carinii pneumonia are likely to be tried against other AIDS-related infections.

Acquired Immunodeficiency Syndrome↗

Constitutional symptoms in patients with germ cell neoplasms.

A patient with a mediastinal germ cell neoplasm evidenced fever, weight loss, pruritus, and painful adenopathy on ingestion of alcohol. Retrospective review revealed that 9 percent of 104 patients with advanced germ cell neoplasm evidence constitutional symptoms at presentation.

Adult↗

Human immunodeficiency virus type 1 detected in all seropositive symptomatic and asymptomatic individuals.

Between February 1987 and October 1988, peripheral mononuclear blood cells (PBMC) from 409 adult individuals antibody positive by Western (immuno-)blot for human immunodeficiency virus type 1 (HIV-1) (56 acquired immunodeficiency syndrome [AIDS] patients, 88 patients with AIDS-related complex, and 265 asymptomatic individuals) were consecutively cultured for HIV-1 or tested for the presence of HIV-1 DNA sequences by a polymerase chain reaction assay (PCR). We isolated HIV-1 or detected HIV-1 DNA sequences from the PBMC of all 409 HIV-1 antibody-positive individuals. None of 131 healthy HIV-1 antibody-negative individuals were HIV-1 culture positive, nor were HIV-1 DNA sequences detected by PCR in the blood specimens of 43 seronegative individuals. In addition, HIV-1 PCR and HIV-1 culture were compared in testing the PBMC of 59 HIV-1 antibody-positive and 20 HIV-1 antibody-negative hemophiliacs. Both methods were found to have sensitivities and specificities of at least 97 and 100%, respectively. In contrast, the sensitivities of serum HIV-1 antigen testing in AIDS patients and asymptomatic seropositive patients were 42 and 17%, respectively. Our ability to directly demonstrate HIV-1 infection in all HIV-1 antibody-positive individuals provides definitive support that HIV-1 antibody positivity is associated with present HIV-1 infection. Moreover, the sensitivities and specificities of PCR and culture for the detection of HIV-1 appear to be equivalent, and both methods are superior to testing for HIV-1 antigen in serum for the direct detection of HIV-1.

AIDS-Related Complex↗

Ploidy of smooth muscle tumours: retrospective image analysis study of formalin fixed, paraffin wax embedded tissue.

The feasibility of using an image analyser, the CAS 100, to assess the ploidy of smooth muscle tumours on formalin fixed paraffin wax embedded tissue was assessed. Various different methods of assessment were compared. A paraffin wax block of 15 leiomyomata and 13 leiomyosarcomata yielded serial sections of 3 microns, 5 microns, and 7 microns and a cytospin preparation (from a 50 micron section). Sections and cytospin preparations were stained with Feulgen and quantified using the CAS 100. The suitability of lymphocytes, previously suggested to be unsuitable as control cells in tissue sections due to the compact nature of their DNA, was assessed in sections and cytospin preparations and compared with endothelial cells, the standard alternative, on the same slide. Despite having a mean nuclear area of only 18.5 microns 2 in sections lymphocytes had a similar diploid peak--that is, 4.1 pg--to endothelial cells (mean nuclear area 39 microns 2). A comparison of 3 microns, 5 microns, and 7 microns sections showed 5 microns to be the optimal thickness. Cytospin preparations yielded histograms of superior quality than those from tissue sections. All 15 leiomyomata had a 5C exceeding rate of less than 0.3%. Ten of 11 histologically malignant tumours had a 5C exceeding rate of more than 5% (mean 14%) in sections and cytospins. Two leiomyosarcomata that had arisen in the lower gastrointestinal tract had a mitotic rate of less than or equal to 1/10 per high power fields and yielded histograms similar to those of the leiomyomata. It is concluded that formalin fixed, paraffin wax embedded tissue can be used for DNA quantification by image analysis; that tissue sections yield poorer results than cytospin preparations; that lymphocytes are reliable control cells in cytospin preparations; and that a population of cell greater than 5C is seen in 90% of leiomyosarcomata.

Cell Separation↗

HIV-1 counseling and testing sites, Minnesota: analysis of trends in client characteristics.

We report here a summary of the data obtained from two HIV-1 antibody counseling and testing sites in Minneapolis-St. Paul for the first 48 months of operation (24,911 persons tested). The HIV-1 antibody seroprevalence rate for all persons tested was 5 percent. The highest seroprevalence rates were in male homosexual/bisexual intravenous drug users (23 percent) and homosexual/bisexual men (13 percent). There was a significant decrease in the HIV-1 antibody seroprevalence rate among clients during the 48-month period from 14 percent in the first six months to 3 percent in the last six months. This decrease coincided with an increase in the number of low-risk female clients and low-risk heterosexual male clients, and a decrease in the number of homosexual/bisexual males participating in the programs. These findings suggest the need for development and implementation of other strategies to identify and reach persons at highest risk for HIV-1 infection.

AIDS Serodiagnosis↗

A cross-sectional analysis of variables impacting on AIDS-related knowledge, attitudes, and behaviors among employees of a Minnesota teaching hospital.

We examined variables that were correlated with the AIDS-related knowledge, attitudes, and behaviors among employees of a 455-bed acute-care Minnesota teaching hospital and its associated clinics, located in a low-prevalence area for HIV infection. In August 1987, an anonymous questionnaire was sent via interdepartmental mail to all employees (2,980), including 270 physicians. The four-page survey obtained demographic information and measured 14 variables, including degree of homosexual bias, degree of homophobia, and AIDS-related knowledge, behaviors, attitudes, and anxiety level. Responses were obtained from 2,351 (79%) of the employees. By multivariate analysis, the following variables were highly correlated with positive behaviors and attitudes toward AIDS patients (p less than .0001): lower homophobia scores, higher AIDS knowledge scores, expressed confidence in AIDS-related medical information, and a greater number of previous contacts with AIDS patients. Those with a family member or close friend with AIDS also showed more positive attitudes and behaviors (p less than .02). Level of education was correlated with knowledge about AIDS (p less than .0001) but was not correlated (p greater than .05) with more positive behaviors or attitudes inrelation to AIDS patients. Educational efforts should attempt to improve hospital employees' knowledge about AIDS and their confidence in AIDS-related medical information. Efforts to address homophobia should also be considered.

Acquired Immunodeficiency Syndrome↗