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P Patterson

Publications and source records attributed to P Patterson.

348 records · Page 20Linked to original sources
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Prevention services received by veterans visiting VHA facilities.

OBJECTIVES: This paper presents rates with which veterans report receiving 13 recommended health promotion and disease prevention services. Results were compared with the U.S. Healthy People 2000 goals. METHODS: Random samples of 300 men and 150 women visiting primary care clinics in six Veterans Health Affairs facilities were drawn. A 66% adjusted response rate was achieved after two mailings (n = 1,703). Weighted averages for each prevention service were calculated. RESULTS: For preventive services targeted to all age groups, both male and female veterans currently exceed the Year 2000 goal in hypertension detection and tobacco counseling. Female veterans also exceed the Year 2000 goal in "almost always" using seat belts. For prevention services targeted to specific age-gender subgroups, both male and female veterans currently exceed the Year 2000 goals for four of the six primary and secondary prevention services. CONCLUSIONS: Both male and female veterans exceed Year 2000 goals for the receipt of nearly half of the preventive services. Nevertheless, additional screening and counseling services should be made available to veterans of all age categories.

Adult↗
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Eruptive cheilitis: a new adverse effect in reactive HIV-positive patients subjected to high activity antiretroviral therapy (HAART). Presentation of six clinical cases.

UNLABELLED: A variety of exfoliative cheilitis has been observed in reactive HIV-1 patients subjected to high activity antiretroviral therapy (HAART). The lesions exhibit exfoliation, crater formation, fissuring, erosions and/or the formation of papules, vesicles and blisters associated to erythema and edema. The condition is not included in the 1993 EEC Clearinghouse classification (1) of oral lesions associated with HIV infection. In an earlier series of 1899 patients (2), we failed to observe this pathology and have only found one similar case described in the literature to date (3). OBJECTIVE: We present a series of 6 patients with HIV infection and morpho-histological alterations of the labial semimucosa, subjected to HAART. MATERIALS AND METHODS: The 6 patients were selected from among 20 HIV-positive individuals treated in our Infectious Diseases Unit with a combination of nucleoside and non-nucleoside reverse transcriptase inhibitors and protease inhibitors requiring stomatological care for painful lesions of the lips and oral cavity. The study was conducted over a 6-month period between May and October 1998. An analysis was made of the case histories, CD4-positive cell counts and viral load. The stomatological explorations were completed with biopsies, hematoxylin-eosin staining and immunohistochemical studies involving AE1 and AE3 monoclonal antibodies, vimentin, protein S-100, carcinoembryonic antigen (CEA), laminin, CD8, HLA-DR, BM-1 and CD31 markers. At the time of detection of the oral lesions, the patients had received different combinations of the following antiretroviral treatments: stavudine (D4T), zalcitabine (DDC), didanosine (DDI), zidovudine (AZT), lamivudine (3TC), nelfinavir (NFV), saquinavir (SQV), ritonavir (RTV), hydroxyurea (HU), indinavir (IDN) and efavirenz (EFV). RESULTS: There were four males and two females (age range 31-42 years). The CD4-positive and viral load ranges were 70-330 cells/mm3 and 200-500,200 copies, respectively. Stomatologic manifestations: The oral clinical manifestations consisted of desquamation, cracks, fissures, scabs, ulcerations, edema, erythema, multiple punctate xanthomas (1 case), dryness and labial semimucosal thickening. Microscopic study: Microscopically, the lesions consisted of ulcerations with adjacent hyperkeratosis and suprabasal vacuolization accompanied by a dense lymphocyte infiltrate within the chorion. Inmunohistochemistry: The immunohistochemical study in turn revealed surface epithelial alterations with AE1-AE3 monoclonal antibody labeling. Membrane glycoprotein activation (laminin) was detected, along with the presence of cytotoxic lymphocytes (CD8) and activated lymphocytes (BM-1). CD31 labeling in turn indicated endothelial activation.

Adult↗