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PubMed1997

Chronic intestinal infection due to subgenus F type 40 adenovirus in a patient with AIDS.

A case of chronic intestinal infection due to adenovirus type 40 lasting for 13 months in a patient with AIDS is described. Adenovirus particles were detected by electron microscopy in biopsy samples taken from the duodenum 3 months after the onset of diarrhoea. The virus was identified as adenovirus type 40 in stool samples by ELISA monoclonal antibodies to adenovirus group antigen (MAd-g2) and types 40 and 41 (MA 40-1 and MA 41-1). No other enteropathogens were found. These data support a causal relationship between adenovirus 40 and the gastrointestinal symptoms of the patient. This is the first reported case of intestinal infection caused by adenovirus type 40 in a patient with AIDS.

AIDS-Related Opportunistic Infections↗

PubMed1997

[Hearing in a geriatric perspective].

To assess whether hearing rehabilitation of older people can be improved by co-operation between the audiology and geriatric departments and the home service, 139 old and frail audiological patients were allocated to three groups with three different fitting procedures: 1) conventional fitting including verification of acoustical gain in the patient's ear; 2) home-fitting by hearing therapists, and 3) home-fitting by a specially trained geriatric nursing assistant, the home help also being present. Outcome was assessed by the ordinary questionnaire mailed to hearing aids users three to four months after fitting and by a geriatric evaluation procedure. The response rate in the conventionally fitted group was highly unsatisfactory (36%) and too small for further data-analysis. In the educational group a tendency was found towards better manipulation skills and significantly higher hearing aid use. However, the response rate was lower than in the geriatric group (71% compared to 81%), and no knowledge of hearing aid use was registered in the home service by this procedure. In the geriatric group a correlation was found between practical ability and use and satisfaction with the hearing aid. However, two thirds of the group were dependent on lasting help for the handling of the aid. Most patients in this group were already known by the hospital and home service, and the individual home help showed an interest in learning about hearing aid use. Home fitting by a joint audiological and geriatric effort in collaboration with the home help has proven feasible and valuable to both patient and home help. Extended co-operation is recommended between the health care and the social sector concerning hearing aid use.

Aged↗

PubMed2005

The interaction of HIV-1 with the host factors.

Human immunodeficiency virus type 1 (HIV-1) is a causative agent of acquired immunodeficiency syndrome (AIDS) in humans. In the last decade, the functions of HIV-1-encoded genes have been intensively studied. These studies have contributed to the development of the effective anti-AIDS drugs directing against the HIV-1-encoded enzymes, namely reverse transcriptase and protease. However, even the combination of these drugs is not sufficient enough to stop the progression of AIDS partly due to the emergence of drug-resistant HIV-1 mutants as well as the severe side effects. Understanding the molecular mechanisms by which cellular factors support the efficient replication of HIV-1 should contribute to develop means to control the progression of AIDS. This field is now expanding rapidly. Here we review the host factors involved in the replication of HIV-1 and highlight some findings that have a substantial impact on the retroviral research.

HIV Infections↗

PubMed1989

Monitoring the AIDS epidemic in the United States: a network approach.

Respondents in the 1988 General Social Survey (GSS) were asked to scan their acquaintance networks to identify all those who had been a victim of a homicide or had acquired immunodeficiency syndrome (AIDS). Estimates of the sex, race, age, and regional breakdowns for homicides in the last year and for people with AIDS were compared with official statistics. The GSS estimates for the distribution of homicide victims replicate the official statistics quite well. The GSS estimates for AIDS cases suggest that the data provided to the Centers for Disease Control may underestimate by a substantial margin the prevalence of AIDS in the white population of higher socioeconomic status, overstate the relative prevalence of the disease in the minority populations, underestimate the prevalence of the disease in the Midwest, and overstate it for the East.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Resources to aid further learning about infection control.

Last year, the National Audit Office published a report outlining progress since its initial analysis of hospital-acquired infection in 2000 (National Audit Office, 2004). It identified that up to 300,000 patients picked up a hospital-acquired infection every year. Contributing factors included: patchy implementation of good infection control practice; a lack of resources for infection control teams; increasing antibiotic resistance; poor isolation facilities; and a lack of data on the extent and cost of hospital-acquired infections. It also identified that a range of approaches was needed to change staff behaviour to reduce the risk of a hospital-acquired infection

Education, Continuing↗

PubMed2001

The use of robotic technology in the LAST operation.

BACKGROUND: The LAST operation represents a good option for single left anterior descending artery (LAD) revascularization. We report our preliminary experience with the LAST operation performed with the aid of the "da Vinci" Intuitive robotic system. METHODS: From January 2000 to May 2001, 12 patients (11 males and 1 female, mean age 62 +/- 8 years) underwent the LAST operation. All patients had a proximal LAD lesion either not suitable for coronary angioplasty or unsuccessfully treated at coronary angioplasty previously. The mean preoperative ejection fraction was 55 +/- 5%. In all patients, left internal mammary artery (LIMA) harvesting was carried out endoscopically using robotic technology. After heparin administration the LIMA was distally divided to check the adequacy of the blood flow. An incision of about 6 cm was then made in the appropriate intercostal space and the LAD was exposed using a special costal retractor. Following the insertion of a temporary intracoronary shunt, the LIMA was anastomosed to the LAD. RESULTS: No hospital or delayed death occurred. Uneventful conversion to midline sternotomy was necessary in one patient who developed ischemic changes and hemodynamic instability. One patient had a revision for postoperative bleeding. All patients were discharged within the first postoperative week and in 4 of them optimal patency of the LIMA graft was angiographically documented. CONCLUSIONS: The use of robotic technology seems to overcome all the drawbacks associated with the LAST operation and enhances the role of minimally invasive surgery in coronary artery revascularization.

Aged↗

PubMed1991

Doctors and AIDS.

Just a year ago most authorities considered the chances of patients contracting AIDS from doctors and other healthcare workers a virtual impossibility. But last week a Florida woman who got AIDS from her dentist lay near death, and two Minneapolis physicians admitted they had treated hundreds of patients since being diagnosed with the virus. Although doctors are at far greater risk than patients, the Minneapolis cases renewed the debate over the right of sides to know each other's HIV status.

Acquired Immunodeficiency Syndrome↗

PubMed2001

Do paramedics make an effort not to transport at the end of their shifts?

OBJECTIVE: To determine if paramedics sign off more patients in the last hour of their shifts and if there is a correlation with the shifts' lengths. METHODS: This was a retrospective study of EMS run report data derived from a computer aided dispatch (CAD) system. The last 200 eight-hour, 12-hour and 16-hour shifts (600 total shifts) in which there was at least one call for service in the last hour were reviewed. Transport/sign-off data were categorized and statistically analyzed. RESULTS: There were not more patients signed off on any shift during the last hour. There was a statistically significantly smaller number of patients signed off in all phases of the eight-hour shifts. CONCLUSION: Decreasing shift lengths to eight hours will significantly reduce the number of patient sign-offs and result in less potential liability.

Emergency Medical Technicians↗

PubMed1998

Breaking the silence, dismantling taboos: Latino novels on AIDS.

As AIDS has ravaged the world in the last two decades, literature has played an important role in giving testimony of the epidemic. According to different communities and particular experiences, AIDS literature can offer ways of coping and surviving. In the last few years the U.S. Latino/a population has been highly affected by AIDS. The first genres to register AIDS were poetry and theatre. In this essay I examine how AIDS is represented in the first four Latino novels to deal with the subject matter: Ana Castillo's So Far from God, Daniel Torres's Morirás si da una primavera, Elías Miguel Muñoz's The Greatest Performance, and Jaime Manrique's latin Moon in Manhattan. My critical reading centers on how AIDS constitutes a new articulation of identity, particularly gay and ethnic identity. Most importantly, I propose that these novels contribute to dismantling homophobia and compulsory heterosexuality, deconstructing sexual and cultural taboos, and breaking the silence on AIDS/SIDA.

Acquired Immunodeficiency Syndrome↗

PubMed2005

Treatment decision aids: conceptual issues and future directions.

BACKGROUND: In the last 10 years, there has been a major growth in the development of treatment decision aids. Multiple goals have been identified for these tools. However, the rationale for and meaning of these goals at the conceptual level, the mechanisms through which decision aids are intended to achieve these goals, and value assumptions underlying the design of aids and associated values clarification exercises have often not been made explicit. OBJECTIVE: In this paper, we present ideas to help inform the future development and evaluation of decision aids. RESULTS: We suggest, (i) that the appropriateness of using any decision aid be assessed within the context of the wider decision-making encounter within which it is embedded; (ii) that goal setting activities drive measurement activities and not the other way round; (iii) that the rationale for and meaning of goals at the conceptual level, and mechanisms through which they are intended to have an impact be clearly thought through and made explicit; (iv) that value assumptions underlying both decision aids and associated values clarification exercises be communicated to patients; (v) that taxonomies developed and used to classify various types of decision aids include a section on value assumptions underlying each tool; (vi) that further debate and discussion take place on the role of explicit values clarification exercises as a component of or adjunct to treatment decision aids and the feasibility of implementing valid measures. CONCLUSION: Further debate and discussion is needed on the above issues.

Canada↗

PubMed1985

[Most recent developments in the field of optical and electronic visual aids for severely visually handicapped and blind patients].

Magnifying spectacles represent one of the indispensable optical aids (Keplerian systems having surpassed Galilean systems during the last years), closed-circuit television, Optacon, and navigating aids based on ultrasound as environmental sensors. -None of the other navigating aids have proved useful. Initial successes have, however, been achieved with a miniature hand-held camera for closed-circuit television and a portable electronic reading system (View-Scan). Genuine progress has been made with the braille information storage systems, which utilize computer technology to store texts which have been read and written, and subsequently to print them or reproduce them on a screen or in synthetic language. Braillex in the Federal Republic of Germany and Versabraille in the U.S.A. are examples of such systems. In special cases a newly developed stereo photocopy system (Minolta) will be useful for newly blinded adults. However, texts in the form of tactile copies have to be highly magnified in order to be palpable and readable.

Blindness↗

PubMed1999

Paediatric AIDS incidence in Europe and the USA, 1985-96.

BACKGROUND: AIDS has shown dramatic increases among women in the last decade; this has facilitated the spread of paediatric AIDS. Incidence rates of AIDS in children are essential for international comparisons at a population level. METHODS: Incidence rates of AIDS 1985-96 by 3-year period in children < 13 years of age were computed for 15 European countries and, for comparative purposes, the USA. For each country, the rates were adjusted for reporting delay and standardised on the world standard population. RESULTS: In European countries with > 100 cases, the steepest rises were seen in the UK (whose rates increased from 0.8/1,000,000 children in 1985-87 to 4.1/1,000,000 in 1994-96), and Spain (from 4.4/1,000,000 to 16.5/1,000,000). In 1985-87, rates were substantially higher in USA (8.3/1,000,000) than in any European country but, in recent years, they have become similar to those of Spain. Very elevated rates were observed in Romania, with incidences of 120.4/1,000,000 in the early 1990s, due to nosocomial HIV transmission. In most countries, 1994-96 rates tended to level off, or decrease. In a few countries (Germany, Greece, Denmark, Austria, and the Netherlands) AIDS incidence rates were < 2 cases per million children in 1994-96. The proportion of cases acquired by transfusion, in 1985-96, is about 20% or less of paediatric AIDS cases in most countries. No substantial heterogeneity emerges between countries in the distribution of AIDS indicator diseases. CONCLUSIONS: During 1985-93, paediatric AIDS incidence rates increased in most European countries and levelled off thereafter. No paediatric AIDS epidemic occurred; in a few countries, incidence rates persisted at around one case per million.

AIDS-Related Opportunistic Infections↗

PubMed1990

Immunopathogenesis of human immunodeficiency virus infection.

The acquired immunodeficiency syndrome (AIDS) is associated with a broad spectrum of opportunistic infections and neoplasias that differ from those occurring in the general population by their high aggressiveness, unusual location, early tendency to generalization, frequent relapse, and short survival. The severe complications of AIDS, however, represent only the last phase in a prolonged course of progressive dysfunction and destruction of the immune system set in motion by the infection with the human immunodeficiency virus (HIV). While substantial progress was achieved in the ultrastructural identification and biochemical characterization of HIV, its mode of action in the causation of AIDS is not yet fully understood. This article explores the main processes involved in the HIV infection and in its role in the origin of AIDS. It describes the phases of HIV infection, investigates the effects of HIV on the various components of the immune system, and analyzes the pathogenesis of the HIV-induced lymphadenopathies and encephalopathy, as well as the causes and mechanisms of AIDS-associated opportunistic infections and opportunistic neoplasias. The total failure of immune surveillance against a host of infectious and oncogenic agents, unprecedented in human pathology, is thus traced to the initial event of specific HIV infection of the CD4 T-lymphocytes.

B-Lymphocytes↗

PubMed1999

The Women and Infants Demonstration Project: an integrated approach to AIDS prevention and research.

The Women and Infants Demonstration Project is a multisite, behavioral intervention research effort funded by the Centers for Disease Control. The project is evaluating a theory-based, integrated intervention model to increase the use of condoms for prevention of both sexually transmitted diseases (STDs) and unintended pregnancy among women and their partners at risk of infection with HIV. The importance of utilizing carefully targeted, credible and persistent risk reduction interventions to effect lasting behavior change has become evident over the last ten years of the AIDS epidemic. The theory-based intervention components being evaluated in this intervention study involve one-on-one stage-tailored outreach; the development and distribution of community-tailored HIV prevention materials, called role-model stories; and the development of organizational and peer networking, all within a community mobilization framework. This article describes each of the intervention components being evaluated during this 5-year study. Such an intervention effort represents an important contribution in the design of community-level AIDS prevention intervention efforts which support individual-level behavioral changes by women at risk for HIV and other sexually transmitted infections.

Adolescent↗

PubMed2004

Patterns of ethnic diversity among the genes that influence AIDS.

Although HIV-1/AIDS emerged late in the last century, more than 42 million individuals have been infected and 25 million have died worldwide, making AIDS, like malaria, a strong selective force for disease-associated genetic factors. Many of the genes that mediate immune response or that are co-opted by HIV-1 for completion of its lifecycle show differences in allele frequencies, as a result of drift, migration or selection. Here we show that the majority of AIDS candidate genes and AIDS restriction genes show significant differences in allele frequencies, possibly the result of historic selective pressures. These genes are undergoing present day natural selection in populations with high AIDS prevalence.

Acquired Immunodeficiency Syndrome↗

PubMed2002

Impact of over-the-counter sales on effectiveness of pharmaceutical aids for smoking cessation.

CONTEXT: Successful smoking cessation is a major public health goal. In controlled clinical trials, nicotine replacement therapy (NRT) and the antidepressant bupropion have been shown to significantly increase cessation rates only for moderate to heavy smokers (> or = 15 cigarettes/d). Nicotine replacement therapy is heavily promoted to the general population by both the pharmaceutical industry and tobacco control advocates. OBJECTIVE: To examine trends in smoking cessation, pharmaceutical cessation aid use, and success in cessation in the general California population. DESIGN, SETTING, AND PARTICIPANTS: The large population-based California Tobacco Surveys of 1992, 1996, and 1999, including 5247 (71.3% response rate), 9725 (72.9% response rate), and 6412 (68.4% response rate) respondents, respectively. MAIN OUTCOME MEASURES: Rates of cessation attempts (> or = 1 day) among smokers in the last year, use of pharmaceutical aids (mostly over-the-counter products since 1996), and cessation success. RESULTS: Between 1992 and 1999, cessation attempts among California smokers increased 61.4% (from 38.1% to 61.5%), and NRT use among quitters increased 50.5% (from 9.3% to 14.0%). A total of 17.2% of quitters used NRT, an antidepressant, or both as an aid to cessation in 1999. In 1996 and 1999, the median duration of aid use (14 days) was much less than recommended, and only about 20% of users had adjuvant one-on-one or group behavioral counseling. Use of NRT increased short-term cessation success in moderate to heavy smokers in each survey year. However, a long-term cessation advantage was only observed before NRT became widely available over-the-counter (August 1996). In 1999, no advantage for pharmaceutical aid users was observed in either the short or long term for the nearly 60% of California smokers classified as light smokers (<15 cigarettes/d). CONCLUSION: Since becoming available over the counter, NRT appears no longer effective in increasing long-term successful cessation in California smokers.

Adult↗

PubMed1987

Molecular evolution and phylogeny of the human AIDS viruses LAV, HTLV-III, and ARV.

A phylogenetic tree for the human lymphadenopathy-associated virus (LAV), the human T-cell lymphotrophic virus type III (HTLV-III), and the acquired immune deficiency syndrome (AIDS)-associated retrovirus (ARV) has been constructed from comparisons of the amino acid sequences of their gag proteins. A method is proposed for estimating the divergence times among these AIDS viruses and the rates of nucleotide substitution for their RNA genomes. The analysis indicates that the LAV and HTLV-III strains diverged from one another after 1977 and that their common ancestor diverged from the ARV virus no more than 10 years earlier. Hence, the evolutionary diversity among strains of the AIDS viruses apparently has been generated within the last 20 years. It is estimated that the genome of the AIDS virus has a nucleotide substitution rate on the order of 10(-3) per site per year, with the rate in the second half of the genome being double that in the first half.

Biological Evolution↗

PubMed1997

[Imaging of AIDS in children].

In children, AIDS is mainly related to materno-foetal transmission. Due to antiviral therapy and prevention of infections, the initially very poor prognosis has improved and the length of survival has increased. There are two groups of children: the first (25%) in which the disease occurs early and is very severe, a second one in which the disease develops later after an asymptomatic period which can last several years. Manifestations of AIDS in children are mainly pulmonary and digestive infections, central nervous system infections are much rarer than in adults, neurologic disorders are mainly due to the HIV itself. Tumors are also rarer than in adults but may occur, including lymphomas and smooth muscle tumors.

Acquired Immunodeficiency Syndrome↗