Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:2.7.10.2 (focal adhesion kinase)
 44,029 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Little is known about the effect of human immunodeficiency virus (HIV) infection on the Central American healthcare system. We describe HIV-related admissions in a Guatemalan medical service. The study was conducted at Guatemala City's largest public hospital. Data were derived from standardized data collection sheets maintained by the HIV testing service and by HIV clinic physicians. Data were collected for 295 medicine admissions of 257 HIV-infected adults during an 18-month period in 1999 and 2000; 30% of the patients were women. Average age was 33 years. Only 12.5% of the patients had been diagnosed with HIV infection prior to 1999 and nearly all had symptomatic AIDS. 60.3% of the patients were diagnosed with HIV infection during their hospitalization. The most common discharge diagnoses were tuberculosis (13.9%), toxoplasmosis, diarrhoea, candida and other fungal infections, and meningitis. Mean length of stay for HIV-positive patients was 17 days. 23.7% of the patients died during their hospitalization; this was double the mortality of non-HIV patients. HIV-infected patients represented 5.8% of the total admissions of the general medical wards. In a country where HIV prevalence is thought to be less than 1%, AIDS is now responsible for over 5% of admissions to a large medical service at a cost of $500,000 per year. These findings underline the importance of HIV infection in Central America and demonstrate the utility of tracking hospital admission data as a method of surveillance.
Int J STD AIDS 2003 Dec
PMID:The emergence of AIDS in Guatemala: inpatient experience at the Hospital General San Juan de Dios. 1467 88

The purposes of this study were to measure incidence and determine risk factors associated with opportunistic infections (OIs) and mortality among an HIV-infected cohort in Nairobi, Kenya. Three hundred and eighty-one seropositive ambulatory adults in Nairobi, Kenya were followed from 1997 to 2000 with participants visiting the clinic every two months and when acutely ill. Acute bronchitis was the most frequent diagnosis, followed by sexually transmitted infections, candida vaginitis (among women), fever, diarrhoea, pneumonia, HIV-associated skin rash, oral candidiasis and urinary tract infection. Associations between the frequency of these diagnoses including survival and sociodemographic factors and initial CD4 count were assessed. A CD4 count <200 cells/mL at recruitment was strongly associated with decreased survival (adjusted odds ratio=3.0, 95% confidence interval 1.7-5.1). These findings may help to target high-risk populations and guide OI prevention and treatment strategies including decisions regarding initiation of antiretroviral therapy in sub-Saharan Africa.
Int J STD AIDS 2004 Feb
PMID:Mortality and burden of disease in a cohort of HIV-seropositive adults in Nairobi, Kenya. 1500 75

Our objective was to describe how genitourinary medicine (GUM) clinics in the North Thames region manage sexually acquired reactive arthritis (SARA), and to compare management with national guidelines. A self-completed questionnaire survey and retrospective case note review was conducted between September and October 2001. Clinicians in 33 clinics were asked to describe their clinic's policy on the management of SARA, and to review the last five cases seen or the last cases seen in the preceding two years, if less than five. Nineteen (58%) clinics took part. There were inter-clinic variations in the investigation and management of patients, with only 63% (12/19) of clinics offering non-steroidal anti-inflammatory drugs (NSAIDs) and 58% (11/19) giving doxycycline 1001mg. twice daily for two weeks for urethritis - the rest using any of three other antibiotic regimens. There was no consistent policy of referral between other specialties and GUM for genital screening and partner notification. A total of 36 male and female case notes were reviewed. Patients without arthritis or joint swelling (5/38, 13%), or with non-typical symptoms such as diarrhoea (5/38, 13%) were diagnosed inappropriately with SARA. Only 33 (87%) had evidence of a sexually transmitted infection (STI) with at least two (5%) of patients being treated with antibiotics despite no apparent indication being present. Only 21 (55%) had documented NSAID therapy. Case identification was difficult due to the lack of a national disease code (KC60) for SARA. The data suggest that a diagnosis of SARA is sometimes being made with no identifiable STI, or where symptoms are more suggestive that another route of infection is likely. A clear guideline within clinics to standardize prescribing of antibiotics is needed and collaborative policies with GUM are needed for other specialties to use when investigating and managing patients with seronegative arthritis. GUM should consider re-introducing a KC60 code for SARA for better case identification.
Int J STD AIDS 2004 Mar
PMID:Management of sexually acquired reactive arthritis in 19 North Thames GUM clinics. 1503 68

HIV seroprevalence was carried out in 42,738 individuals attending the STD Centre of a New Delhi hospital from September 1990 to December 2001. The different epidemiological parameters of the patients in Group 1 (asymptomatic HIV-seropositive individuals) and Group 2 (AIDS cases), were compared in four spans A, B, C, D. Significant rise in seroprevalence from 0.4% to 4.4% was observed with time. The patients in Group 1 were mainly 15-19 years followed by 30-44 years age group. Overall, the Male:Female ratio in Groups 1 and 2 were 3:1 and 6:1, respectively. The transmission was predominantly heterosexual in both the groups. The patients with sexually transmitted infections (STIs) emerged as the most prominent category in Group 1, showing a steady rising trend till 1999 and stabilizing thereafter. Ulcerative STIs, mainly syphilis, showed maximum association. In most of the cases, the infection was acquired by promiscuous males from female commercial sex workers or casual acquaintances and further transmitted to their spouses. Tuberculosis was the most common opportunistic infection. However, patients presented with fever, loss of weight and diarrhoea in increasing number during time D. The present study reiterates the importance of early management of STI patients and counselling of high risk groups, early partner notification and routine antenatal HIV check-up in the prevention and control of HIV/AIDS infection in third world countries like India.
Int J STD AIDS 2004 Nov
PMID:Changing pattern of HIV infection in a tertiary care hospital in New Delhi, India. 1553 63

AIDS wasting syndrome results in loss of lean body mass and body cell mass. This 12-week, open-label study used bioelectrical impedance analysis to measure body composition changes in 24 patients with AIDS wasting syndrome receiving recombinant human growth hormone (r-hGH). The primary endpoint was percentage monthly change in body weight before/after r-hGH. Secondary endpoints included change from baseline in body composition (bioelectrical impedance analysis), isometric strength and CD4+ count. Twenty patients completed the study: r-hGH resulted in mean weight gains (+2.7%, P = 0.146), and significant increases in mean body cell mass (+8.0%, P = 0.0211), lean body mass (+4.8%, P = 0.0373) and water (+5.5%, P < 0.023). Body fat decreased throughout, but not significantly. r-hGH was generally well tolerated; the most frequent adverse events were fever (7.3%) and diarrhoea (6.3%). Thus, bioelectrical impedance analysis can detect improved body cell mass independent of changes in body weight resulting from r-hGH treatment in patients with AIDS wasting syndrome.
Int J STD AIDS 2005 Apr
PMID:Use of bioelectrical impedance analysis to determine body composition changes in HIV-associated wasting. 1589 85

HIV voluntary counselling and testing (VCT) reduces high-risk sexual behaviour. Factors associated with HIV infection in VCT clients have not been well characterized in northern Tanzania. We prospectively surveyed 813 VCT clients in Moshi, Tanzania. Clients were administered a questionnaire on sociodemographic characteristics, sexual behaviour, and health status. Blood was taken for rapid HIV antibody testing. Factors associated with HIV seropositivity were identified using multivariate logistic regression analysis. Of 813 clients, the seroprevalence was 16.7%. The strongest associations with seropositivity were reporting diarrhoea (odds ratio [OR] 10.4, 95% confidence interval [CI] 3.6-29.9), an ill sexual partner (OR 6.3, 95% CI 3.0-12.9), or being a woman (OR 3.5, 95% CI 2.0-6.3). In a separate regression, the number of symptoms also predicted HIV infection (OR 2.1, 95% CI 1.6-2.6). VCT clients who tested positive had more HIV-related symptoms suggesting presentation at a later stage of HIV infection.
Int J STD AIDS 2005 Oct
PMID:Sociodemographic and clinical characteristics of clients presenting for HIV voluntary counselling and testing in Moshi, Tanzania. 1621 18

An HIV-1-infected adult presented with a short history of dyspnoea, productive cough and myalgia with fever. Shortly after presentation, he developed the abrupt onset of high-volume watery diarrhoea: stool culture grew Shigella sonnei. At the same time, he became hypoxaemic, and thoracic imaging showed bilateral lower lobe consolidation/collapse. Culture of sputum and blood was negative. The patient recovered with fluid resuscitation and ciprofloxacin monotherapy. This is the first reported case of pneumonia complicating S. sonnei dysentery in an HIV-infected adult.
Int J STD AIDS 2005 Nov
PMID:Pneumonia complicating Shigella sonnei dysentery in an HIV-infected adult male. 1630 74

The objective of the pre-travel consultation is to evaluate the risks associated to travelling and to inform the traveler about their nature and severity and how to prevent them. The evaluation of the risks takes into account the visited country, the type of travel and the characteristics of the traveler. The prevention of feco-oral transmitted diseases, namely traveler's diarrhea, relies primarily on the respect of standards of food and beverage hygiene. Information should be given about other general risks (road accidents, STD's and HIV...). This consultation is the opportunity to update the routine immunizations for adults and children, and to give advice about required (yellow fever vaccine for subsaharan Africa and the amazonian region, tetravalent meningococcal vaccine for the pilgrimage el Hadj) and recommended vaccinations (hepatitis A for all travels with low sanitary conditions; according to destinations: typhoid fever, tick-borne encephalitis, japanese encephalitis, rabies...). Malaria prophylaxis includes preventive measures against mosquito-bites at night and chemoprophylaxis adapted to chloroquine resistance level in the country of destination. In any case, a patient with fever occurring within 2 months after returning from an endemic region needs to take a medical advice because of the potential risk of malaria.
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PMID:[Assessment of travel-associated risks and advice to travelers]. 1763

Dasatinib, a potent inhibitor of BCR-ABL in vitro, is effective for patients with chronic myelogenous leukemia (CML) resistant or intolerant to imatinib. To provide a more definitive assessment of dasatinib in chronic-phase (CP)-CML, we report extended follow-up of a phase II trial, presenting data for the entire patient cohort (N=387). Dasatinib (70 mg) twice daily was administered to patients with imatinib-resistant or -intolerant CP-CML. With median follow-up of 15.2 months (treatment duration, <1-18.4 months), a complete hematologic response was attained or maintained in 91% of patients. A major cytogenetic response (MCyR) was attained or maintained by 59% (52% imatinib resistant and 80% imatinib intolerant); this was complete in 49% of patients (40% imatinib resistant and 75% imatinib intolerant). Of 230 patients achieving an MCyR, 7 experienced disease progression. Fifteen-month progression-free survival was 90% while overall survival was 96%. Grade 3/4 thrombocytopenia and neutropenia were reported in 48 and 49% of patients, respectively. Non-hematologic toxicity (any grade) consisted primarily of diarrhea (37%), headache (32%), fatigue (31%), dyspnea (30%) and pleural effusion (27%). Pleural effusions were classified as grade 3 in 6% of reported events, with no incidence of grade 4. Dasatinib is associated with high response rates in patients with imatinib-resistant or -intolerant CP-CML.
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PMID:Dasatinib induces durable cytogenetic responses in patients with chronic myelogenous leukemia in chronic phase with resistance or intolerance to imatinib. 1840 16

CP-690 550 inhibits Janus kinase 3 with nanomolar potency. In this dose-escalation study, we assessed the safety, tolerability, effects on lymphocyte subsets, and pharmacokinetics of CP-690 550 when coadministered with mycophenolate mofetil in stable renal allograft recipients for 28 days. Twenty-eight patients were enrolled. Six patients received CP-690 550 5 mg twice daily (BID), 6 patients received 15 mg BID, 10 patients received 30 mg BID, and 6 patients received placebo. The most frequent adverse events were infections and gastrointestinal (abdominal pain, diarrhea, dyspepsia, and vomiting). CP-690 550 15 mg BID and 30 mg BID were associated with a mean decrease in hemoglobin from baseline of 11% and a mean decrease in absolute natural killer cell counts of 50%. CP-690 550 30 mg BID was also associated with a mean increase in absolute CD19(+) B-lymphocytes of 130%. There were no changes in the number of neutrophils, total lymphocytes, platelets, or CD4(+) or CD8(+) T cells; clinical chemistry; vital signs; or electrocardiograms from the pretreatment baseline. Administration of CP-690 550 without a concomitant calcineurin inhibitor resulted in CP-690 550 exposures consistent with previous studies in nontransplant subjects. Additional dose-ranging studies are warranted to evaluate the safety and efficacy of CP-690 550 in renal transplant recipients over longer treatment duration.
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PMID:Phase 1 dose-escalation study of CP-690 550 in stable renal allograft recipients: preliminary findings of safety, tolerability, effects on lymphocyte subsets and pharmacokinetics. 1855 20


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