Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0001175 (AIDS)
 120,706 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

HIV-infected patients are at markedly increased risk for neurological dysfunction, which may occur at any level of the neuraxis (see Table 1). The most common syndromes--AIDS dementia complex, vacuolar myelopathy, and possibly distal symmetric peripheral neuropathy--appear to be related to HIV infection within the nervous system, rather than due to the immunoincompetence caused by HIV. However, the mechanism(s) by which HIV causes these syndromes, e.g., infecting neurons or oligodendroglia directly, interfering with neurotrophic factors, effecting toxic monokine production, etc., is unknown. Early, albeit incomplete, success with azidothymidine is encouraging. Less commonly, neurological syndromes may be secondary to the immunoincompetence produced by HIV. Many different etiologies--most of which are treatable--have been encountered, but a few of these (cerebral toxoplasmosis, cryptococcal meningitis, primary CNS lymphoma, and progressive multifocal leukoencephalopathy) are responsible for most of the opportunistic complications. Marked differences in symptoms and signs between AIDS patients and immunologically normal patients may complicate recognition of some of these diseases (e.g., herpes simplex encephalitis). Finally, some HIV-associated syndromes, e.g., inflammatory demyelinating polyradiculoneuropathy and retinal microvasculopathy, are of unknown etiology.
 ...
PMID:The neurology of human immunodeficiency virus infection. 285 54

555 consecutive cases in which cerebrospinal fluid (CSF) was sent for cell count were reviewed to determine which cerebrospinal-fluid tests affect diagnosis or therapy. Among 334 cases (60%) with a normal opening pressure, cell count, and protein, 1385 additional tests were done, but such tests were useful in only 3 patients (0.9%) with multiple sclerosis. Among 148 consecutive cases of bacterial, chronic infectious, and malignant meningitis the opening pressure, cell count, or protein was abnormal in all but 3 (2 childhood bacterial meningitis and 1 cryptococcal meningitis in a patient with the acquired immunodeficiency syndrome). If the opening pressure, cell count, and protein are normal, no additional CSF tests are needed in most instances; however, in immunocompromised patients and in those with possible multiple sclerosis or childhood bacterial meningitis additional tests may be indicated.
 ...
PMID:Laboratory testing on cerebrospinal fluid. A reappraisal. 287 90

Early reports suggested that hemophiliacs with factor IX deficiency (Christmas Disease) may be at less risk for developing the acquired immunodeficiency syndrome (AIDS) than patients with classic hemophilia. We evaluated 12 factor IX deficient patients for clinical and immunologic abnormalities related to infection with the human immunodeficiency virus (HIV). Antibody to HIV was not detected in these patients prior to 1982. By 1985, 66 percent (eight of 12) patients were seropositive. All three concentrates available commercially before 1985 were associated with seropositivity. Furthermore, seropositive hemophiliacs had received on average significantly more factor IX concentrate than seronegative hemophiliacs (27,825 +/- 17,976 (S.D.) versus 1,250 +/- 1,500 factor units/year, (p less than 0.02). Half of the seropositive individuals had generalized lymphadenopathy with splenomegaly. Two seropositive patients have developed AIDS, one with cryptococcal meningitis and another with a large cell immunoblastic lymphoma. Infection with HIV has occurred with high frequency in hemophiliacs who received unmodified factor IX concentrates.
 ...
PMID:The spectrum of human immunodeficiency virus infection in patients with factor IX deficiency (Christmas disease) 303 83

Clinical symptoms of the central and peripheral nervous system occur in about 40% of patients wit HIV infection. At autopsy, CNS lesions can be demonstrated in even higher percentages. Primary sequelae of HIV infection--either due to direct viral effects or the immunopathologic response of the human host--are acute aseptic meningitis or mengingo-encephalitis, HIV encephalopathy, myelopathy, neuropathy, and myositis. Secondary consequences of immunodeficiency in AIDS are opportunistic infections with other viruses, bacteria, fungi, and protozoa, e.g. CMV, HSV and HZV encephalitis, mycobacterial CNS infections, neurosyphilis, cryptococcal meningitis, and last but not least cerebral toxoplasmosis. The main secondary malignoma of the CNS is lymphoma. Together these disorders form a complex spectrum of central and peripheral neurological symptoms.
 ...
PMID:[Neurologic complications of AIDS]. 304 48

Acquired immune deficiency syndrome (AIDS) in children has until recently been under-reported, since the initial Centers for Disease Control definition of AIDS was restrictive. The case definition has now been revised. Most children with AIDS acquired their infection perinatally and have a parent with established AIDS-related complex or AIDS or belong to a high-risk group. Prior to March 1985, children also acquired human immunodeficiency virus from a contaminated blood product transfusion or from factor replacement for hemophilia. In the United States, AIDS in children occurs predominantly in cities with large populations of intravenous drug users. There are a number of differences between the clinical manifestations of human immunodeficiency virus infection in children compared with adults. For example, recurrent bacterial infection is more common in children, perhaps reflecting the abnormal B cell function that occurs relatively early in the disease course. Certain opportunistic infections (e.g., toxoplasmosis, cryptococcal meningitis) are less common in children than adults. Lymphocytic interstitial pneumonia does not occur in adults but is found in 30 to 50 percent of children. On the other hand, Kaposi's sarcoma and other malignancies are less common in children. Treatment has consisted largely of general supportive care in hospital or at home; this is dependent on the availability and utilization of resources and financial support. However, as anti-retroviral therapy becomes available, studies in children have been initiated. It is hoped that in the future it may be possible to prevent the disease; in the meantime, earlier diagnosis and better therapy are important goals.
 ...
PMID:Acquired immune deficiency syndrome in children. Current problems and therapeutic considerations. 304 85

Nearly 40% of AIDS patients develop neurological complications during the course of their illness, and about 10% experience neurological symptoms as the initial manifestations of AIDS. The most common neurological complication (14% of AIDS patients) is human immunodeficiency virus (HIV) encephalopathy, but opportunistic viral and nonviral infections and neoplasms are also quite common; the most frequent among these are cryptococcal meningitis, toxoplasmosis, primary central nervous system (CNS) lymphoma, progressive multifocal leukoencephalopathy, and herpesvirus infections. Most of the nonviral infections and neoplasms are potentially treatable. Neurological syndromes include diffuse and regional encephalopathies, myelopathy, meningitis, intraaxial cranial neuropathies, and retinopathy. About 10% of AIDS patients develop a CNS mass lesion; the chief causes of these lesions are toxoplasmosis and primary CNS lymphoma. Since the clinical profiles of the various diseases overlap to a great extent, differential diagnosis requires a thorough workup, including magnetic resonance imaging or computed tomography brain scanning, examination of the cerebrospinal fluid, and, frequently, brain biopsy. Because AIDS patients have a high incidence of multiple intracranial pathologies, the diagnostic workup may have to be repeated to identify all of the diseases present.
 ...
PMID:Central nervous system dysfunction in acquired immunodeficiency syndrome. 306 5

The current rate of progression of persistent generalized lymphadenopathy to acquired immunodeficiency syndrome (AIDS) was tested in a cohort of 105 homosexual men in London, UK. 5 patients were lost to follow-up, and the remaining 100 were seen every 3 months. All tested positive for the human immunodeficiency virus antibody. Previous clinical observations had shown oral candida; anemia; leucopenia; thrombocytopenia; enthrocyte sedimentation rate 15 mm in the 1st hour to be possible predictors of AIDS. 5 of the 13 patients who developed AIDS during a mean follow-up period of 22 months (range 12-32) developed Pneumocystis carinii; 5 Karposi's sarcoma; 1 both; 1 P carinii and cryptosporidiosis; and 1 cryptococcal meningitis. A life table technic calculation showed that over 3 years the probability of patients with persistent generalized lymphadenopathy progressing to AIDS was 20.9%. Of the clinical features examined, those most likely to indicate progression to AIDS were Oral candida (relative risk (RR)=12); Lymphopenia (RR=7); Erythrocyte sedimentation rate 15mm (RR=7); and anemia (RR=6). There were figures for median time before AIDS onset and the range of variation of these median times for these symptoms, e.g. oral candida, 8 months median; range of 1-24 months. Similar prospective studies performed in the US are reviewed. It is determined that a clinical examination and hematological measurements are useful in determining progression risk.
 ...
PMID:From persistent generalised lymphadenopathy to AIDS: who will progress? 310 80

We have presented a case of a male homosexual with documented acquired immune deficiency syndrome in whom sudden sensorineural hearing loss developed after a series of opportunistic infections and before a massive intracerebral hemorrhage. Two major possible causes of his hearing loss are (1) actual involvement of spiral ganglion or acoustic division of the eighth cranial nerve by HTLV III virus, or (2) cryptococcal meningitis. He ultimately died after a series of neurological complications developed. These complications, which are common in patients with AIDS, include progressive dementia, obtundation, and coma. As the number of patients with AIDS in our society increases over the next 5 years, it will become more important for the otolaryngologist to recognize the complications of this disease that involve the ear, nose, throat, head, and neck. Sudden sensorineural hearing loss is one of these complications. The acquired immune deficiency syndrome, at this point, might best be treated by an approach of preventive medicine. However, such an approach would have far-reaching social and political implications--perhaps more so than in other venereally spread diseases. In the interim, the otolaryngologist-head and neck specialist is required to recognize AIDS as it manifests itself in the head and neck. In this case, sudden-onset sensorineural hearing loss was the otolaryngologic presentation of the AIDS.
 ...
PMID:Sudden hearing loss and acquired immunodeficiency syndrome. 312 Jan 12

In many areas of Africa where AIDS is endemic, facilities for laboratory diagnosis are too limited to reliably diagnose opportunistic infections. Therefore, the World Health Organization defined a clinical case definition of AIDS in which 2 major signs and at least 1 minor sign must be present to diagnose AIDS. The major signs are: weight loss greater than 10%, diarrhea for more than 1 month, and prolonged fever for more than 1 month. The minor signs are: persistent cough for more than 1 month, generalized pruritic dermatitis, recurrent herpes zoster, oropharyngeal candidiasis, chronic disseminated herpes simplex, and generalized lymphadenopathy. (The presence of Kaposi's sarcoma or cryptococcal meningitis are sufficient by themselves for a diagnosis of AIDS.) 72 patients in 4 hospitals in Equateur Province of Zaire were used to test the reliability of the clinical case definition. 21 (29%) of the patients were HIV seropositive, and 22 (32%) fulfilled the clinical criteria. From these data the sensitivity of the case definition was 52%, specificity was 78%, positive predictive value was 50%, and negative predictive value was 80%. Since positive predictive value rises with prevalence and HIV infection is maximal in the 20-40 age group, restricting the case definition to this age group would increase its predictive value. Exclusion of patients with tuberculosis would reduce the number of false positive results.
AIDS 1988 Jun
PMID:Evaluation of the WHO clinical case definition for AIDS in rural Zaire. 313 18

Diagnosis of clinical AIDS can be difficult for clinicians in Africa, where there is only limited access to the sophisticated bacteriological diagnostic facilities needed for diagnoses based on the criteria laid down by the Center for Disease Control in the US. The most common presentation of AIDS in Africa is as an enteropathic condition known as 'Slim.' Based on this and other common presentations of the disease in Africa, a group of clinicians in Bangui, Central African Republic, drew up a list of criteria for the diagnosis of AIDS in Africa which are based on patient history and examination and the exclusion of other conditions rather than on serological confirmation of HIV infection. The major criteria are 1) unexplained fever for longer than 1 month; 2) unexplained diarrhea for longer than 1 month; and 3) weight loss greater than 10% of previous weight. Minor symptoms are presence of a maculopapular rash, oral candidiasis or thrush, herpes zoster or shingles, aggressive or uncontrollable herpes simplex, unexplained cough for longer than 1 month, or enlarged lymph nodes in more than 1 extrainguinal site. The finding of 2 major symptoms and at least 1 minor one is enough for diagnosis. These criteria have been found to be useful. However, they do not cover all the presentations which have been associated with AIDS. Unusual presentations of HIV infected persons which have been seen in Africa include serially developing abscesses in pyomyositis, gall bladder diseases, pericarditis or myocarditis, diseases of the Central Nervous System (cryptococcal meningitis, toxoplasmosis, non-specific leuko-encephalitis, atraumatic paraplegia, acute psychosis or chronic deterioration in mental capacity, lymphoma of the brain), prodromal illnesses, swollen lymph nodes, herpes zoster or shingles in young adults, or tumours of the lymphatic system. Differential diagnosis is extremely important.
 ...
PMID:Clinical manifestations of AIDS in tropical countries. 319 42


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>