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 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although case reports of herpes simplex virus (HSV) causing acute hepatitis in otherwise healthy adults have appeared recently in the literature, a prospective study of the incidence of HSV-hepatitis in the general population hitherto has not been reported. In the present study, serum samples from 124 young adults attending a sexually transmitted disease clinic with either genital herpes infections (n = 86) or non-herpes sexually transmitted diseases (n = 38) (controls) were analyzed for liver enzyme abnormalities (including aspartate aminotransferase [AST] and alanine aminotransferase [ALT]). Twelve of eighty-six (14%) herpes-infected patients had mildly abnormal liver enzyme tests (less than or equal to twice the upper limit of normal) as opposed to only 1 of 38 controls (2.6%), (P less than .05). All individuals in the herpes-hepatitis group were anicteric, and only two complained of constitutional symptoms (malaise and fatigue). Liver enzyme tests were repeated in nine herpes-hepatitis patients 1 week after their genital lesions had resolved, and in six of nine patients the results had returned to within normal limits. Four patients subsequently returned at the onset of a recurrence of their genital herpes. In all four, serum ALT levels were elevated from the previous occasion, and in three of the four levels just exceeded the upper limit of normal. One patient was followed through three recurrences of his genital herpes. In that individual, the extent of liver enzyme abnormalities appeared to correlate with the presence or absence of his genital lesions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Genital herpes and hepatitis in healthy young adults. 301 68

History of diagnosed illnesses, medical symptoms, and reproductive outcomes and their relation to combat intensity and herbicide exposure were studied, via a mailed questionnaire, among 6810 American Legionnaires who served during the Vietnam War (42% in Southeast Asia, 58% elsewhere). Heart disease, venereal disease, and benign fatty tumors were reported significantly more often by Vietnam veterans than by controls. Combat intensity was significantly dosage-related to history of high blood pressure, ulcers, arthritis and rheumatism, genito-urinary problems, nervous system disease, major injury, hepatitis, and benign fatty tumors. Agent Orange exposure was significantly dosage-related to history of benign fatty tumors, adult acne, skin rash with blisters, and increased sensitivity of eyes to light. Rates of the latter two conditions and of change in skin color were especially elevated in men whose military occupations involved direct handling of herbicides. Five "symptom complex" scales were constructed via factor analysis to measure degrees of feeling faint, fatigue or physical depression, body aches, colds, and skin irritation. Means of all five scales were significantly higher in Vietnam veterans compared to controls, and in herbicide handlers compared to nonhandlers. Both combat and Agent Orange exposure were significant, independent predictors of each of the five scales. Neither combat nor Agent Orange exposure was associated with difficulty in conception, time to conception of first child, or to birthweight or sex ratio of offspring, but maternal smoking was strongly related to reduced birthweight. The percentage of spouses' pregnancies which resulted in miscarriages was significantly higher for Vietnam veterans than controls (7.6% vs 5.5%, P less than 0.001). Logistic regression analysis showed that Agent Orange exposure and maternal smoking were both independently and significantly associated with miscarriage rates in a dose-related manner.
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PMID:Health and reproductive outcomes among American Legionnaires in relation to combat and herbicide exposure in Vietnam. 326 69

The epidemiology, clinical course, diagnosis, and attempted treatments of herpes genitalis are reviewed. Herpes genitalis is an increasingly common sexually transmitted disease for which there is no effective treatment. It can occur in either sex and is mot commonly first found in patients 14 to 29 years old. Initial exposure to the virus may result in prolonged local symptoms (pain, itching, discharge) and signs (ulcerative lesions) as well as fever, malaise, myalgias, and fatigue. After the initial exposure, the virus may be found in a latent stage in the dorsal nerve root ganglia in the sacral area, and recurrences of disease may ensue. The frequency and clinical course of recurrent genital herpes can be of varying duration and severity. Although antiviral substances, immune potentiators, topical surfactants, and photodynamic inactivation have been used to treat genital herpes infections, there is no proven effective therapy.
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PMID:Genital herpes simplex virus infection: clinical course and attempted therapy. 701 31

A cross-sectional study of a cohort of 49 male human immunodeficiency virus (HIV)-infected intravenous drug users attending the Infectious Diseases Unit of the National University of Malaysia during 1991-94 yielded a clinical profile of these patients. The mean age of respondents was 33.2 years and the mean duration of intravenous drug use was 12.7 years. On average, these men had known of their HIV-positivity for 53.2 weeks. Intravenous drug use was the only reported HIV risk factor in 34 men (69%). Clinical symptoms at intake included fatigue (49%), weight loss (47%), night sweats (31%), fever (14%), and diarrhea (6%), while clinical findings included hepatomegaly (57%), lymphadenopathy (35%), and oral thrush (29%). Anemia (82%), leucocytosis (53%), hypoalbuminemia (43%), hyperglobulinemia (88%), elevated liver enzymes and hyponatremia (57%) were frequent laboratory findings. The prevalences of hepatitis B virus, cytomegalovirus, and toxoplasma infection were 12.1%, 72.7%, and 59%, respectively. A total of 91 diagnoses were made in these 49 patients: most common were pneumonia, tuberculosis, bacteremia, infective endocardiditis, mycotic aneurysm, and psychiatric disorders. The mean duration of known progression to acquired immunodeficiency syndrome (AIDS) in the 7 patients at this stage was 391 days. Pneumocystis carinii pneumonia was the most common AIDS-defining illness. Three months into the study, 19 men (57%) had defaulted, reflecting the difficulties of involving drug addicts in research and intervention projects. Moreover, 16 patients (33%) were first confirmed HIV-positive at presentation to the hospital, suggesting that many drug users' HIV status remains unknown until they develop symptoms requiring hospital care.
Int J STD AIDS 1997 Feb
PMID:A study of Malaysian drug addicts with human immunodeficiency virus infection. 906 11

We aim to assess the age-related differences in psychological stress and depression in patients with human immunodeficiency virus (HIV) infection. Prospective, longitudinal, observational study of patients with HIV followed at a university affiliated VA Medical Center. Fifty-six consecutive patients with HIV infection aged 19-68 were studied. Data on demographics, living arrangements, education, employment, income, social, religious, and community support, medical status, psychological stress, depression, and coping was assessed at baseline and every 6 months. Instruments for psychological testing included Beck Depression Inventory, Profile Mood Status (POMS) scale and ways of coping scale (inventory of coping with illness scale). Sixty-nine per cent (38/56) of the patients were older than 35 years of age. Older patients exhibited significantly greater emotional and psychological stress; the mean POMS score for older patients was 56.8 as compared to 21.5 for younger patients (P = 0.004). Older patients had significantly greater depression (P = 0.001), higher tension and anxiety (P = 0.005), greater anger and hostility (P = 0.03), greater confusion and bewilderment (P = 0.01), and more fatigue (P = 0.003) as compared with younger patients. Older patients were significantly more likely to have intravenous drug use as an HIV risk factor (P = 0.02), less likely to be employed (P = 0.005), and more likely to use non-traditional therapies (P = 0). Intravenous drug use was an independent predictor of psychological stress in older patients. Patients with HIV, older than 35 years of age, are significantly more likely to suffer from depression and psychological stress; intravenous drug use was an independent predictor of stress. Interventions for the treatment of depression should be especially sought in this subgroup of patients with HIV.
Int J STD AIDS 1997 Apr
PMID:Psychological stress and depression in older patients with intravenous drug use and human immunodeficiency virus infection: implications for intervention. 914 58

Our objective was to compare the effect of 2 regimens for treatment of Mycobacterium avium complex (MAC) bacteraemia in an HIV-positive population on symptoms and health status outcomes using a substudy of an open-label randomized controlled trial. The study was conducted in 24 hospital-based human immunodeficiency virus (HIV) clinics in 16 Canadian cities. Patients had HIV infection and MAC bacteraemia and were given either rifampin 600 mg, ethambutol 15 mg/kg daily, clofazimine 100 mg daily and ciprofloxacin 750 mg twice daily (4-drug arm) or rifabutin 600 mg daily (amended to 300 mg daily in mid-trial), ethambutol 15 mg/kg daily and clarithromycin 1000 mg twice daily (3-drug arm). The primary health status outcome was the change on the 8-item symptom subscale of the Medical Outcome Study (MOS)-HIV Health Survey adapted for MAC. Changes on other MOS-HIV subscales and on the Karnofsky score were also evaluated. Patients on the 3-drug arm had better outcomes on the MOS-HIV symptom subscale at 16 weeks (P=0.06), with statistically significant differences restricted to night sweats and fever and chills (P < 0.001). The proportion of patients improving on the symptom subscale relative to baseline was 55% on the 3-drug arm and 40% on the 4-drug arm. Patients on the 3-drug arm also had better Karnofsky score at 16 weeks (P < 0.001) and better outcomes on the social function, mental health, energy/fatigue, health distress and cognitive function subscales of the MOS-HIV. The 3-drug arm is superior to the 4-drug arm in terms of impact on MAC-associated symptoms, functional status and other aspects of health status.
Int J STD AIDS 2000 Apr
PMID:Symptomatic and health status outcomes in the Canadian randomized MAC treatment trial (CTN010). Canadian HIV Trials Network Protocol 010 Study Group. 1077 83

The aim of the study was to assess adherence with antiretroviral medication in a sample of HIV patients in Hong Kong and identify predictors of adherence. The study used a cross-sectional correlational design. Adherence behaviour was assessed with the use of self-reports. Other scales assessed knowledge with HIV medication, coping, health locus of control, anxiety, depression and fatigue. A blood sample was also obtained to assess CD4+ counts and viral load. Sociodemographic characteristics and medical information were obtained from the medical records. A high adherence rate was found in this sample of 136 predominantly Chinese patients. There were only 13.7% of the patients being classified as non-adherent. Predictors of adherence included high self-efficacy in terms of being certain that the medication schedule will be followed all or most of the time as directed, low tension-anxiety scores, and low intensity of nausea and vomiting (R2=0.304). An expanded regression model revealed additional factors influencing adherence, including coping variables, pain and numbness in the hands and feet, age, disease stage, internal locus of control, fatigue, family support and taking medication twice daily. This model explained 49% of the variance in adherence. The results suggest that adherence is a multidimensional concept. Every effort should be made to assess in individuals those variables found to affect adherence and alter them whenever possible. Continuous support of patients and individualized medication programmes that will help patients adjust their treatment to their lifestyle are recommended.
Int J STD AIDS 2002 May
PMID:Factors associated with adherence to antiretroviral medication in HIV-infected patients. 1197 33

The injectable contraceptive depot-medroxyprogesterone acetate (DMPA) dissolves slowly and is released over 3 months to suppress ovulation. It is more than 99% effective at preventing pregnancy. More than 30 million women in 90 countries have used DMPA and none have died from using it. A World Health Organization [WHO] study showed that DMPA did not significantly increase the risk of breast cancer or other cancers. One study points to a small reduction in bone density with DMPA use, but the reduction did not become larger with long-term use and may even be reversible. The US Food and Drug Administration (FDA) thoroughly reviewed these studies and the experiences of DMPA users. This review resulted in the FDA's approving DMPA as a contraceptive in October, 1992. Almost all DMPA users experience menstrual changes with irregular bleeding and spotting occurring during the 1st few months. After 12 months, at least 50% of DMPA users experience amenorrhea, which some women consider a benefit. Other possible but rare side effects are weight gain, headache, breast tenderness, loss of libido, depression, nervousness, and fatigue. It takes longer for past DMPA users to conceive after stopping DMPA use than users of other contraceptive methods, but by 18 months more than 90% of past DMPA users who wanted to become pregnant conceived. DMPA does not protect users from sexually transmitted diseases (STDs) or HIV/AIDS. They need to use latex condoms to prevent STD/HIV transmission. DMPA users must return to their health care provider every 3 months for another injection. DMPA is a viable contraceptive for women wanting a safe, reliable, long-term, reversible contraceptive. Any woman wanting to use DMPA should discuss it with her provider.
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PMID:Facts about injectable contraception. 1228 37

An experimental study on the mechanical behavior of human dentin and the influence of age was conducted. Beams with rectangular cross-section were sectioned from the coronal dentin of virgin extracted molars (N = 76) that were obtained from (N = 70) patients between 17 and 80 years of age. The beams were loaded in either quasi-static 4-point flexure or 4-point flexural fatigue to failure and the stiffness, strength and fatigue properties were evaluated. In characterizing the fatigue response the beams were divided into two age groups that were regarded as young (17 < or = age < or = 30, mean +/- std. dev. = 25 +/- 5 years) and old (50 < or = age < or = 80, mean +/- std. dev. = 64 +/- 9 years) dentin. Results from monotonic loading showed that both the flexural strength and strain to fracture of dentin decreased significantly with age. The fatigue life of dentin increased with a reduction in cyclic stress amplitude and the fatigue strength of young dentin was greater than that of old dentin at all cyclic stress amplitudes. The endurance strength of young dentin (at 10(7) cycles) was approximately 44 MPa, whereas the old dentin exhibited an endurance strength of approximately 23 MPa. Based on differences in the mechanical behavior and microscopic features of the fracture surfaces from the young and old specimens, aging appears to result in an increase in both the rate of damage initiation and propagation in dentin.
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PMID:Effects of aging on the mechanical behavior of human dentin. 1562 51

The development of body weight gain and lipodystrophy due to antiretroviral therapy may lead to disturbances in sleep, particularly the obstructive sleep apnoea (OSA) syndrome. A retrospective review of the medical records of consecutively identified HIV-infected subjects who were diagnosed with OSA by overnight polysomnography between January 1, 2003 and December 31, 2004 was performed. Twelve HIV-infected subjects with OSA confirmed by polysomnography (total apnoea/hypopnoea index > or = 5) were identified. Daytime somnolence, fatigue, and snoring were the most common symptoms identified. Eleven (92%) subjects were overweight/obese, and seven (58%) had lipodystrophy. Eleven (92%) had a neck size > or =40.0 cm. Increased neck circumference, overweight or obese body mass index, and lipodystrophy are therefore potential risk factors for OSA among HIV patients. Clinicians caring for HIV patients with these characteristics should inquire about daytime somnolence, fatigue, and snoring and consider evaluation for a sleep-related disorder such as OSA. Overnight polysomnography can aid in the diagnosis of sleep disturbances.
Int J STD AIDS 2006 Sep
PMID:Obstructive sleep apnoea among HIV patients. 1694 53


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