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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors have specified the following criteria for the withdrawal of embryonal tissue at their department: 1) only tissue from dead fetus is allowed to be used in neurotransplantation; 2) embryonal tissue is to be obtained after spontaneous abortions from volunteers or from women asking for artificial abortion; 3) the women should be informed about the curative purposes of embryonal tissue voluntary donorship and they must give a written consent; 4) decision on abortion should be separated from the use of embryonal tissue; 5) women should not know recipients; no payments should be made for tissue; 6) the donor is not permitted to impregnate in order to use embryos for research or clinical purposes; 7) sampling of BWR, HBsAG, anti-HIV, cytomegalovirus, herpes I and II is to be made for serologic examinations and that from the cervix for cultivation and sensitivity, as well as ultrasound verification of a germinal age is done in potential donors; 8) consent should be signed to embryonal brain transplantation by recipient or his legitimate deputy if the recipient is certifiable. The above criteria should protect both the donor and the recipient. The use of embryonal tissue cultures seems to be promising. In addition to legal and ethic problems, immunological problems and problems concerning the aseptic withdrawal of embryonal tissue are falling off.
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PMID:[The legal and ethical aspects of nerve tissue transplantation]. 133 6

The prevalence of HIV infection in women at end of pregnancy, irrespective of outcome, was determined in a comprehensive survey of both women and medical centres during successive 4-week periods in four areas of the Paris region, France. Blood samples were tested anonymously for antibodies to human immunodeficiency virus (HIV)-1 and HIV-2. Of the 11,593 blood samples 0.40% (95% confidence interval [CI] 0.28-0.51) were positive for HIV-1 and 0.02% (95% binomial interval [BI] 0.002-0.065) for HIV-2. Seroprevalence was higher among women with ectopic pregnancy (2%) (95% BI 0.24-7.04); the rate in women having an elective or therapeutic abortion was more than twice that in those delivering babies (0.70% vs 0.28%, p less than 0.05, relative risk 2.54, 95% CI 1.36-4.75). Studies with neonatal HIV seroprevalence as a surrogate for HIV prevalence in pregnant women would underestimate prevalence in these women.
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PMID:HIV infection at outcome of pregnancy in the Paris area, France. 135 8

The changing patterns of adolescent sexual behavior and changing conditions are described for the developing world, as well as reproductive health methodologies of the WHO in dealing with these changes. The lessons learned and future directions are also presented. Adolescence is viewed as a dynamic transition period. There are nonuniform changes in biological, physical, and social development. Sexuality is a fundamental quality of human life, which is important for health, happiness, individual development, and preservation of the human race. Health in a WHO definition is not just the absence of disease or infirmity. It is physical, mental, and social well being. The changes which have impact on sexuality are 1) the predominance (50%) of the world's population 25 years and predominance living in developing countries (33% or 1.5 billion are between 10-24 years and 80% are living in developing countries), 2) the plethora of youth living in unstructured and impoverished living conditions, 3) the communication explosion across cultural boundaries, and 4) the increase in travel, tourism, and migration. There are models, pressures, and opportunities for sexual contact. Nuclear families, single-parent families, and no families are replacing the extended multigenerational families of traditional societies. Puberty is coming earlier. The traditional patterns of marriage are described and contrasted with western youth with unparalleled freedom to make decisions. The pressures of early premarital intercourse are reflected in unwanted pregnancies, induced abortions, sexually transmitted diseases, and AIDS or HIV infection. Unsafe abortion has the increasing risk of septic abortions, illness, future infertility, and death. General trends in marriage in developed and developing countries are provided. The WHO use multiple approaches: the Narrative Research Approach, which involves adolescent workshops and role plays that are turned into questionnaires; the Grid Approach, which explores interdisciplinary stages of adolescent health; the Counseling Skills Training workshop which strengthens interpersonal communication skills; the Gatekeeper Design, which directs systematic questions to key policy makers who turn the questions to managers and administrators who do the same for service providers in order to make appropriate and effective policy changes the User/System Interaction model, which uses youth and service provider input to determine the suitability of services; and Drama, which is used to measure audience reaction. The involvement of youth in the process is an important lesson learned, and all who have contact with youth need the same set of information. Dialogue dispels the greatest enemy, fear.
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PMID:Changing patterns of adolescent sexual behavior: consequences for health and development. 139 Jul 84

A global overview of reproductive health outlines major challenges for action. Worldwide, 60 million to 80 million couples suffer from infertility. At the same time, there is a striking unmet need for contraception in developing countries. Unsafe abortion practices result in between 115,000 and 204,000 deaths each year. Female genital mutilation in one form or another continues to exist in around 40 countries. A second generation of organisms has now made sexually transmitted diseases the most common group of notifiable diseases in most countries. For the year 2000, it is projected that there will be a cumulative total of about 40 million HIV infections in men, women and children. About half a million women die each year because of complications related to pregnancy and childbirth. A total of about 15 million infants and children die annually, mostly from preventable childhood diseases. At least 17% of all babies in developing countries are born with a low birth weight.
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PMID:Reproductive health: a global overview. 139 66

Researchers analyzed 1991 data on 678 12-45 year old women attending either a university-based family planning clinic, 8 Planned Parenthood clinics, or the private practice or health maintenance organization clinic of 8 physicians in southeast Texas to determine the characteristics of these women who accepted Norplant shortly after its approval in the US and their overall attitude towards Norplant. Most acceptors were 25 years old (64.1%) and not married (67.4%). In fact, 45% were 21 years old which was higher than expected. Norplant was 1 of the first contraceptives used by 44% of the women. Further, these women had only recently chosen to prevent unplanned pregnancy. The mean family size was 1.2. 35 of the women did not want any more children. The remaining 67% used Norplant to space births. 32.5% of the women had experienced at least 1 abortion, which was significantly higher than the national adjusted rate. The leading reasons for choosing Norplant included dissatisfaction with previous methods (55.5%), its convenience (38.7%), and confidence in its effectiveness (20.8%). 44% of the women were not concerned about Norplant. The main concerns of the other women were pain during insertion (21.9%), menstrual changes (17.9%), and hormonal effects (16.2%). Further, 11.8% were worried about Norplant's effect on future pregnancies. Most women (61.1%) had previously used oral contraceptives (OCs). 5.3% had used no method in the last 3 months. 42.2% had used condoms either alone or with a spermicide. Yet, 48% of them would now either stop using them or use them sometimes. They constituted 40% of the unmarried women. This resulted in an increased risk of acquiring a sexually transmitted disease or HIV among 25% of the sample. Medicaid patients paid nothing for Norplant or its insertion. Patients who received Norplant via the physician training program paid nothing for Norplant but did for its insertion. Some clinic patients made required copayments of $9-$100. Private practice patients paid $500-$750 for Norplant and its insertion.
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PMID:Characteristics and attitudes of early contraceptive implant acceptors in Texas. 142 82

WHO has released its report on global reproductive health. The greatest development in reproductive health in the past few decades has been a significant growth in the use of contraceptives (9% of married women in 1965-70 to 50% in 1985-90). This expanded use of contraceptives has resulted in a considerable fertility decline. The total fertility rate (TFR) in developing countries has fallen from 6.1 in 1965-70 to 3.9 in 1985-90. The most popular contraceptive methods are, in order, female sterilization, IUD, oral contraceptives, condoms, and vasectomy. Had the global campaign to increase access to family planning (FP) services had been delayed just 10 years, there would have been more than 400 million more people on the planet than there are now. The TFR in the US took 58 years to fall from 6.5-3.5, while the same decrease took 27 years in Indonesia, 15 years in Colombia, 8 years in Thailand, and 7 years in China. East Asia has experienced the greatest fertility declines, while Africa has experienced the least. In East Asia, about 70% of couples use contraceptives, compared to 14% in Africa. About 95% of people in East Asia have access to FP services, while only 9% do in sub-Saharan Africa (60% for all developing countries). 36-53 million induced abortions occur annually (32-46/1000 women of reproductive age), indicating the high degree of unwanted pregnancies and unmet need for FP. 15-22 million of these abortions are illegal abortions. High abortion rates do not always reflect liberal abortion laws. The Netherlands has a very low abortion rate, yet it has a liberal abortion law. More than 60 million couples worldwide suffer from infertility. Pelvic infection caused by sexually transmitted diseases (STDs), aseptic abortion, or delivery-related infection causes most cases of acquired infertility (36% in developed countries vs. 85% in Africa). At least 250 million new cases of STDs occur annually. As of early 1992, 2 million people suffered from AIDS and 10-12 million from HIV infections.
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PMID:Steep decline in world fertility rates: contraceptive use up sharply. 146 19

To evaluate decision-making factors of pediatric surgeons when faced with ethical dilemmas in a clinical setting, questionnaires were mailed to members of the Canadian Association of Paediatric Surgeons. The surgeons were asked to respond to scenarios regarding ethical dilemmas in the treatment of children. Fifty-one responses (57%) were computer analyzed based on chosen responses to the clinical dilemma and demographic factors such as age, sex, marital status, country of citizenship, religion, and "religiousness," a determination of religious conviction as viewed by the respondent. In addition, ethical convictions were sought regarding abortion, fetal research, AIDS, HIV testing, denial of medical care due to religious beliefs (Jehovah's Witness), and limitations in health care access for indigents. In general, respondents found it difficult to separate ethical guidelines for determining aggressive treatment--absolute value of life; best interests of the child; parental authority; and ability of the child to engage in social, intellectual, or emotional attachments (quality of life)--in the face of actual patient care issues. In fact, results of this survey indicate that the operating surgeon applies his/her medical knowledge and surgical "experience" to each individual case, incorporating his or her own ethical beliefs (in a respondent's words: "In the operating room, the surgeon must satisfy his own conscience in making decisions") while cognizant of legal guidelines for "standard care" ("Decisions would be based on personal experience, and what the local society believes to be right").(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Spinning the wheels: a CAPS survey of ethical issues in pediatric surgery. 147 94

HIV infection in pregnant women has been shown to have an adverse effect on the fetus and newborn. We undertook this study to examine the adverse effect of maternal HIV-1 infection on two outcomes of the previous pregnancy, as reported by the women: childhood mortality under the age of 3 years and spontaneous abortion. Some 6605 consecutive women who presented to a large urban hospital in Malawi for antenatal care were interviewed and tested for HIV-1 antibody. Of these 4229 (64%) were multiparous and 833 (19.7%) were seropositive for HIV-1. A history of under-3 mortality of the previous pregnancy was more common in HIV-1 seropositive than HIV-1 seronegative women (35% versus 15%, P less than 0.001). In the previous pregnancy, death of infants and children under 3 years was 77 and 119 per 1000 respectively for HIV-1 seronegative mothers, but increased to 171 and 292 per 1000 in infants and children under 3 years for HIV-1 seropositive mothers. History of child mortality was independently associated with positive HIV-1 serology, positive syphilis serology, low socioeconomic status, young age and not having married. There was no correlation between history of child mortality and reported symptoms of HIV/AIDS by infected mothers, except for history of tuberculosis which was reported more often by mothers whose child had died (4% versus 1%, P less than 0.036).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A retrospective study of childhood mortality and spontaneous abortion in HIV-1 infected women in urban Malawi. 822 53

It has been assumed that HIV-positive women avoid having children in view of the risk of perinatal transmission, however, one recent study refuted this notion. Investigators from the State UNiversity of New York Health Science Center at Brooklyn compared 98 seropositive pregnant women with a matched group of 108 expectant seronegative women following them through pregnancy and 1 1/2 years thereafter. Pre- and posttest counseling included information on pregnancy options (including abortion), the chances of perinatal transmission of HIV, and the health risks of pregnancy in HIV positive women. For up to 4 years subsequently the women received family planning counseling, services, and periodic physical assessments with recording of later pregnancies. Significantly more seropositive than seronegative women terminated pregnancies: 6 of the 34 seropositive women who learned of their HIV status early had an abortion vs. only 1 of 32 seronegative women. However, 20 seropositive women and 19 seronegative women had 1 or more live births during the follow-up period. The reasons for women's reproductive decisions were reported as religious beliefs, willingness to risk transmission, and psychological problems. Helping women find self-fulfillment in areas other than childbearing and empowering women to do things other than having children was proposed by the researchers. Nurses in women's health centers could counsel young women about careers, contraception, and serve as role models. In additions, women's partners should be involved in education about HIV infection.
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PMID:HIV and reproductive choice: surprising findings. 152 98

This paper deals with the management of pregnant women with HIV infection. The virus is transmitted by the mother to 20-30 percent of the infants, and therapeutic abortion should be offered to women whose pregnancy does not exceed 26 weeks of amenorrhoea. If pregnancy is pursued, the mother must be investigated for sexually transmitted diseases which are particularly frequent in this population and may have repercussions on the newborn. Pneumocystis carinii pneumonia is the most common opportunistic infection in pregnancy. In case of T4-cell depletion chemotherapy with pentamidine must be instituted. Hygienic and dietetic measures should be applied to avoid listeriosis and toxoplasmosis. Serological tests for toxoplasmosis are necessary in all HIV patients, with chemoprophylaxis in case of increased IgG levels. Thrombocytopenia usually responds to human immunoglobulins. At delivery, there is no need to modify the usual obstetrical procedures. During the post-partum period, another pregnancy must be avoided by good compliance with a reliable contraceptive method. As for the preventive treatment of mother-to-child HIV transmission, at the moment only AZT can be considered, but its effectiveness remains to be evaluated in therapeutic trials.
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PMID:[Pregnancy in HIV infected women. Current therapeutic indications]. 153 74


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