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

There have been reports in the medical community of hesitation regarding the administration of didanosine to adult HIV patients because of the fear of the documented toxicities associated with didanosine. The most worrisome toxicities include pancreatitis and peripheral neuropathy. With close observation and follow-up, these toxicities can almost always be avoided or easily reversed. This article attempts to allay these fears so that the practitioner can administer this effective antiretroviral confidently and safely. The development of nucleoside and the pharmacology of didanosine are discussed. Drug administration information is provided, including a description of the different forms of didanosine currently available. Guidelines for assessing toxicities associated with didanosine, as well as suggestions for patient education, are also provided. Data gathered at the National Cancer Institute in the phase I didanosine trial indicate that early detection and discontinuation of didanosine, in nearly all cases, can limit or lessen the extent of morbidity.
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PMID:Didanosine use in the adult HIV patient. 146 32

Otolaryngologic manifestations of AIDS have been described in the past. In this study, I had examined 14 adults with nasal obstruction and mouth breathing. Nine patients also reported deafness--unilateral in three of them and bilateral in six. All of them revealed a mass in the nasopharynx, either on the posterior rhinoscopy or the x-ray neck-lateral view. To exclude nasopharyngeal malignancy, all of the patients underwent examination of the nasopharynx while under general anaesthesia and biopsy. The histopathologic diagnosis in every patient was nonspecific, reactive lymphoid hyperplasia, which has been described in the background of HIV infections. Four were already confirmed HIV-positive and 10 were found positive on the HIV antibody test. A strong association was established between seropositivity, adenoid hypertrophy, and secretory otitis media in adults.
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PMID:Seropositivity, adenoid hypertrophy, and secretory otitis media in adults--a recognized clinical entity. 147 Apr 53

Sera from U.S. patients with SLE, RA, and various malignancies, clinically normal individuals with sero-activity to HIV, AIDS, and from pregnant women were tested for the presence of anti-c-myc antibodies. In an ELISA using recombinant human c-myc protein as the antigen, no difference in mean antibody titer was generally detected in these sera when compared to normal controls. Only three malignancy sera (two myeloid leukemia and only one lymphoma) and two patients with AIDS-related lymphoma exhibited exceedingly higher levels of anti-c-myc antibody. However, significantly elevated anti-c-myc antibody levels were found among 20 patients with African Burkitt's lymphoma (Ghana) and 20 normal Ghanians, thus apparently reflecting an autoimmune phenomenon prevalent in the endemic region. These findings indicated that elevated levels of anti-c-myc antibodies are not a general characteristic of patients with diseases that have been associated with increased expression of c-myc.
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PMID:Autoantibodies to c-myc protein: elevated levels in patients with African Burkitt's lymphoma and normal Ghanians. 147 33

Almost one quarter of all deaths among residents of Camberwell District Health Authority during 1990 occurred without the district ('transferable deaths'). These deaths differed from total deaths in that the main cause of study deaths was cancer, and many of these cases died in a hospice with which the district has no direct contact. However, the commonest location of deaths was in hospitals (57% of study death locations) and the majority of these cases died in London teaching hospitals with whom there are major contracts. As the three inner London South East Thames districts, including Camberwell, propose to merge into a single purchasing authority in 1993, all London hospitals where Camberwell residents died in this survey would be covered by the current range of contracts set by the three districts. The study identified a small but important group of deaths from HIV/AIDS, where it seems that people travelled, particularly, to West London for terminal care. A high proportion of deaths from injury and poisoning were either suicides or open verdicts. There were less transferable deaths among the major ethnic minorities in the district than expected, particularly among those of African and Caribbean descent. This may be due to the age and disease patterns in these populations, but may also require study into the need for terminal care among these groups. Transferable deaths are a useful source of epidemiological information and can highlight local health service strengths and deficits.
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PMID:Transferable deaths during 1990 for residents of Camberwell Health Authority. 147 36

From May 1987 to July 1990, 45 cases of Hodgkin's disease (HD) were recorded by the French Registry of HIV-associated tumors. Thirty-nine patients were male and median age was 30 years. Twenty-two cases had mixed cellularity type (MC), 18 nodular sclerosis, two lymphocyte depletion and three were not classified. Thirty-four patients had advanced HD clinical stages (CS III and IV). Thirty-six patients (80%) presented with B symptoms. Bone marrow involvement was diagnosed in 12 patients. Mediastinal involvement was present in only 4/30 patients (12%). Risk groups for AIDS were homosexuality in 18 cases, intravenous drug abuse in 17, both in one, and other in nine cases. In 40 cases (89%), HD occurred before any AIDS-related episode. Median CD4 cell count at HD diagnosis was 304 cells/microliters. Seventy-nine percent of the patients achieved complete remission with standard therapy, but hematological and infectious complications were very frequent. The rate of progression to AIDS was 71% at three years and opportunistic infections (mainly pneumocystis carinii pneumonia) were the most frequent cause of death. Overall two-year survival was 41% (78% for patients with initial CD4 cell count higher than 300 cell/microliters and 0% for those with CD4 cell count lower than 300/microliters). HD-HIV has a specific clinical profile as compared to primary HD, with a predominance of MC type and advanced clinical stage, without mediastinal involvement (88%). This study provides a basis for future clinical trials on HD-HIV: intensity of chemotherapy should be adapted to CD4 cell count; pneumocystis carinii prophylaxis is mandatory in all cases. Zidovudine should be included during and after HD treatment; the potential role of hematological growth factors has still to be evaluated.
Bull Cancer 1992
PMID:[Hodgkin's disease associated with HIV infection: clinical characteristics and development. French registry of tumors associated with HIV infection]. 148 23

A small nodule on the middle finger of the right hand of a right-handed dentist was removed and found to be benign. The lesion recurred and showed increased collagen deposition and vascularity; it was diagnosed as a dermatofibroma. In the absence of a specific incidence of trauma, the cause of such a lesion is a matter of speculation. Such lesions can develop as local tissue reactions to wounds that are the result of routine operatory procedures. This points to the need for careful handling of sharp instruments. Because of the serious consequences of a malignancy or infection from HIV, nodules and other lesions of unknown etiology that appear suddenly should not be ignored.
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PMID:Skin tumors may imitate infectious processes. 149 64

RU-486 or mifepristone is best known as an antiprogestin and an abortifacient, but it has broad medical applicability. The drug is also a potent blocker of corticosteroid receptors, and it has shown promise in the treatment of breast cancer, inoperable meningioma, and cushing's disease. Cushing's is a model for the symptomatology of aging which may involve enhanced response to corticosteroid. RU-486 has reversed the osteoporosis, thinning of skin, muscle atrophy, obesity, adult onset diabetes, depression, hypertension, and immunosuppression associated with this disease. RU-486 may be of value in aiding cervical dilation, lactation, and the treatment of endometriosis. In addition, breast, bowel, kidney tumors, hepatomas, endometrial cancer, and fibrosarcomas can show corticosteroid dependency, suggesting that RU-486 may have clinical value against inoperable tumors. In a preliminary 1987 phase I study, in estrogen-positive, chemotherapy-refractory breast cancer patients in Montpelier, France, Ru-486 produced objective tumor regression (6 of 22) that was prolonged (3 months) in 4 patients. Clinical relief of bone pain was observed in 7 of 23 patients with a decline in carcinoembryonic antigen (CEA) tumor makers in 8 patients. Growing in vitro data also show that RU-486 can directly inhibit breast cancer cell proliferation. RU-486 has application for HIV infection, based on data that there is a serum factor in AIDS patients that enhances corticosteroid lympholysis. IN addition, the immune restorative action of RU-486 suggests that it could counteract the immunosuppression seen in aging, in cancer, or in viral or stress-related disease, which has recently focused clinical attention on its potential in the treatment of senile dementia and depression. Scientific conferences and workshops are needed to alert scientists, physicians, and the public to the potential medical benefits of this drug.
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PMID:RU 486: how abortion politics have impacted on a potentially useful drug of broad medical application. 150 96

The prevalence of hairy leukoplakia was determined among 176 symptomatic HIV seropositive patients seen at the outpatient department of the Institute of Tropical Medicine in Antwerp, Belgium. Moreover, systematic tongue biopsies were performed during postmortem examination of 21 patients with AIDS, 100 HIV seronegative immunocompromised patients with haematologic or other malignancies and 100 HIV seronegative non-immunocompromised patients who died at the University Hospital Antwerp. Hairy leukoplakia was observed in 52 (29.5%) of the outpatients, but only in one (5%) of the AIDS patients in the postmortem study (P = 0.03). An explanation for this difference may be that significantly more AIDS patients who died had received either acyclovir or ganciclovir during the 3 months prior to the postmortem examination than the HIV seropositive outpatients during the 3 months prior to examination. Hairy leukoplakia occurred more often in Caucasian homosexual men with HIV infection (38%) than among heterosexual Africans with HIV infection (17%) (P = 0.06). Hairy leukoplakia was observed in none of the HIV seronegative patients.
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PMID:The prevalence of hairy leukoplakia in HIV seropositive and HIV seronegative immunocompromised patients. 150 55

Since July 1986 we started with following all patients with condylomata acuminata including HIV-testing and human papilloma virus (HPV) identification by DNA-DNA-hybridisation (southern blot). Seventy patients are included, 39 of them are seropositive. The ratio male to female is 59 to 11, in seropositives 35 to 4, in negatives 24 to 7. The average age is 28 and 31 years respectively. The number of homosexuals and junkies is significantly higher in seropositives. Seventeen patients are in HIV-stage II, 11 in stage III and 10 in stage IV according to CDC-classification. Characteristic for the seropositives was an extensive growth on the rectal mucosa and the very rapid growth of initially subtotally resected lesions in order to prevent stenosis. Sixty-five patients were treated by one stage radical operation with electrocauter. Surprisingly recurrency is more frequent in seronegatives, however, the lesion is much smaller in this group. A hypothesis to explain this observation is brought forward. Postoperative complications occurred only in HIV-stages III and IV. We therefore recommend single shot antibiotic prophylaxis in these patients. The HPV-identification showed no malignancy associated HPV-types in both groups but a higher incidence of HPV 11 in higher HIV-stages which we cannot explain. We conclude from our series that, if operation is indicated, one stage radical electrocoagulation of condylomata acuminata is a necessary procedure in seropositive patients and a save one in negative patients but antibiotic prophylaxis should be given in stage III and IV. Anal condylomata acuminata are a hint for possible HIV-positivity.
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PMID:[Anal condylomata acuminata in HIV positive patients]. 150 8

Much progress has been made in the therapeutic use of immunotoxins since the first clinical trials, especially in the prevention and treatment of AGVHD. This is also further discussed in this symposium by Champlin. Research in immunotoxin use has gone beyond cancer and into the treatment of immunologic disorders, such as rheumatoid arthritis and HIV infection. Before further advances can take place several problems must be overcome, including the rapid clearance of immunotoxin by the liver, the generation of anti-immunotoxin antibodies, and poor penetration by the immunotoxin in solid tumors. Other obstacles to the wide use of immunotoxins are the heterogeneity of tumor cells, the shedding of tumor antigens into the circulation, and the inability to identify neoplastic renewal cell specific antigens that are not cross-reactive with normal tissues. Despite these obstacles, the early success of immunotoxins, especially in hematologic malignancies, reinforces the feasibility of designing rational targeting reagents in cancer therapy.
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PMID:Therapeutic use of immunotoxins. 150 95


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