Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acquired Immune Deficiency Syndrome (AIDS) is now viewed as a chronic disease requiring long-term management. As a result, more persons with AIDS (PWAs) are seeking long-term care in facilities that have primarily served the elderly. In some regions, however, the nursing home market into which PWAs may introduce new demand is a market already characterized by excess demand. In light of this, competition for limited long-term care resources may develop between the frail elderly and PWAs. The nursing home industry has raised many issues regarding the feasibility of admitting AIDS patients as residents, but little is known about how important these issues are in deciding admissions policy. How the industry perceives and resolves the concerns it has regarding delivery of care to PWAs can affect the overall long-term care system and thus affect the traditional users-the frail elderly. Knowing the concerns and preferences of the industry may help guide and anticipate future changes in the system. In this pilot study, a random sample of 250 nursing home administrators in the five highest AIDS-incidence areas in the United States was surveyed to determine (1) the industry's concerns and issues regarding AIDS care, (2) data regarding requests for admission by PWAs to nursing homes, and (3) data concerning the industry's preferred way of delivering AIDS care. Important admissions policy issues cited by the respondents included the ability to meet special care needs, costs of care, and inadequate reimbursement. The majority also believed the most appropriate methods of providing care were special care units for AIDS within nursing homes or dedicated HIV/AIDS nursing facilities.
 ...
PMID:Defining the challenges of providing long-term care: the case of the nursing home industry's response to the AIDS epidemic. 1018 52

Infection with HIV, the virus that causes AIDS, is now considered a chronic disease of years rather than an acute condition resulting in death. AIDS in older adults accounts for 11% of all AIDS cases. This article discusses current epidemiological trends and statistics; HIV risk factors related to aging; immunity and the aging process; diagnosis and treatment challenges; as well as gerontological nursing implications related to HIV prevention and counseling for adults age 50 and older. HIV infection is preventable. Nurses have a unique opportunity to develop theory-based intervention programs to reduce risk behaviors, while encouraging healthy behaviors in the older adult population.
 ...
PMID:HIV and the older adult. 1039 94

Despite the increasing acceptance of quality of life (QOL) as a critical endpoint in medical research, there is little consensus regarding the definition of this construct or how it differs from perceived health status. The objective of this analysis was to understand how patients make determinations of QOL and whether QOL can be differentiated from health status. We conducted a meta-analysis of the relationships among two constructs (QOL and perceived health status) and three functioning domains (mental, physical, and social functioning) in 12 chronic disease studies. Instruments used in these studies included the RAND-36, MOS SF-20, EORTC QLQ-30, MILQ and MQOL-HIV. A single, synthesized correlation matrix combining the data from all 12 studies was estimated by generalized least squares. The synthesized matrix was then used to estimate structural equation models. The meta-analysis results indicate that, from the perspective of patients, QOL and health status are distinct constructs. When rating QOL, patients give greater emphasis to mental health than to physical functioning. This pattern is reversed for appraisals of health status, for which physical functioning is more important than mental health. Social functioning did not have a major impact on either construct. We conclude that quality of life and health status are distinct constructs, and that the two terms should not be used interchangeably. Many prominent health status instruments, including utility-based questionnaires and health perception indexes, may be inappropriate for measuring QOL. Evaluations of the effectiveness of medical treatment may differ depending on whether QOL or health status is the study outcome.
 ...
PMID:Distinguishing between quality of life and health status in quality of life research: a meta-analysis. 1898 26

Telecare has the potential--to extend home-care services normally delivered by conventional means. In the USA, government reductions in health-care financing have been matched by a growing interest, on the part of commercial health-care insurers, in cost reductions and cost-effective care planning. This review identifies emerging trends in home care. Several telecare demonstration projects have been undertaken with patients with coronary heart disease and HIV/AIDS. These projects have attempted to develop new methods of providing cost-effective care for a growing patient population with chronic disease.
 ...
PMID:Home telecare in the United States. 1050 53

Cross-cultural quality of life measurement and psychosocial assessment in oncology have become reality with the translation and international validation of quality of life questionnaires. The Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System, under development since 1987, produced its 4th version in November 1997. The FACIT system includes the Functional Assessment of Cancer Therapy (FACT), the Functional Assessment of Human Immunodeficiency Virus Infection (FAHI) and the Functional Assessment of Multiple Sclerosis (FAMS). These questionnaires were developed in North America and, to date, many have been translated into almost 30 languages. One of the strengths of this ongoing translation project is its use of input from patients, linguists, psychologists and physicians internationally to assure that the wording of Version 4 is more cross-culturally relevant and more sensitive to measuring the psychosocial impact of illness in cultures outside the United States. Statistical analysis, aggregation of patient comments, and comments from linguists and users of the translated versions are used as needed to revise item wording to ensure clarity and consistency across languages. A 'decentering' approach is also used to adapt the source (English language) document in response to problems encountered during its translation.
 ...
PMID:Using cross-cultural input to adapt the Functional Assessment of Chronic Illness Therapy (FACIT) scales. 1052 59

Much progress has been made in the therapy of pediatric HIV infection, which has been transformed from a usually fatal disease into that of a chronic disease model. Early, aggressive therapy with the goal of complete suppression of viral replication (undetectable plasma virus) should be the therapeutic goal, but this new, more hopeful environment has been created at the cost of complexity and compromises in quality of life. The rapid pace of new developments and therapeutic complexities argue strongly for care in specialized centers or, at least, frequent consultation. Efforts are ongoing to develop simpler, more effective therapeutic regimens that suppress and ultimately eradicate infection and that stimulate immune reconstitution.
 ...
PMID:Antiretroviral therapy of HIV infection in children. 1069 46

Tuberculosis continues to be the most prevalent cause of death from an infectious agent globally, and its interaction with HIV is having devastating effects, particularly in Sub-Saharan Africa. Over the past decade, my laboratory has developed small animal models of pulmonary infection, which have revealed new information regarding the nature of acquired immunity, and subsequent immunopathology, in the lungs. We propose that cell mediated immunity comprises two separate elements; protective immunity, driven by IL-12 and IFN; and DTH, mediated by TNF and driven by chemokines. The generation of a CD4 response is critical to both processes, but other cells are also involved in the overall control of the infection. These include gamma delta T cells, which we believe control the inflammatory influx of cells; CD4+ NK cells, which may play a role in focussing lymphocytes into lung granulomas; and CD8 T cells, which play a currently undefined role after initial expression of immunity and establishment of chronic disease in the lungs has ensued. Complex interactions between these populations of cells appear to control the influx of mediator cells into the lungs and then focus them at sites of infection. Prior to adequate expression of protective immunity the correct expression of chemokine and adhesion molecules is critical. A better understanding of these processes will hopefully in turn lead to better vaccine design, a topic which is also addressed in this paper.
 ...
PMID:Tuberculosis: recent progress in basic immunity and vaccine development. 1072 42

Macrophages play a central role in the immune response and are major targets for chronic infection with viruses such as HIV. Recent studies on macrophage differentiation have shown the existence of classical activation and the counter-balancing anti-inflammatory alternative activation states. In the 'balanced macrophage activation hypothesis' we propose that macrophage activation is a cyclic process that balances these two states to achieve proper immunologic function. Dysregulation of this cycle would, therefore, be associated with various forms of chronic disease. This model has been utilized in the drug development of WF10, a novel macrophage-targeted drug, currently in advanced clinical testing for the treatment of HIV disease.
 ...
PMID:Balanced macrophage activation hypothesis: a biological model for development of drugs targeted at macrophage functional states. 1072 2

Worldwide, more than one million children are infected with human immunodeficiency virus (HIV) and in the United States it has become the sixth leading cause of death among 15-24-year-olds. Despite the trend of increasing rates of infection, advances in therapies have led to survival past 5 years of age for more than 65% of infected children. This global health threat will therefore continue to have a significant impact on child and adolescent psychiatry and psychology. This paper reviews current studies and reports on the consequences of the acquired immunodeficiency syndrome (AIDS) epidemic in the psychiatric care and development of children and adolescents infected by HIV. From a search of all the English-language-based literature on pediatric AIDS, 140 studies are reviewed which address HIV infection and its psychological and social implications. Several topics of mental health significance are examined: (1) the epidemiology of HIV, (2) neurocognitive development among those infected, (3) psychological impact of infection, and (4) the family and social context of HIV. The transition of HIV from an acute, lethal disease to a subacute, chronic disease has enormous implications for the neurocognitive and psychosocial development of children and families. As children and adolescents infected with HIV continue to live longer, normal developmental milestones and educational needs will take on new significance. Many children will continue to be adversely impacted by non-HIV factors such as poverty, inadequate medical services, and a lack of social support. This review outlines recent developments that hold promise to effectively reduce the treatment burden on the infected, their families, and health care providers and to decrease the incidence of transmission to the uninfected.
 ...
PMID:Children and adolescents living with HIV and AIDS: a review. 1076 77

Several large observational studies have documented the reduced risk of opportunistic infections among recipients of potent combination antiretroviral therapy. These data raise the question of whether subjects who respond to antiretroviral therapy need to continue prophylaxis for opportunistic infection. Factors to consider when deciding whether it is safe to discontinue prophylaxis include the following: (1) the risk of developing the specific opportunistic infection; (2) the consequences of the infection (morbidity and availability of effective therapy); (3) both the short-term and long-term toxicity of the agent used for prophylaxis; (4) the potential for drug interactions between the agent used for prophylaxis and other therapies for human immunodeficiency virus infection; (5) the psychological benefit of discontinuing a treatment during the course of a chronic disease; (6) the risk of development of drug resistance during prophylaxis; and (7) costs. This article reviews current data on predicting risk of opportunistic infection, the most critical of these factors.
 ...
PMID:Discontinuing prophylaxis for opportunistic infection: guiding principles. 1077 Sep 14


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