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

Lay diagnoses of death collected at burial sites were validated against two 'gold standards': the hospital discharge diagnosis of causes of death obtained by a surveillance of hospital deaths (including autopsy results) and the physician review of verbal autopsies (VAs) that were carried out for a sample of cemetery records. The diagnostic indicators of the lay diagnoses were then used to provide estimates of the share of AIDS-attribuTable mortality. The verbal autopsy results provide an independent estimate of the percentage of AIDS deaths. From a total of 21,274 burial records, 2546 hospital discharge diagnoses, 1480 outcomes of autopsies and 200 adult verbal autopsies were gathered over a period of 1 year starting from February 2001. Independent of the gold standard, lay diagnoses such as lung disease and cold have a specificity of about 90% and a combined sensitivity of about 55% in determining AIDS mortality. Without a significant loss in specificity, the sensitivity increases to 60-65% when diarrhoea, TB, herpes zoster and mental or nerve problem are included. We thus conclude that even in the presence of a reluctance to talk of HIV/AIDS, lay diagnosis of causes of death can be used for monitoring AIDS mortality. Lung disease and cold, in particular, have become well-known euphemisms for AIDS in the community. The share of AIDS deaths in the adult population (20-54) is estimated at 68%, without noticeable differences between men and women. Our results confirm the high impact of HIV/AIDS on mortality as was estimated by epidemiological projections for Addis Ababa.
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PMID:Lay diagnosis of causes of death for monitoring AIDS mortality in Addis Ababa, Ethiopia. 1472 23

Pneumocysts have been detected in the sputum in patients with nonspecific lung diseases (56 +/- 2%), including those with acute (43 +/- 4%) and chronic (63 +/- 3%) pneumocystosis, in those with a severe course (70.8 +/- 8%); in those with a satisfactory condition (48 +/- 3%); in those with occupational hazards (78 +/- 7%) in smokers (56 +/- 7%); in those without occupational hazards (39 +/- 3%); in those with an inflammation in the upper lobe of the lung in the presence of pneumonia (84 +/- 7%), in cold (62 +/- 3%) and warm (48 +/- 4) seasons, in north (66 +/- 3%) and south (28 +/- 4%) regions. P. carini per ml of sputum numbers in the range of 165 +/- 15 to 195 +/- 25; that in upper lobar pneumonia is 330 +/- 55. In patients with HIV/AIDS, P. carini has been found in the sputum in patients infected with HIV parenterally (66 +/- 4%) and sexually (54 +/- 5%); cysts per ml of sputum number 240 +/- 20 and 200 +/- 20, respectively; the content of CD4+ per microliter of blood is 480 +/- 40 and 205 +/- 30, respectively.
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PMID:[Epidemiological characteristics of pneumocystosis in the Ukraine]. 1504 42

Zinc is an essential micronutrient for human growth, development, and immune function. Zinc deficiency impairs overall immune function and resistance to infection. Mild to moderate zinc deficiency can be best detected through a positive response to supplementation trials. Zinc supplementation has been shown to have a positive effect on the incidence of diarrhea (18% reduction, 95% CI: 7-28%) and pneumonia (41% reduction, 95% CI: 17-59%), and might lead to a decrease in the incidence of malaria. Zinc has also proven to decrease the duration of diarrhea by 15% (95% CI: 5-24%). Maternal zinc supplementation may lead to a decrease in infant infections. Studies assessing the role of zinc supplementation among persons with HIV, tuberculosis, and the common cold have not been conclusive. Two studies have shown zinc supplementation to decrease child mortality by more than 50%. Zinc clearly has an important role in infant and childhood infectious diseases; programs to increase the intake of zinc among deficient populations are needed.
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PMID:Zinc and the risk for infectious disease. 1518 21

Herpesviruses cause a wide variety of human diseases ranging from cold sores and genital herpes to encephalitis, congenital infections and lymphoproliferative diseases. These opportunistic viruses cause major problems in immunocompromised individuals such as transplant recipients, cancer patients, and HIV-infected persons. The current treatment of these infections is not optimal and there is a need for more active, less toxic compounds that might be used in place of or in addition to current therapies. We have evaluated a new series of 4-oxo-dihydroquinolines, which have a different mechanism of action than nucleosides and have activity against multiple herpesviruses. Of the four new compounds evaluated, two (PHA-529311 and PHA-570886) had greater activity than the parent, PHA-183792, against several herpesviruses and one (PHA-568561) was as effective as the parent. A fourth, PHA-243672, was considerably less effective. They had greater efficacy against cytomegalovirus (CMV) than the other herpesviruses tested and also had activity against acyclovir-resistant herpes simplex virus and varicella-zoster virus isolates and ganciclovir or foscarnet-resistant CMV isolates. These results confirm the broad-spectrum efficacy of these compounds against multiple herpesviruses and suggest that members of this class may have a potential role for treatment of a variety of herpesvirus infections.
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PMID:Inhibition of herpesvirus replication by a series of 4-oxo-dihydroquinolines with viral polymerase activity. 1570 36

The rhinoviruses that are instrumental in causing about one-third of the outbreaks of the common cold present us with some 100 or so serotypes whose convalescent sera do not cross-neutralise. A similar situation prevails with the organism that causes gonorrhoea. Both the HIV and the protozoan causing malaria are notorious for their ability to evade the immune system by changes to their antigenic profile. Similarly, we face continual changes in the antigenic determinants of the influenza virus. It is clear that we require vaccine for these diseases that provide protection against a wide variety of basic variants. This can be achieved, as was shown by Arvind Kumar, who, in his PhD project, generated monoclonal antibodies to cross-reacting yet neutralising epitopes of a number of rhinoviruses. Such antibodies also neutralised some Coxsackie viruses as well as some of the types of Poliovirus. This demonstration of feasibility will be explored further in my paper with a view to arriving at a general approach to the production of vaccines whose humoral and cellular responses can neutralise a wide cross-section of serotype variants.
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PMID:On the need for, and the delivery of, cross-protective vaccines. 1575 65

Over the past two decades, HIV diagnostics have been essential in detecting and monitoring infection, and continue to play a major role in saving lives throughout the world. As technology evolved, screening, confirmatory, and HIV monitoring assays have been improved and offer better alternatives to address blood screening, surveillance, diagnosis, and patient management. Molecular methods are critical in detecting early infection and for managing patients on anti retroviral therapy whose viral infection may become resistant to therapy. In addition, modifications to conventional methods have introduced new assays, such as sensitive/less sensitive (detuned) assays that can estimate when someone was infected, thereby providing a useful tool for epidemiologic incidence estimates and enrollment into specific intervention programmes for recently infected persons. Many of the newly evolving technologies are essential for use in resource-limited countries because they can address cost issues, limited infrastructure, and a lack of formally trained personnel. Newer rapid HIV kits can be stored in a wide range of temperatures (2-30 degrees C) to address cold-chain issues, can use easily-collected fingerstick blood and oral fluids, and have one-step procedures that are relatively foolproof. Manual CD4 lymphocyte count assays that require only a light microscope and haemacytometer and more simple assays to estimate viral load are appropriate for developing countries where sophisticated instrumentation cannot be supported. Technologic advances with HIV diagnostics continue to address outstanding and new issues associated with diagnosis and the monitoring of infection by providing more simplified, cost-effective, and accurate testing throughout the world.
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PMID:HIV testing technologies after two decades of evolution. 1581 61

The gamma interferon (IFN-gamma)-inducible protein 30 (IP-30) signal peptide -11 to -3 (LLDVPTAAV) is a prominent self peptide expressed with the class I human histocompatibility leukocyte antigen A2 (HLA-A2). Stimulation of peripheral blood mononuclear cells (PBMC) from HLA-A2 human immunodeficiency virus type 1 (HIV-1)-infected individuals with an HLA-A2-restricted HIV protease (PR) peptide 76-84 (LVGPTPVNI) activated cytotoxic T lymphocytes (CTL) against the IP-30 signal peptide. Since HIV-1 PR 76-84 stimulated CD8+ T cells from these individuals to secrete IFN-gamma, we tested whether the activation of IP-30-specific CTL in vitro resulted from T-cell cross-reactivity or from up-regulation of IP-30 by IFN-gamma. Neither high levels of exogenous IFN-gamma nor incubation of PBMC with other HIV peptides triggering substantial IFN-gamma release activated IP-30-specific CTL. Although the IP-30 signal peptide did not stimulate IFN-gamma release from freshly isolated PBMC, it activated CTL in vitro against itself and HIV PR 76-84. Peptide-stimulated IFN-gamma release, cold target inhibition, and HLA-A2/immunoglobulin dimer-mediated binding and depletion of effector cells all indicated that in vitro stimulation with HIV PR 76-84 or the IP-30 signal peptide activated a comparable population of cross-reactive effector cells. Neither IP-30 nor HIV PR 76-84 activated CTL against themselves following in vitro stimulation of PBMC from non-HIV-infected HLA-A2 individuals. Peptide titrations indicated higher-avidity T-cell interactions with HIV PR 76-84 than with the IP-30 signal peptide. These data indicate that HIV PR 76-84 is a heteroclitic variant of the IP-30 signal peptide -11 to -3, which has implications for immune memory and autoimmunity.
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PMID:Cross-reactive cytotoxic T lymphocytes against human immunodeficiency virus type 1 protease and gamma interferon-inducible protein 30. 1582 67

Cold urticaria is defined as a urticarial and/or angioedematous reaction of the skin to contact with cold objects, water or air. Types of urticaria associated with infectious diseases, such as mononucleosis, rubeola, varicella, syphilis, hepatitis, and HIV infection have been reported. We present the case of a patient who developed cold urticaria associated with acute serologic toxoplasmosis. The patient was a 34-year-old man who for the previous 2 months had presented cutaneous pruritus accompanied by several papular lesions in parts of the skin exposed to cold as well as those in contact with cold water. The result of an "ice-cube test" was positive. Serologic tests for Toxoplasma gondii showed an IgG level of 68 UI/ml and were positive for IgM, while a test for cryoglobulins was positive. One month later cryoglobulins were negative and a serologic test for T. gondii showed an IgG concentration of 75 UI/ml and positive IgM. Three months later cryoglobulins were still negative, IgG for T. gondii was 84 UI/ml, and IgM was positive. After 6 months cryoglobulins were still negative, IgG level was 68 UI/ml and IgM was still slightly positive. In the final evaluation, 14 months later, IgG level was 32 UI/ml and IgM was negative. The patient continues to present clinical manifestations of cold urticaria, although he has experienced some improvement and his tolerance to cold has increased after treatment with cetirizine.
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PMID:Cold urticaria associated with acute serologic toxoplasmosis. 1594 32

The survey (EPD) took place during December 2002-January 2003 and presents renal care in Greece. A questionnaire, structured at European level and translated into Greek, was sent to all dialysis centres (114) by post. The questionnaire was returned from 74 centres (64.9%). Some important results were: low use of peritoneal dialysis (13.3%), half of PD patients over 65 years old, one ninth of patients on transplantation waiting list, isolation for HBV positive patients (less for HCV and HIV), high use of AV fistulae (71.2%), maintenance and repair of dialysis machines by company technicians, absence of renal dieticians and social workers (but availability from hospital employees) one nurse every 5.54 patients (3.72 if nurse assistants are included), disinfection between shifts carried out chemically (hot or cold) and puncturing of vascular access performed mainly by nurses and nurse assistants. Data can be used to pressurise government for more scientists in the multidisciplinary team to be hired in hospitals, develop further research topics and to develop continuous education programmes.
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PMID:European practice database: results from Greece. 1608 28

In most low-income countries, clinical assessment is the only tool available to distinguish an upper respiratory infection (cough or cold) from pneumonia requiring antibiotics. The severity of the pneumonia, determined from the clinical signs, will determine which patients require more potent antibiotic regimens and supplementary oxygen. Careful assessment of the respiratory rate, chest in-drawing, ability to feed normally, cyanosis and level of consciousness are used to make the diagnosis of pneumonia and determine the severity. Co-morbid disease such as malnutrition, measles, HIV infection and malaria increase mortality due to pneumonia, and signs of these diseases must be looked for so that appropriate treatment can be started. This article carefully describes the signs that should be looked for in children presenting with a cough or difficult breathing to any health care worker.
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PMID:Assessing the child with cough or difficult breathing. 1610 27


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