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 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective study of the neurological problems arising in HIV-I seropositive patients in a single defined geographical area was undertaken. Ninety patients were referred for a neurological opinion from a total known HIV-I seropositive population of 436. Minor problems were frequently encountered early in the course of disease (20 at CDC stage II, 12 at CDC stage III), including seizures related to drug abuse in six. The most frequent neurological problem in those patients in CDC group IV (58 patients) were the AIDS dementia complex (14 patients), an axonal sensorimotor neuropathy (12), toxoplasmosis (nine) and cryptococcal meningitis (three). All patients with a structural lesion had appropriate focal signs on examination. The value and role of CT cranial scanning in the diagnosis of toxoplasmosis is discussed and the importance of recognizing potentially treatable causes of both intellectual impairment and cytomegalovirus-related neuropathies is stressed. This is the first report of an unselected series of patients at all stages of HIV-I related neurological disease from a single UK centre.
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PMID:The neurological features of HIV-positive patients in Glasgow--a retrospective study of 90 cases. 132 56

We studied 100 unselected parenteral drug abusers for infection with hepatitis C, B, A and D virus (HCV, HBV, HAV and HDV). Seventy-six percent had serological evidence of HCV infection. 12% were positive for HBsAg and at least one marker of HBV infection was present in 69%. These results were significantly higher than in a matched control population. Compared to controls, the prevalence of anti-HAV (65%) was not significantly increased in drug addicts. Of the anti-HCV-positive drug addicts, 80.3% had at least one marker of HBV infection compared to 33.3% of anti-HCV-negative cases (p less than 0.001). No such correlation was found between the prevalence of HCV or HBV infection markers and the presence of anti-HAV. Antibodies against HDV were detected in 16 (16%) of the samples from drug addicts. No significant association was found between antibodies to HCV and gender, age and duration of drug abuse. The risk of HBV infection increased significantly with years of drug abuse but was not associated with age and sex. The presence of anti-HAV was related to age only. Sixteen (16%) of the subjects were definitely positive for anti-HIV-1, but at the time of the study they were asymptomatic. No significant association was found between the presence of anti-HIV and the prevalence of serological markers of HBV, HCV, HAV and HDV infection.
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PMID:Prevalence of markers of hepatotropic viruses among drug addicts in Warsaw, Poland. 132 68

While much of the current literature concurs that neuropsychological decline does not occur among gay men in the early stages of HIV infection, there is no comparable body of evidence with regard to seropositive intravenous drug users (IVDU). In this study, 45 seropositive (CDC groups 2, 3, and 4a) IVDU in recovery and 55 seronegative IVDU in recovery were given a complete battery of neuropsychological tests measuring attention, language, visual-motor, memory, and conceptual skills. The groups were not significantly different in age, incidence of childhood and adult head injury, types of drugs used, length of use of cocaine, crack, amphetamines and hallucinogens, overdose history, and length of time in recovery. In addition, groups were statistically corrected for education level and length of heroin use. Results indicate that the seropositive participants scored significantly lower on measures of divided attention, visual short-term memory, graphomotor speed and accuracy, auditory language shortterm memory and abstract concept formation. Further analyses revealed that 18% of participants with Persistent Generalized Lymphadenopathy (CDC group III) and 27% of those with constitutional disease (CDC group IVa) were neuropsychologically impaired, as their performance was two standard deviations or more below the normative mean on two or more measures. These results are similar to the reported performance of gay men with full-blown AIDS in a number of studies. It is hypothesized that because of premorbid neurological insult, the toxic effects of drug abuse on brain tissue, and the immunosuppressive effects of the drugs, subcortical brain cells of IVDU are more vulnerable to the invasion of HIV, and neurological deterioration may occur at earlier stages of HIV Spectrum Disease in IVDU than in gay men.
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PMID:Neuropsychological impairment among intravenous drug users in pre-AIDS stages of HIV infection. 134 38

Kaposi's sarcoma (KS) is an uncommon cutaneous neoplasm with an increased incidence among Jews and Italians of Europe and North America and Negroes of equatory Africa. In recent years, several cases have been diagnosed in AIDS patients and in patients who have undergone organ transplantation or received immunosuppressant treatments. We have diagnosed five cases of KS over a 3-year period in our department. They include four men and one women, aged from 58 to 79 years, and who were born and had lived in Tainan. They all denied a history of homosexuality, multiple sexual partners, or drug abuse. HIV (Human immunodeficiency virus) screening test were negative. Two patients had taken 'black pills' (usually containing steroids) for a long period of time and also had generalized dermatophytosis. One of these two patients had a cytomegalovirus infection and died of Salmonella septicemia and upper GI bleeding. Although the English literature seems to indicate that KS is rare among Asians. Our present experience coupled with two other recently reported cases from Taiwan and the unpublished observations of some other dermatologists suggest that KS is not all that rare in Taiwan.
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PMID:[Kaposi's sarcoma in Tainan: report of five cases]. 135 63

In a sample of 55 consecutive methadone maintenance admissions to our clinic, 42% were diagnosed with antisocial personality disorder (ASPD) using the National Institute of Mental Health Diagnostic Interview Schedule NIMH DIS. Individuals with ASPD exhibited greater risk for HIV infection as defined by more sexual contacts, needle use and equipment sharing. Data at 1 year follow-up were obtained on this group of patients. The objective was to compare the ASPD and non-ASPD groups with regards to demographics, drug abuse history, outcome and retention in treatment. There were no significant differences between the groups on any demographic or treatment outcome variables. Survival analysis indicated that there were no group differences in treatment retention. In conclusion, although there were no differences in treatment outcome between ASPD and non-ASPD groups it is possible that ASPD patients who drop out of treatment will be at higher risk for contracting and spreading HIV within the IV drug using population. These data also suggest that in this population the diagnosis of ASPD using primarily behavioral traits as measured in the NIMH-DIS-III, has little utility in predicting treatment outcome.
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PMID:Antisocial personality disorder, HIV risk behavior and retention in methadone maintenance therapy. 139 6

Responsibility for many of the problems of intravenous drug abuse and human immunodeficiency virus (HIV) infection lies with community care agencies, such as general practitioners, community psychiatric and district nurses and drug agencies. It is in general practice that this burden is most clearly observed, given that general practitioners are in charge of the day-to-day care of patients. In an attempt to quantify this workload in an inner city practice with 11,200 patients, data were gathered from several sources relating to drug use and HIV infection. The study identified 432 patients who had consulted with problems of drug abuse and/or HIV infection over the period 1981-90. Among this group of patients 161 (37%) were HIV antibody positive. Among 191 drug abusers who were still registered with the practice in 1990 dihydrocodeine was the most commonly prescribed substitute treatment (130 patients) and only nine patients were prescribed methadone. Forty seven per cent of drug users continued to inject drugs occasionally. However, analysis of urine samples revealed that there was a shift away from injecting mainly heroin to multiple drug use, including benzodiazepines, usually originating from prescribed sources. Drug abusers who were HIV positive consulted their general practitioner significantly more often over one year than those who were not (mean 24.9 versus 15.8 consultations, P < 0.01). However, there was no significant difference between these two groups in terms of days spent in hospital. A total of 61 patients were referred to a community psychiatric nurse over an eight month period.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Problems of drug abuse, HIV and AIDS: the burden of care in one general practice. 129 50

Alarming proportions of teenagers in Greenland start to have sex early in life, sleep with multiple partners, and do not use condoms regularly. There is a rather relaxed attitude toward casual sex among the general population in Greenland. There exists a commensurately high incidence of gonorrhea, syphilis, cervical cancer, and other sexually transmitted diseases. 8000 new cases of gonorrhea were diagnosed in 1987, but only 2000 new cases have been diagnosed annually since 1990. This latter incidence is still high for the total population of 55,000 which resides in scattered settlements along the west coast of the protectorate. Greenland is at high risk for a heterosexual HIV epidemic. Thus far, Greenland has benefited by a late introduction of HIV to the society, lack of drug abuse, few opportunities for homosexual contacts, good communication and information systems, good schools, and good health care. As of September 1991, 32 HIV-seropositives had been identified from a serosampled population of 18,000; 11 of the positives were female. Studies of youth's knowledge and sexual behavior were conducted in 1988 and 1989. This repeat study surveyed all students in vocational training and all 10th graders in public schools in April 1991 through self-administered questionnaires. The group of 1201 student respondents represents 85% of all individuals in the target groups. It should be pointed out that 10th grade is the last mandatory year of the elementary school system in Greenland and that 461 respondents were under age 18 and 740 were 18 years or older. 83% had had their sexual debut. Among the sexually experienced, 54% reported first having sex before the age of 15 years. 17% of males and 11% of females reported having more than 10 sex partners in the previous year. 26% of males and 42% of females reported more than 15 intercourses per month. Consistent or most of the time use of condoms was, however, reported by only 29% of males and 24% of females. Compared to earlier surveys, the age of sexual initiation declined and respondents reported both a greater number of sex partners and a higher frequency of sexual intercourse. Denmark, yet residing in Greenland. These findings indicate that while 5 years of intensive education and prevention campaigns have succeeded in improving health personnel, teacher, and student knowledge about AIDS, no marked change has taken place in the sexual habits of the young. It is, therefore, concluded that an AIDS prevention campaign must not be based exclusively upon the promotion of condom use, but should aim to stop the decline in age of sexual debut, reduce the degree of excessive sexual promiscuity, and address alcohol abuse. These steps must be taken now to had off a self-sustained HIV epidemic as the prevalence of HIV grows in this population.
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PMID:An update on knowledge and sexual behaviour among students in Greenland. Monitoring of the stop-AIDS campaign. 148 52

Prevalence of markers of HBV infection was tested in two cohorts of drug addicts: in 140 addicts whose sera were drawn in the years 1985-1986 and in 100 addicts whose sera were drawn in the years 1988-1989. HBsAg was found in 10 (7%) patients in the earlier cohort and in 12 (12%) addicts in the latter, while at least one marker of HBV infection was present in 39% and 69%, respectively No correlation was found between the presence of markers of HBV infection and age, gender, or HIV status, however, duration of drug abuse increased the risk of HBV infection. There was no difference in mean titres of anti-CMV and anti-HSV-1 between subjects with and without HBV markers what suggests that the tested markers were specific.
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PMID:[Markers of HBV infection in drug addicts]. 152 36

Health care workers in three AIDS hospital units in the Paris region were interviewed to analyse the issues related to the care of addicted HIV patients in the light of principles and practices regarding drug abuse treatment in France. Health care workers report a large variety of disruptive incidents involving some addicted in-patients. To deal with these difficulties, physicians advocate the separation of drug abuse treatment and HIV disease treatment. However, practices differ between the three settings regarding the management of patients. In two units, a contract is made with the patient covering general and specific rules of hospital stay and sanctions should the contract be broken. In the third unit, the use of such a contract is considered to be a continuation of drug abusers' stigmatization and an obstacle to the adoption of the 'sick role' by the addicted patient.
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PMID:Hospital care for drug users with AIDS or HIV infection in France. 152 4

The National Institute on Drug Abuse (NIDA), the lead Federal agency charged with research on reducing the demand for illicit drugs in the US, has actively pursued the associated challenge of reducing drugs-related HIV transmission. Drug abuse-related spread of the virus occurs not only through sharing contaminated needles but also sexually to partners and perinatally from infected mothers to their offspring. Through a national research and demonstration program, NIDA supports primary AIDS risk reduction activities focused on identifying effective drug abuse prevention and treatment strategies. AIDS is increasingly a disease found in women, children, minorities, and people who live in rural areas. NIDA's efforts are clearly responsive to the changing nature of this epidemic. Among the many promising initiatives currently underway are a medications development program to find new pharmacotherapies for treating drug addiction; an array of National AIDS Outreach Demonstration Projects implementing alternative control strategies for drug abusers not attracted to or successful in drug abuse treatment; establishment of several treatment research units for designing and conducting studies on treatment effectiveness; and a variety of programs aimed at identifying and potentially reducing the risks of prenatal drug use to both mother and child. Effective dissemination of our findings is particularly critical to the overall impact of our research efforts. Collaborative activities teaming NIDA with a multitude of organizations also addressing AIDS related issues are designed to provide a synergistic impact on this complex and multifaceted public health crisis.
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PMID:Drug abuse research and HIV/AIDS: a national perspective from the US. 155 34


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