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

Corynebacterium diphtheriae septicaemia is rarely encountered, usually in very particular situations: children with severe congenital heart disease or after heart surgery. Rare cases have been reported in immunodepressed adults or drug addicts. We observed a case in a formerly healthy 41-year-old woman who was hospitalized for fever unresponsive to bacampicillin. In this patient, no portal of entry could be identified; there was no history of past surgery nor drug abuse. The patient was not immunodepressed and HIV serology was negative. The last anti-diphtheria vaccination had been given at the age of 12 years. Corynebacterium diphtheriae var. metis was identified on five blood cultures. The in vitro Elek test revealed that the strain was non-toxic. Echocardiography did not show any signs until the fourth examination performed 1 month after onset of fever and 15 days after initiating effective adapted antibiotic treatment with amoxicillin-clavanic acid. Mitral vegetations with grade 2 regurgitation completely regressed after 5 weeks of treatment. After 5 months of follow-up, the patient is in good health and no mitral damage has been observed. This is to our knowledge the first case report of Corynebacterium diphtheriae in a formerly healthy adult. In the literature 12 other cases in adults all concerned immunodepressed subjects or drug abusers. The question is raised as to whether Corynebacterium diphtheriae is undergoing mutation. The germ could persist as a commensal host and explain a certain number of the recent observations in drug abusers and immunodepressed patients.
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PMID:[Non-toxic Corynebacterium diphtheriae septicemia with endocarditis in an earlier healthy adult. First case and review of the literature]. 789 17

The prevalence and incidence of left ventricular (LV) dysfunction was examined in patients infected with the human immunodeficiency virus (HIV). Sixty-nine randomly selected patients diagnosed with HIV infection who were followed in HIV clinics were prospectively evaluated by 2-dimensional echocardiography. Mean follow-up duration was 11 months. Additionally, 39 consecutive HIV-infected patients referred to the Cardiomyopathy Service and found to have LV dysfunction by 2-dimensional echocardiography were also studied. Of the 39 referred patients, 34 (87%) were referred for recent onset, unexplained, congestive heart failure. During this time, the HIV clinic population comprised 1,819 alive and actively followed patients; the 39 cardiomyopathy referrals therefore constituted a crude rate of 2.1% for this population. Of the 69 prospectively studied patients without clinical heart disease, a 14.5% prevalence of global LV hypokinesia and an incidence of 18%/patient-year were found. During a maximal 18-month follow-up period, 4 prospective patients (5.8%) developed symptoms of congestive heart failure. A greater proportion of prospective and referred patients with LV dysfunction had CD4 counts < 100/mm3 (62 and 79%, respectively) than did that of those without LV dysfunction (35%). In conclusion, the high rate of unexpected LV dysfunction in this HIV-infected population suggests that early cardiac contractile abnormalities may involve a significant number of patients, most of whom have low CD4 counts. A subgroup of these patients appears to progress to symptomatic congestive heart failure.
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PMID:Prevalence and incidence of left ventricular dysfunction in patients with human immunodeficiency virus infection. 846 88

Projection disease incidence, prevalence, and net morbidity is often needed when individuals are likely to die, either disease free or after the disease has developed. Examples of this include remission of cancer or heart disease in elderly people who can die from these or other causes and occurrence of a particular acquired immune deficiency syndrome illness in human immunodeficiency virus type 1 (HIV-1) disease. Death is not an ancillary event but, rather, indicates either and end to disease morbidity or an end to risk to ever develop the disease. Thus, time to disease survival analyses that censor disease-free individuals at death can produce misleading results. The paper describes several useful quantifications of disease and death for this setting. A paradigm that utilizes Kaplan-Meier functions to estimate these quantities is introduced. The approach anchors on a four-stage disease/death model: stage A, living without disease; stage B, dead without ever developing disease; stage C, developed the disease and living; and stage D, dead after developing the disease. An application is made to projecting cytomegalovirus disease in a cohort of HIV-1-infected users of zidovudine and Pneumocystis prophylaxis from the Multicenter AIDS Cohort Study (MACS) during 1989-1993. At 3 years after a CD4+ count below 100/microliters, a man had an 18.7%, 46.3%, 5.3% or 29.9% chance, respectively, to be in stage A, B, C, or D. This man, on average, had 0.28 years of cytomegalovirus morbidity during these 3 years.
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PMID:Projecting disease when death is likely. 861 Jul 8

Heart disease is common in HIV, but often asymptomatic. As improved therapies prolong the lives of HIV-infected patients, an increase in symptomatic heart disease can be expected.
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PMID:Managing HIV. Part 5: Treating secondary outcomes. 5.9 HIV-related cardiovascular disease. 861 40

The objective was to describe the extent to which HIV infection has become a major cause of death among young adults in Denmark. The design used was retrospective review of underlying causes of death recorded in the National Danish Register of Causes of Death on the basis of submitted death certificates. Analysis of mortality statistics revealed, that from 1980 to 1993 AIDS became the 5th leading cause of death among men 25 to 49 years of age in Denmark after cancer, accidents, suicide and heart disease. AIDS among women had little impact on the vital statistics in the period. In the municipalities of the City of Copenhagen AIDS was the major cause of death among men already from 1990 and in 1993 death from AIDS comprised 25% of all causes (n = 107, death rate = 88/100,000). The rising rates of deaths attributed to AIDS among younger men show no sign of decreasing neither in the capital nor in the country as a whole.
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PMID:[AIDS--the leading cause of death among young adult men in Copenhagen and Frederiksberg]. 865 Aug 13

As more effective therapies have produced longer survival times for HIV-infected patients, non-infectious complications of late stage HIV infection such as the development of severe global left ventricular dysfunction (dilated heart muscle disease) have emerged. The demographic and clinical characteristics of HIV-infected patients who develop dilated heart muscle disease as well as potential risk factors are, as yet, poorly characterized. Of 174 patients enrolled in a prospective longitudinal study, a total of nine patients, all with CD4 T cell counts < 200 mm-3, developed symptomatic heart disease (congestive heart failure n = 7, sudden cardiac death n = 1 and cardiac tamponade n = 1); three of these patients developed progressive cardiac dysfunction leading to primary cardiac failure and death. An additional 55 HIV-infected patients referred to our Cardiomyopathy Service were found to have global left ventricular dysfunction, with 84% having New York Heart Association Class III or IV congestive heart failure on presentation. Clinical characteristics associated with severe symptomatic cardiac dysfunction included low CD4 T cell counts, myocarditis associated with non-permissive cardiotropic virus infection on endomyocardial biopsy and persistent elevation of anti-heart antibodies. No relationships to any specific HIV risk factor or opportunistic infection were found. These findings suggest that a severe form of HIV-related dilated heart muscle disease is largely a disease of late stage HIV infection. Virus-related myocarditis and cardiac autoimmunity may play a role in the pathogenesis of progressive cardiac injury. Long-term longitudinal studies of larger HIV-infected cohorts are warranted to identify clinical, behavioral and immunologic risk factors.
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PMID:Dilated heart muscle disease associated with HIV infection. 868 2

Between 1939 and 1994, nine cases of Chagas disease have been reported in French Guiana: seven in the acute phase including two that were fatal and two in the chronic phase with cardiac sequellae. A tenth case of transient parasitemia was described but the patient's clinical status was not mentioned. Screening by xenodiagnosis revealed one subclinical infection. Heart disease is a highly specific manifestation of Trypanosoma cruzi infection, this being consistent with the known presence of zymodeme 1 in the sylvatic reservoir and reduviid vectors. The low incidence of positive serology (0.7% in a group of 740 subjects in whom serum samples were tested by indirect immunofluorescence) indicates that the disease is not currently becoming endemic. The main animal reservoirs for infection are small land marsupials (Didelphis marsupialis being the most frequently infected) and edentata especially armadillos (Dasypus novemcinctus). A peridomestic cycle, implicating D. marsupialis and Philander oppossum, plant-eating marsupials, with Rhodnius pictipes as the vector is highly active. Further study is necessary to ascertain another mechanism involving R. prolixus as a vector in dwellings in urban areas. Outbreaks require careful epidemiologic surveillance. French Guiana should no longer be considered as an enzootic area but as an area of risk for sporadic Chagas disease with epidemiologic features similar to those of the disease in dense Amazon forest areas. Appropriate measures must be taken to screen and promptly manage Chagas disease in the population. Special care is needed for concurrent HIV-T. cruzi infection due to the severity of this combination. Preventive measures are also needed to preclude transfusional infection.
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PMID:[Trypanosoma cruzi in French Guinea: review of accumulated data since 1940]. 876

The present article provides an overview of epidemiological studies in Japan. The origin of modern epidemiology of Japan can be traced back into the late 19th century. Baron K. Takaki at that time made brilliant epidemiological studies on beriberi and was thus able to eradicate the disease long before vitamin B1 deficiency was identified as the cause of the disease. Epidemiological studies really began to flourish in Japan after the end of World War II. Since the most of infectious diseases have been controlled, epidemiological studies on cancer, heart disease, stroke, and other chronic diseases have become the main target of investigations. It may be cautioned that, among infectious diseases, tuberculosis is still a serious health problem today and HIV infection has become a threatening health issue although the number of AIDS patients reported was still about 1,000 for the whole country in 1995. In contrast to other industrialized countries, heart disease is far less common in Japan, probably reflecting still not-too-rich diet among Japanese. There are a number of unique or unusual epidemiological studies in Japan, including a long-term surveillance of those who were exposed to A-bomb irradiation in 1945. Readers are encouraged to refer to detailed description of each, specific topic presented in this volume. Essential vital statistics are also presented as background information of epidemiological studies in Japan.
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PMID:Epidemiological studies in Japan. 880 Feb 69

Approximately 14 million persons worldwide are estimated to be infected with HIV-1. As more effective therapies have produced longer survival times for HIV-infected patients, new complications of late-stage HIV infection including HIV-related heart disease have emerged. The most common and life-threatening cardiovascular complication of HIV infection is the development of primary heart muscle disease associated with severe global left ventricular dysfunction (also termed cardiomyopathy). Other less common forms of symptomatic heart disease in HIV-1-infected patients are pericardial effusion with cardiac tamponade, high-grade arrhythmia with sudden cardiac death, and systemic embolization caused by nonbacterial thrombotic endocarditis or infective carditis. The demographic and clinical characteristics of HIV-infected patients who develop cardiomyopathy as well as potential enhancing risk factors are as yet poorly characterized. This review briefly describes the various presentations and potential causes of symptomatic HIV-related heart disease and discusses the challenge facing clinicians who evaluate HIV-infected patients presenting with serious cardiac manifestations of their disease.
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PMID:Cardiomyopathy and other symptomatic heart diseases associated with HIV infection. 883 75

A.B.R. was employed to examine auditory pathways in a group of 78 newborn infants at risk and one of 20 normal infants. The impaired newborn group suffered of various risk factors or pathologies: 20 premature infants, 12 undersize (small for date), 12 with breathing distress, 11 hiv positive, 5 with neonatal jaundice, 4 suffered of convulsion, 4 at risk for hereditary deafness, 4 born by mothers with mellitus diabetes, 2 with dolichocefalia, 1 with the Albers-Schomberg syndrome, 1 with congenital heart disease and 1 with congenital glycogenosis. The results of A.B.R. of the risk group were compared statistically employing the "t Student's test" with those of the group of normal infants. The influence of risk factors in the first group on alterated A.B.R. parameters was then examined using a step-by-step logistic regression analysis method. The result showed a significant increase in a latency of waves V and III and inter-waves I-V and III-V in risk infants, while wave I and I-III internals were normal. These findings appear to demonstrate that in infants at risk, brainstem acoustic pathways are more sensitive to damage than the cochlea and acoustic nerve. This could be explained by the different degree of maturation that exists between the central acoustic pathways and the coclea and acoustic nerve. Analysis of the influence of pathologies and risk factors on A.B.R. indicate that birth weight followed by chronological age and length of the gestation period are significant in the development of A.B.R. alterations. The Albers-Schomberg syndrome, dolicocephalia, microcephalia, congenital glicogenosys, hiv infection, breathing difficulty and neonatal jaundice proved to be the main pathologies responsible for bringing about A.B.R. alterations.
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PMID:[The study of factors affecting ABR in high risk newborn infants]. 892 57


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