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

In most countries throughout the world, except those affected by the HIV-Aids epidemic, populations are increasing in size, rapidly getting older, and becoming more sedentary. This combination, along with the adoption of unhealthy habits such as cigarette smoking and consumption of an animal-based rather than a plant-based diet, will result in chronic degenerative diseases becoming the most common cause of disability and premature death throughout the world during the first twenty-five years of this new millennium. As more and more populations acquire the technology that reduces the need to exercise for transportation, occupation or maintaining a household, lack of activity quickly becomes a major risk for coronary heart disease, stroke, hypertension and noninsulin dependent diabetes mellitus. This lack of activity appears to contribute to other disorders such as osteoporosis and selected site-specific cancers. In older persons, inactivity can become a major reason for loss of physical independence and a reduction in their quality of life. Public health approaches will be needed to reverse this trend of increasing "hypokinetic" diseases as the computer/communication revolution becomes worldwide. These public health programs will need to be supported by government and corporate changes in policies that provide time, facilities and incentives for maintaining an appropriately active life-style. The goal should be for all adults to perform at least 30 minutes of moderate to vigorous intensity exercise on most days.
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PMID:[Sports, exercise and health. On the way into a new century]. 1114 77

The relationships between periodontitis and systemic disease and conditions, environmental factors, and behavioral influences are evolving rapidly. Success in preventing and treating periodontal diseases may well rest to a large extent on our understanding of the relevant influences which may exacerbate and perpetuate the disease process. As researchers work to clarify these relationships, we as practitioners must continue to alter our treatment in the best interests of the patient's overall health. The impact of recent findings on the development and progression of periodontitis relevant to diabetes mellitus, HIV, genetic susceptibility, smoking, stress, and osteoporosis is reviewed.
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PMID:Periodontitis--the risks for its development. 1119 18

The Society for the Advancement of Women's Health Research reports that women are more likely to have autoimmune diseases, osteoporosis, and sexually transmitted diseases than men. For example, women are 10 times more likely to contract HIV through unprotected intercourse with a partner who is infected. Further research will determine the significance of these differences.
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PMID:Some ailments found guilty of sex bias. 1136 95

Total body bone mineral content (TBBMC) was measured by dual energy x-ray absorptiometry in a cross-sectional study of 51 prepubertal HIV-infected children and 262 healthy prepubertal children aged 4.2 to 14.7 years. The mean TBBMC +/- SD was lower in HIV-positive children than in HIV-negative controls (955 +/- 325 vs. 1,106 +/- 273 g, respectively; p =.0006). Reductions in TBBMC remained in the HIV-positive group after adjusting for age, sex, and race by analysis of covariance (p <.001). Differences in TBBMC between HIV-positive and HIV-negative groups persisted when height and weight were also accounted for in the analysis (p =.027). The magnitude of the difference in TBBMC between the groups increased with age. In the HIV-positive group, no associations were observed between TBBMC and use of a protease inhibitor, duration of treatment with antiretroviral medications, viral load, or CD4 cell count. TBBMC is decreased in HIV-infected children. As a result of compromised bone mineral accrual, HIV-infected children may be at increased risk for osteoporosis and related complications.
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PMID:Bone mineral content is lower in prepubertal HIV-infected children. 1198 60

Numerous anecdotal reports, clinical observations, and newly published studies provide evidence of the growing interest and concern about body shape changes and metabolic complications seen in HIV infection. At first believed to be a single complication caused by the protease inhibitor class of antiretroviral therapy, the focus of research is shifting to distinct syndromes with multiple causes. In this unfolding story, peripheral fat atrophy, central fat accumulation, dyslipidemia, and glucose disregulation characterize the more commonly recognized syndromes. Osteoporosis and osteopenia have been recently observed. While the etiologies await discovery, the long-term consequences of these metabolic changes demand the expertise of clinicians not formerly considered "front-line" in HIV/AIDS treatment, such as orthopaedic nurses.
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PMID:Metabolic complications of HIV and AIDs. 1202 72

There are a growing number of reports of bone problems (avascular necrosis and osteonecrosis) among people with HIV. These problems are caused by a lack of blood supply in the bone, which leads to the deterioration and death of bone tissue. Generally, bones try to repair themselves. But bones that support a lot of weight, like the hip, can weaken when this condition occurs. This may cause the bone to fracture or collapse. This condition can also lead to severe pain and inflammation or overgrowth of bone in and around the joints (osteoarthritis). While still relatively uncommon, people should be aware of reports of avascular necrosis that have led to hip fracture or dislocation. Symptoms of pain associated with avascular necrosis also commonly affect the shoulder and/or knee. Avascular necrosis is different from osteoporosis, a general term for a progressive loss in bone density that results in skeletal (bones that make up the framework of the body) weakness.
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PMID:Bone problems. 1217 Oct 7

Much attention has been paid to the emerging complications of HIV infection in patients receiving HAART. Recently, there emerged a potentially increased risk of bone problems like osteopenia, osteoporosis and osteonecrosis as patients live longer. It could be a drug side effect, a consequence of prolonged exposure to HIV and/or activated immune cells characteristic of HIV infection, or a consequence of immune system changes that accompany suppression of virus by the drugs. Future research should focus on the etiologic mechanisms, define the incidence and prevalence prospectively, determine the relationship with HAART (especially the rule of protease inhibitors), and help to guide management. Only when the mechanism for HIV-related versus HAART-related changes can be defined, will we be much closer to designing specific interventions.
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PMID:HIV-1, HAART and bone metabolism. 1217 83

There has been significant concern that the dental curriculum and system of clinical education, in particular, is not designed to take advantage of the explosion in knowledge in biomedical science and its application to the health of the public. Although there are some examples of innovations in dental education on a global scale that have the capacity to increase the assimilation of basic and clinical knowledge, most of the dental education models are mired in the traditional '2 + 2' approach to education. This can be seen in North America and the European '2 + 3' model or the stomatological '4 + 2' approach. In each of these systems, the basic and behavioural science courses continue to be perceived as hurdles over which students must leap in order to reach the clinical programmes where there is little opportunity to use basic science information to advance patient care and treatment. Examples of issues that are not well represented include: innovations in imaging; diagnosis; bio-materials; science-based approaches to clinical practice; novel approaches to therapeutics; interactions between the oral, dental and craniofacial complex and systemic health and disorders; the role of oral infections and systemic disease; the increasing appreciation of chronic diseases and disorders such as osteoporosis and diabetes that affect oral tissues; the promise of bioengineering, tissue engineering and biomimetics; the potential use of saliva as a diagnostic tool; the understanding of oral complications of cancer treatment; the treatments of HIV/AIDS diseases and hepatitis; the use of dental and dental hygiene staff on health-care teams to deal with issues such as birth defects, orofacial trauma, head and neck cancer, chronic pain management and so on. There seems to be an excessive emphasis on restorative dentistry and, to a lesser extent, on the more biological approaches to diagnosis, prevention and therapeutics. This continued lack of integration of basic and clinical sciences in the curriculum continues to foster a dental workforce that is highly technically competent to provide specific clinical services but poorly equipped to evaluate and implement new biological approaches to diagnosis, therapeutics and intervention. Unfortunately, after many attempts by organized dental symposia aimed at the integration of basic and clinical sciences, there has been little discernible curricular change. It appears that there is an opportunity through this global congress to identify the best practices in the various global curricula that could change this paradigm in dental education and lead us toward the education of a more scientifically orientated practitioner-one who can take advantage of innovations in new and emerging technologies in their application to patient care. It is the challenge of this section to try to ascertain the best method or methods by which dental education promotes research to the dental student and what research represents in terms of critical thinking and evidence-based approaches to dental education and clinical practice.
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PMID:1.4 Research and the dental student. 1239 Feb 58

Lung cancer is associated with smoking and age, both of which are associated with comorbidity. We evaluated the impact of comorbidity on lung cancer survival. Data on 56 comorbidities were abstracted from the records of a cohort of 1,155 patients. Survival effects were evaluated with Cox regression (outcome crude death). The adjusted R(2) statistic was used to compare the survival variation explained by predictive variables. No comorbidity was observed in 11.7% of patients, while 54.3% had 3 or more (mean 2.97) comorbidities. In multivariate analysis, 19 comorbidities were associated with survival: HIV/AIDS, tuberculosis, previous metastatic cancer, thyroid/glandular diseases, electrolyte imbalance, anemia, other blood diseases, dementia, neurologic disease, congestive heart failure, COPD, asthma, pulmonary fibrosis, liver disease, gastrointestinal bleeding, renal disease, connective tissue disease, osteoporosis and peripheral vascular disease. Only the latter was protective. Some of the hazards of comorbidities were explained by more directly acting comorbidities and/or receipt of treatment. Stage explained 25.4% of the survival variation. In addition to stage, the 19 comorbidities explained 6.1%, treatments 9.2%, age 3.7% and histology 1.3%. Thirteen uncommon comorbidities (prevalence <6%) affected 21.2% of patients and explained 3.5% of the survival variation. Comorbidity count and the Charlson index were significant predictors but explained only 2.5% and 2.0% of the survival variation, respectively. Comorbidity has a major impact on survival in early- and late-stage disease, and even infrequent deleterious comorbidities are important collectively. Comorbidity count and the Charlson index failed to capture much information. Clinical practice and trials need to consider the effect of comorbidity in lung cancer patients.
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PMID:Impact of comorbidity on lung cancer survival. 1251 1

To provide an overview of the epidemiologic parameters of emerging adverse effects associated with antiretroviral therapy for human immunodeficiency virus (HIV) disease. All available antiretroviral agents are associated with significant adverse drug effects. Of particular interest are newly emerging suspected adverse drug effects which were not generally noted in pre-marketing trials nor captured under current standard clinical care practices. Suspected antiretroviral toxicities meeting these criteria include: HIV-associated lipodystrophy which can include peripheral lipoatrophy, lipohypertrophy and metabolic abnormalities; hyperlactatemia and lactic acidosis; and metabolic bone abnormalities such as decreased bone mineral density, osteoporosis and osteonecrosis. Results of prospective and observational studies reported to date suggest that these abnormalities, while aetiologically complex, are likely attributable to treatment factors and may be intricately interrelated. The medical management of these symptoms remains unsatisfactory given the unexplored efficacy of traditional approaches in the HIV positive population. While the pathogenic mechanism of these disorders remains obscure, a theory of tissue-specific mitochondrial toxicity has been proposed. With the continued introduction of novel therapies and standard treatment with combination therapy, new adverse events will continue to emerge among persons being treated for HIV disease. Beyond their immediate clinical implications, these events may contribute to changing patterns of antiretroviral utilisation including therapy initiation, adherence and cessation.
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PMID:Emerging drug toxicities of highly active antiretroviral therapy for human immunodeficiency virus (HIV) infection. 1252 86


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