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

Chemokines constitute a large and still growing family of structurally-related small (8-10 kDa) cytokines that have chemotactic activity for leukocytes. Recently, some receptors for chemokines were reported to be used as a co-receptor by HIV at infection. In addition to their well-established role in inflammatory response and recently-reported role as a co-receptor for HIV, recent data suggest that chemokines and their receptors physiologically and pathologically play crucial roles as the mediators for intercellular communication among the cells intrinsic to and recruited into the brain; i.e., neurons, astrocytes, microglia, endothelial cells and leukocytes. Some chemokines such as SDF-1 and fractalkine are constitutively produced in the brain, implicating that they have an important role in maintenance of CNS homeostasis or determination of the patterning of neurons and/or glial cells in developing brain and normal adult brain. Chemokines such as MCP-1, MIP-1 alpha and CINC were shown to be induced by various neuroinflammatory stimuli, suggesting that they are involved in various neurodegenerative diseases such as multiple sclerosis, Alzheimer's disease, stroke and AIDS dementia syndrome. Chemokines and their receptors are potential targets for therapeutic intervention in neurodegenerative diseases.
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PMID:[Chemokines as mediators for intercellular communication in the brain]. 1087 3

The objective of this study was to elucidate the mechanisms of an ischemic stroke in a human immunodeficiency virus, type 1 (HIV)-infected population. Several clinical and autopsy studies have suggested an increased incidence of strokes in HIV-infected persons. These studies have been performed on diverse populations with numerous confounds for strokes, including, drug abuse and coexistent opportunistic infection. Because of these confounding factors, it has been difficult to assess whether a unique stroke propensity exists among HIV-infected persons. A retrospective case-controlled study was carried out of patients registered in the Durban Stroke Data Bank (DSDB) (n=1298) located in KwaZulu Natal province of South Africa. Sixteen per cent of all strokes in young (<50 year old) black Africans living in KwaZulu Natal province on the east coast of South Africa reported to the DSDB occurred in association with HIV infection. This HIV-infected population was free of drug abuse and relatively devoid of opportunistic infections. The incidence rate of HIV in this stroke population paralleled that of the young black population at large, suggesting no significant overall increased rate of stroke in association with HIV. However, when compared to strokes occurring in an age- and sex-matched, HIV-seronegative control population, the cryptogenic stroke was more common in the HIV-infected population. Although the incidence of rate of stroke appeared to be no higher among HIV-infected young black Africans in the KwaZulu province than among HIV-seronegative controls, the increased incidence of a large vessel cryptogenic stroke in the former suggests the presence of a co-existent prothromobotic state.
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PMID:Cerebrovascular disease in young, HIV-infected, black Africans in the KwaZulu Natal province of South Africa. 1087 12

Methylphenidate is a commonly used medication in the United States. This central nervous system stimulant has a mechanism of action distinct from that of amphetamine. The Food and Drug Administration has approved methylphenidate for the treatment of attention-deficit/hyperactivity disorder and narcolepsy. Treatment with methylphenidate has been advocated in patients with traumatic brain injury and stroke, cancer patients, and those with human immunodeficiency virus infection. Placebo-controlled trials have documented its efficacy as an adjunctive agent in the treatment of depression and pain. This article reviews the current understanding of the mechanism of action and efficacy of methylphenidate in various clinical conditions.
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PMID:Methylphenidate: its pharmacology and uses. 1090 87

We report eight cases of hemiballism. Six patients had diabetes mellitus, one patient presented with porencephaly after cranial trauma and one patient had a HIV-associated fungic granuloma (cryptococcus). In the diabetic group three patients had non-ketotic hyperglycemia; two of them with striatal hemorrhage, and the remaining three presented with an ischemic stroke. Hemichorea occurred in 75% of our patients, predominantly in the right side of the body. Six patients had good improvement with treatment with haloperidol and two patients had to undergo a thalamotomy, one of them with good results. In our series of eight patients with hemiballismus we observed an association with diabetes mellitus and stroke, and good clinical improvement.
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PMID:[Hemiballism: report of eight cases]. 1097 12

Palliative day care has expanded rapidly in the recent years, but the types of care available vary. To understand more about the different models of day care we conducted a questionnaire survey of the 43-day care centres in North and South Thames Regions in England (total population 13.75 million). The questionnaire covered: management, staffing and organizational policies; the numbers, types and reasons for referral; and the services and care provided. Forty (93%) centres responded. Centres had operated for between 1 and 16 years, mean 8 years. A total of 2268 day care places (mean per centre, 57) were available per week--with an estimated 1.77 places per 10,000 population. Twenty centres had never had a waiting list or had to prioritize patients; 30 had a discharge policy. The mean time the longest patient had been attending was 4.5 years, range 1-12 years. There were a total of 3627 new referrals per year or 3.06 per 10,000 population. Of the 2054 patients recorded by day care centres during a week of detailed monitoring, 1850 (90%) had cancer and 204 had other diseases--most commonly HIV or AIDS, motor neurone disease or stroke. Thirty-four centres were managed by nurses, two by social work or social service professionals, and the remainder by people with other backgrounds. Most units had doctors, nurses, chaplains, managers, aromatherapists and hairdressers, but occupational therapists, social workers, chiropodists, dietitians and music and art therapists were much more varied, as was whether these posts were paid. The most common activities were: review of patients' symptoms or needs, monitoring symptoms, bathing, wound care, physiotherapy, hairdressing and aromatherapy. Centres describing themselves as more or mostly social were less likely to undertake daily assessment of new symptoms and wound care (chi-squared 13.0, 10.1, respectively, df 4, P < 0.05). However, we found no significant differences between centres describing themselves as more medical or more social in reported levels of staffing, who was in charge, funding or most activities. The findings suggest that there are core activities offered in palliative day care, but also variations in medical assessments, nurse-led clinics, trips, art and music therapy, and artistic activities.
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PMID:Palliative day care: what do services do? Palliative Day Care Project Group. 1097 79

A broad spectrum of neuropathologic changes are encountered in the brains of heroin abusers. The main findings are due to infections, either due to bacterial spread from bacterial endocarditis, mycoses, or from HIV-1 infection. Other complications include hypoxic-ischemic changes with cerebral edema, ischemic neuronal damage and neuronal loss, which are assumed to occur under conditions of prolonged heroin-induced respiratory depression, stroke due to, for example, thromboembolism, vasculitis, septic emboli, hypotension, and positional vascular compression. Myelopathy is believed to be the result of an isolated vascular accident within the spinal cord due to an as yet unknown mechanism. A distinct entity, spongiform leukoencephalopathy, has been described mainly after inhalation of pre-heated heroin. A lipophilic toxin-induced process was considered to be due to contaminants and to be induced or enhanced by cerebral hypoxia, but a definite toxin could not be identified. At the cellular level, abnormalities in signal transduction systems and changes of various receptor densities have been reported. The exact etiology of the different neuropathological alterations associated with heroin abuse is still unclear, but may also be related to additional substances used as adulterants.
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PMID:The neuropathology of heroin abuse. 1097 59

Memantine, a non-competitive NMDA antagonist, has been approved for use in the treatment of dementia in Germany for over ten years. The rationale for use is excitotoxicity as a pathomechanism of neurodegenerative disorders. Memantine acts as a neuroprotective agent against this pathomechanism, which is also implicated in vascular dementia. HIV-1 proteins Tat and gp120 have been implicated in the pathogenesis of dementia associated with HIV infection and the neurotoxicity caused by HIV-1 proteins can be blocked completely by memantine. Memantine has been investigated extensively in animal studies and following this, its efficacy and safety has been established and confirmed by clinical experience in humans. It exhibits none of the undesirable effects associated with competitive NMDA antagonists such as dizocilpine. The efficacy of memantine in a variety of dementias has been shown in clinical trials. Memantine is considered to be a promising neuroprotective drug for the treatment of dementias, particularly Alzheimer's disease for which there is no neuroprotective therapy available currently. It can be combined with acetylcholinesterase inhibitors which are the mainstay of current symptomatic treatment of Alzheimer's disease. Memantine has a therapeutic potential in numerous CNS disorders besides dementias which include stroke, CNS trauma, Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS), epilepsy, drug dependence and chronic pain. If memantine is approved by the FDA for some of these indications by the year 2005, it can become a blockbuster drug by crossing the US$1 billion mark in annual sales.
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PMID:Evaluation of memantine for neuroprotection in dementia. 1106 Jul 51

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

A major government-sponsored study of nerve growth factor for treating HIV-related neuropathy has recently been revived after it was canceled earlier this year by Genentech, Inc. of South San Francisco, which holds a patent for the use of the drug. Human nerve growth factor has been shown to be the most promising therapy for treating HIV-related neuropathy, the most common neurological complication in AIDS. The AIDS Clinical Trials Group (ACTG) of the National Institute of Allergy and Infectious Disease and the National Institute of Neurological Disorders and Stroke have, for three years, been developing a study of 180 randomly assigned volunteers to receive low-dose nerve growth factor, high-dose nerve growth factor, or placebo. However, in January 1995, Genentech informed the government that it would not provide the drug--although almost all of the financial cost of the study was to be paid for by the ACTG. After major protests by experts and community organizations, Genentech reinstated its earlier agreement to provide the drug for the ACTG study. The trial, known as ACTG 291, is expected to go forward.
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PMID:Nerve growth factor: major trial canceled, revived after protest. 1136 4

The New York State Division of Human Rights has fined Marcus Garvey Nursing Home and its administrator $75,000 after the home placed a stroke patient with HIV in isolation for more than nine months. [Name removed] was placed in confinement after being persuaded to be tested for and found to be positive for HIV antibodies. Officials at the nursing home argued that the confinement was to protect [name removed] from opportunistic infections he could acquire from other patients. [Name removed]'s isolation ended two weeks after he filed a complaint with the Division of Human Rights against the nursing home. The Division initially ordered the nursing home and its administrator to pay [name removed] $150,000 in damages for mental anguish. However, the court said the award was excessive when compared to similar cases.
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PMID:N.Y. facility fined $75,000 for isolating patient for nine months. 1136


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