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

The principal method of measuring total body water (TBW) is by isotope dilution. Also, the doubly labelled water method, which is the method of choice for measuring total energy expenditure (TEE) in free-living individuals, includes calculation of TBW as the dilution space of the tracer. TBW was measured in 261 subjects (135 males and 126 females), aged 3-87, including healthy children, children with HIV and adults with non-insulin dependent diabetes mellitus (type 2 diabetes), mild hypertension, pancreatic cancer and lung cancer, either in studies of body composition or TEE. A linear relationship was found between TBW and height in all subjects. When TBW is plotted against height cubed (Ht3, m3) the regression line can be forced through the origin. Considering only adults with 18.5>body mass index <29.9 and all children (n=220), this yielded TBW (l)=7.40 x Ht3, R2=0.95. This simple linear relationship between measured TBW and Ht3 compared favourably with other prediction methods, assuming TBW is a constant proportion (55%) of body weight and TBW predicted from height and weight (mean difference between measured and predicted TBW 0.55 l compared with -1.95 and -1.20 l, respectively). Absolute errors were greater at higher TBW, but use of a log10 transformation reduced this effect. This simple relationship of TBW with Ht3 is too crude to be used as a body composition predictor in individual subjects as it ignores, for instance, body shape. However, it can be used as a quality control tool. Here, use of a log10 transformation and residual plot can serve to identify outliers, which can be checked for gross errors in data input and if necessary samples are re-analysed.
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PMID:A simple prediction of total body water to aid quality control in isotope dilution studies in subjects 3-87 years of age. 1619 62

Gene therapy aimed at the respiratory epithelium holds therapeutic potential for diseases such as cystic fibrosis and lung cancer. Polyethylenimine (PEI) has been utilized for gene delivery to the airways. In this study, we describe a new modification of PEI, in which an oligopeptide related to the protein transduction domain of HIV-1 TAT was covalently coupled to 25 kDa PEI (PEI) through a heterobifunctional polyethylenglycol (PEG) spacer resulting in a TAT-PEG-PEI conjugate. Improved DNA reporter gene complexation and protection was observed for small (approximately 90 nm) polyplexes as well as significantly improved stability against polyanions, Alveofact, bronchial alveolar lining fluid and DNase. To determine polyplex toxicity in vitro, MTT assays were performed and, for in vivo testing, the mice bronchial alveolar lavage was investigated for total cell counts, quantity of neutrophils, total protein and TNF-alpha concentration. All parameters suggest significantly lower toxicity for TAT-PEG-PEI. Transfection efficiencies of both PEI and TAT-PEG-PEI polyplexes with DNA were studied under in vitro conditions (A549) and in mice after intratracheal instillation. While luciferase expression in A549 cells was much lower for TAT-PEG-PEI (0.2 ng/mg protein) than for PEI (2 ng/mg), significantly higher transfection efficiencies for TAT-PEG-PEI were detected in mice. Reporter gene expression was distributed through bronchial and alveolar tissue. Thus, TAT-PEG-PEI represents a new approach to non-viral gene carriers for lung therapy, comprising protection for plasmid DNA, low toxicity and significantly enhanced transfection efficiency under in vivo conditions.
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PMID:Nano-carriers for DNA delivery to the lung based upon a TAT-derived peptide covalently coupled to PEG-PEI. 1629 9

HIV infection predisposes patients to AIDS-defining malignancies, some of which, such as Kaposi's sarcoma and non-Hodgkin lymphoma, can affect the lungs. In 1996, AIDS-related mortality started to fall sharply in industrialized countries following the introduction of highly active antiretroviral treatments (HAART). This was accompanied by an increase in the proportion of deaths attributable to non AIDS-defining solid tumors, and especially lung cancer (LC). The increased risk of LC relative to the general population of the same age seems to be due partly to a higher prevalence of smoking among HIV-infected subjects. The average age of HIV-infected patients at LC diagnosis is about 45 years. Most patients are symptomatic at diagnosis and have only mild or moderate immunosuppression. LC is diagnosed when it is locally advanced or metastatic (stages III-IV) in 75-90% of cases, as in patients with unknown HIV serostatus. Adenocarcinoma is the most frequent histologic type. The prognosis of LC is poorer in HIV-infected patients than in the general population. Data on the efficacy and toxicity of chemotherapy in this setting are rare and rather imprecise. Surgery remains the reference treatment for localized disease in patients with adequate functional status and general health, regardless of their immune status. Prospective clinical trials are needed to define the optimal LC treatment strategies in HIV-infected patients.
Lung Cancer 2006 Jan
PMID:Lung cancer, a new challenge in the HIV-infected population. 1630 Aug 54

Eventhough the advent of highly active antiretroviral therapy (HAART) has dramatically improved patient outcome and provided a significant shrinking of the cases and severity of opportunistic infections, AIDS malignancies have become responsible of a new vexing challenge in HIV patient care and cure. Indeed, malignant tumors currently rank among the leading cause of morbidity and mortality in patients infected with HIV. In addition to the AIDS-malignancies, non-AIDS defining tumors have a higher incidence than the general population such as Hodgkin disease, lung cancer, cutaneaous cancer and anal cancer. These malignant tumors are generally characterized by a more aggressive behaviour at diagnosis and a poorer outcome compared with the same tumors in the general population. Although recent therapeutic advances have been made in chemotherapy, combinations with antiretroviral agents, for many of these malignancies the pronostic remains poor and there is a deeply lack of current therapeutic guidelines for these cancer patients care and cure. These recommendations might be the fruit of a new networking between HIV specialists and oncologists and of an improving knowledge of the pathogenesis and clinical features of these AIDS non-defining tumors.
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PMID:[Non-AIDS-defining malignancies in HIV patients: clinical features and perspectives]. 1645 4

Since the discovery of the 32-base-pair deletion in the CCR5 chemokine receptor gene (CCR5-Delta32) and its effect on HIV-1 infection and AIDS progression, many genetic factors affecting AIDS have been identified. Here we quantify the impact of 13 of these factors on AIDS progression using a new statistic based on the mutual information between causal factors and disease, the explained fraction. The influence of causal factors on disease is commonly measured by the attributable fraction statistic, but the attributable fraction is a poor measure of the extent to which a factor explains disease because it considers only whether a factor is necessary, not whether it is sufficient. The definition of the explained fraction, which is analogous to R or the explained variation for regression models, extends naturally to multiple factor levels. Because the explained fraction is approximately additive, it can be used to estimate how much of epidemiological data is explained by known genetic or environmental factors, and conversely how much is yet to be explained by unknown factors. We show that 13 genetic factors can cumulatively explain 9% of slow progression to AIDS, an effect comparable to the effect of smoking on lung cancer.
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PMID:Using mutual information to measure the impact of multiple genetic factors on AIDS. 1676 24

Significant racial, ethnic, and socioeconomic health disparities have been documented in asthma, lung cancer, sarcoidosis, vaccine-preventable pneumonias, tuberculosis, and HIV-related pulmonary infections. Given the complex causation of health disparities,and their resistance to simple interventions, the authors propose a three-dimensional approach for eliminating racial and ethnic health disparities in America. The three dimensions include surveillance and monitoring, research into causes and potential cures, and rapid-cycle testing of interventions to reduce or eliminate disparities.
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PMID:A three-dimensional approach to the elimination of racial-ethnic disparities in lung health. 1688 62

AIDS related mortality has fallen sharply in industrialised countries since 1996 following the introduction of highly active antiretroviral therapy. This has been accompanied by an increase in the proportion of deaths attributable to non-AIDS defining solid tumours, especially lung cancer. The risk of developing lung cancer seems to be higher in HIV infected subjects than in the general population of the same age, partly because the former tend more frequently to be smokers and, especially, intravenous drug users. The carcinogenic role of the antiretroviral nucleoside drugs and their interaction with smoking needs to be examined. Interestingly, there is no clear relationship between the degree of immunosuppression and the risk of lung cancer, so the reason for the increased risk is unknown. The mean age of HIV infected patients at the time of lung cancer diagnosis is 45 years and most are symptomatic. Lung cancer is diagnosed when locally advanced or metastatic (stage III-IV) in 75-90% of cases, similar to patients with unknown HIV status. Adenocarcinoma is the most frequent histological type. The prognosis is worse in HIV infected patients than in the general lung cancer population. Efficacy and toxicity data for chemotherapy and radiation therapy are few and imprecise. Surgery remains the treatment of choice for localised disease in patients with adequate pulmonary function and general good health, regardless of immune status. Prospective clinical trials are needed to define the optimal detection and treatment strategies for lung cancer in HIV infected patients.
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PMID:Lung cancer in HIV infected patients: facts, questions and challenges. 1707 36

Using D-pinitol (= 3-O-methyl-D-chiro-inositol) as starting material, a concise synthesis of 4/5-deoxy-4/5-nucleobase derivatives 11-19 has been achieved. The key intermediate 9 was obtained in good yield via an epoxidation from mono-methanesulfonate of D-pinitol. The process of opening of the epoxide ring in 9 by nucleobases appeared to be regioselective in presence of 1,8-diazabicyclo[5.4.0]undec-7-ene (DBU). All the synthesized carbocyclic nucleosides were assayed against several viruses and tumors such as HIV-1, HSV-1, and HSV-2, and lung and bladder cancer. However, only compounds 14b, 14a, 16a, 16b, and 19 showed mild inhibitory effect against human lung cancer cell lines (PG) with IC50 values ranging from 50 to 100 microM, and the other compounds did not exhibit any significant antiviral activity or cytotoxicity even at concentrations up to 200 microM.
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PMID:Synthesis of 4/5-deoxy-4/5-nucleobase derivatives of 3-O-methyl-D-chiro-inositol as potential antiviral agents. 1719 27

Lung cancer has a high death rate, especially with HIV in one group of patients studied recently. Researchers are finding that most of the fatalities are due to late diagnosis; as many as 80% of the deaths from lung cancer in the general population might be prevented by CT screening to find the tumors early. The patients with HIV were often relatively healthy, so doctors did not suspect that they had cancer.
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PMID:Lung cancer: very high death rate with HIV, huge reduction possible with CT screening for early diagnosis. 1723 96

We present our experience with skeletal involvement of Pneumocystis jiroveci (ex P. carinii) infection in an HIV-seropositive patient. The objective of this study was to alert clinicians to the possibility that extrapulmonary P. jiroveci could affect the skeletal system in HIV-infected patients with extremely rapid progression. P. jiroveci infection of skeletal system has been rarely described elsewhere. A 51-year-old man complained of fever for six weeks, cough, anorexia, fatigue, and chest pain. He was found to be HIV seropositive. Repetitive (six samples) sputum and bronchoalveolar lavage fluid microbiologic tests were negative. High-resolution chest computed tomography (CT) scan revealed a small pulmonary mass. Abdominal CT scan revealed lesions in liver, spleen, kidneys, adrenal glands, lumbar vertebrae, and sacrum. Brain and skull CT scan was normal. A fine-needle biopsy of the lung mass was unrevealing. Cytological examination of sputum specimens showed findings consistent with non-small-cell lung carcinoma. Nineteen weeks post-presentation, the patient reported low-back pain. Within 24 hours after the onset of low-back pain, he developed focal neurological deficits, and a magnetic resonance imaging (MRI) of the skull and spine showed osteolytic lesions of the temporal bones bilaterally, multiple vertebral lesions, and lesions of sacrum and iliac bones. Radiotherapy of the lumbar spine and pelvis was given. Sternal aspiration was performed. Cytological examination revealed P. jiroveci. In conclusion, we describe a rare case of disseminated P. jiroveci infection in an HIV-seropositive patient, with multiple skeletal lesions, especially in the skull and in vertebrae region, and concomitant non-small-cell lung cancer, with a very poor prognosis.
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PMID:Multi-skeletal Pneumocystis jiroveci (carinii) in an HIV-seropositive patient. 1733 Dec 92


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