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

A manic syndrome in eight patients with AIDS is described. On the basis of clinical, neuropsychological, laboratory, magnetic resonance imaging, and epidemiological evidence, the authors suggest that the manic syndrome was secondary to HIV infection. The patients also developed concomitant cognitive impairment.
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PMID:Manic syndrome in AIDS. 155 63

Progressive dementia has been described in AIDS patients as the most significant neurologic complication, related to HIV-1 infection directly rather than to opportunistic infections. As the virus seems to enter brain early in the course of infection, incipient dementia or subclinical cognitive impairment have been assumed to occur in otherwise asymptomatic HIV-1 seropositive individuals. A review of relevant neuropsychological studies indicates that this suspicion receives no support in large well-controlled studies. The natural history of AIDS dementia is still not clearly delineated, but encephalopathy seems to develop only with or after systemic immunosuppression.
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PMID:[HIV infection and the development of dementia]. 186 63

Patients with the acquired immunodeficiency syndrome (AIDS) represent a novel referral population for rehabilitation services. Limited information about the rehabilitation needs of individuals with human immunodeficiency virus infection is available. We reviewed 51 consecutive patients with AIDS referred to a rehabilitation consult service. Common problems encountered included generalized deconditioning (27%) and neurologic dysfunction (45%). Neurologic presentations were diverse and included hemiparesis, diffuse cognitive dysfunction and dementia, myelopathy, myopathy and peripheral neuropathy. Other patients were referred for wound care as well as the management of the local effects of Kaposi's sarcoma, various musculoskeletal syndromes and new onset blindness. Problems identified included impaired mobility (76%), difficulty with self-care (57%), impaired cognition (29%) and uncontrolled pain (37%). Among the rehabilitation interventions utilized were therapeutic exercise (73%), gait aids (45%), bathroom and safety equipment (45%), orthotics (29%), vocational counseling (4%), pain management (29%) and whirlpool treatments (10%). Five patients were too ill or refused treatment. We conclude that AIDS patients referred for rehabilitation have a wide variety of physical deficits, demonstrate a considerable degree of functional impairment and may require multiple rehabilitation interventions.
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PMID:Experience with rehabilitation in the acquired immunodeficiency syndrome. 187 78

A consultation on the neuropsychiatric aspects of HIV-1 infection was held at the World Health Organization (WHO) headquarters January 11-13, 1990. Of topics discussed, participants concluded that a group of conditions characterized by cognitive and motor impairment can be described. New terminology was suggested accordingly. Participants found that otherwise health HIV-1 seropositive patients were no more likely than HIV-1 seronegative patients to manifest clinically significant cognitive impairment. The serological screening of asymptomatic patients for HIV-1 in attempts to protect public safety was therefore deemed unnecessary. Hallucinations and delusions being not infrequent in AIDS and ARC patients, they may be indicative of cognitive impairment or later accompanied by symptoms pointing to diagnosis of delirium or dementia. Acute psychotic disorders outside of evidence of cognitive impairment may result as anomalies described within the text. Depressive syndrome may result outside of severe depressive episode or major depression due to recent diagnosis as HIV-1 positive and/or as the first stage of HIV-1 dementia. DIstinguishing between ARC and the above-mentioned states as the cause of this syndrome may be difficult. Consultation participants cited stress associated with HIV-1 infection or disease to be conditioned by several factors. Finally, neuropsychiatric disorders due to HIV-1 opportunistic processes were discussed. Country-level recommendations included preparing health workers for a wide range of neuropsychiatric conditions in the HIV-1 positive patient, and notifying then that otherwise healthy HIV-1 positive patients may not show clinically significant signs of cognitive impairment. Recommendations followed in urging health services to prepare for a large burden of neuropsychiatric illness in AIDS and ARC patients; governments should support services and train health workers accordingly. Pre- and post-serological testing counseling was stressed, with facility for and understanding of the special needs of HIV-1 positive patients' families and involved health staff. Research on the neurological and mental health needs of patients should be given high priority with attention given to the immediate policy and care implications. Final qualification of the difficulty involved in generalizing research findings to apply across sociocultural and geographical contexts was provided with mention in the text of a WHO multicenter study addressing this concern in its pilot phase at the time of publication. Neurological tests were designed for use in this study to be culturally nonspecific.
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PMID:Neuropsychiatric aspects of HIV-1 infection. 228 2

A patient presented with a subacute cerebellar syndrome in absence of cognitive impairment or other symptoms. He became demented several months after the onset of the disease. Necropsy demonstrated the typical features of the AIDS dementia complex and severe loss of Purkinje cells of the cerebellum. Patients with subacute cerebellar dysfunction should be evaluated for the presence of human immunodeficiency virus infection.
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PMID:Subacute cerebellar syndrome as the first manifestation of AIDS dementia complex. 232 31

A group of 34 homosexual men with acquired immune deficiency syndrome (AIDS) spectrum disorders were assessed for cognitive impairment on a range of neuropsychological tests. There were 17 patients with AIDS, and 17 with AIDS-related complex (ARC). Although none of the patients showed signs of the severe dementing syndrome that has been described in persons with HIV infection, they demonstrated signs of cognitive impairment consistent with organic brain dysfunction. The profile of deficits shown by AIDS and ARC patients could be broadly grouped into disorders of recent and delayed memory and learning, generalized cognitive slowing, and reduced mental flexibility. Considerations of the clinical and neuropathological similarities between subcortical dementing syndromes and HIV-related cognitive impairment suggest that in both processes the pathogenesis of the observed deficits may involve disruption of frontodiencephalic projections.
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PMID:Neuropsychological investigation of patients with AIDS and ARC. 233 17

Atrophy and white matter changes seen on magnetic resonance imaging scans have been observed in association with the acquired immunodeficiency syndrome dementia complex, but these appear to be late findings relative to clinical expression. We report a new magnetic resonance imaging observation in patients with early cognitive impairment due to human immunodeficiency virus infection. Fifty-two patients had a total of 86 magnetic resonance imaging scans during the study period. All scans were obtained with a 1.5-T system. The proton density spin echo (repetition time of 2000 milliseconds and echo delay time of 30 milliseconds) study demonstrated high-signal lesions in the region of the splenium of the corpus callosum and in the crura of the fornices. The lesions demonstrated no contrast enhancement with gadopentate dimeglumine. Pathological examination was performed in five patients. The fornix-subcallosal abnormality may be related to the memory dysfunction in patients with human immunodeficiency virus-related cognitive impairment.
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PMID:Magnetic resonance imaging findings in HIV cognitive impairment. 234 91

There are conflicting reports on the early effects of human immunodeficiency virus (HIV) infection on the nervous system. Some studies have suggested that there may be early cognitive impairment, while others have refuted this. We describe the results of extensive neuropsychological testing in a group of 40 infected subjects. These indicate that the degree of impairment is closely related to confounding factors other than the infection itself. Our conclusion is that the early stages of HIV disease are not associated with a high frequency of cognitive impairment if these confounding variables are taken into consideration.
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PMID:The importance of confounding factors in the evaluation of neuropsychological changes in patients infected with human immunodeficiency virus. 239 57

A group of patients with HIV infection in various stages of the disease was studied with regard to CSF, neuroradiological and neuropsychological aspects. A considerable number of them showed signs of CNS involvement, as revealed by abnormalities in all the three fields investigated, despite a frequently unremarkable neurological examination. The findings of CSF alterations, neuroradiological abnormalities and selective cognitive impairment in the absence of opportunistic infections of the CNS support the hypothesis of an early and direct action of HIV on the nervous system.
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PMID:May preclinical markers of brain infection by HIV be detected? A cognitive, CSF and neuroradiological investigation. 262 16

One hundred and ninety-two out-patients with HIV infection were interviewed in a standardised manner at two London hospitals. Almost all had revealed their diagnosis to others, one-quarter receiving negative reactions from confidants. Thirty-one per cent had significant psychiatric problems, almost half of whom reported emotional problems before HIV infection. Twenty-two per cent complained of difficulties with memory or concentration, of whom 12.5% had objective cognitive impairment on brief assessment. Excessive health ruminations were an important indicator of more extensive psychological problems. This degree of psychological distress is in keeping with reports for patients with other medical conditions, and overall, patients appeared to have adapted well, despite the obvious stigma and poor prognosis of their condition.
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PMID:Psychosocial status of 192 out-patients with HIV infection and AIDS. 277 51


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