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

Cholera asiatic is an acute infection of the intestinal tract through Vibrio cholerae bacteria causing diarrhea, dehydration, and kidney failure. It was discovered by Robert Koch in 1883 on his study trip in Egypt. Transmission is mostly through drinking of contaminated water and sometimes by consumption of infected food such as seafood. Cholera originates from southeast Asia, mainly India where it already appeared in ancient times. It spread from India in pandemic waves in the last few centuries throughout the world up to 1923 in Europe. Epidemics were nonetheless registered in India, China, Japan, Iran, and Egypt (1947). There was a pandemic in Peru in 1991 (caused by hyperinflation-induced malnutrition, contaminated water, and untreated sewage pouring into the sea) that also affected the neighboring countries, and small epidemics among Kurdish refugees and Bangladeshi catastrophe victims. On June 5, 1981 the deaths by atypical pneumonia of 5 homosexual men were reported to the Centers for Disease Control in Atlanta, Georgia, which was the beginning of the acquired immunodeficiency syndrome (AIDS) epidemic caused by HIV. WHO's latest figures indicated a total of 366,455 AIDS patients in 162 countries, but a higher estimate of 1.4 million was more likely. As of April 1991 and estimated 8-10 million adults were infected with HIV, 6 million of them in Africa, south of the Sahel. In the next century 15-20% of the working population will die of AIDS leaving behind 10 million orphans. Tuberculosis has also been activated as an opportunistic disease of HIV infection. Up to 55% of African TB patients were also infected with HIV. Some predict that the AIDS pandemic will equalize the population growth by an average of 300,000 deaths/year.
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PMID:[Epidemics return and new ones are added]. 178 18

The newly recognized human pathogenic mycoplasma M. fermentans (incognitus strain) causes a fatal systemic infection in experimental monkeys, infects patients with AIDS, and apparently is associated with a fatal disease in previously healthy non-AIDS patients. An apparently immunocompetent male who lacked evidence of HIV infection developed fever, malaise, progressive weight loss, and diarrhea and had extensive tissue necrosis involving liver and spleen. M. fermentans (incognitus strain) was centered at the advancing margins of these necrotizing lesions. Following the treatment of 300 mg doxycycline per day for 6 weeks, he recovered fully. He has no fever or diarrhea, and his abnormal liver function tests have returned to normal. He regained all lost strength and 14 kg of lost weight and has remained disease free for more than 1 year.
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PMID:Histopathology and doxycycline treatment in a previously healthy non-AIDS patient systemically infected by Mycoplasma fermentans (incognitus strain). 178 66

AIDS incidence is sharply growing in all countries. Doctors specialists in all fields of medicine may come in contact in the process of treatment with HIV carriers or patients suffering from AIDS, when the clinical picture is vividly manifested. The most frequently encountered HIV-dependent complex of symptoms includes persisting fever, lymphadenopathy, weight loss, diarrhoea. Blood test for HIV antibodies confirms the diagnosis. Treatment of surgical diseases in HIV-infected patients is justified in the latent period of the syndrome. In a marked clinical picture of AIDS and the presence of an opportunistic infection the patient survives no longer than 18 months. It is advisable in such cases, in the interest of the patient and the surgeon, to refrain from undertaking a planned operation because its mortality is very high. Only emergency interventions are indicated. During contact with a HIV-infected patient the medical staff must follow strictly the rules of hospital hygiene and antisepsis . The work must be carried out in gloves, protective glasses, and masks, and injure of the hands with sharp instruments must be avoided. The personnel must be trained and educated in working with HIV-infected patients.
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PMID:[Characteristics of surgeon's work with HIV-infected patients]. 180 95

Researchers analyzed data on 667 patients admitted between March 9 and September 14, 1988 to the Kenyatta National Hospital in Nairobi, Kenya to verify the contribution of Salmonella and Shigella species to hospital acquired infections and to identify factors associated with admission and nosocomial infection. Laboratory personnel isolated Salmonella and Shigella in 12.5% (10% and 2.5% respectively) of the 360 patients with nosocomial diarrhea. Their overall prevalence was 3% and 2.5% respectively. These 2 bacteria were isolated from rectal swabs from 19 of the 27 hospital units. Most of the isolates were restricted to 5 units. All of the Salmonella isolates at admission were children under 13 years old (3.6% of 556 children). Shigella prevalence at admission was 2.5% for children and 3.6% for adults. The risk of nosocomial diarrhea caused by these 2 bacteria was much greater in children older than 6 months and younger than 6 years than in children of other ages (odds ratio [OR]=21.7; p=.006). The most significant variables which independently affected nosocomial diarrhea caused by these bacteria in children were recent antimicrobial therapy (OR=26.4; p=.001) and living in crowded homes (OR=1.2; p=.02). Another determinant was poor hair color indicating malnutrition (p=.03). Even though there were no significant differences between adults with nosocomial diarrhea caused by these bacteria and those with no nosocomial diarrhea, sharing a room with people with diarrhea, being in the hospital within the last 30 days, and being HIV-1 positive were factors that almost reached significance. In fact, 9 of their 22 (41%) adults with positive cultures of Salmonella were HIV=1 positive yet Salmonella was not isolated from any of the 70 HIV-1 positive patients at admission. Salmonella contributed greatly to nosocomial diarrhea at this hospital. The hospital should evaluate and redesign its control measures within available limited resources.
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PMID:Salmonella and Shigella gastroenteritis at a public teaching hospital in Nairobi, Kenya. 181 76

Patients with HIV infection were studied to assess the efficacy of octreotide, a somatostatin analogue, in the long-term management of refractory diarrhoea. Dosage of subcutaneous octreotide was increased progressively at 48 h intervals from 150 to 300, 750 and 1500 micrograms/day according to response. Twenty-nine patients, 21 with Cryptosporidium enteritis, one with Isospora belli enteritis and seven with no identifiable pathogen were selected for the study; four of these were excluded from the study because of death during the first month (two cases), abdominal pain and acute pancreatitis (one case each). Twenty-five patients were evaluable for response. Ten patients (four with Cryptosporidium enteritis, five without an identifiable pathogen and one with I. belli enteritis) achieved a complete response (40%) and nine cases (all with cryptosporidial enteritis) had a partial response (36%). Patients with higher weight and Karnofsky performance status and non-cryptosporidial enteritis had a better response to treatment. Mean durations of treatment and response were 4.2 +/- 4.2 and 4.4 +/- 4.5 months, respectively. In the absence of specific agents for cryptosporidial enteritis and HIV enteropathy, octreotide was found to be useful in the management of chronic diarrhoea in AIDS patients.
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PMID:Efficacy of octreotide in the management of chronic diarrhoea in AIDS. 181 31

Ultrastructural studies were done on developmental stages of Enterocytozoon bieneusi obtained from HIV seropositive patients suffering from diarrhea. The presence of elaborate multilamellar structures suggest that they give rise to various membrane systems needed for rapid production of disseminating stages.
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PMID:Characteristics of the microsporidian Enterocytozoon bieneusi: a consequence of its development within short-living enterocytes. 181 27

Human antibody response to Cryptosporidium parvum has been previously shown as involving immunoglobulin (Ig)M and IgG isotypes. The interest in anti-cryptosporidial IgA antibody response has been recently stimulated by studies on the therapeutic effects of secretory IgA antibodies to Cryptosporidium in animal models and in patients. In the present study, isotypes of serum anti-Cryptosporidium antibodies have been characterized in donors of the following categories: (a) healthy adults, (b) healthy children, (c) immunocompetent children with transient cryptosporidial diarrhea, (d) HIV-infected patients without clinical and parasitological evidence of Cryptosporidium infection and (e) AIDS patients with cryptosporidial diarrhea. Antibodies were detected using C. parvum oocysts purified by density gradient centrifugation from bovine faeces. The IgA antibodies were revealed using alpha-chain specific antibodies. Indirect immunofluorescence analysis with oocysts was used as control. Although high levels of serum antibodies of the IgA class were detected in some donors in the group of healthy adults, elevated values were consistently found in HIV-infected patients. Higher values were found in HIV patients with clinical cryptosporidiosis. The presence of a secretory component in serum IgA antibodies in these patients has been documented. Data indicate that IgA serum antibodies are produced as well as IgM and IgG antibodies upon contact with the parasite, and suggest that elevated IgA serum antibodies to Cryptosporidium are not associated with protection in HIV patients.
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PMID:Characterization of anti-Cryptosporidium IgA antibodies in sera from immunocompetent individuals and HIV-infected patients. 181 57

Fifty to eighty per cent of patients with AIDS-related complex or AIDS have gastrointestinal symptoms, the most common being dysphagia, diarrhea, or perianal lesions. The symptomatology varies from a mild "gay bowel syndrome" to a severe "diarrhea wasting syndrome". In patients with lymphadenopathy syndrome and AIDS the mucosal CD4/CD8 ratio is decreased, and the IgA-producing plasma cells of the mucosa are diminished in number as compared with HIV-negative controls. AIDS enteropathy, the etiology of which remains unclear, seems to be associated with direct infection of the intestinal mucosal cells with HIV. Clinical and therapeutic aspects of some opportunistic infections, such as Candida albicans, cytomegalovirus, and Herpes simplex virus-infection are discussed in this part.
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PMID:[Gastrointestinal manifestations of AIDS. 1: Basic considerations and viral infections]. 185 16

Case management strategies for the nutritional support of patients infected with the human immunodeficiency virus (HIV) are evolving as the disease becomes less rapidly fatal and more chronic. Nutritional status changes in advanced HIV infection are similar in many respects to protein-calorie malnutrition. Current clinical effort and research focuses on the beneficial effects of preserving lean body mass and keeping asymptomatic patients in good nutritional status by preventing micronutrient deficiencies and by treating preexisting nutritional problems rather than attempting to intervene late in the disease's course, after secondary malnutrition has already developed. Nutrition support and intervention trials only late in the disease process have not been promising in reversing weight loss once it has occurred. Special diets, such as lactose- or gluten-free diets, may be helpful in some cases as asymptomatic treatment of some opportunistic infections, and such measures may slow additional losses. However, secretory diarrhea, which often seems to be inherent to the disease itself, is not ameliorated by such measures. Current research is focusing on the potential role of glutamine in slowing malabsorption and on combinations of diet and drug treatments. Asymptomatic patients are now the focus of concern. Preserving good nutritional status by attention to preventing weight loss and loss of lean body mass and assuring food safety are primary. Symptomatic patients require specific assistance depending on the presence of opportunistic infections and the drugs required. Specific nutrition support measures depend on whether or not the gut is functional.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Nutrition support of HIV+ patients. 185 4

A longitudinal (10-22 month) evaluation of intestinal symptoms and function was performed in five children with symptomatic human immunodeficiency virus (HIV) infection. All received cotrimoxazole, ketoconazole, and immunoglobulins. A search for enteric pathogens and intestinal function tests were repeatedly performed in all patients. Mild episodes of diarrhea were observed in two children. One had cow's milk protein intolerance. Giardia lamblia was found in an asymptomatic carrier. Evidence for impaired intestinal function was found in all patients. These consisted of positive D-xylose and iron oral loads, increased steatorrhea, increased fecal excretion of alpha 1-antitrypsin, abnormal intestinal permeability, and increased food antibody levels. Our results suggest that severe diarrhea may be uncommon in children with HIV infection receiving antimicrobial prophylaxis, but that the intestinal function is frequently, and often markedly, impaired.
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PMID:Impaired intestinal function in symptomatic HIV infection. 186 78


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