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

The authors studied new-onset seizures in 60 heterosexual black South African HIV-infected patients who had not used IV drugs. An intracranial space-occupying lesion was identified in 53% of patients, meningitis in 22%, and no additional cause in 25%. Of the patients with an identifiable cause, 64% had probable tuberculosis (tuberculoma or tuberculous meningitis). The majority of patients had late-stage HIV infection (CD4 counts <200/mm(3)).
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PMID:New-onset seizures associated with HIV infection. 1109 14

Patients presenting with neurologic symptoms and evidence of focal brain disorders should be evaluated immediately. The clinical presentation of focal brain lesions reflects the function in the area of brain involved. Typical symptoms or signs can include motor or sensory deficits, visual complaints, headache, seizures, or changing level of arousal. Initial studies of key importance include magnetic resonance brain imaging with and without a contrast agent such as gadolinium. When clinically safe, lumbar puncture for detailed cerebrospinal fluid (CSF) analysis is very helpful in the differential diagnosis. Combined clinical, radiologic, and diagnostic evaluation of the CSF can often provide solid evidence of the cause of the lesion(s) and may obviate the need for brain biopsy. The status of systemic human immunodeficiency virus (HIV) infection is important in the differential diagnosis, choice of therapy, and prognosis. Thus, concurrent evaluation of the history and status of the HIV infection is vital. Determination of a specific cause of symptomatic focal lesions is important; this should be pursued aggressively unless the global status of the subject suggests that therapy would be futile. With current therapy, many patients presenting with aggressive focal brain lesions can be successfully treated and can return to productive lives.
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PMID:Focal Brain Lesions in People with HIV. 1109 6

OBJECTIVE: To review the neurologic manifestations of AIDS in all children and adolescents who were seen by specialist doctors at 2 centers in Santos, Brazil, over the past 7 years. MATERIALS AND METHODS: Files of all patients aged 17 and under who were infected by HIV and admitted to 2 specialized AIDS centers between 1990 and 1997 were reviewed. RESULTS: Of the 239 children and adolescents admitted to AIDS centers, 20 presented with a variety of neurologic complications, including focal motor signs, altered tonus, retarded neurodevelopment, cognitive disturbances, intractable headache, seizures, and coma. Opportunistic infections were the exception, an important difference from the adult population of the same area. CONCLUSION: Neurologic complications of AIDS in children and adolescents in the city of Santos, Brazil, were relatively unusual, found in less than 10% of this population. The neurologic involvement did not increase the mortality of these children and adolescents. These finding may be attributable to the quality of diagnoses, treatment, and follow-up of children infected with HIV by specialized professionals in adequate institutions.
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PMID:Neurologic Manifestations of AIDS in Children and Adolescents: A Review of Cases in Santos, Brazil. 1110 5

A non-HIV-infected 63-y-old woman presented seizures and coma during the course of Mycobacterium tuberculosis infection. Computerized tomography scan led to the diagnosis of a large compressive brain abscess. The patient died with multiorgan failure. Systematic central nervous system investigations should be done in cases of disseminated tuberculosis.
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PMID:Fatal Mycobacterium tuberculosis brain abscess in an immunocompetent patient. 1120 Mar 88

The sedative/hypnotic thalidomide was withdrawn from the worldwide market nearly 40 years ago, because of its teratogenic and neurotoxic effects. Thalidomide was later found to very effectively suppress erythema nodosum leprosum (ENL). The US Food and Drug Administration (FDA) has approved Thalomid (thalidomide) capsules for the acute treatment of the cutaneous manifestations of moderate to severe ENL. Thalidomide is currently under investigation for the treatment of a wide variety of diseases, including conditions thought to have an inflammatory or immune basis, malignancies and complications of infection with HIV. Interest in the potential anti-inflammatory, immunomodulatory and anti- angiogenic effects of thalidomide has resulted in off-label use of prescription thalidomide. During the first 18 months of spontaneous postmarketing adverse event surveillance for Thalomid, 1210 spontaneous postmarketing adverse event reports were received for patients treated with prescription thalidomide for all therapeutic indications, including off-label use. The most common adverse events spontaneously reported would have been expected on the basis of the current Thalomid labelling/product information. The current labelling/product information reflects what was known about the risks associated with thalidomide therapy in limited patient populations at the time of the approval of Thalomid. With the postmarketing use of thalidomide in populations other than patients with ENL, it becomes increasingly important to identify patient groups that may be particularly susceptible to specific adverse drug effects and to identify conditions under which specific adverse events may be more likely to occur. Oncology patients may represent a patient population with increased susceptibility to thalidomide-associated adverse effects, including thromboembolic events. Consideration of the spontaneous postmarketing safety surveillance data may help to identify and characterise factors associated with increased risk in this and other patient groups. Serious unexpected adverse events reported with sufficient frequency to signal previously undetected product-event associations for which there may potentially be plausible evidence to suggest a causal relationship have included seizures and Stevens-Johnson syndrome. The potential effects of thalidomide on wound healing are also being closely monitored. Premarketing human clinical trials of drug products are inherently limited in their ability to detect adverse events. Broader postmarketing experience with thalidomide in more varied patient populations and more experience in the setting of long term thalidomide use will increase our ability to detect rare adverse events and to identify signals that may need to be evaluated in more controlled settings.
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PMID:Thalomid (Thalidomide) capsules: a review of the first 18 months of spontaneous postmarketing adverse event surveillance, including off-label prescribing. 1123 21

Human herpesvirus-6 (HHV-6) and HHV-7 are newly recognized ubiquitous human viruses first discovered in patients with AIDS or lymphoproliferative disorders. Much more information is available about the clinical characteristics of infection with HHV-6 than HHV-7. Primary infection with HHV-6 occurs in early childhood and is most commonly manifested as an undifferentiated highly febrile illness, with seizures noted to be the most common complication. A subset of children develop the classic manifestations of roseola infantum or exanthem subitum. Other neurologic diseases in adults such as encephalitis and multiple sclerosis also have been linked to HHV-6; however, the role of HHV-6 in these clinical entities has not been fully elucidated. Although HHV-6 and HIV are both tropic for CD4+ lymphocytes and interact in vitro, there is no evidence at present that HHV-6 plays a role in HIV disease. HHV-7 is similar to HHV-6 in genetic organization and structure. Little is known of the clinical characteristics of infection with HHV-7 or its ability to cause disease in children or reactivation in adults.
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PMID:A practitioner's guide to human herpesvirus-6 (HHV-6) and human herpesvirus-7 (HHV-7). 1136 39

New Jersey State Superior Court Judge Jose L. Fuentes has ruled unconstitutional a state law allowing victims of sexual assault to require their accused attackers to be tested for HIV. Fuentes says the 1993 law intrudes on defendants' right to privacy and constitutes an illegal search and seizure while leaving the victim with no useful information about her own HIV status. The decision resulted from a case involving an attack on a mentally retarded 10-year-old Hudson County girl by three boys, ages 14 and 15. The boys were charged with aggravated sexual assault by forcing oral and anal sex on the girl. The prosecution moved to have the boys tested for HIV under terms of the 1993 state law. On behalf of the boys, the American Civil Liberties Union (ACLU) argued that the testing amounted to an unconstitutional search and seizure. In reaching his decision, Fuentes relied on defense testimony from experts in the field of HIV and sexual assault, who testified that the victim would receive little useful information from the HIV-antibody tests. The judge found that the state law involved a substantial intrusion into the Fourth Amendment protection against unreasonable searches and seizures. A prosecutor for the case plans to appeal the decision.
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PMID:Judge voids N.J. law allowing testing of rape defendants. 1136 2

The Appellate Division of a New Jersey Superior Court ruled that two statutes allowing sexual assault victims to require their assailants to undergo HIV-antibody testing are constitutional. This decision marks the first time the Fourth Amendment has been addressed by a New Jersey appeals court. In 1995, three teenage boys sexually assaulted a 10-year-old mentally retarded girl. Her guardians moved to have the boys tested for HIV. Superior Court Judge, Jose L. Fuentes, initially concluded that such testing would constitute an intrusion on the defendants' search and seizure rights without reassuring the victim of her own HIV status. The three-judge panel of the New Jersey Appeals Court overturned the decision, explaining that the victim's rights outweigh the assailants' right to Fourth Amendment protection. Courts in California, Illinois, and Washington have upheld mandatory testing in cases of criminal assault.
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PMID:Court upholds law allowing testing of rape defendants. 1136 67

The U.S. Navy's seizure of a civilian's HIV lab report was upheld by the 9th U.S. Circuit Court of Appeals. The Navy's actions were ruled to be key elements of a criminal investigation of an HIV-positive naval officer who engaged in unprotected sex. The civilian [name removed], and the officer, [name removed] [name removed], engaged in unprotected sexual acts on a number of occasions after [name removed] assured [name removed] he was HIV-negative. When [name removed] learned that [name removed] was HIV-positive, he reported [name removed] to his commanding officer. [Name removed] was under orders not to engage in sex without a condom. If [name removed]'s claims were correct, [name removed] could face court martial and discharge from the Navy. The Navy obtained a search warrant for [name removed]'s apartment and discovered a lab report showing [name removed] tested positive for HIV antibodies. The report was seized as evidence against [name removed] sued the Navy investigators claiming violation of his Fourth Amendment protection. A U.S. District Judge and the 9th Circuit Court found in favor of the defendants. The Navy's interest in collecting evidence of a serious crime outweighed [name removed]'s interest in protecting the confidentiality of his HIV status.
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PMID:Navy acted properly in seizing civilian's HIV test report. 1136 64

Terry Parker, a 42-year-old from Toronto, has treated his epilepsy with marijuana since he was in his teens. His disease subjected him to frequent seizures, and caused him to undergo a right temporal lobotomy in an effort to suppress the seizures. After other ineffective medical procedures, he began smoking marijuana, which lessened his symptoms. He kept a diary of drug use and effect, on the advice of his physician, and the doctor later gave him a letter specifying that he needed marijuana for medicinal purposes. His seizures have led to more than one hundred hospitalizations for injuries incurred during the episodes. An Ontario court ruled in December that he can now grow his own marijuana legally, and threw out charges for possession and trafficking. Judge Sheppard ruled that denying Parker marijuana was an infringement of his Charter right to life, liberty, and security. The Crown has requested an appeal, however, Parker is free to grow marijuana in the meantime. Contact the Canadian Foundation for Drug Policy for further information on the medical uses of marijuana.
Can HIV AIDS Policy Law Newsl
PMID:The Terry Parker case: marijuana for epilepsy -- and soon for HIV/AIDS? 1136 83


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