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

We report the case of a 61-year-old homosexual male who came to our observation because of a recent onset occipital and left frontoparietal headache, weakness, anorexia, hyperosmia and hypergeusia and psychomotor slowing, apathy and fatuous behavior. This case, besides the old problem of the differential diagnosis of intracranial mass lesions in HIV-positive patients, induces one to examine more closely the relationship between HIV, brain abscesses and Eikenella corrodens. We suspect that the primary infection was in the oral cavity, since HIV-positive patients have a higher incidence of atypical gingivitis and typical periodontitis due, among others, to Eikenella corrodens.
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PMID:A case of brain abscess by Eikenella corrodens in a HIV-positive patient. 1462 22

HIV incidence is rising more rapidly in some areas of Central and Eastern Europe than anywhere else in the world. Carrying out effective HIV prevention programs requires the presence of "bridges" that can reach community populations most vulnerable to the disease. Nongovernmental organizations (NGOs) are in a natural role to conduct HIV prevention programs. The Directors of 29 HIV prevention NGOs representing almost all countries in Central and Eastern Europe participated in in-depth interviews by telephone. The broad topics of these interviews included descriptions of the three largest programs conducted by each NGO during the past six months, at-risk target populations served, major barriers faced, and funding sources that sponsored HIV prevention activities. NGO programs most often targeted injection drug users (IDUs); other stigmatized groups were less frequently served by NGOs in the sample. The most common types of prevention activities were needle exchange, HIV prevention peer education, and delivering AIDS presentations and distributing educational materials. Among the major barriers that hampered effective conduct of HIV prevention programs were a shortage of available financial resources, governmental indifference or opposition, and AIDS-related stigma. National governments rarely provided substantial funds for NGO programs, and most funding came from United Nations agencies or private foundations. The information sources reported to be most helpful in assisting NGOs in program development were sharing ideas with other NGOs, participating in conferences, and accessing information from the Internet. A number of programs reported by the NGO Directors were innovative, outstanding, and comprehensive. Five such exemplary programs are described in this article. HIV epidemics in the region are still potentially controllable. NGOs need immediate support so that they can carry out their community-based activities on a larger scale.
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PMID:HIV prevention nongovernmental organizations in Central and Eastern Europe: programs, resources and challenges. 1506

This study assessed the programmes, resources, and needs of HIV-prevention nongovernmental organizations (NGOs) in 75 countries in Africa, Central/Eastern Europe and Central Asia, Latin America and the Caribbean. Multiple databases and expert recommendations were used to identify one major HIV-prevention NGO in the capital or a large city in each country, and in-depth interviews were conducted with each NGO Director. Most NGOs are carrying out their programmes with minimal funding and few regularly employed personnel. Most are highly dependent on international donors, but reliance on small grants with short funding periods limits programme development capacity. HIV-prevention activities varied by region, with African NGOs most likely to use peer education and community awareness events; Eastern European NGOs most likely to offer needle exchange; Latin American NGOs to have resource centres and offer risk reduction programmes; and Caribbean organizations to use mass education approaches. Across regions, NGOs most often targeted the general public and youth, although specialized at-risk groups were the additional focus of attention in some regions. Limited funding, governmental indifference or opposition, AIDS stigma, and social discomfort discussing sex were often cited as barriers to new HIV-prevention programmes. NGOs are critical service providers. However, their funding, programmes, and resource capacities must be strengthened if NGOs are to realize their full potential in HIV prevention.
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PMID:Programmes, resources, and needs of HIV-prevention nongovernmental organizations (NGOs) in Africa, Central/Eastern Europe and Central Asia, Latin America and the Caribbean. 1628 71

Progressive multifocal leukoencephalopathy is an infection of the immunosuppressed, especially of AIDS, patients. The disease is caused by the JC virus and is exceptionally rare in children. The diagnosis is based on MRI and on the detection of JC virus DNA in the cerebrospinal fluid. Progression is relentless in most cases. The only treatment of proven benefit is restoration of the immune system by highly active antiretroviral therapy. We report the case of a 15S-year-old HIV-infected boy. After several months of fatigue he developed apathy, head tilt, diplopia, motor apraxia and unsteady gait. Physical examination revealed mild cerebellar signs. MRI showed a 30-mm large, non-enhancing, hyper-intense area in the right cerebellar hemisphere and the middle cerebellar peduncle. JC virus DNA was detected in the cerebrospinal fluid. Two weeks later the MRI showed progression. The patient's condition rapidly worsened and he died four months after the onset of the disease. Autopsy revealed widespread lesions of the cerebellar hemispheres and the brainstem. The case presented is peculiar owing to the young age of the patient, the unusual localization and the unifocal nature of the lesion.
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PMID:Progressive multifocal leukoencephalopathy in an HIV-infected child. 1760 2

Tuberculosis (TB) claims a life every 10 seconds and global mortality rates are increasing despite the use of chemotherapy. But why have we not progressed towards the eradication of the disease? There is no simple answer, although apathy, politics, poverty and our inability to fight the chronic infection have all contributed. Drug resistance and HIV-1 are also greatly influencing the current TB battle plans, as our understanding of their complicity grows. In this Review, recent efforts to fight TB will be described, specifically focusing on how drug discovery could combat the resistance and persistence that make TB worthy of the moniker 'The Great White Plague'.
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PMID:Drugs versus bugs: in pursuit of the persistent predator Mycobacterium tuberculosis. 1807 42

The cellular hallmarks of Alzheimer's disease (AD) accumulate in the living brain up to 30 years before the characteristic symptoms of dementia can be identified. Brain changes in AD are difficult to distinguish from those in normal ageing, and this has led to the development of powerful computational methods to extract statistical information on the brain changes that are characteristic of AD, mild cognitive impairment (MCI) and different dementia subtypes. Time-lapse maps can be built to show how the disease spreads in the brain, and where treatment affects the disease trajectory. Here, we review three computational approaches to map brain deficits in AD: cortical thickness maps, tensor-based morphometry and hippocampal/ventricular surface modelling. Anatomical structures, modelled as three-dimensional geometrical surfaces, are mathematically combined across subjects for group or interval comparisons. Mathematical concepts from computational surface modelling, fluid mechanics and multivariate statistics are exploited to distinguish disease from normal variations in brain structure. These methods yield insight into the dynamics of AD and MCI, showing where brain changes correlate with cognitive or behavioural changes such as language dysfunction or apathy. We describe cortical and hippocampal changes that distinguish dementia subtypes (such as Lewy-body dementia, HIV-associated dementia and AD), and we describe brain changes that predict recovery or decline in those at risk. Finally, we indicate which computational methods are powerful enough to track dementia in clinical trials, on the basis of their efficiency and sensitivity to early change, and the detail in the measures they provide.
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PMID:Computational anatomical methods as applied to ageing and dementia. 1844 48

In China, HIV-related stigma is considered as a formidable barrier in the combat against the HIV epidemic. There have been few qualitative investigations on HIV-related stigma in China, especially among a vulnerable population of rural-to-urban migrants. Based on 90 in-depth interviews conducted in 2002-2003 with rural-to-urban migrants in Beijing and Nanjing, China, this study examines the forms and expressions of HIV-related stigma from migrants' perspectives regarding HIV infection and individuals at risk of HIV infection. Consistent with the general framework on stigma, Chinese rural-to-urban migrants' attitudes toward HIV infected individuals take forms of denial, indifference, labeling, separation, rejection, status loss, shame, hopelessness, and fear. These stigmatizing attitudes were mainly derived from fears of AIDS contagion and its negative consequences, fears of being associated with the diseases, and culturally relevant moral judgments. In addition to universal AIDS stigma, both traditional Chinese culture and socially marginalized position of rural migrant population have contributed to culturally unique aspects of stigmatizing attitudes among rural-to-urban migrants. These multifaceted manifestations of HIV-related stigma suggest that HIV stigma reduction intervention needs to address multiple aspects of HIV stigma and stigmatization including personal, cultural, institutional, and structural factors.
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PMID:Expressions of HIV-related stigma among rural-to-urban migrants in China. 1884 89

Apathy is commonly reported by patients infected with HIV. No previous work has assessed the relationship between white matter and apathy in HIV. The authors aimed to determine whether apathy in HIV reflects a direct effect of the virus on subcortical brain regions or a secondary neuropsychiatric symptom. Thirteen HIV+ participants with apathy, 13 HIV+ participants with no apathy, and 10 healthy comparison subjects were examined using diffusion tensor imaging in the region of the anterior cingulate and corpus callosum. Results of the study confirmed the hypothesis which anticipated changes associated with apathy in white matter tracts that relay through the medial prefrontal cortex.
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PMID:White matter correlates of apathy in HIV-positive subjects: a diffusion tensor imaging study. 2068 38

Felching (sucking or eating semen out of someone's anus) is a sexual behavior about which virtually nothing has been written in the scholarly literature, despite the fact that it appears to be a not-uncommon practice among certain subpopulations of men who have sex with men (MSM). This study examined three broad research questions: (1) How common is felching? (2) How does a desire for felching relate to other HIV risk practices and risk behavior preferences? (3) What factors are associated with the desire to engage in felching? The data were from a content analysis study of one of the largest Internet websites specifically targeting MSM looking for partners for unprotected sex. A total of 1,316 profiles on the site were analyzed and selected randomly based on users' ZIP codes. Felching was mentioned as a sought-after practice in approximately one-sixth of the men's profiles. Men who wanted to find felching partners were significantly more likely than those not searching for felching partners to seek other types of risky sex, including unprotected oral and unprotected anal sex, and various enhanced risk preferences (e.g., having sex while high, multiple-partner sex, unwillingness to withdraw the penis prior to internal ejaculation). Multivariate analysis revealed several factors that were related to an interest in identifying partners online for felching, including race/ethnicity, indifference to sex partners' HIV serostatus, several sensation-seeking measures (e.g., wanting "wild" or "uninhibited" sex, self-identification as a "bug chaser"), and eroticizing ejaculatory fluids.
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PMID:Felching among men who engage in barebacking (unprotected anal sex). 2157 5

Methylphenidate is a psychostimulant originally used for the treatment of attention-deficit disorder. Methylphenidate inhibits neuronal neurotransmitter transporters involved in the uptake of dopamine and norepinephrine at the level of the synapse. Inhibition of these transmitter transporters leads to increased concentrations of dopamine and norepinephrine in the synapse, which results in increasing alertness. The stimulant effect of methylphenidate has been used for the treatment of major depression, poststroke depression, cognitive enhancement in patients with brain tumors, neurodegenerative disorders, HIV disease, fatigue, and as a treatment for delirium and sedation associated with opioid use. Other areas where methylphenidate has been evaluated include gait disorders in the elderly individuals and the treatment of apathy in dementia. Analgesic effects have been demonstrated in preclinical models but true analgesic effects remain to be proven in humans. This article reviews the current use of methylphenidate for symptom management with a critical look at the evidence base for its efficacy in the conditions described.
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PMID:Methylphenidate: established and expanding roles in symptom management. 2214 57


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