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

The use of autologous blood is a well established and extremely popular technique to decrease the necessity for homologous transfusions and the attendant risks of hepatitis, HIV, and HTLV--I/II infections. The most beneficial timing for autologous reinfusion of predonated blood remains unknown. The present study was undertaken to determine the optimal timing of autologous blood reinfusion in elective spinal surgery. Fifty-seven patients were prospectively individually randomly allocated into early versus delayed reinfusion groups prior to undergoing elective spinal surgery by a single surgeon. Three surgical subgroups were entered into the study: anterior/posterior (A/P) spinal fusion patients, posterior thoracolumbar scoliosis fusion patients (PSF), and degenerative posterior lumbar fusion patients (LF). Randomization was successful in that three was no significant difference in male to female ratio, age, preoperative hemoglobin, or number of units predonated between the early and delayed reinfusion groups. Likewise, there was no significant difference in the details of the operative procedure when compared as a group for the early versus delayed reinfusion groups. A significant increase in the postoperative day #1, 2 and 3 hemoglobin was seen in the early reinfusion group, while there was no significant difference seen in the postoperative day #7 hemoglobin between the early versus delayed reinfusion group. There was no effect of surgical grouping on these significant comparisons. Earlier patient mobilization was also seen in the early reinfusion groups for the A/P and PSF groups. There was no difference in patients' subjective evaluation of satisfaction and discomfort between the early or delayed reinfusion groups as determined by blinded interview on days 1, 3, 5, and 7 postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Early versus late replacement of autotransfused blood in elective spinal surgery. A prospective randomized study. 836 75

Oral hairy leukoplakia appears as white vertical stripes on the lateral borders of the tongue and occurs almost exclusively in HIV infected patients. The clinical appearance of hairiness is a result of emergence of floss of the parakeratinized epithelial surface. The etiologic agent seems to be Epstein-Barr virus, which may be diagnosed by in situ hybridization on tissue sections. Illustrations are shown from the case of a 30 year-old man. Approximately 25-30% of HIV positive patients have been reported to be affected by oral hairy leukoplakia. Although not causing any pain or discomfort the lesion is of clinical importance, since it may be the first sign of the development of AIDS. Moreover, for some patients who do not know their HIV infection status it may be the first sign of infection, and should alert the physician to the need to HIV test the patient.
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PMID:[Oral hairy leukoplakia. Epithelial hyperplasia in immunodeficient persons related to Epstein-Barr virus]. 839 16

The development and validation of the HIV-Quality Audit Marker (HIV-QAM), an instrument designed to measure changes in the status of hospitalized AIDS patients due to nursing care, is reported. The HIV-QAM is designed to capture the nurse data-collector's judgment of the status of the patient based upon observations, interviews, record reviews, and listening to inter-shift report. The final version of the 10 item HIV-QAM includes three scales, Self-care (six items; Cronbach's alpha = 0.89), Ambulation (two items, alpha = 0.88), and Psychological Distress (two items, alpha = 0.84). Content validity was supported by selection of items from pre-existing scales, generation of items based on care plans for HIV/AIDS patients, and review and critique of items by a panel of nurse experts. Construct validity was supported by principal components factor analysis and multi-trait scaling analysis. Convergent and divergent concurrent validity with patient symptoms and intensity of nursing care required was demonstrated. The predictive validity of the HIV-QAM for mortality at 3 and 6 months after hospital treatment for Pneumocystis carinii pneumonia was also shown.
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PMID:The HIV quality audit marker (HIV-QAM): an outcome measure for hospitalized AIDS patients. 851 70

A case is 48 years-old Japanese man who had a history of frequent sexual contact with prostitutes in Thailand and the Philippines. He presented with chief complaint of chest discomfort in April 1995. His chest X-ray film showed right mediastinal lymph node swelling in other hospital and the sputum smear was strongly positive for acid fast bacilli. In May 1995, he was admitted to our hospital and serological tests for HIV were positive both by EIA and Western blot methods. The CD4 lymphocyte count was 167/microliters. He was diagnosed as a case of AIDS according to the criteria proposed by the AIDS surveillance committee of the Japanese Ministry of Health and Welfare. Although numerous tubercule bacilli were detected in sputum, the chest X-ray did not show abnormal shadow in lung fields. So the diagnosis of bronchial tuberculosis was suspected by these apparently contradictory findings and the bronchoscopy was performed. Biopsy specimen of the bronchial mucous membrane obtained by bronchoscopy confirmed the presence of acid fast bacilli by Ziehl-Neelsen's staining method, however, histological findings were atypical of tuberculosis. A month after the initiation of treatment with isoniazid, rifampicin and ethambutol and AZT, his clinical symptoms improved and the sputum smear and the culture tests for tubercule bacilli converted to negative. Complications of AIDS, (Pneumocystis carinii infection, Cytomegalo virus infection, Kaposi's sarcoma, etc) other than tuberculosis have not developed to date. In the past reports, we could not find reports of bronchial tuberculosis with AIDS. Tuberculous granuloma formation was scarce in this case, and it was suspected that bronchial tuberculosis with AIDS would show characteristic sign as same as pulmonary tuberculosis with AIDS.
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PMID:[A case of AIDS with bronchial tuberculosis]. 867 92

Two measures of health-related quality of life in 65 HIV-infected individuals were compared in a cross-sectional design. The Quality of Well-Being Scale (QWB) results in a single score ranging from death to perfect health. The MOS-HIV Health Survey (MOS-HIV, 34-item version) gives scores in 11 dimensions. The QWB score distinguished subjects with AIDS from those who were asymptomatic (p = 0.027). For the seven multi-item scales of the MOS-HIV, Cronbach's alpha ranged from 0.85-0.95, indicating good internal consistency reliability. Clinical HIV-infection status was significantly associated with the dimensions of Overall Health (p = 0.002), Role Function (p = 0.022), Social Function (p = 0.037), Energy/Fatigue (p = 0.027) and Health Distress (p = 0.025). All eleven dimensions of the MOS-HIV were significantly correlated with the QWB score (Spearman's coefficient = 0.405-0.670; for all, p < 0.01) and the QWB score could be predicted from the MOS-HIV dimension scores using multiple regression. The QWB and the MOS-HIV may be useful in assessing health-related quality of life in patients infected with HIV.
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PMID:The use of two measures of health-related quality of life in HIV-infected individuals: a cross-sectional comparison. 899 97

Records of 133 AIDS patients treated at the Internal Medicine and Cardiology Service of the University Hospital in Brazzaville between January 1986 and December 1995 were analyzed. During the 10 years, 342 patients with AIDS were admitted, of whom 133 (38.9%) had recently developed cardiopathies. Patient ages ranged from 17 to 78 years (average, 35 years). 75 were male and 58 female. Clinical manifestations were often minor or even absent, but patient histories revealed functional symptoms. The patients were generally in an advanced stage of HIV infection. Clinical examination showed myocarditis to be the most frequent condition, with 81 cases (61%). Isolated liquid pericarditis was observed in 47 cases, including 15 with blockage. 25 patients showed mitral insufficiency, 16 tricuspid insufficiency, 2 aortic insufficiency due to infectious endocarditis, and 2 myocardial infarct. In 17 cases the onset was abrupt, with influenza-like symptoms. Standard cardiac radiography demonstrated cardiomegaly in all cases. Only 23 of the 133 electrocardiograms were considered normal. The other 110 showed various anomalies, of which the most frequent and significant was diffuse and concordant inversion of the T waves. Cardiac ultrasound in the 90 patients examined allowed diagnosis of 58 cases of myocarditis, 27 of liquid pericarditis not associated with myocarditis, and 5 of infectious endocarditis. 20 deaths were observed. The condition was stabilized in 85%. The fatality rate for AIDS-related cardiopathy is relatively low, on the order of 15-20%. Early diagnosis allows initiation of treatment, which often reduces patient discomfort.
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PMID:[The heart and AIDS]. 902 16

We examined the relationship of somatic complaints to coping behaviors and mood states among 50 HIV-positive patients without AIDS. Although no patients fulfilled the DSM-III-R criteria for mood disorders including major depression, scores for depressive symptoms were significantly higher in the HIV-positive patients than in healthy persons. Although depressive symptoms in HIV patients may not be strong enough to warrant a psychiatric diagnosis of mood disorders, these patients may be prone to depressive symptoms. The HIV patients indicated a tendency toward somatic complaints more frequently than their healthy counterparts. The scores for depressive symptoms were significantly and positively correlated with scores for avoidance coping responses. The presence or absence of six complaints (i.e., general fatigue, abdominal distress, chest pain or discomfort, and numbness or chills) could be discriminated based on the score of avoidance coping responses. The results of this study suggest that avoidance coping responses associated with depressive symptoms accompany several somatic complaints in HIV patients without AIDS.
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PMID:Liaison psychiatry and HIV infection (I): Avoidance coping responses associated with depressive symptoms accompanying somatic complaints. 907 52

The diagnosis and treatment of oral mucosal lesions in HIV infected individuals is of importance. Oral lesions are reliable indicators of HIV infection and immunosuppression. They are important for staging HIV disease, they have been used as clinical markers in trials to test drug efficacy, and to determine the correct time for institution of treatment for HIV or prophylaxis against opportunistic infections. For the patients, they can cause pain, loss of taste and severe discomfort, leading to decreased quality of life. In more severe cases, they can disseminate and become life-threatening. Several types of lesions may affect the oral mucosa of HIV infected individuals. Although caused by different etiological agents, these lesions may have similar clinical appearance. They may also look like other oral mucosal lesions not commonly associated with HIV infection. Their correct diagnosis is important so adequate treatment can be prescribed. This article provides information to the dentist in private practice on how to elaborate a differential diagnosis and arrive to a final diagnosis of oral mucosal lesions in HIV infected individuals.
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PMID:Oral lesions and HIV. An approach to the diagnosis of oral mucosal lesions for the dentist in private practice. 936 Apr 40

In the last few years, the allergenic potential of latex has been receiving greater attention. While latex allergies have been widely reported in the literature, the prevalence and severity have rapidly increased in the last few years. The role of rubber in the prevention of HIV infection has played a part in recognizing the allergenic potential, as with increased emphasis on infection control in the dental office has come an increase in complaints of adverse reactions to surgical gloves. A review of the literature reveals latex allergy problems to be not confined to gloves, but to articles of clothing, rubber dam material, and other latex-containing materials. Life-threatening cases have been reported. Little information in the literature concerns the extent of the problem among dental personnel. The dental professional may be faced with not only discomfort for the dental staff, but also compromising reactive possibilities in certain patients. There is a need for development of alternative protective products for the dental office, since elimination of barrier protection is not a viable alternative to infection control.
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PMID:Latex allergies and adverse reactions: a review of the literature. 952 Jul 56

With the increasing incidence of hepatitis B and HIV, and the increasing awareness of the risk and prevalence of hepatitis C, it is becoming even more necessary to adopt stricter policies to safeguard personnel and to reduce the risk of transmission. Previous studies have shown a need for eye protection, protective clothing and the use of double-gloving during operative or interventional procedures. The risk of infection is much less with unbroken skin and conversely more likely when hollow needles are used. Arguments against the routine use of double-gloving include the loss of dexterity and the discomfort incurred, and the potential loss of dexterity that might theoretically result in more rather than fewer needle-stick injuries.
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PMID:A randomized controlled trial of double-versus single-gloving in vascular surgery. 956 Apr 97


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