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

Chronically ill children who require life-long i.v. infusions in regular intervals (i.e. Agammaglobulinemia, HIV-infection) can be traumatized by such painful procedures. Some children gradually accept such infusions, whereas other children become sensitized and react with increasing fear and resistance. We report on our experience with a combined method of local anaesthesia and active role-plays enacting the i.v. infusion on a puppet. In more than 230 applications (approximately 11 per child) in our outpatient clinic, 19/20 children reported significantly less pain sensations after the 2nd or 3rd application. The children learned to handle actively the threatening situation. The method of local anaesthesia with Lidocaine/Prilocaine and role playing is suitable to relieve pain and reduces distress of such invasive events as regular i.v. infusions are.
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PMID:[Reduction of pain perception of chronically ill children by intermittent infusion therapy]. 848 96

In the last few years many articles have been published on AIDS, the mechanism of transmission, prophylaxis and therapeutic possibilities; however, very few publications are available related with anesthesia of patients infected with HIV or AIDS. The authors have therefore undertaken this review in which following a brief description of the etiology, pathogenesis, physiopathology and treatment of the disease, the problems of anesthesia are specifically dealt with. The need for knowing the different active or latent clinical alterations, such as neurologic (encephalitis, meningitis, peripheral neuropathies, myelopathies, etc.), respiratory (pneumonias by Pneumocystis carinii), cardiovascular (myocardiopathies), digestives (oropharingeal candidiasis, hepatopathies), psychologic (drug addiction), hematic (anemias, leucopenias) coagulopathies, nephropathies, etc. must be emphasized. Before the possibility of such a broad pathology good evaluation and preoperatory preparation is essential. With regard to anaesthetic technique, regional anesthesia is of choice except in certain cases of neuropathies. Although patients with a high degree of immunosuppression present a high risk of infections of the nervous system, the global risk is lower than if general anesthesia with prolonged artificial respiration were received.
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PMID:[Anesthetic considerations in patients with human immunodeficiency virus infection]. 851 24

When IVDUs who lose peripheral access turn to their necks, they invite a spectrum of unique complications that require particular management and treatment. While many of these complications are infectious, other possibilities include vocal cord paralysis and needle fragment foreign bodies. Work-up of these patients must include a very thorough history and physical exam, particularly of the head and neck, complete with a laryngeal exam. All patients should undergo imaging studies, including plain films, CT or MRI of the neck, and other studies as appropriate. Laboratory studies should include HIV and hepatitis serologies. Because of the risks to the surgical team, neck explorations, when indicated, should be performed under general anesthesia with strict adherence to universal precautions. Further management includes early referrals to methadone clinics, although unfortunately poor patient compliance is usual. Public campaigns aimed at prevention are useful, although limited, and should be encouraged.
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PMID:Diagnosis and management of complications of self-injection injuries of the neck. 894 88

Dirofilaria repens is an endemic canine parasite in the Mediterranean area. Human infestation is rare. We observed a case in an HIV-positive patient who presented an ocular filaria which was successfully removed under local anesthesia. In man, filariae may be expulsed without a parasite cycle or complete a growth cycle, depending on the individual's immunological status. The disease has been known in southern France for several centuries, mainly in lagoons near the Mediterranean seaside. A review of the literature however shows that observation of clinical cases is rare, only 46 cases having been reported to date. Outcome is favorable.
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PMID:[Dirofilariasis in France: a case in Languedoc in an HIV-seropositive patient]. 895 57

Tuberculosis is one of the most widespread diseases, occurring in more than eight million persons, and about three million die annually of tuberculosis. In industrialized countries, the incidence has increased significantly over the last 10 years. HIV infection is a main factor leading to this increase. Outbreaks of nosocomial tuberculosis among patients and healthcare workers have been reported. Tuberculosis is often caused by multidrug-resistant bacilli in patients with HIV infection. Physicians must be aware of this danger and careful adherence to guidelines is required to prevent further nosocomial spread of the disease. Airborne transmission by inhalation of infectious aerosol justifies appropriate measures for respiratory isolation to protect medical staff and other patients from the transmission of tuberculosis. In combination with some anaesthetic agents, antituberculous drugs may be responsible for hepatic toxicity. Influence of tuberculosis on regional anaesthesia and mechanical ventilation is also considered.
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PMID:[Pulmonary tuberculosis in 1996. Recent data and practical consequences for the anesthesiologist]. 918 Sep 84

The purpose of this report is to describe the management of gingival vitiligo in a black female. This patient was referred by her psychiatrist to the Mount Sinai Hospital Dental Department (Toronto) for assessment of progressive loss in gingival pigmentation. According to her psychiatrist this loss of pigmentation, which the patient indicated may be considered in Africa as a hallmark of HIV infection, was a significant exogenous factor in relation to the patient's ongoing clinical depression. After obtaining informed consent, a modification of a tattooing method used for skin was applied to the patient's attached gingival tissues. Test sites were tattooed prior to performing full gingival tattooing under local anaesthesia. The results demonstrate that it was possible to restore this patient's gingival pigmentation in a highly esthetically acceptable manner. The resulting coloration was reminiscent of the patient's natural pigmentation that had been lost ostensibly because of her systemic disorder. Our findings also showed that the artificial pigmentation established via the tattoo method was stable 4 months postoperatively and continues to be stable, as expected. A profound improvement in the patient's mood was noted.
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PMID:Management of gingival vitiligo with the use of a tattoo technique. 966 Mar 42

Manifestations of herpes zoster ophthalmicus (HZO) infection are well known in HIV-seropositive White patients in developed countries, but this association has not been previously noted in African AIDS patients. This paper analyzes 8 cases (3 men and 5 women) 24-40 years of age who were treated at the Eye Department of the University of Nigeria Teaching Hospital, Enugu, for HZO in 1994-97. Of the 6 patients who consented to HIV screening, 4 were HIV-seropositive. One of the HIV-infected patients had been treated for pulmonary tuberculosis a year prior to the present illness, but the remaining 7 were in apparent good health. The patients presented with skin eruptions in the area of distribution of the trigeminal nerve on the affected side of the face and head. Visual acuity was impaired in all 8 cases. The most common ocular findings were lid edema, ptosis, conjunctival infection, corneal anesthesia, keratitis, uveal inflammation, and abnormal pupillary reaction. The severity of presentation was similar in HIV-positive and HIV-negative patients and all improved during follow-up; however, clinical improvement was less rapid or pronounced among the HIV-positive patients. These findings suggest that HZO infection in young Africans should be regarded as a possible indicator of HIV infection.
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PMID:Herpes zoster ophthalmicus and HIV infection in Nigeria. 970 97

By the end of 1995, a total of 79 occupationally acquired HIV cases had been documented worldwide among health care workers. As part of a larger study on the sexual and occupational risks of HIV among Dutch expatriates, 99 medical professionals (48 physicians and 51 nurses, midwives, or anesthesia assistants) who had worked in AIDS-endemic areas were identified. 96% of physicians and 92% of nurses had last worked in sub-Saharan Africa--typically in rural areas or refugee camps. When tested upon return to the Netherlands, none of these health care professionals was HIV-infected. However, 71% of physicians and 51% of nurses experienced at least one percutaneous exposure (mean number, 2.0 and 1.9, respectively) during an average stay abroad of 2.3 and 1.2 years, respectively. 235 of the 337 accidents described involved solid needles. Given an estimated HIV prevalence in the patient population of 19%, an HIV transmission per accident of 0.3%, and 1.9 percutaneous exposures per year, the occupational HIV risk per health worker per year in countries with high HIV prevalence can be estimated as 0.11%. Most injuries occurred during routine acts and tended to be self-inflicted as a result of negligent needle disposal, recapping errors, cleaning materials for reuse, carelessness due to fatigue, or rushing. Accidents with solid needles were significantly more likely to occur if more procedures were performed, the stay abroad was longer, co-workers were local, and management consisted of local personnel. Worry about occupational exposure to HIV was reported to occur sometimes in 68% of physicians and nurses, regularly in 12%, and often in 6%. HIV prevention programs for health workers should address not only how to prevent occupational exposure, but also how to prepare for the emotional responses to exposure and the consequences this may have for sexual behavior.
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PMID:Occupational risk of HIV infection among western health care professionals posted in AIDS endemic areas. 982 64

We reviewed the records of 12 patients with HIV infection (one stage I, three stage II, two stage III, six stage IV) who received 15 surgical procedures under general or lumbar/epidural anesthesia. We discussed surgical indications, their poor wound healing and precautions for preventing the risk of transmission of HIV to health care workers. Six emergency and nine elective operations were performed. Postoperative complications developed after three emergency and three elective operations. Ten patients showed delay of wound healing which was not directly correlated with the CD4+ cell count. No operative deaths occurred. In any stage of HIV infection, not only palliative but also curative operations can be performed as long as HIV infection, opportunistic infections and HIV-related neoplasms can be controlled. Late stage wound healing is poor, but the wound will heal without keloid formation, although it takes two to three times longer than usual. For operating on patients with HIV infection precautions for preventing needle sticks, sharp injuries and blood exposure should be learned and used by health care workers. As a result, surgical staff members will be able to perform operations safely on HIV-infected patients to improve both quality of life and the prognosis of their disease.
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PMID:Surgery in patients with HIV infection: indications and outcome. 986 9

Anesthesiologists as well as patients are at risk for acquiring blood-borne infections such as hepatitis and AIDS. We surveyed 2,530 anesthesiologists, a 10% random sample of the members of the American Society of Anesthesiologists, with a response rate of 57.1%, to determine the incidence of accidental needlestick exposure among anesthesia personnel and whether anesthesiologists are adhering to infection control guidelines to protect themselves and their patients from exposure to infectious diseases. Eighty-eight percent of respondents reported at least 1 accidental needlestick in the past 10 years; 21% received a needlestick from a high-risk patient and 4.5% a needlestick from a known HIV-positive patients. Residents reported significantly more accidental needlesticks from known HIV-positive patients (8.5%). Mucous membrane, open cut, eye, or other significant exposure to HIV-contaminated blood or body fluids was sustained by 8.34% of respondents in the past 10 years. Sixty percent of respondents reported they almost never reuse common syringes now compared with a 40.8% non-reuse rate (P < 0.001) in a similar survey on infection control practices conducted in 1990. Sixty-three percent reported they almost never reuse a vasopressor syringe compared with the 1990 non-reuse rate of 52.5% (P < 0.001). In the current survey, 39% of anesthesiologists reported reusing syringes from one patient to another and 36% reported reusing the same vasopressor syringes for different patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Accidental needlesticks: do anesthesiologists practice proper infection control precautions? 1015 Mar 51


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