Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recently health education has played an important role in educating homosexual men and the general community about HIV infection, in influencing in favor of smoke-free environments, in increasing immunization, and in increasing community awareness about a safe water supply. Health education must not only increase knowledge and encourage behavior change toward a healthy life style, but also create social, political, and economic conditions that augment and support healthy living. For instance, hospitals need to make it easier for mothers to breast feed their infants and to provide easier access to health services. Social marketing techniques have been successful in the promotion of ideas and products for health, but people's initiatives, political commitment, supportive policies, a healthy environment, and healthy life styles contribute to health development. In order to facilitate social action, efforts must focus on 1) promoting health literacy at the community level and stimulating collective action to improve conditions, 2) mobilizing community resources at the systems level for local actions, and 3) at the policy and political levels articulating and giving a high priority to health needs as sound economics and as a political asset, not just a social imperative. Alliances must be built beyond the health sector. Limitations must be overcome: working in isolation, working at singular levels, working in poverty, and lacking skills and experience for undertaking initiatives. The process is complex and easy solutions are not possible. Exchanging knowledge and information will facilitate the process. WHO has identified some principal strategies for encouraging social action: advocacy, empowerment, and social support. The implementation of these strategies will lead to improved programs and outcomes now and in the future.
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PMID:Social action for health: emerging perspectives for health education. 161 18

Two therapeutic modalities, zidovudine (targeting retroviral replication) and cyclosporin A (targeting immunopathologic consequences of retroviral expression) were evaluated in a murine model of AIDS. In previous studies, cyclosporin A treatment (40 or 60 mg/kg/day) before and after infection with LP-BM5 murine leukemia viruses protected against the development of immunodeficiency disease. The present study extends these findings. First, a low dose of cyclosporin A (20 mg/kg/day) was ineffective, and treatment initiated 5 days after infection did not protect against virus-induced lymphoproliferation and hypergammaglobulinemia. Second, zidovudine added to drinking water (0.1 mg initiated 5 days after infection and continued for 8 weeks) was more effective than 0.2 mg/mL given day 5-12 after infection. This treatment reduced lymph node size, disease severity as determined histologically, retrovirus-induced gp70 expression, and IgE (but not IgM and IgG) levels. Third, combined treatment had an additive, protective effect on lymphocyte proliferative capacity. This successful dual therapeutic strategy in a mouse model has potential applicability for similar approaches in treating human immunodeficiency virus infection.
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PMID:Effect of cyclosporin A and zidovudine on immune abnormalities observed in the murine acquired immunodeficiency syndrome. 163

The 24 amino acid peptide RP135 corresponds in its amino acid sequence to the principal neutralizing determinant (PND) of the IIIB isolate of HIV-1. Although the sequence of the PND is highly variable, its central part, containing the sequence GPGR, is conserved in most HIV isolates. Using 2D NMR and CD spectroscopy, we have studied the conformation of RP135 and of two shorter versions: one (P547) that includes the GPGR sequence with the N-terminal part of the peptide and the other (P344) that includes GPGR and the C-terminal segment of RP135. In water, the C-terminal part of RP135 was found to exist in several transient turnlike conformations ("nascent helix"). A helical conformation was found to be stabilized by the addition of TFE. A transient turn was observed also in the GPGR sequence, both in water and in aqueous TFE solutions. While no nascent helix conformations could be observed in the N-terminal part of RP135 in water, a helical conformation was partially stabilized by the addition of TFE. The conformations of the two shorter versions of the peptide were similar to those of the corresponding parts of RP135, except that the transient turn in GPGR could not be detected in P547 dissolved in water. The turn in GPGR was previously predicted by Larosa et al. (1990) and was observed by Chandrasekhar et al. (1991) in the PND peptide of HIV-1MN (RP142), which shares only 56% identity with RP135. However, nascent helix conformations were not observed in aqueous solutions of RP142.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Solution conformation of a peptide corresponding to the principal neutralizing determinant of HIV-1IIIB: a two-dimensional NMR study. 163 31

Use of condoms has been advocated as an important method of reducing the risk of human immunodeficiency virus (HIV) transmission among high-risk groups such as homosexual and bisexual men, prostitutes, intravenous drug users, adolescents, and hemophiliacs. Despite risk-reduction education campaigns directed to gay men since the early 1980s, evidence shows continued deficits in condom-use skills and knowledge among gay men. Because most failures in the use of condoms are attributed to errors in use, increasing knowledge and skills in condom use is important in preventing HIV infection. Two groups of homosexual and bisexual men were sampled, those entering a risk-reduction education program and participants in a Gay Pride event. They were surveyed on their current sex practices and their efforts to reduce their risk of HIV infection. They were asked about their numbers of sex partners, specific sexual behaviors, use of condoms, types of condoms used, and lubricants used for genital-anal sex. The characteristics of those surveyed were similar to those of respondents in other studies of risk reduction among gay men. The use of an oil-based lubricant with condoms has been shown to weaken latex and to increase the likelihood of condom breakage, which use of water-based lubricants does not. Among respondents who reported having genital-anal sex, 60 percent reported use of an oil-based lubricant with a condom at least once during the year before the survey. Gay men in sexually exclusive relationships engaged in less consistent use of condoms for receptive genital-anal sex than did single gay men. The duration of their relationship with a partner was unrelated to the consistency of risk reducing behaviors practiced by men in sexually exclusive relationships. Gay Pride participants engaged in sexual behavior that was relatively more risky for HIV transmission than did the other group. Gay Pride participants used condoms less consistently for genital-anal sex than did the risk-reduction program entrants.The findings indicate the need for better risk reduction education efforts directed to gay men. Continued improvement in these efforts will require assessing the effectiveness and consistency of risk reduction efforts, determining the potential for gay men to relapse into more risky behavior, and identifying gaps in the knowledge of risk-reduction efforts among gay and bisexual men. Risk reduction programs need to emphasize motivational factors, provide basic information on how one determines the content of lubricants, explain why water-based lubricants only should be used, and teach how to use condoms properly. Active outreach is needed to gay and bisexual men who are unlikely to voluntarily enroll in risk-reduction programs.
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PMID:Inappropriate lubricant use with condoms by homosexual men. 164 45

We undertook an observational study of 1307 consecutive surgical procedures at San Francisco General Hospital to record descriptions of intraoperative exposures to blood and other body fluids, determine the factors predictive of these exposures, and identify interventions that might reduce their frequency. During a two-month period, circulating nurses took note of parenteral and cutaneous exposures to blood and recorded information about all procedures. In a follow-up validation study, 50 additional procedures were observed by the study investigators to determine the accuracy of the data collected by the nurses. A total of 960 gloves used by surgical personnel during the validation study were examined to determine the perforation rate. Accidental exposure to blood (parenteral or cutaneous) occurred during 84 procedures (6.4 percent; 95 percent confidence interval, 5.1 to 7.8 percent). Parenteral exposure occurred in 1.7 percent. The risk of exposure was highest when the procedures lasted more than three hours, when blood loss exceeded 300 ml, and when major vascular and intraabdominal gynecologic surgery was involved. Neither knowledge of diagnosed human immunodeficiency virus (HIV) infection nor awareness of a patient's high-risk status for such infection influenced the rate of exposure. Double gloving prevented perforations of the inner glove and cutaneous exposures of the hand. We conclude that all surgical personnel are at risk for intraoperative exposure to blood. Our data support the practice of double gloving and the increased use of water-proof garments and face shields to prevent mucocutaneous exposures to blood. No evidence was found to suggest that preoperative testing for HIV infection would reduce the frequency of accidental exposures to blood.
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PMID:Risk of exposure of surgical personnel to patients' blood during surgery at San Francisco General Hospital. 198 67

Human immunodeficiency virus 1 (HIV-1) reverse transcriptase has been found to conduct error-prone synthesis on DNA and RNA templates. We find here that tolerance of an A:G mispair with poly(rA) as template is particularly strong, such that extensive poly(dG) synthesis is conducted. This type of extensive misincorporation is not observed with several reference DNA polymerases. Surprisingly, HIV reverse transcriptase processivity and kcat for dGMP misincorporation and normal dTMP incorporation are about the same. However, the Km value for dGTP in poly(dG) synthesis is approximately 1000-fold higher than the Km for dTTP in poly(dT) synthesis. Comparison of thermodynamic parameters for dGMP misincorporation and normal dNMP incorporation indicates a lower energy of activation for dGMP misincorporation than for normal dNMP incorporation. Entropy of activation (delta S*) for normal dTMP incorporation is positive (approximately 10 cal/kmol), whereas delta S* for dGMP misincorporation is negative (-36 cal/kmol). Since differences in delta S* are usually considered to reflect differences in solvation for the transition state complex, these results are consistent with the interpretation that the active site of HIV reverse transcriptase is flexible enough to misincorporate dGMP without the usual dispersion of water molecules.
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PMID:Thermodynamics of A:G mismatch poly(dG) synthesis by human immunodeficiency virus 1 reverse transcriptase. 170 95

Facial Kaposi's sarcoma is a severe psychological problem for HIV-infected patients if systemic chemotherapy or interferon therapy is not possible. To help these patients, it is important to offer a palliative treatment that is suitable for outpatients and is not complicated by severe side-effects but still yield satisfactory cosmetic results. A total of 65 patients with 216 facial Kaposi's sarcomas were treated with cryosurgery (92 tumours, 29 patients), intralesional chemotherapy with vincristine (28 tumours, 12 patients), radiotherapy (87 tumours, 15 patients) and camouflage (multiple tumours, 9 patients). Cryosurgery is the treatment of choice for small (less than 1 cm) macular or slightly nodular Kaposi's sarcoma. Larger nodular tumours are better treated by intralesional chemotherapy (single doses of 0.01-0.1 mg vincristine per tumour) or low-dose radiotherapy (3-4 x 4 Gy). These palliative treatment methods are not indicated in cases of rapid tumour progression and dissemination; in such cases, camouflage (covering the tumours with water-resistant make-up) is helpful as a local palliative measure.
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PMID:[Facial kaposi's sarcoma. Palliative treatment with cryotherapy, intralesional chemotherapy, low-dose roentgen therapy and camouflage]. 171 2

To detect the earliest structural changes in the brain in human immunodeficiency virus (HIV) infection, 118 gay men and 115 parenteral drug users enrolled in a study of the natural history of HIV infection underwent magnetic resonance imaging evaluations. Routine T2-weighted and heavily T2-weighted scans for quantification of brain water were obtained, blinded to HIV serostatus. Atrophy and foci of increased signal did not correlate with any medical, immunologic, neurologic, or neuropsychologic parameters in the group as a whole, or in the gay men or parenteral drug user subgroups. Three subjects had progressive multifocal leukoencephalopathy and one had central nervous system lymphoma. In a subgroup in whom intracranial water percent was calculated, correlations were found with CD4 counts and CD4/CD8 ratios. We conclude that standard magnetic resonance imaging of the brain does not differentiate asymptomatic and mildly symptomatic HIV-positive individuals from HIV-negative individuals, regardless of risk group. However, intracranial water percent may distinguish HIV-positive from HIV-negative individuals because it correlates with raw CD4 counts and CD4/CD8 ratios.
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PMID:A prospective controlled study of magnetic resonance imaging of the brain in gay men and parenteral drug users with human immunodeficiency virus infection. 172 62

The topic of this paper is the demonstration of the combined effectiveness of condom and spermicide use. It is reasoned that 2 methods, which separately provide only moderate efficacy, act together independently and the probability of both failing is the product of the 2 probabilities of failure. Spermicides have a typical user failure rate of 21% and condoms 12%; combined, the 1st year probability of failure among typical users is 2.5%. Under perfect use, where there is correct use for every act of intercourse, the assumption of independence is very likely, and efficacy would be a high as steroidal implants. In addition to highly efficacious protection from pregnancy, there is protection form HIV and other sexually transmitted infections (STD). Spermicides referred to are rubber compatible, not oil based, and conform to the IPPF Agreed Test for Total Spermicidal Power. Condoms are defined as good quality which resist breakage and conform to the International Condom Standard, 1990. It is also advised that, in the event of condom breakage without spermicide, genitalia be washed immediately with soap and water to minimize risk. Also, proper douching that directs liquid sideways, not toward the cervix, should further reduce risk, It is underscored that contraceptive efficacy is not an effectiveness rate, but a failure rate. Effectiveness is the proportionate reduction in the risk of conception per cycle or infection per coitus caused by use of a method. The per cycle probability of conception is fecundability. The model described for combined use and STD use; it is based on the assumption that 1) the probability of conception and effectiveness and thus the per cycle probability of failure for the method is constant over time, and 2) there are 13 cycles per year. What is ignored is that failure rates decline among typical users with duration of use, so that life table procedures are not necessary. The annual probability of failure during perfect use of condoms and spermicides would by .00045, and if failure doubled, the probability would still be only .00186. Any lubricant also helps to reduce breakage of condoms, thereby enhancing efficacy. The probability of failure for spermicidally lubricated condoms during perfect use would be .005. If the annual probability of condom failure were doubled to 4% and spermicide effectiveness were the lowest at 73%, then the failure rate would be only 1%.
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PMID:Efficacy of the simultaneous use of condoms and spermicides. 826 74

Some patients need medical preparation and physician counseling before traveling to eastern European countries. In addition to baseline immunizations, a measles booster, a polio booster, typhoid vaccination, and immune globulin prophylaxis against hepatitis A may be indicated. Advice should also be given regarding air pollution, contaminated food and water, civil unrest, motor vehicle mishaps, and each country's policy on HIV screening. Because the level of healthcare may be poor, contact with American or British embassies or consulates is recommended in an emergency.
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PMID:Travel in eastern Europe. Guidelines for patients. 189 30


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