Gene/Protein Disease Symptom Drug Enzyme Compound
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Garlic may play an invaluable role in the prevention and therapy of the major causes of death. Anecdotal, basic, and clinical research data are confirming the efficacy of this herb in the treatment of hyperlipemia, cancer, heavy-metal intoxication, infectious diseases, hypertension, free-radical damage, and immune deficiency states. Garlic's broad antimicrobial spectra and its ability to modulate immunity may play a strategic role in the acquired immunodeficiency syndrome pandemic. A review of the literature supports a greater scrutiny of this herb's therapeutic potential.
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PMID:Garlic revisited: therapeutic for the major diseases of our times? 329 May 2

The challenge of achieving health for all is enormous in the face of 500,000 maternal deaths a year; the fact that 2.9 billion people lack clean water and sanitation; the AIDS epidemic and malaria prevalence; substance abuse; population aging; runaway urbanization; environmental degradation; and violent human conflicts. To develop new ways of thinking and approaches, programs initiated by the Health Foundation of the Rogosin institute of New York entitled Problem-Solving for Better Health. The basic concept was that available limited resources (preventive, therapeutic, information, talent, and community) are seldom fully utilized, rather than are often wasted. The program involves attendance of a workshop lasting 3-5 days by 60 health professionals. The problem-solving strategies are discussed in large groups with a handbook for supporting presentations. Community involvement and international collaboration are stressed, and follow-up site visits take place after 6 months. The Health Foundation's INFO-MED computer program and interactive information centers provide up-to-date information for professionals working on health problems. In China, 54 professionals collaborated to solve health problems. In 1992, progress reports for 21 projects dealt with anxiety, violent behavior, attention-deficit disorders, hyperlipidemia, and wound healing. In Brazil, 53 health professionals were enrolled in 1990 and prepared some 50 solutions to problems, including patterns of violence among young males in Sao Paulo and nutritional deficiencies in slums. Six projects were implemented with 36 under development. In Ghana, 65 professionals devised solutions to problems in 1991, 12 projects are under way, and 1 on hearing problems in school children is ready for national implementation. In the US, a team from the University of Illinois Medical School launched a program in 1992 on geriatric, pediatric, and women's health issues. In Guyana, 70 professionals participated in a workshop in 1992 to strengthen community-based programs. In Nigeria, also in 1992, 78 participants prepared protocols on family planning, guinea-worm eradication, and environmental health.
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PMID:Problem-solving for better health. 814 91

A new non-linear mathematical model was constructed in order to perform in vivo quantification of the RES phagocytic function. This method is based on the same technical facilities as used for the routine liver-spleen scintigraphy with radiocolloids [1, 2]. But kinetic modeling of dynamic Tc-99m-sulfur colloid data produced estimations of the functional RE-parameters: the clearance rate of the colloidal particles, the rate of phagocytosis, and the RES functional volume, which can not be obtained by classical approaches. This non-linear model was designed on the basis of the principal characteristics of particulate material interaction with macrophages (attachment, phagocytosis, digestion) [3, 4, 5]. The theoretically examined behavior of this in vivo mathematical model corresponds with the experimental behavior of the RES. The mathematical expression of the dynamics is the system of non-linear differential equations with constant coefficients that have no analytical solution. Fitting of the normalized heart blood time-activity curve was obtained to identify the unknown model parameters via non-linear regression. For this purpose general interactive PASCAL procedure IDPAR for a PDP-11/34 computer was used (an IBM PC version is also available). Two to three iterations were needed to estimate the set of unknown parameters for any patient study (1-1.5 min). A very good fitting was obtained between experimental and model curves in every case of different pathologies (error of the approximation is about 2-3%). Studies were performed using an in vivo bolus injection of 3.6 mg/80 kg commercially available colloid KOREN labeled with 3m-Ci 99m-Tc (analog of TCK-1). Our method was used to determine the RES functional parameters for patient groups with different levels of the RES dysfunction. Obtained results illustrate the possibilities of our technique to quantitatively estimate not only great pathology (portal cirrhosis), but also small changes of the RE-function (case of hyperlipidemia and ulcer gaster). In all patient groups marked changes of Tc-99m-sulfur colloid turnover were observed. In general, tracer clearance from the circulation was decreased, and the rate of phagocytosis and the RES volume were diminished compared with controls. The effect of a reduction of phagocytosis increases when the RES dysfunction becomes stronger. It can be shown that a non-parametric Wilcoxon-Mann-Whitney test gives a significant difference (P95%) for these patient groups. Further, we represent the possibility of using the model for monitoring changes of the RES-function parameters during and after therapy. The quantitative test of the RES function can significantly enhance the diagnosis and management of different diseases. Serial colloidal studies may document changes in the RES-function for the tumors, cirrhosis, hyperlipidemia, reticulosis, hepatitis, thrombosis, infection, AIDS, burn injury, shock and trauma patients. The technique may be useful for the different RES investigations with laboratory animals. Created computer software can be used as a tool for kinetic models, simulation, and unknown parameters identification.
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PMID:A non-linear mathematical model for the in vivo evaluation of the RES phagocytic function. 859 76

The purpose of this report is to examine health-related quality of life (HRQoL) as measured by the Medical Outcomes Study Short Form-36, across patient populations with chronic disorders and to compare quality of life (QoL) in these subjects with normative data on healthy persons. Six studies, within the Center for Research in Chronic Disorders at the University of Pittsburgh School of Nursing, in patients with urinary incontinence, prostate cancer, chronic obstructive pulmonary disease (COPD), acquired immune deficiency syndrome (AIDS), fibromyalgia and hyperlipidaemia provided the data for analysis. The results demonstrated that not only did the prostate cancer and hyperlipidaemia patients have the highest QoL across the chronic disorders, but their QoL was comparable to normative data on healthy persons. Homebound, elderly, incontinent patients had the lowest QoL for physical functioning, whereas patients hospitalized with AIDS had the lowest QoL in general health and social functioning. Patients with COPD had the lowest QoL in role-physical, role-emotional and mental health. Patients with fibromyalgia had the lowest QoL in bodily pain and vitality. Compared to normative data, patients with urinary incontinence, COPD, AIDS and fibromyalgia generally had lower QoL. Prostate cancer and hyperlipidaemia patients had QoL comparable to normative data. Compared to normative data, patients with urinary incontinence, COPD, AIDS and fibromyalgia had more variability for role-emotional. AIDS patients had more variability on physical functioning, bodily pain and social functioning compared to the normative data. These data suggest that patients with various chronic disorders may have QoL that is lower in most domains compared to a healthy population. However, there may be differences in the domains affected as well as the extent of variation across specific chronic disorders.
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PMID:Health-related quality of life in chronic disorders: a comparison across studies using the MOS SF-36. 948 Nov 51

Treatment for HIV infection in the past 3 years has significantly improved the prognosis of people infected with HIV. Protease inhibitors have played a critical role in this improved prognosis. Recent findings indicate, however, that protease inhibitors may cause significant alterations in lipid metabolism. This study reviewed the incidence of lipid abnormalities associated with the use of three different protease inhibitor therapies and identified that 56% of those who were assessed had abnormal elevated lipids. Following initiation of the protease inhibitor, a significant increase in cholesterol was found in 80% of the patients on norvir/saquinavir, 51% of patients on indinavir, and 47% of patients on nelfinavir. These lipid alterations have added a new and unexpected health risk for HIV-infected persons. The risks of therapy with protease inhibitors may have a greater life-threatening potential than the disease itself. This article will review the published findings suggestive of protease inhibitor hyperlipidemia and will highlight the findings of these events in a clinical setting. The purpose of this article is to alert the nursing community of this potential serious side effects and to make recommendations that may be put into practice so that complications may be reduced.
J Assoc Nurses AIDS Care
PMID:Lipid abnormalities associated with protease inhibitors. 1006 7

In the past 3 years, treatment for HIV infection has significantly improved the prognosis for HIV-infected persons. The administration of protease inhibitors for the treatment of HIV infection has had a significant role in the reduction of AIDS-related complications. Recent findings have indicated that protease inhibitors may significantly increase lipids to levels that pose a health risk that may be greater than the illness itself. This article reviews the initial findings of a study that investigated the impact of interventions for the treatment of protease inhibitor-related hyperlipidemia. The purpose of the study was to determine if initiation of interventions based on the National Cholesterol Education Program Guidelines would be effective in lowering protease inhibitor-related hyperlipidemia without disrupting the effectiveness of the HIV therapy. A total of 45 HIV-infected individuals who were taking a protease inhibitor and had abnormally elevated lipids were enrolled into this study. Mean serum cholesterol level prior to initiation of a protease inhibitor regimen was 170 mg/dl as compared to a mean cholesterol at time of enrollment of 289 mg/dl and triglycerides of 879 mg/dl. Interventions included diet and exercise and the prescription of gemfibrozil alone or in combination with atorvatstatin. During the course of the study, overall intervention significantly reduced serum cholesterol level to 201 mg/dl (p. 01) over a study period of ten months. Case studies of five medical events related to hyperlipidemia are included. Currently, 26 participants continue in the study. Sixteen participants discontinued protease inhibitor therapy during the course of the study and thus ended their participation.
J Assoc Nurses AIDS Care
PMID:Intervention for hyperlipidemia associated with protease inhibitors. 1039 60

Patients with AIDS who are receiving therapy with HIV protease inhibitors have been widely reported to be afflicted with a syndrome characterized by lipodystrophy (fat redistribution favoring the accumulation of abdominal and cervical adipose tissue), hyperlipidemia, and insulin resistance. HIV protease inhibitors have been suggested to have a direct role in modulating adipocyte differentiation. To address this hypothesis, several HIV protease inhibitors were studied for their ability to either augment or inhibit the differentiation of murine 3T3-L1 preadipocytes. Dose-responsive inhibition of adipogenesis by several protease inhibitors was noted as measured by reduced triglyceride accumulation and attenuated induction of three differentiation marker genes -- aP2, lipoprotein lipase, and Adipo Q. Potential mechanisms for altered adipocyte function, including direct binding to PPARgamma or inhibition of PPARgamma-mediated gene transcription were effectively excluded.
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PMID:Inhibition of adipocyte differentiation by HIV protease inhibitors. 1056 84

This descriptive study investigated quality of life issues, biochemical indices, and nutritional parameters of individuals with HIV/AIDS before the initiation of protease inhibitors (PI) and after PI therapy. Telephone interviews were conducted with 45 men and women who were diagnosed with HIV/AIDS. A 26-item subjective questionnaire was used to determine intake of liquid nutritional supplements, use of micronutrient and herb supplements, adherence to modified diets, gastrointestinal symptoms, employment status, sociability, and ability to conduct activities of daily living. A medical chart review was conducted to collect data on biochemical indices, weight, medication regimens, and incidence of opportunistic infections. The results of the study suggest that HIV/AIDS individuals gain weight, improve CD4 counts, and decrease HIV RNA viral load while on PI-based drug combination therapy. Opportunistic infections decreased, quality of life was improved, and blood albumin was elevated. Hyperlipidemia, that is, elevations in total cholesterol and triglycerides, was observed in study participants (44% and 40% of patients, respectively) after PI therapy. These findings support the need for future investigations to examine the long-term influence of PI-based combination drug therapies on nutrient intake, body composition, and quality of life of persons with HIV/AIDS.
AIDS Patient Care STDS 1999 Jul
PMID:Perception of quality of life of persons with HIV/AIDS and maintenance of nutritional parameters while on protease inhibitors. 1087 May 96

The introduction of HAART has changed the nutritional status of HIV patients. In the pre-protease inhibitor (PI) era, more than 60% of HIV-positive persons presented with protein energy malnutrition (PEM) and vitamin and mineral deficit. This caused progressive physical-metabolic wasting (wasting syndrome/cachexia) and increased susceptibility to opportunistic infections and drug toxicity. PEM was a concurrent cause in 80% of deaths attributed to AIDS. Since 1996, the year in which PIs were introduced, the number of patients dying as a result of AIDS has decreased by two thirds, and cachexia is no longer the AIDS terminal phase in developed countries. But different patterns of nutritional status changes have appeared in association with the use of newer anti-HIV therapies and with longer survival of HIV-infected patients. A new clinical and laboratory syndrome--lipodystrophy syndrome--now affects patients receiving PI-based therapy. This syndrome consists of changes in body shape that are caused by an abnormal redistribution of fat. Fat accumulates in the abdominal area (truncal and visceral obesity), in the axillary pads (bilateral symmetric lipomatosis), and in the dorsocervical pads ("buffalo hump," "bull neck") but decreases in the legs, arms, and nasolabial and cheek pads (peripheral lipodystrophy). Hyperlipidemia and insulin resistance are also frequently present (metabolic syndrome X). Pathogenic mechanisms of lipid and fat tissue disturbances are discussed in this article, and the clinical approach to patient management and therapeutic options for lipodystrophy and lipid dysmetabolism is evaluated.
AIDS Read 2000 Jun
PMID:Reversal of cachexia in patients treated with potent antiretroviral therapy. 1088 68

Both nature and prognosis of cardiac complications occurring in patients infected by the Human Immunodeficiency Virus-1 (HIV-1) have changed considerably since the introduction of highly acive and anti-retroviral triple therapy ("HART"). Opportunist cardiac infections have thus been displaced and side effects of drugs now occupy the primary aetiological role. Torsades de pointe may be exceptionally triggered by anti-infectious agents such as pentacarinat or trimethoprime-sulfamethoxazole, as are those induced by the association of ketoconazole and terfenadine or cisapride, the dangers of which are well known and the prevention more effective, especially with the association with HIV antiproteases which inhibit the cytochrome P450. The diagnosis of iatrogenic myocardial dysfunction is more difficult, except when it occurs acutely as with phosphonoformate (Foscarnet), or interleukine-2. Progressive cardiomyopathy caused by -interferon and dideoxynucleosides (zidovudine, didanosine and zalcitabine), reversible on withdrawal of the drug responsible in half the cases, should be distinguished from those due to the HIV itself (therapeutic relay) or to another associated cause (alcohol, coronary artery disease). The coronary complications of diseases treated by antiproteases usually occur in smokers whose cholesterol and triglyceride levels are rapidly increased with HAART. In a series of 9 patients (amongst 700 treated with the antiproteases), after the acute phase of myocardial infarction during which the interventional approach is often preferred, the medium-term prognosis is relatively good, on condition that the patients correct the hyperlipidaemia and give up smoking.
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PMID:[Cardiac side effects of anti-HIV agents]. 1097 35


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