Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Surgeons routinely work with potentially infectious materials. The risk of acquiring a disease from one percutaneous exposure is 0.3-0.4% for human immunodeficiency virus (HIV) 6-30% for hepatitis B virus (HBV) and 2.7-10% for hepatitis C virus (HCV). Rates of blood contacts vary but may reach up to 11.9 per 100 h in the operating room. Residents are at highest risk, and obstetrics and gynaecology surgeons suffered the highest rate of exposures (10%) as a group. Contributing risk factors include trauma or emergency orthopaedic procedures, high patient blood loss, long procedures and holding tissue by hand while suturing. However, across occupations, nurses and other health workers experience greater risks than surgeons regarding potentially infectious exposures. Preventive measures such as the HBV vaccine and protective devices (i.e. self-capping needles, needle-free i.v. systems and improved barrier materials) have reduced the occupational risk of acquiring a blood-borne infection, which allows attention to be given to the psychosocial risks which may be more significant, yet are often overlooked. Doctors are at greater risk of divorce, alcoholism, substance abuse and suicide than are members of comparable professional groups. One study found that general surgeons had the highest rates of suicide of all doctors. According to family surveys, surgeons tend to be oblivious to the effects of work stressors, and may benefit from greater self-awareness; sharing of feelings and responsibilities with colleagues, family and patients; being willing to delegate work to others; setting work limits; and broadening perspectives in their approach to work.
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PMID:Occupational health in surgery: risks extend beyond the operating room. 757 89

Prevention of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) among adolescents is increasingly recognized as an important public health priority. Sexual risk acts associated with HIV/AIDS transmission (unprotected sexual intercourse with multiple partners of unknown serostatus) are typically initiated by late adolescence, with many youths engaging in sexual relations earlier. Despite being well informed about HIV/AIDS and having positive attitudes toward HIV/AIDS prevention, adolescents have not changed their behavior in response to the pandemic. AIDS-prevention programs must be tailored to consider stereotypic sex roles, gay youths' sexual orientation, and substance abuse. Intensive prevention programs focusing on helping youths perceive HIV as a problem, motivate them to act safely, and implement safe acts by acquiring coping skills, access to condoms and health care, and identifying individual barriers to implementing safe acts have successfully reduced adolescents' risk acts. However, avenues for broad-scale dissemination of such programs or alternative models to change youths' behaviors must be identified.
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PMID:AIDS prevention with adolescents. 757 8

There has been an upsurge of tuberculosis in many parts of the world in the past decade. The high rates of drug-resistant tuberculosis currently reported in many countries are alarming. The most catastrophic phenomenon is the emergence of multidrug-resistant strains of Mycobacterium tuberculosis. These organisms have caused epidemic outbreaks in nosocomial and health-care settings in the USA and some European countries. In addition to immigration, poverty, alcoholism and intravenous substance abuse, human immunodeficiency virus (HIV) infection has also had a significant impact on the prevalence of drug resistance, since amongst these patient groups a common factor giving rise to drug resistance is noncompliance. Rapid drug susceptibility tests are needed, and effective chemotherapy regimens with newly developed drugs in combination with traditional second-line antituberculosis agents for established multidrug-resistant tuberculosis are urgently being sought. There is also a quest for other novel modalities of therapy. Measures should be actively adopted to prevent the development of drug resistance. Well formulated short-course chemotherapy as initial treatment and ensurance of compliance are the most important components. The organization of a national tuberculosis control programme with a sound and adequately functioning infrastructure remains the most effective strategy to combat the resurgence of tuberculosis and to curtail drug resistance.
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PMID:Drug-resistant tuberculosis in the 1990s. 758 89

To describe characteristics of persons with late (at or after death) acquired immunodeficiency syndrome (AIDS) diagnosis, we analyzed national surveillance data among all persons with AIDS diagnosed through December 1991 under the pre-1993 AIDS case definition and with a known date of death. Late diagnosis was present in 15.8% of 163,202 decreased persons with AIDS and in 15.3% of decreased men with AIDS, 20.6% of women, 12.1% of whites, 20.0% of blacks, 21.1% of Hispanics, 12.3% of men who have sex with men (MSM), 21.9% of injecting drug users (IDU), and 19.6% of persons exposed to human immunodeficiency virus (HIV) through heterosexual contact. When age, race/ethnicity, sex, geographic region, and transmission mode were included in logistic regression analyses, among adults/adolescents, late diagnosis was more likely among persons 40 years or older than among those 13-39 years old, among blacks and Hispanics than among whites, and among IDU and persons exposed to HIV through heterosexual contact than among MSM. Although children (less than 13 years of age) were more likely to have late diagnosis than adults and adolescents, late diagnoses among children did not differ significantly by race/ethnicity, sex, geographic region, or transmission mode. Late AIDS diagnosis, especially among ethnic minorities and IDU and their sex partners, may represent delays in HIV diagnosis and care. In addition to not receiving early clinical intervention, persons who are diagnosed later in the course of HIV disease represent missed opportunities for receiving prevention efforts such as education, counseling, and substance abuse treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Characteristics of persons with late AIDS diagnosis in the United States. 763 46

The proportion of total reported cases of acquired immune deficiency syndrome (AIDS) in US women increased annually between 1988 and 1994 from 10% to 18%, indicating an urgent need for prevention measures. Interventions designed to reduce unsafe sex and drug-using behaviors in women have been limited. Barriers to human immunodeficiency virus (HIV) prevention for women include a disproportionately low investment of resources, inadequacy and inaccessibility of substance abuse treatment programs, the crack/cocaine epidemic and resulting unsafe sex behaviors, lack of a woman-controlled method to prevent sexual transmission of HIV, and unique social and cultural factors that limit women's power in sexual decision making. Some interventions have been successful in reducing women's risk behaviors. Expanding prevention efforts targeted to women is necessary in order to stem the rising rate of HIV infection.
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PMID:Prevention of HIV infection in women: overcoming barriers. 765 51

Lesbians have unique health concerns that often go unaddressed in a medical setting that assumes heterosexuality. These may include cancer screening, sexually transmitted diseases, human immunodeficiency virus (HIV), depression, substance abuse, relationship issues, pregnancy, and parenting. Awareness of the barriers faced by lesbians seeking care, and an inclusive approach to the patient will allow primary care providers to be more effective in their interactions with all patients.
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PMID:Lesbian health issues for the primary care provider. 765 Apr 96

Heroin-associated nephropathy (HAN), a complication of intravenous heroin abuse, was initially recognized at Kings County Hospital in Brooklyn, NY, in the early 1970s. Our recent experience indicates that after a steady incidence of new cases of HAN throughout the mid-1980s, a sharp decrease in incidence of new cases occurred starting in 1989. We sought to explore possible explanations for what amounts to disappearance of a previously prevalent disease. By means of retrospective analysis of a hospital-specific registry of new cases of end-stage renal disease (ESRD) at Kings County Hospital in Brooklyn, incidence curves from 1981 through 1993 for new cases of HAN, diabetes-induced renal disease, and human immunodeficiency virus-associated nephropathy were constructed. From hospital computer records, the number of admissions directly related to opioid abuse were extracted and charted. Unpublished surveillance records of the New York State Office of Alcoholism and Substance Abuse Services as well as reports from the New York City Department of Health, Office of AIDS Surveillance and the US Department of Justice Drug Enforcement Administration were used to determine the pattern of change in the prevalence of heroin abuse. Additionally, we used analysis of "street" heroin by the Drug Enforcement Administration to draw curves detailing drug cost and purity in New York City. There were no new cases of ESRD due to HAN for the years 1991 through 1993. The rates for new cases of ESRD due to diabetes and hypertension remained relatively constant throughout this interval.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Disappearance of uremia due to heroin-associated nephropathy. 774 21

The prevalence of tuberculosis in the homeless is on the rise. The presence of human immunodeficiency virus and multidrug-resistant tuberculosis in the homeless has contributed to this high prevalence. Several factors, including alcoholism, substance abuse, and psychiatric illness, combine to make it difficult to diagnose and treat tuberculosis in the homeless. Medical providers are likely to encounter homeless individuals in a number of settings, including emergency departments, community and free clinics, public hospitals, and health maintenance organizations. Appropriate screening, prevention, and treatment should be undertaken in collaboration with local health departments. The use of directly observed therapy and of the treatment regimens published by the Centers for Disease Control and Prevention improves treatment outcomes among the homeless.
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PMID:Tuberculosis in the homeless. 777 31

This review focuses on the prevalence, causes, evaluation, and treatment of headache in individuals infected with human immunodeficiency virus type 1 (HIV-1). Headaches, one of the commonest medical complaints in the general population, occur frequently in patients infected with the HIV-1. HIV-related headaches can occur at any time during the infection: at seroconversion, during the incubation period, in patients with symptomatic HIV-1 infection, or after an AIDS-defining illness. Causes of HIV-related headaches include HIV-1 itself, opportunistic conditions, or HIV-specific medications. Migraines, tension-type headaches, depression, and substance abuse enter into the differential diagnosis, particularly in the early stages of disease. The headaches seen in this population reflect a complex web of interactions imposed by immune competency, multiple etiologies, treatments, and premorbid conditions. Prompt recognition and early treatment of headache is essential since it may improve quality of life and, depending on the diagnosis, prolong survival. Physicians need to be alert and adaptable when assessing HIV-infected individuals with headache since multiple causes can exist in the same patient and new syndromes, complications, and investigational drugs are continually being identified.
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PMID:Headache and the human immunodeficiency virus type 1 infection. 777 85

A review of the literature indicates that the association between human immunodeficiency virus (HIV) and prostitution varies by geographic region and can be altered substantially by well-planned public health interventions. In most African countries and in Asian countries such as Thailand, the rate of HIV infection among female prostitutes is substantially higher than the rate in the general population. Relatively few commercial sex workers in South and Central America are HIV-positive; however, their extremely high rates of infection with sexually transmitted diseases indicates the potential for future epidemic spread of HIV. In Europe and North America, HIV infection is most prevalent among drug-injecting or crack-using prostitutes. Neglected has been research on the high incidence of HIV among male transvestite and transsexual prostitutes. The lowest levels of condom use in commercial sex encounters have been recorded in regions in developing countries with the highest HIV prevalence. Also of concern are high condom breakage rates (20-50%) among female prostitutes who use petroleum-based lubricants and male prostitutes who practice anal sex. Valuable would be quantification of the additional HIV risk resulting from sex with a prostitute. Other recommended research areas include estimates of the number of male and female prostitutes working in certain geographic areas, mechanisms for monitoring condom use and substance abuse among prostitutes, the impact of HIV infection on movement into and out of prostitution, the dynamics of prostitute-client condom negotiation, and profiles of the clients of male prostitutes.
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PMID:Prostitution and HIV: what do we know and where might research be targeted in the future? 771 99


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