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)

Investigated was the prevalence of human immunodeficiency virus (HIV) among mentally ill criminal offenders admitted to Thailand's Nitichitawej Hospital for Forensic Psychiatric Services from September 1988-February 1989. There were 325 admissions; the average age was 32.4 years. 47% had committed murder or acts of grievous bodily harm, 33% were confined for offenses against property, and 6% were arrested for drug possession. In terms of psychiatric diagnoses, the majority (78%) were schizophrenic. 18 (5.6%) had a primary diagnosis of drug addiction, but 92 (28.3%) indicated they were substance abusers. Only 6 cases (1.8% prevalence) of HIV infection were found in this population. Four of the HIV-infected prisoners had a primary diagnosis of drug addiction; the remaining two were diagnosed with schizophrenia, but both these men had a history of substance abuse. When the HIV prevalence rate was recalculated for mentally ill patients who acknowledged a history of substance abuse, it increased to 33.33%; moreover, it rose to 35.29% when computed among those arrested on drug charges. These rates are consistent with those recorded among non-institutionalized drug abusers in Thailand (around 30%). It is recommended that forensic psychiatric units take precautions to prevent the spread of HIV through homosexual activity among inmates.
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PMID:The prevalence of HIV infection among mentally ill offenders in Thailand. 786 8

We analyzed data from a multisite study of 1,063 gay or bisexual men attending sexually transmitted disease clinics to evaluate factors predicting failure to disclose human immunodeficiency virus (HIV) risk behaviors to clinic staff and the extent of such failure. We compared data from a brief screening assessment on unprotected anal and oral sex with data on the same behaviors from a subsequent detailed interview. We also compared behavioral data from screening and the interview with data on diagnoses of rectal gonorrhea abstracted from medical charts. Of 523 men reporting unprotected anal sex at interview, 29% failed to report this behavior at screening. Men failing to disclose unprotected anal sex were also less likely to disclose engaging in unprotected oral sex. Among men reporting no unprotected anal sex, either at screening or interview, 1.6% were diagnosed with rectal gonorrhea. Logistic regression analyses comparing men who did and did not disclose at screening having engaged in unprotected anal sex showed that men who failed to disclose reported greater involvement in gay organizations, greater perceived peer support for condoms, fewer episodes of unprotected anal sex in the last four months, and lower rates of substance abuse treatment. Our data suggest that men who failed to disclose may have lower risk levels, and may be more integrated into the gay community. Brief interviews, as opposed to detailed ones, also may underestimate incidence of unsafe sex. Where feasible, HIV risk assessment and counseling and laboratory screening should be routinely provided to all clinic attendees, regardless of self-reports.
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PMID:Failure to disclose HIV risk among gay and bisexual men attending sexually transmitted disease clinics. 791 36

Substance abuse is a major public health problem in the United States today. Studies are showing increasing evidence of the serious medical and psychosocial consequences of drug use across all age groups. Of great concern are the problems of infants born to addicted mothers, the increased incidence of cardiovascular complications in young people due to cocaine use, and the extremely high risk of exposure to human immunodeficiency virus. There is no socioeconomic group that is left untouched by substance abuse. Yet, for various reasons this disease is probably the most ignored or underdiagnosed disease in the primary care setting. This article provides information about addiction and suggests key areas for history taking, physical exams, and collection of laboratory data that may help in primary care screening. When concrete information about the consequences of drug use is provided to addicts they may be motivated to seek treatment without feeling threatened.
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PMID:Primary care screening for substance abuse. 806 59

Considering the official figure on drug-related deaths in Austria, the problem of substance abuse has dramatically worsened over the last years. There is a distinct lack of comprehensive information concerning drug-related deaths in Austria, although deaths of drug users may be potentially important indicators of the extent of drug-related problems in the population. The results of examinations performed on 372 deceased substance abusers at the Institute of Forensic Medicine in Vienna between 1985 and 1992 are presented. Drug-related deaths are defined according to the official definition issued by the Austrian Federal Ministry of Internal Affairs. A distinction was made between injecting drug users and non-injecting drug users with respect to infectious diseases transmitted by sharing of paraphernalia. Between 1985 and 1992 there was a distinct increase in drug-related deaths. In approximately 30% an accidental single substance intoxication, mainly due to morphine, was found. A connection with a better quality of street drugs is assumed but not proven. In 207 corpses more than one drug, including alcohol, was detected. During the investigation there was an evident trend towards multi-substance abuse patterns. Furthermore, blood alcohol concentration, an additional risk factor for narcotic overdose, was strongly associated with higher age. The small number of examined drug injectors found positive for the human immunodeficiency virus type-1 (HIV-1) makes it difficult to draw any kind of conclusion regarding the HIV-I seroprevalence among injecting drug users in Vienna.
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PMID:Drug-related deaths between 1985 and 1992 examined at the Institute of Forensic Medicine in Vienna, Austria. 808 Nov 83

Psychiatric admissions of patients infected with the human immunodeficiency virus (HIV) over a 5-year period (1986-1991) are reviewed. Ninety-one patients were studied. Suicidal thoughts/attempt was the most common reason for hospital admission. The two most common diagnostic categories were 1) organic mental syndrome, and 2) substance abuse/dependence. Forty-five percent of the patients either initiated their discharges or drastically improved without the use of psychotropic medications. The authors suggest that outpatient psychiatric facilities can provide psychiatric care for HIV-infected patients seeking it.
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PMID:Characteristics of HIV-infected patients in an inpatient psychiatric setting. 813 30

The aim of this study was to determine the contribution of injected-drug-use complications to the utilization of inpatient care by persons infected with human immunodeficiency virus (HIV). Retrospective chart review was done of all hospital admissions between January 1, 1991, and December 31, 1991, with outpatient records reviewed to establish CD4 counts within 3 months of the date of admission. The participants included 284 consecutive admissions (189 patients); admissions were divided into two groups according to the Center for Disease Control 1993 expanded AIDS definition: those with AIDS (CD4 count, < 200 cells/microliters) and those with early HIV disease (CD4 count, > 200 cells/microliters). Thirty percent of admissions occurred among persons with early HIV disease. Among 189 individuals admitted to the hospital, 84% were male, 62% were white, and 48% had injected drugs. Early HIV disease admissions were more likely to involve active injection-drug users (82% vs. 33%; p < 0.01). Admissions related to injected-drug use constituted 60% of early HIV disease hospitalizations, and this number rises to 72% if bacterial pneumonia is included as a substance abuse complication. Admissions related to injected-drug use constituted 27% of AIDS admissions; this number rises to 51% if bacterial pneumonia is included. Early HIV disease admissions were significantly shorter (9.9 vs. 12.6 days) and less expensive (mean charge, $9,592 vs. 12,873) than AIDS admissions but still accounted for 25% of inpatient HIV charges. Hospitalizations among HIV-infected persons early in the course of HIV disease are most often related to the medical complications of injected-drug use and account for a substantial expenditure of hospital resources.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Injected-drug use: complications and costs in the care of hospitalized HIV-infected patients. 815 41

The empowerment and affirmation of lesbian, bisexual, and gay students is long overdue. This article explores how human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS), substance abuse, violence and hate-related crimes, suicide, and heterosexism all adversely affect the physical and emotional health of nonheterosexual college students. College health services must expand their current scope and practice and assume a leadership role in combating all forms of oppression by actively incorporating and addressing the unique health issues and needs of the lesbian, bisexual, and gay population. This article provides a brief overview of the relevant healthcare issues for lesbians, bisexuals, and gays; examples of heterosexism in college health services; and recommendations for institutional and personal and professional change.
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PMID:Challenging heterosexism in college health service delivery. 820 Nov 34

The objectives of this study were to assess attitudes, knowledge, and behavior related to human immunodeficiency virus (HIV) antibody testing of adolescents and young adults undergoing treatment for alcohol and drug problems. Setting and subjects were 101 adolescents and young adults enrolled in a New England substance abuse rehabilitation program. All subjects had heard about acquired immunodeficiency syndrome (AIDS) and 84% desired an HIV antibody test if it were anonymous and confidential. If found to be HIV positive, 83% stated that they would be less likely to continue substance-abuse treatment, 64% would be more likely to continue drug use, and 62% would be more likely to continue alcohol use. The likelihood of continuing school would decrease for 60%. Sixty percent would be more likely to increase use of condoms. Males were more likely than females to want to leave treatment and school, return to alcohol and drug use, and increase risk-taking behavior (p < 0.02). These findings suggest that teenagers undergoing treatment for substance-abuse problems require careful and comprehensive pre- and post-test counseling and follow-up when undergoing HIV antibody testing. Deciding when to test for HIV may impact on the success of substance-abuse treatment, as well as ability to control spread of HIV infection.
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PMID:A survey of attitudes, knowledge, and behavior related to HIV testing of adolescents and young adults enrolled in alcohol and drug treatment. 824 Dec

Directors of 14 public health departments were surveyed for their perceptions on the impact of 20 critical events of the 1980s on public health performance. The departments were selected in 1979 from among those that were highly regarded by public health experts for exemplary performance, especially with regard to personal health services. The departments were the subjects of intensive case studies in 1979, 1983, and again in 1992. The public health functions that were most benefited in the 1980s were assessment and policy development. The assurance function was equivocally affected. Greatest positive impact was exerted by the acquired immunodeficiency syndrome-human immunodeficiency virus epidemic, by increase in fee income, and by the Institute of Medicine report, "The Future of Public Health." Negative influences, especially on the assurance function were exerted by loss of Federal grants, demographic changes, substance abuse, and economic downturn. Other critical events had equivocal or idiosyncratic effects. Analysis of public health practice according to the functions of assessment, policy development, and assurance appears to have utility for purposes of evaluation and planning.
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PMID:The impact of critical events of the 1980s on core functions for a selected group of local health departments. 826 53

Healthcare for the homeless is often crisis-oriented and fragmented. Homelessness may be associated with ongoing healthcare problems such as tuberculosis, human immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS), and substance abuse. The purpose of this study was to identify the anesthesia services required by homeless individuals from an urban area. The anesthesia records of all individuals (N = 40) identified as being homeless and receiving care at one New York City medical center during a 12-month period were reviewed. Approximately one-half (47.5%) of the 40 patients in the study did not require general anesthesia but intubation only. Most of these intubations were for cardiac/respiratory arrests of unknown cause, drug/alcohol overdose, or multiple trauma. Of the 21 patients requiring surgery, 15 had emergency procedures such as splenectomy, appendectomy, exploratory laparotomy, incarcerated hernia repair, and reduction of fractures. The findings of this study support previous research which indicates that most homeless people enter into care for emergency rather than elective services.
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PMID:Anesthesia for the homeless. 829 92


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