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)

The past decade has witnessed an unprecedented upturn in tuberculosis morbidity and outbreaks of difficult- to-treat and highly lethal multidrug-resistant tuberculosis. In the early 1990s, a national consensus developed among public health officials to define more comprehensively the problem, and in January 1993, expanded tuberculosis surveillance was implemented nationwide. Carefully selected epidemiologic and case management variables were added to the Report of Verified Case of Tuberculosis form. Information is collected on the health status and treatment of patients, including human immunodeficiency virus status, drug susceptibility test results, and the initial drug regimen. Completion of therapy and use of directly observed therapy are also monitored. The new surveillance system allows a comparison of the quality of care of patients in the public and private sectors. Additional epidemiologic variables include membership in high-risk groups (the homeless, residents of correctional or long-term care facilities, migrant workers, health care workers, and correctional employees) and substance abuse (injecting drug use, non-injecting drug use, and excess alcohol use). The additional information derived from expanded tuberculosis surveillance is crucial to optimal patient management, policy development, resource allocation, as well as program planning, implementation, and evaluation at Federal, State, and local levels.
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PMID:The need for epidemic intelligence. 861 Jan 88

Twelve cases of necrotizing fasciitis were identified retrospectively over a 5-year period. All were associated with a history of substance abuse by injection or with diabetes. Eleven of the 12 infections were associated with beta-hemolytic Streptococcus, a mixed anaerobic aerobic infection, or both. Three of five patients tested for human immunodeficiency virus had positive test results. A wide extensile approach was used to debride necrotic fascia. An average of 3 debridements were necessary, with a range of 1-6 debridements. Two patients under-went shoulder disarticulation because of uncontrollable infection. The rapid and destructive nature of this disease makes early recognition, aggressive debridement, and antibiotic therapy necessary to minimize morbidity.
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PMID:Necrotizing fasciitis of the upper extremity. 884 69

Individuals with a substance use disorder who are infected with human immunodeficiency virus (HIV) provide physicians with challenging issues for both medical management and drug treatment. Using a case presentation format, we present an overview of some of the major issues involved in delivering effective primary care for these individuals. A detailed medical and substance use history is critical to sort common complaints that can be seen both in HIV infection and with drug use. Physicians must be able to recognize withdrawal syndromes and differentiate those signs and symptoms that may be attributed to specific drugs. A two-phase model of drug abuse treatment takes into account both detoxification and maintenance of abstinence. Primary care physicians should be able to initiate the process of substance abuse treatment and refer the patient to appropriate substance abuse programs when necessary. Pharmacological approaches to long-term abstinence with heroin addiction include methadone, LAAM, and naltrexone. While clinically challenging, HIV-infected substance users can be successfully managed using the general principles of primary care.
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PMID:The substance-using human immunodeficiency virus patient: approaches to outpatient management. 887 15

The discovery of the ability of the nervous system to communicate through "public" circuits with other systems of the body is attributed to Ernst and Berta Scharrer, who described the neurosecretory process in 1928. Indeed, the immune system has been identified as another important neuroendocrine target tissue. Opioid peptides are involved in this communication (i.e., neuroimmune) and with that of autoimmunoregulation (communication between immunocytes). The significance of opioid neuropeptide involvement with the immune system is ascertained from the presence of novel delta, mu, and kappa receptors on inflammatory cells that result in modulation of cellular activity after activation, as well as the presence of specific enzymatic degradation and regulation processes. In contrast to the relatively uniform antinociceptive action of opiate and opioid signal molecules in neural tissues, the presence of naturally occurring morphine in plasma and a novel mu3, opiate-specific receptor on inflammatory cells adds to the growing knowledge that opioid and opiate signal molecules may have antagonistic actions in select tissues. In examining various disorders (e.g., human immunodeficiency virus, substance abuse, parasitism, and the diffuse inflammatory response associated with surgery) evidence has also been found for the involvement of opiate/opioid signaling in prominent mechanisms. In addition, the presence of similar mechanisms in man and organisms 500 million years divergent in evolution bespeaks the importance of this family of signal molecules. The present review provides an overview of recent advances in the field of opiate and opioid immunoregulatory processes and speculates as to their significance in diverse biological systems.
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PMID:Opioid and opiate immunoregulatory processes. 887 41

Once thought to be under control, tuberculosis is now the number one cause of infection-related death worldwide and the sixth most significant cause of death overall. Transmission occurs by inhalation of airborne droplet nuclei that can be viable for days, and is facilitated by substance abuse, poverty, overcrowding, malnutrition, and, most importantly coinfection with human immunodeficiency virus. This article describes the history and current status of tuberculosis as a growing global health problem, transmission of the disease, risk factors for the general public and health care workers, and prevention of the disease.
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PMID:Tuberculosis: disease of the past, disease of the present. 896 16

The human immunodeficiency virus (HIV) epidemic poses unprecedented challenges to the health-care system. Caregivers must contend both with the complicated clinical syndromes associated with HIV infection and with issues that are central to the epidemic, such as discrimination, isolation, poverty, and substance abuse. Our HIV treatment program combines and enhances the resources of an academic medical center in a multidisciplinary care model. All patients, regardless of payor class, are offered services from 10 different disciplines. The same team of clinicians follows patients in the clinic and hospital. The program is flexible, non-hierarchical, and open to community participation. This approach may be a useful model for other institutions.
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PMID:One approach to care for patients infected with human immunodeficiency virus in an academic medical center. 898 23

Approximately one-quarter of the acquired immunodeficiency syndrome (AIDS) cases reported in Maryland are women. African-American women account for 80% or more of the cases in the Baltimore-Metropolitan area. Human immunodeficiency virus (HIV)-positive women are frequently dealing with a constellation of social problems including lack of resources, care-taking responsibilities for extended families, histories of substance abuse, and loss of others to AIDS. This article is an attempt to describe the social context of living with HIV/AIDS to Maryland physicians.
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PMID:Maryland women living with HIV/AIDS. 898 52

Although the exact number of homeless adolescents is unknown, it is estimated that this population may exceed 2 million. Literally living on the streets, homeless youth are at risk for a variety of physical, psychosocial, and spiritual health problems. Many engage in "survival sex," exchanging sexual favors for necessities of food, clothing, and shelter. Such risky sexual behaviors make them vulnerable to sexually transmitted diseases, including human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), and unintended pregnancies. Many have serious, diagnosable mental health problems, whereas others suffer various consequences of substance abuse. There is a need for comprehensive and holistic health care services, for which the majority of homeless youth have very limited access. Holistic nursing can provide creative interventions for thus vulnerable population.
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PMID:Health risks of homeless adolescents. Implications for holistic nursing. 914 91

Children of substance abuse mothers have an increased risk of severe pathological disorders such as perinatal diseases (prematurity, intrauterine growth retardation, infections) with their neurological and respiratory complications and sequelae, and transmission of drug addiction related infections, ie human immunodeficiency virus, hepatitis B and C virus, syphilis. Many of these children present a drug withdrawal syndrome characterized by restlessness and jetteriness during the neonatal period. This is frequently followed by a post withdrawal period of several weeks duration with crying, excitement, sleep and feeding difficulties. Although these drug withdrawal manifestations have no incidence on the vital prognosis, it severely impairs the mother-infant interaction. Despite these disorders it appears that the outcome of these children is mainly related to their familial environment which is exposed to many risk factors: mother-child separation, violence, delinquency, precariousness, unhealthy housing, prostitution, drug dependency, parental death or imprisonment... Early medico-psycho-social intervention starting during pregnancy and a prolonged support for several years are the only way to improve their spontaneously poor outcome.
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PMID:[Management of drug addict pregnant women and their children]. 918 Oct 22

Most opiate users are injection drug users (IDUs). A significant percentage of IDUs have antisocial personality disorder (APD). APD has been found by some researchers to be an additional risk factor for human immunodeficiency virus (HIV) infection in IDUs. The present study evaluated the association of sociodemographic characteristics, substance abuse history, and several measures of antisociality including the DSM-III-R diagnosis made by the Personality Disorder Examination, the California Psychological Inventory-Socialization Scale, and Hare's Revised Psychopathy Checklist, to behaviors associated with HIV risk in 289 opiate-dependent methadone-maintained subjects. The presence of drug- and sex-related risky behaviors measured by the Risk Assessment Battery was predicted more consistently by measures of personality traits associated with antisociality than by a diagnosis of APD.
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PMID:Validity of three measures of antisociality in predicting HIV risk behaviors in methadone-maintenance patients. 929 31


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