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)

Because of their survival life-style, homeless youth are at extremely high risk for contracting life-threatening and debilitating diseases, such as acquired immunodeficiency syndrome and hepatitis B, and for engaging in chronic substance abuse; yet health services are often limited and not easily accessed. This article describes an innovative health-screening project for 150 homeless youth between the ages of 11 and 23 years in an urban metroplex. The Homeless Youth Services Project was the initial phase of a multiphase project to investigate the social and health services available to homeless youth. The study project was a collaborative effort between several community agencies that shared the multiple goals of identifying the homeless adolescent population, documenting the rate of human immunodeficiency virus (HIV) seroprevalence and level of risk, and identifying community services and resources. Results of the screening project included the psychosocial and physical risks associated with homeless adolescents as well as the laboratory results of blood and urine screens. Consistent with the literature, the study population had a history of runaway behavior; physical, sexual, and substance abuse; and high rates of HIV seroprevalence and hepatitis B. Implications for advanced practice nurses working with homeless youth are also addressed.
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PMID:A collaborative model for community-based health care screening of homeless adolescents. 930 28

Seldom in the history of medicine has an entire generation of patients with an incurable, progressive, and ultimately fatal disease suddenly been offered the prospect of extended survival and even, perhaps, a "second life." The relatively simultaneous appearance of 2 major treatment developments has created profound changes in therapeutic options and outlook. The first development is an assay of serum levels of human immunodeficiency virus viral copies, providing a critical tool for clinical decision making. The second is the marketing between December 1995 and April 1997 of 4 human immunodeficiency virus protease inhibitors that, combined with previously available antiviral medications, achieve a new level of efficacy. With the advent of these changes come multiple psychiatric research and policy issues. These include the development of strategies to establish and maintain medication adherence. This is a critical task, given the complexity of combination therapy regimens and the rapid onset of viral resistance to protease inhibitors within days to weeks of missed or suboptimal dosing. The psychological issues to be studied include the process of restructuring lives and expectations in the event of clinical benefit or managing the distress associated with clinical failure. Other research questions include the effects of restored health on the appraisal of human immunodeficiency virus risk behaviors, assessment of effect of neurocognitive functioning, and unanswered questions about psychotropic or protease inhibitor drug interactions due to their shared metabolic pathways. Behavioral scientists can inform provision of care to patients who may be considered difficult to treat, such as those with severe and persistent mental illness or active substance abuse or the homeless. This includes the provision of empirical data regarding individual and situational characteristics that are likely to promote or impede adherence, as well as innovative provision systems. Psychiatry can make notable contributions during this turning point in human immunodeficiency virus therapeutics and research.
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PMID:A 'second life' agenda. Psychiatric research issues raised by protease inhibitor treatments for people with the human immunodeficiency virus or the acquired immunodeficiency syndrome. 936 63

The diagnosis and management of infectious complications associated with injection drug use (IDU) are among some of the more challenging aspects of working with substance abusing populations. As the population of injection drug users age, we expect the number and severity of these complications to increase. Commonly seen infections, such as bacterial endocarditis and bacterial infections of bones, joints, and soft tissue, are now frequently complicated by concurrent immunodeficiency. Parenterally and sexually transmitted viral hepatitis is responsible for significant IDU morbidity and mortality. The human leukemia/lymphoma virus types I and II are increasing in prevalence in the IDU with uncertain long-term clinical effects. Immune dysfunction has been described in the IDU for decades, but the impact of host immune compromise on the transmission and the course of HIV-1 has yet to be fully appreciated. The integration of the treatment of substance abuse and its concurrent psychiatric disorders with the management of infectious complications, including immunodeficiency, promises to improve patient compliance with possible savings of overall medical costs.
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PMID:Current management of infectious complications in the injecting drug user. 956 47

This 3-month study evaluated the effects of hyperbaric oxygen on drug-induced neuropathies in 22 patients with human immunodeficiency virus. All patients included in the study had been taking an antiretroviral medication for at least 12 months and had subjective symptoms of numbness or tingling, lethargy, and a decrease in deep tendon reflex. Patients with an active substance abuse history or Kaposi's sarcoma were excluded. Of the 20 patients who completed the series, 17 had significant improvement, 2 had a demyelinating disorder that may have affected the outcome, and 1 had no change.
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PMID:The effectiveness of intermittent hyperbaric oxygen in relieving drug-induced HIV-associated neuropathy. 964 Sep 6

Injection drug use is the single most important risk factor for acquiring hepatitis C virus (HCV) infection. Injection drug users acquire this infection rapidly after initiating injection practices, and up to 90% of them are chronically infected with HCV. HCV infection is a major cause of chronic liver disease, and persons infected with HCV are at risk for chronic hepatitis, cirrhosis, and primary hepatocellular carcinoma, and they risk transmitting HCV infection to others. Preventive measures for HCV infection are limited. The heterogeneous nature of HCV and its ability to undergo rapid mutation appear to prevent the development of an effective neutralizing immune response, obstructing development of a vaccine. Prevention of HCV infection must rely on educational and programmatic efforts aimed at preventing drug use, providing substance abuse treatment for persons who inject illicit drugs, and encouraging safer injection practices. These efforts should include messages about the risk and prevention of all blood-borne pathogens, including HCV, hepatitis B virus, and human immunodeficiency virus.
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PMID:The importance of preventing hepatitis C virus infection among injection drug users in the United States. 966 17

The Greater Bridgeport Adolescent Pregnancy Program (GBAPP), based on its skills in sex education, pregnancy, and sexually transmitted disease prevention, developed the Teen Outreach and Primary Services (TOPS) project, an innovative teen-focused community outreach model to expand and ensure access to health and support services for primarily underserved minority adolescents and young adults at risk for or living with the human immunodeficiency virus (HIV). TOPS is supported by the Special Projects of National Significance Program, HIV/Acquired Immunodeficiency Syndrome (AIDS) Bureau, Health Resources and Services Administration. The target population for TOPS is inner-city minority youth (ages 15-24 years) at high risk for HIV or HIV positive. Services ranging from outreach to intensive case management were provided to 2173 youth in the project. The number of HIV-positive youth has increased from three in the first year of the project to 17 in 1997. TOPS provides outreach, case management, HIV counseling and testing, risk-reduction activities, and referrals for housing, entitlements, specialty HIV clinics, and substance abuse counseling and treatment. A group of peer educators has been recruited from among the target population and is trained and paired with the staff to provide outreach services, peer counseling, and education, and to assist with recreational opportunities.
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PMID:Bridgeport's Teen Outreach and Primary Services (TOPS) project: a model for raising community awareness about adolescent HIV risk. 971 53

The survival of human immunodeficiency virus (HIV)-positive adolescents may be abbreviated by delays in health care delivery. Methods of linking youth with services have not been well studied. With support from the Special Projects of National Significance Program, the Youth and Acquired Immunodeficiency Syndrome (AIDS) Projects' (YAP) Adolescent Early Intervention Program offers early intervention health care services to all affected youth in Minnesota, a state with mandatory reporting of HIV/AIDS cases. The conceptual framework is a novel application of traditional public health disease surveillance strategies to link HIV-positive adolescents with health care services. The target population is composed of all 13-22-year-old HIV-positive persons reported to the Minnesota Department of Health (MDH). MDH staff locate and contact HIV-positive youth, conduct structured interviews regarding health status and needs, and facilitate enrollment at YAP. Sixteen male and 20 female participants (mean age 21 years; 56% people of color; 32% gay or bisexual) reported serious health risks, including inconsistent condom use (83%), poverty (78%), high school dropout (56%), unemployment (50%), illegal conduct (50%), medical debt (42%), unstable living situations (33%), running away (33%), substance abuse (33%) and attempted suicide (28%). More than one third reported each of six HIV-related symptoms. Seventy-five percent of participants sought advocacy/case coordination; 56%, clinical trials of experimental therapies; and 50%, vocational training and access to entitlement/eligibility programs. Linking HIV-positive youth to care is a valuable extension of the work of disease intervention specialists in states with similar reporting systems.
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PMID:The University of Minnesota Youth and AIDS Projects' Adolescent Early Intervention Program: a model to link HIV-seropositive youth with care. 971 59

The relative rates of acquired immunodeficiency syndrome (AIDS) were calculated among racial/ethnic populations using Centers for Disease Control and Prevention HIV (human immunodeficiency virus)/Surveillance reports assuming that racial/ethnic distributions reflect that of the US Census Data from 1990. For comparison, a rate of 1 was assigned to whites in each calculation. The overall relative rates were whites--1, African Americans--4.7, Hispanics--3, Asian/Pacific Islanders--0.4, and Native Americans--0.5. Acquired immunodeficiency syndrome surveillance data show higher rates of AIDS for African Americans and Hispanics compared with whites, Asians/Pacific Islanders, and Native Americans. The relative rates for African Americans and Hispanics compared with whites were highest for injecting drug users, heterosexual contact, and pediatric patients. These results led us to explore possible explanations for increased AIDS reporting in African Americans and Hispanics. We then explored available national datasets regarding those variables. The analyses indicate that variables such as access and receptivity to HIV prevention and treatment efforts, race/ethnicity, sexual behaviors, sexually transmitted diseases, socioeconomic status, and substance abuse interact in a complex fashion to influence HIV transmission and progression to AIDS in affected communities.
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PMID:Relative rates of AIDS among racial/ethnic groups by exposure categories. 1006 84

The Food and Drug Administration (FDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) formerly the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) are revising the conditions for the use of methadone in the maintenance treatment of narcotic addicts. The final rule allows, contingent on FDA and State approval, public and nonprofit private narcotic treatment programs to provide interim maintenance treatment to patients awaiting placement in comprehensive maintenance treatment and to require all narcotic treatment programs to provide counseling on preventing exposure to, and the transmission of, human immunodeficiency virus (HIV) disease.
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PMID:Methadone in maintenance treatment of narcotic addicts; joint revision of conditions for use; interim maintenance treatment; human immunodeficiency virus disease counseling--FDA and SAMHSA. Final rule. 1017 34

There has long been a popular conceptual linkage between human immunodeficiency virus (HIV) acquisition and substance abuse involving "needles". Indeed, in vitro studies demonstrate that these substances promote the replication of HIV. Included in these in vitro studies is a linkage or association of tissue damage and viral load with the actions HIV envelope protein gp120 with substances of abuse. However, detailed epidemiological studies have not supported this association of substance abuse and HIV acquisition, viral load and exacerbated tissue damage. It is with this understanding that we undertake a reevaluation of the in vitro studies within the context of the microvascular immune environment. In this regard, a counter-intuitive hypothesis emerges, namely, that specific substances of abuse may afford a degree of protection from HIV infection. This new hypothesis involves the neural, immune, and vascular signaling molecule nitric oxide.
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PMID:Substance abuse and HIV-gp120: are opiates protective? 1020 62


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