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 patient was a 31 year old male complaining discomfort in the epigastrium. Endoscopy of the upper gastrointestinal tract indicated multiple gastric ulcers. Biopsy specimen taken from the ulcerous region indicated giant cells accompanying intranuclear inclusion bodies in the gastric mucosa. Since the patient tested positive to cytomegalovirus (CMV)-IgM antibody, he was assumed to have gastric ulcers caused by CMV infection. However, the patient was cured without the administration of antiviral agent because no definite immunodeficiency status was observed. The result of present study indicated that endoscopic biopsy is useful for diagnosing gastrointestinal lesion attributable to CMW infection.
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PMID:A multiple gastric ulcer case caused by cytomegalovirus infection. 910 Apr 66

Although preliminary reports indicate that fatigue is a common symptom of human immunodeficiency virus (HIV) disease, little empirical research has focused on its prevalence or characteristics among patients with acquired immunodeficiency syndrome (AIDS). We assessed the frequency of fatigue and its medical and psychological correlates, in a cross-sectional survey of ambulatory AIDS patients. Ambulatory patients with AIDS who participated in a study of quality life (N = 427) were classified into fatigue/no fatigue groups based on their responses to fatigue items on the Memorial Symptom Assessment Scale (MSAS) and the AIDS physical symptom checklist. Self-report inventories were also administered to assess psychological distress, depressive symptoms, and overall quality of life. Medical information was elicited through clinical interview and review of medical chart. Fifty-four percent of the patients endorsed both of the fatigue items from the MSAS and the AIDS physical symptom checklists, and were classified as having fatigue. Women were significantly more likely to report fatigue than men (chi square = 5.28, df = 1, P < 0.03), and patients reporting homosexual contact as their transmission risk factor were significantly less likely to report fatigue than were patients reporting injection drug use or heterosexual contact (chi square = 5.13, df = 2, P < 0.03). The presence of fatigue was significantly associated with the number of current AIDS-related physical symptoms [t(425) = 8.00, P < 0.0001], current treatment for HIV-related medical disorders (chi square = 12.51, df = 1, P < 0.0001), anemia [t(174) = -2.35, P < 0.02], and pain (chi square = 36.36, df = 1 P < 0.0001). Patients with fatigue also had significantly poorer physical functioning ability [Karnofsky: t(422) = -6.27, P < 0.0001], as well as greater degree of overall psychological distress and lower quality of life [F(5,418) = 23.79, P < 0.0001], as measured by the Brief Symptom Inventory, Beck Depression Inventory, Beck Hopelessness Scale, Functional Living Inventory for Cancer (modified for AIDS), and the MSAS Psychological Distress Subscale. Fatigue is a common symptom in ambulatory AIDS patients and is associated with significant physical and psychological morbidity.
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PMID:Fatigue in ambulatory AIDS patients. 956 17

Questionnaires administered to 387 young people (mean age, 18.8 years) from nine randomly selected rural and urban secondary schools in Uganda's Kabarole District confirmed the effectiveness of acquired immunodeficiency syndrome (AIDS) health education efforts in this population. 84.7% of students indicated they had received school-based AIDS education and the overall knowledge level was high, exemplified by the fact that 83% were aware that individuals infected with human immunodeficiency virus (HIV) can appear healthy. 37.1% of students perceived themselves as at risk of HIV infection in the next five years. On the other hand, 80.6% expressed the intent to use condoms and 73.1% felt able to acquire them. 73.1% opposed discrimination against persons with AIDS. Regression analysis indicated that about 25% of the variance in perceived condom use self-efficacy was accounted for by perceptions as to condom effectiveness. 49% of the variance in female's intention to use condoms was explained by self-efficacy, perceived condom effectiveness, perceived susceptibility to HIV, perceptions of AIDS severity, condom acquisition self-efficacy. and confidence in terms of partner discussions about sexual histories. In males, however, these six variables explained only 25% of the variance, suggesting that there are unidentified determinants of condom use. These findings did indicate a need for school-based skills development, possibly through role play, to reduce young people's discomfort with condom purchasing and discussions of sexual histories.
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PMID:HIV-preventive cognitions amongst secondary school students in Uganda. 1016 Feb 27

Perianal infections caused by herpes simplex virus are common in immunocompromised patients. The cutaneous presentation in these patients is often atypical, overlaps with the clinical features of other diseases, poses a difficulty in diagnosis, and responds poorly to treatment. An immunocompromised patient with chronic lymphocytic leukemia, treated with oral corticosteroids, presented with chronic perianal ulcerations. This patient was referred for evaluation and treatment of "recalcitrant" pyoderma gangrenosum. Prompt diagnosis was possible when the clinical features were recognized and appropriate biopsy and cultures were obtained. We describe an atypical presentation of herpes simplex virus associated with both an endogenous and exogenous induced immunodeficiency, and stress the importance of routinely performing cultures on all perianal ulcerations and anal fissures to avoid the misdiagnosis, inappropriate treatment, and prolonged discomfort of these afflicted patients.
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PMID:Atypical presentation of herpes simplex virus in a patient with chronic lymphocytic leukemia. 1046 7

A sample of approximately 200 undergraduate students beginning their nursing education responded to questionnaire items concerning experience and levels of comfort working with diverse client groups. Students reported little discomfort with racial/ethnic groups, but reported they would have considerable difficulty working with lesbian, gay, or bisexual clients, and patients with human immunodeficiency virus. Their reasons for discomfort were examined.
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PMID:Experiences and comfort with culturally diverse groups in undergraduate pre-nursing students. 1078 60

Discomfort, lack of confidence in skills, and environmental constraints may cause primary care providers to miss opportunities to discuss human immunodeficiency virus (HIV) risk with patients. We used a systems approach to address both intrapersonal and environmental barriers to HIV risk assessment and prevention counseling in a managed care clinical setting. The design was one-group pretest/posttest. The study took place in two primary care clinics of a large Pacific Northwest managed care organization. Participants (n = 49) included physicians, physician assistants, nurse practitioners, registered nurses, and social workers. The intervention included training, clarification of provider/staff roles, assess to tools and materials, and reminders/reinforcers. Outcome measures were provider attitudes, beliefs, outcome expectations, knowledge, confidence in skills, and perceived supports and barriers, measured by written pretest/posttest surveys administered 12 months apart. Seven months after the most intensive part of the intervention, providers' attitudes and beliefs were more favorable to HIV risk assessment and prevention counseling. They were less likely to express frustration with high-risk patients (decrease from 100% to 79% agreement, p = 0.001) and more confident that their advice would be effective with gay men and single adult heterosexuals (p = 0.002 and 0.005, respectively). They reported more confidence in their training in sexual history taking (p = 0.0003) and their skills assessing readiness for change (p = 0.007), and more support in practice environments. This study demonstrated that it is possible to affect important personal and environmental factors that influence primary care providers' HIV prevention behavior using an interactive, real-world systems approach. Further research is needed on providers' impact on patient behavior.
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PMID:HIV prevention in primary care: impact of a clinical intervention. 1153 Jul 65

Retaining African-American women who are human immunodeficiency virus (HIV) positive in longitudinal research is crucial to improving prevention and treatment in this population. Interviews with 22 African-American HIV-positive women conducted at the end of a 2-year study indicated that over the course of the study, reports of discomfort with participation gave way to reports of appreciating the benefits of participation. Women commented on the importance of their relationships with researchers, in which they received benefits and provided a service to the researchers. We postulate that developing reciprocity between research teams and participants may be helpful in retaining African-American women in research.
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PMID:Reciprocity and retaining African-American women with HIV in research. 1184 Apr 8

We determined the immunogenicity and safety of reimmunization with the 23-valent polysaccharide pneumococcal vaccine in patients infected with human immunodeficiency virus type 1 (HIV-1). Patients immunized >5 years earlier (initially within 1 year of HIV-1 seroconversion) were randomized to receive vaccine (n=57) or placebo (n=30). Persons with recent HIV-1 seroconversion (n=14) were immunized for the first time. Preimmunization levels of capsule-specific immunoglobulin G were similar in all groups. Reimmunized patients showed a significantly lower frequency and magnitude of antibody responses compared with persons with recent HIV-1 seroconversion. Reimmunized patients did not show adverse virologic or immunologic changes, but some reported local discomfort (15%) or fever (8%). Thus, the limited responses after reimmunization of HIV-1-infected patients with the current 23-valent vaccine mandates the need for a more effective reimmunization schedule, more immunogenic vaccines, or other behavioral and therapeutic interventions.
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PMID:Reimmunization with 23-valent pneumococcal vaccine for patients infected with human immunodeficiency virus type 1: clinical, immunologic, and virologic responses. 1185 Aug 63

The purpose of this study was to assess the prevalence of distress, anxiety, and depression in persons with human immunodeficiency virus (HIV) infection and determine the feasibility of screening in an urban HIV primary care setting. A convenience sample of 101 patients in the waiting room of an acquired immunodeficiency syndrome clinic completed two questionnaires, the Hospital Anxiety and Depression Scale (HADS) and the Distress Thermometer. The patient's demographic, medical, and psychiatric histories were obtained through chart review. The results of the Distress Thermometer revealed that 72.3% had a score of 5 or greater, demonstrating high distress. The results of the HADS revealed that 70.3% had high anxiety, with a score of 7 or greater. On the HADS depression questions, 45.5% had a score of 7 or greater, indicating depression. Analysis of the total HADS scores, including anxiety and depression, revealed that 53.5% had a score of greater than 15 and were experiencing significant distress. Patients with high viral loads were more likely to be distressed (P < 0.0005). Patients with high viral loads were also more likely to have higher anxiety or depression scores on the HADS. Patients who had CD4 counts higher than 500/mm(3) were less likely to be depressed. This study demonstrates a high prevalence of distress, anxiety, and depression among persons with HIV. The HADS and the Distress Thermometer showed a good correlation with each other (P < 0.0005), and these questionnaires can provide a simple and efficient method for rapid screening in an HIV clinic setting.
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PMID:The prevalence of distress in persons with human immunodeficiency virus infection. 1192 52

Onychomycosis (fungal nail infection) is common and causes considerable discomfort and pain for many otherwise health patients. However, onychomycosis is especially prevalent in some patient groups seen regularly by community nurses (e.g. the elderly and people with diabetes, human immunodeficiency virus (HIV) infection or psoriasis). This article discusses the causes and types of onychomycosis, and examines in detail the various treatments available. Both the infection and its treatment can cause several clinical problems including drug interactions, difficulties with differential diagnosis and compromise of clinical outcomes. In particular, onychomycosis can undermine foot care in people with diabetes. The role of community nurses in treating and preventing onychomycosis is discussed.
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PMID:Fungal nail infections: far more than an aesthetic problem. 1204 99


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