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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The HIV wasting syndrome and other HIV-associated weight loss is a major problem in HIV-infected patients. The available data strongly suggest that wasting is associated with decreased survival. It may also further impair immune function. A variety of etiologies probably contribute to this wasting, including hypermetabolism, alterations in metabolism, lessened oral intake, malabsorption, cytokine effects, and endocrine dysfunction. The relative contributions of each of these etiologies to wasting probably varies considerably from patient to patient. Successful treatment calls for identification of possible etiologies of wasting in the individual patient with AIDS. Further treatment may include treating underlying conditions and controlling such symptoms as diarrhea, nausea, or fever. Nutritional support, including both parenteral and enteral nutrition, has shown some promise of efficacy, and a variety of drugs appears to be helpful. Future treatment to reverse wasting may include the use of several of these agents in combination. Currently, there is much that clinicians can do to evaluate and treat the HIV wasting syndrome, with significant potential benefits to their patients.
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PMID:The HIV wasting syndrome: a review. 820 46

The Clinton Administration is continuing to block the research efforts of Dr. Donald Abrams, University of California, San Francisco, to study the safety and effectiveness of marijuana in stimulating the appetites and reducing nausea of people with AIDS wasting syndrome. Dr. Abrams does not require money for the study, but he does need a supply of the marijuana. Since the National Institute on Drug Abuse (NIDA) is the Federal agency responsible for the supply of marijuana for clinical research, NIDA informed Dr. Abrams that he must submit a grant application to an NIH peer-review panel that will determine whether the research protocol has scientific merit. After submitting a grant proposal, the National Institute of Allergy and Infectious Diseases (NIAID) rejected Dr. Abrams' application. The Marijuana Policy Project contends that the peer-review approval is a ploy to block research, or delay it until after the presidential election. They continue to work to persuade Congress to require NIDA to provide marijuana to all FDA-approved medicinal marijuana studies, as it did in the late 1970s and early 1980s. A sample letter-to-the-editor advocating the use of marijuana as a useful medicine for the treatment of AIDS and other diseases is also included.
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PMID:Medical marijuana--once again--blocked. Marijuana Policy Project. 1136 29

Although the incidence of most AIDS-defining opportunistic infections, including HIV wasting syndrome, has dramatically decreased since the introduction of highly active antiretroviral therapy (HAART), previous studies have shown that weight loss and wasting are still common in HIV-infected persons. We examined the 6-month risk and determinants of > or =5% weight loss during the period when the use of combination antiretroviral therapy and HAART was commonplace among 713 participants enrolled in the Nutrition for Healthy Living cohort in Boston, Massachusetts between 1995 and 2003. There was a significant 50% increase in the 6-month risk of > or =5% weight loss in the later HAART years (1998-2003) compared with the early HAART years (1995-1997) among most of the participants who reported they were not trying to lose weight (P = 0.002). In addition to calendar time, several other variables were significantly independently associated with risk of > or =5% weight loss, including use of injection drugs; living below the federal poverty level; higher body mass index (BMI; > or =25 kg/m(2)); lower CD4 cell count; higher HIV viral load; and presence of diarrhea, nausea, or fever. The characteristics of weight loss in the later HAART years did not differ from the early HAART years with respect to initial body composition (eg, weight, BMI, triceps skinfold thickness) or changes in body composition during the periods of weight loss. In summary, we have found that the risk of > or =5% unintentional weight loss over 6-month intervals is on the rise in our cohort of HIV-infected participants, despite better control of HIV infection in recent years. Although we still do not know the exact cause of this increase, the fact that it exists indicates the need for clinicians who take care of HIV-infected patients to continue to pay attention to weight loss among particular segments of their patient population. This is particularly important because recent studies have shown that even a 5% weight loss in 6 months markedly increases the risk of death.
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PMID:Increasing risk of 5% or greater unintentional weight loss in a cohort of HIV-infected patients, 1995 to 2003. 1612 85