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 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

AIDS knowledge and attitudes among the most educated sector of the population were explored in a 1994 survey involving 433 university students and faculty from southern India (Andhra Pradesh and Tamil Nadu) and selected research and technical staff of the Public Health Service. Although most respondents were aware that sexual intercourse (95%) and injecting drug use (85%) can transmit HIV, and that shaking hands (95%) and mosquito bites (86%) can not, 63% did not know that breast feeding is a mode of transmission and 71% incorrectly identified blood donation as an HIV risk factor. 95% knew it is impossible to identify an HIV-infected individual on the basis of appearance, but only 24% realized seropositive persons can be asymptomatic. 42% believed that those with HIV should be quarantined and 31% favored barring infected students from college classes. 90% harbored at least 1 negative view toward people with AIDS (e.g., they deserve their fate or they should kill themselves); knowledge and education independently correlated with decreased hostility. 85% agreed that AIDS is a very serious problem in India and, despite their negative attitudes toward persons with AIDS, 93% favored increased government spending on AIDS education. Overall, these findings indicate that high levels of education are associated with above-average knowledge of HIV and its transmission; however, the sexually conservative nature of Indian society has impeded a compassionate stance toward people with AIDS, even among the most educated.
AIDS Care 1997 Jun
PMID:Dynamics of knowledge and attitudes about AIDS among the educated in southern India. 929 Aug 37

HIV-associated neurological manifestations: dementia, myelopathy, and neuropathy, have become one of the commonest causes of neurological disorders in young people. Cognitive impairment develops in about 30 p. 100 of patients with AIDS and frank dementia in 15 to 20 p. 100 with an annual incidence after AIDS of approximatively 7 p. 100. Typically, the onset of dementia is relatively abrupt over a few weeks or months. The clinical manifestations of the encephalopathy now termed "HIV-dementia", suggest predominant subcortical or frontal involvement. Typical presentation includes apathy and inertia, memory loss and cognitive slowing, minor depressive symptoms and withdrawal from usual activities. Neurological examination may show hypertonia of lower limbs, tremor, clonus, frontal release signs and hyperactive reflexes. Terminally, the patient is bedbound, incontinent, abulic or mute with decorticate posturing leading to death over 3 to 6 months. However, a stabilisation and even a regression of the cognitive disorders have been observed following antiretroviral treatment. Radiological features of HIV dementia include both central and cortical atrophy and white matter rarefaction. However they are neither invariable nor specific. Together with CSF examination, they are more important to exclude opportunistic infections. Indeed, although a completely normal CSF profile may reasonably exclude the diagnosis; at present, no single test or combination of tests can reliably diagnose HIV dementia. Although the clinical characteristics of HIV-dementia are now clearly established, its pathogenesis is unclear and its pathological counterpart remains a matter of debate. A number of "HIV-induced" lesions may be found in the brain of AIDS patients and their causative role in HIV-dementia has been considered. They include HIV encephalitis due to productive CNS infection by the virus, diffuse white matter pallor "HIV-leukoencephalopathy" reflecting an abnormality of the blood brain barrier, involvement of the grey matter, "diffuse poliodystrophy", with neuronal loss that results, at least partly, from a process of programmed cell death and axonal damage. These changes are variably associated in patients with HIV dementia, however none of them can be closely related to the cognitive disorders. This suggests that the neuronal dysfunction underlying HIV-dementia results from different mechanisms that are variably associated and may interact mutually. These include production of viral proteins, microglial activation with consequent production of neurotoxic factors such as proinflammatory cytokines, free radicals, derivates of arachidonic acid, or quinoleic acid, and blood borne neurotoxic factors in particular cytokines.
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PMID:[Dementia and human inmmunodeficiency virus infection]. 983 49

Trimethoprim-sulfamethoxazole (TMP-SMX) is a widely administered antibiotic that is well tolerated by most patients. Hypersensitivity reactions and gastrointestinal intolerance are the most common adverse events associated with it. Central nervous system adverse effects such as tremors are less common and occur primarily in patients with acquired immune deficiency syndrome. A 29-year-old immunocompetent man developed a tremor while taking TMP-SMX. The tremor resolved within 2 days after the drug was discontinued.
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PMID:Trimethoprim-sulfamethoxazole-induced tremor in an immunocompetent patients. 1060 97

Students from a nursing school of Delhi were surveyed anonymously using a self-administered questionnaire to explore various AIDS-related apprehensions and their possible reasons. The observations revealed that, majority of the students and their families/friends feared that these students were at risk of contracting HIV infection while providing routine patient care. A large number of students also opined that they would feel uncomfortable while talking, hugging, shaking hands, and sharing a room with an HIV positive person. The main reasons for their apprehensions were unsatisfactory anti-AIDS campaigning by the government, non-availability of sufficient protective measures in the health care settings, inadequate professional education related to prevention of HIV infection, and increase in HIV transmission following false sense of security due to excessive condom promotion. Findings of the study imply imparting factual knowledge addressing the concerns and removing misconceptions which influence attitudes and willingness of the nursing students to provide care to the HIV positives/AIDS patients, facts regarding efficacy of various preventive measures, and provision of counselling services in the event of exposure.
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PMID:AIDS-related apprehensions among nursing students of Delhi. 1093 97

Interleukin-6 (IL-6), a major cytokine with diverse effects on cells mainly of the immune and hematopoietic systems, has been linked to several neurological disorders such as acquired immune deficiency syndrome dementia, multiple sclerosis, and Alzheimer's disease. Central nervous system (CNS)-specific expression of IL-6 caused neurodegeneration, massive gliosis, and vascular proliferation in transgenic mice. However, the effects of systemically circulating IL-6 and its receptor IL-6Ralpha on the CNS are unknown. IL-6Ralpha is the specific component of the IL-6 receptor system and hence an important co-factor of IL-6. IL-6Ralpha is bioactive in a membrane-bound and in a soluble (s) form. We investigated the effects of systemically elevated levels of either human IL-6 or human sIL-6Ralpha or both on the CNS of transgenic mice. Although IL-6 and sIL-6Ralpha single transgenic mice were free of neurological disease, IL-6/sIL-6Ralpha double-transgenic mice showed neurological signs, such as tremor, gait abnormalities, and paresis. However, these mice also frequently showed prominent general weakness probably because of the systemic effects of IL-6/IL-6Ralpha such as liver damage and plasmacytomas. IL-6/sIL-6Ralpha transgenic mice exhibited massive reactive gliosis. Lack of signs of neuronal breakdown versus ample astrogliosis suggested that astrocytes were selectively affected in these mice. There was neither vascular proliferation nor inflammatory infiltration. Ultrastructural analysis revealed blood-brain barrier (BBB) changes manifested by hydropic astrocytic end-feet. However, albumin immunohistochemistry did not reveal major BBB leakage. Our results indicate that increased and constitutive systemic expression of IL-6 together with its soluble receptor sIL-6Ralpha is less harmful to the brain than to other organs. The BBB remains primarily intact. IL-6/IL-6Ralpha, however, might be directly responsible for the selective activation of astrocytes.
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PMID:Astrocytic alterations in interleukin-6/Soluble interleukin-6 receptor alpha double-transgenic mice. 1107 9

This paper intends to investigate the connection between HIV transmission knowledge and prejudicial attitudes towards people with HIV/AIDS (PWAs), with an emphasis on exploring the pattern of cognitive profile in response to knowledge questions. Data for the present study were derived from the 'Health Attitudes and Health Seeking Behavior Study', a telephone survey of a nationally representative sample, aged 20 to 70, from April to May 1997 in Taiwan. A total of 2,471 respondents who had heard of AIDS and knew that it was infectious were included in the analysis. Based on answers to four transmission-route items (blood transfusion, mother-foetus, sexual contacts, needle sharing) and two casual-contact items (shaking hands and sharing utensil), a variable 'pattern of knowledge performance' was constructed, by which the respondents were clustered into five knowledge groups. Bivariate and multivariate analyses illustrated the greater explanatory power of pattern of knowledge performance rather than additive scoring of knowledge items to PWAs' prejudice. Moreover, it was the responses to casual-contact rather than transmission-route questions that made a greater contribution to PWAs' prejudice. Special attention is given to the possible perceptual undertaking inherent in the five types of knowledge group. To implement effective AIDS prevention campaigns and interventions, the design for increasing the risk perception of the correct HIV transmission routes should differ from that of reducing the risk perception of the casually transmitted routes.
AIDS Care 2002 Aug
PMID:Pattern of responses to HIV transmission questions: rethinking HIV knowledge and its relevance to AIDS prejudice. 1220 57

Clinically relevant movement disorders are identified in 3% of patients with HIV infection seen at tertiary referral centres. In the same setting, prospective follow-up shows that 50% of patients with AIDS develop tremor, parkinsonism or other extrapyramidal features. Hemiballism-hemichorea and tremor are the most common hyperkinesias seen in patients who are HIV positive, but other movement disorders diagnosed in these patients include dystonia, chorea, myoclonus, tics, paroxysmal dyskinesias and parkinsonism. Patients with movement disorders usually present with other clinical features such as peripheral neuropathy, seizures, myelopathy and dementia. In the vast majority of patients, hyperkinesias result from lesions caused by opportunistic infections, particularly toxoplasmosis, which damage the basal ganglia connections. On the other hand, parkinsonism and tremor can result from dopaminergic dysfunction resulting from HIV itself or the use of antidopaminergic drugs. The management of patients who are HIV positive who present with movement disorders involves recognition and treatment of opportunistic infections, symptomatic treatment of the movement disorder and the use of highly active antiretroviral therapy (HAART). The most effective treatment of cerebral toxoplasmosis in patients with HIV infection is the combination of sulfadiazine and pyrimethamine. Symptomatic treatment of the movement disorder is often disappointing: hemiballism improves with antipsychotics, but tremor, parkinsonism and other phenomena usually fail to respond to available therapies. Preliminary data suggest that HAART may be helpful in the symptomatic control as well as prevention of movement disorders in patients who are HIV positive.
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PMID:HIV-related movement disorders: epidemiology, pathogenesis and management. 1226 60

This is a critique of a study by Howlett, Nkya, Mmuni, Missalek, published in AIDS (1989), which reports on clinical findings in 200 AIDS patients at the Kilimanjaro Christian Medical Center in Tanzania between 1985-88. For 135 of these patients, the study concentrates on the clinical neurological symptoms of AIDS. General symptoms included weakness (98%); wasting (92%); fever (79%); diarrhea (75%); maculo-papulor rash (71%); and candidiasis (57%). Neurological symptoms included AIDS dementia complex (54%); retinal abnormalities (23%); areflexia (21%); pyramidal tract signs (19%) and tremor and incoordination (19%). This study is the most detailed published examination to date of the clinical neurological symptoms associated with AIDS in African patients. In spite of the weaknesses of the study the paucity of laboratory investigations and the lack of autopsy information and the frequency of different infections affecting the nervous system in African AIDS patients, the study will be referenced in all future works on the neurology of AIDS in Africa. (Author's modified).
WHO AIDS Tech Bull 1989 Oct
PMID:Neurological disorders in AIDS and HIV disease in the northern zone of Tanzania. 1228 84

This training exercise helps health workers to understand what it might feel like to be at risk for HIV infections and/or to be infected with the virus. Participants stand in a circle with their eyes closed, and the facilitator walks around them and taps one of them on the shoulder. This person is, thus, anonymously designated as being HIV-positive. All the participants then mill around and decide whether to shake hands with each other or not. Shaking hands is symbolic of having unprotected intercourse. Depending on the size of the group, they can shake hands with 3 or 4 people. If the person whose hand they shake scratches their palm, then they were exposed to HIV, and they must then scratch the palm of any other hands they shake. With the "HIV exposed" people sitting in an inner circle and the "HIV unexposed" in an outer circle, discussion can then center on how it feels to be exposed and what factors would influence the decision to have counseling and/or testing. Then the inner circle people are instructed to have the test and are randomly assigned cards which read "negative" or "positive." Those with negative cards move to the outer circle and the discussion centers on how they feel and how those with positive cards feel and how this would change their behavior. At the end, all participants must be reminded that this was simply a training exercise.
AIDS Action 1995 Feb
PMID:Understanding HIV. Training exercise for health workers. 1228 24

According to the Wenhui Daily newspaper, the number of people infected with HIV in Shanghai, China, is growing rapidly and could surpass 16,000 next year, dramatically up from the current level of 183 confirmed cases. Many Shanghai residents lack basic information about HIV/AIDS and how to protect themselves against becoming infected. For example, more than one-third of people surveyed in the city were unaware that condom use during sexual intercourse reduces the risk of HIV transmission, and 20-50% of people believed that HIV can be spread by swimming, shaking hands, or touching objects handled by HIV-infected individuals. Wenhui Daily cited unspecified health officials as the source of its information. Nationwide, China has reported less than 8000 confirmed cases of HIV infection, although more than 300,000 people are thought to be infected. 1.2 million people are projected to be infected with HIV in China by 2000. The youngest person known to be infected with HIV in Shanghai is a 21-month old infant whose mother transmitted the virus during pregnancy. China's leaders have only recently begun to take steps to check the spread of HIV and to teach the public how to protect itself.
AIDS Wkly Plus 1999 Jan 25
PMID:Increasing number of people infected by HIV in Shanghai, China. 1232 60


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