Gene/Protein Disease Symptom Drug Enzyme Compound
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This prospective, controlled trial with crossover group design compares the effectiveness of active compression-decompression (ACD) cardiopulmonary resuscitation (CPR) and standard CPR on the outcomes of victims of prehospital cardiac arrest. In three UK cities, victims of non-traumatic, out of hospital cardiac arrest, over the age of 8 years received either standard or ACD-CPR on arrival of ambulance personnel. Main outcome measures were return of spontaneous circulation, survival to be admitted to the intensive care unit, survival to hospital discharge, and neurological outcome. A total of 576 patients (STD-CPR, n=309; ACD-CPR, n=267) were analysed. The treatment groups were similar with respect to age, gender, proportion of witnessed arrests, initial cardiac rhythm, and call to advanced life support interval. The proportion of patients receiving bystander CPR was higher in the ACD group (37.1% vs. 28.5%; P=0.028). The interval between collapse and defibrillation was longer in the ACD group (12.3 min vs. 10.4 min; P=0.028). There was no difference between the STD-CPR and ACD-CPR groups in survival to admission to the intensive care unit (13.6% vs. 13.8%; P=0.93) or hospital discharge (4.8% vs. 6.0%; P=0.67). There was no difference between the groups with respect to the neurological outcome of those patients surviving to hospital discharge. Analysis of important subgroups also showed no benefit for ACD-CPR. We conclude that there was no improvement in outcome with ACD-CPR when used by ambulance personnel in Cardiff and Portsmouth.
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PMID:The United Kingdom pre-hospital study of active compression-decompression resuscitation. 967 Oct 87

Estonia, one of the Baltic countries, regained its independence in 1991, after the collapse of the USSR. This process led to great changes in every sphere of life--in politics, in the economy and in medicine. The service providing care for sexually transmitted infections (STIs) was involved in the process of these changes, too. However, freedom was followed not only by great happiness, but also by social destabilization and transformation of the old moral norms, the most evident features of which were the dramatic rise in crime, a sexual revolution and public prostitution. These 2 great simultaneous transformations in the STI care system and public mores led to the rapid increase of STIs in Estonia in the first half of the 1990s. Now some stabilization, and even a fall in incidence has occurred.
Int J STD AIDS 1999 Oct
PMID:Sexually transmitted infections in Estonia. 1058 35

Situated in Southeastern Europe, with a surface of 237,500 km2 and a population of over 22 million, Romania was a special case in the evolution of global AIDS crisis. After the first reported case in a homosexual male in 1985, five years elapsed till the epidemiological investigations done in the Institute of Virology, Bucharest (1-4) provided strong evidence for what may represent the world's largest iatrogenic transmission of blood-borne pathogens in children. On the basis of Epidemiological Fact Sheet concerning Romania provided by UNAIDS/WHO Working Group on Global HIV/AIDS and STD Surveillance we offer a couple of graphics which are considered important for informed decision-making and planning at national and regional levels. We emphasize the lack of availability of many specific data both on epidemiological and socio-behavioral indicators. Structural collapse in Eastern Europe sets the scene for the rapid spread of HIV/AIDS among young people and the lack of information may contribute to an unexpected rebound of the epidemic.
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PMID:Romanian HIV-AIDS epidemic after a decade of evolution. 1160 80

Lactic acidosis (LA), a rare but life-threatening adverse effect associated with antiretroviral therapy, has been reported with an increasing frequency since the mid-1990s. From June 1994 to June 2002, a total of six patients, four males and two females with a median age of 43 years (range, 30 to 74 years), had been diagnosed with LA. The estimated incidence of LA was 5.1 per 1000 patient-years (PYs) on highly active antiretroviral therapy (HAART) (95% confidence interval [95% CI], 4.5-5.5 per 1000 PYs) and 4.4 per 1000 PY on nucleoside analogues (NAs) (95% CI, 3.9-4.7 per 1000 PYs). Their median body mass index at diagnosis of LA was 17.6 kg/m(2) (range 16.3 to 22.6 kg/m(2)). The median CD4+ lymphocyte count at the initial diagnosis of HIV infection and at the onset of LA was 38 cells/ micro L (range, 4 to 103 cells/ micro L) and 108 cells/ micro L (range, 79 to 224 cells/ micro L), respectively. The most common symptoms were nausea, vomiting, and dyspnoea. All of the patients had findings suggestive of NA-related mitochondrial toxicity, such as myositis, pancreatitis, fatty hepatitis, peripheral neuropathy or lipodystrophy. The prescribed NA related to LA were stavudine in six patients, lamivudine, five, and didanosine, one. Despite treatment, all patients died of persistent circulatory collapse following LA. The median duration from diagnosis to death was eight days (range, 4-17 days). Our report highlights that clinicians caring for patients with AIDS should be alerted to the potentially fatal LA associated with antiretroviral therapy when patients present with low body mass index, lipodystrophy, unexplained abdominal symptoms, dyspnoea, or elevated aminotransferases.
Int J STD AIDS 2004 Apr
PMID:Fatal lactic acidosis associated with highly active antiretroviral therapy in patients with advanced human immunodeficiency virus infection in Taiwan. 1507 19

An HIV-1-infected adult presented with a short history of dyspnoea, productive cough and myalgia with fever. Shortly after presentation, he developed the abrupt onset of high-volume watery diarrhoea: stool culture grew Shigella sonnei. At the same time, he became hypoxaemic, and thoracic imaging showed bilateral lower lobe consolidation/collapse. Culture of sputum and blood was negative. The patient recovered with fluid resuscitation and ciprofloxacin monotherapy. This is the first reported case of pneumonia complicating S. sonnei dysentery in an HIV-infected adult.
Int J STD AIDS 2005 Nov
PMID:Pneumonia complicating Shigella sonnei dysentery in an HIV-infected adult male. 1630 74