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Jeon JW, Yoon HJ, Kim JS, Ryu IH, Choi JW, Kim MG, Na YM, Yun HJ. A case on streptococcal pneumonia associated with leptomeningitis, osteomyelitis and epidural abscess in a patient with AIDS. Tuberc Respir Dis (Seoul) 2014; 76:80-3. [PMID: 24624217 PMCID: PMC3948856 DOI: 10.4046/trd.2014.76.2.80] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 09/06/2013] [Accepted: 09/26/2013] [Indexed: 11/24/2022] Open
Abstract
Patients with acquired immunodeficiency syndrome (AIDS) are at higher risks of bacterial pneumonia than the general population, and the pathogen is the most commonly involved Streptococcus pneumoniae. We hereby report a case of pneumococcal pneumonia associated with leptomeningitis, osteomyelitis and epidural abscess in a patient with AIDS. He is being successfully treated with ampicillin/sulbactam and clindamycin. And because the pneumococcal infection is usually associated with morbidity and mortality rates in the setting of AIDS, we should consider for pneumococcal vaccinations among the AIDS populations.
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Schram A, Labonté R, Sanders D. Urbanization and international trade and investment policies as determinants of noncommunicable diseases in Sub-Saharan Africa. Prog Cardiovasc Dis 2014; 56:281-301. [PMID: 24267436 PMCID: PMC7111622 DOI: 10.1016/j.pcad.2013.09.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There are three dominant globalization pathways affecting noncommunicable diseases in Sub-Saharan Africa (SSA): urbanization, trade liberalization, and investment liberalization. Urbanization carries potential health benefits due to improved access to an increased variety of food imports, although for the growing number of urban poor, this has often meant increased reliance on cheap, highly processed food commodities. Reduced barriers to trade have eased the importation of such commodities, while investment liberalization has increased corporate consolidation over global and domestic food chains. Higher profit margins on processed foods have promoted the creation of ‘obesogenic’ environments, which through progressively integrated global food systems have been increasingly ‘exported’ to developing nations. This article explores globalization processes, the food environment, and dietary health outcomes in SSA through the use of trend analyses and structural equation modelling. The findings are considered in the context of global barriers and facilitators for healthy public policy.
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de Campos FPF, Zerbini MCN, Felipe-Silva A, Simões AB, Lovisolo SM, da Fonseca LG, Laborda L. Unusual clinical presentation of anaplastic large cell lymphoma. Autops Case Rep 2014; 4:21-27. [PMID: 28652989 PMCID: PMC5470561 DOI: 10.4322/acr.2014.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Accepted: 03/15/2014] [Indexed: 11/28/2022]
Abstract
Anaplastic large cell lymphoma (ALCL), a well-recognized entity, presents a varied clinical picture and epidemiological characteristics associated with the expression of the anaplastic lymphoma kinase (ALK) protein. When classic symptoms are present (weight loss, fever, and night sweats) and combine with enlarged and easily accessible peripheral lymph nodes, diagnosis is not that difficult. But when the clinical presentation is nonspecific, a tough diagnostic task is required. HIV infection is highly associated with neoplastic disorders-mainly with those of hematological origin. However, ALCL is exceptionally associated with HIV infection, and the few reported cases are ALK- ALCL. The authors report two cases of ALK+ ALCL with the unusual clinical presentation: one is associated with the HIV infection and the other presents as a fever of unknown origin (FUO) without peripheral lymphadenopathy. The latter was autopsied and was characterized by nodal and extra nodal involvement. The authors call attention to the plurality of clinical presentation of this group of lymphomas, and the early indication of bone marrow examination in cases of an FUO with elevated hepatic enzymes and lactic dehydrogenase.
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Complementary therapy provision in a London community clinic for people living with HIV/AIDS: a case study. Complement Ther Clin Pract 2013; 20:65-9. [PMID: 24439648 DOI: 10.1016/j.ctcp.2013.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 09/06/2013] [Accepted: 10/03/2013] [Indexed: 11/22/2022]
Abstract
AIM To present a case study of complementary therapy (CT) provision within a community HIV multi-agency service in a Northwest London deprived area. METHODS Anonymised routine service data were provided for all clients (n = 1030) August 2010 to October 2012. Face-to-face meetings provided feedback from volunteers (9 CT-using clients and 9 staff). RESULTS CT-users were demographically similar to other clients. Support for coping with HIV was commonly cited as a service benefit. Over 26 months 1416 CT sessions were provided; 875 aromatherapy and 471 shiatsu. CT-users' most common concerns were pain (48%), stress (15%) and insomnia (13%), few had heard of or used CT before. Perceived mental and emotional benefits included relaxation,stress relief, relieving musculoskeletal aches and pains. Service challenges included time and funding, though staff felt CT may be cost-effective. CONCLUSIONS CT may provide important support and treatment options for HIV disease, but cost effectiveness requires further evaluation.
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Tomazini B, Bandeira R, Aragão T, Borges JCA, Sasdelli R, Salgado VP, de Campos FPF, de Lima PP. Co-infection of disseminated histoplasmosis and tuberculosis in an AIDS patient. AUTOPSY AND CASE REPORTS 2013; 3:49-58. [PMID: 31528618 PMCID: PMC6671895 DOI: 10.4322/acr.2013.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Accepted: 09/14/2013] [Indexed: 11/23/2022] Open
Abstract
Histoplasmosis is a fungal disease caused by the dimorphic fungus Histoplasma capsulatum, recognized as an AIDS-defining illness since the Center for Disease Control's revision criteria in 1985. This infection is reported to be present in 5-20% of AIDS patients, and in 95% of the cases it is manifested in its disseminated form. Serum antibodies and/or antigen research can make diagnosis, but the demonstration of the agent by culture or histopathological examination remains the gold standard methods. Co-infections in patients with AIDS are well known; however, reports on disseminated tuberculosis and histoplasmosis are scarce. The authors report the case of a female patient who presented a short-course history of weight loss, fever, and mild respiratory symptoms, with hepatosplenomegaly and lymphadenopathy. Laboratory workup called attention to anemia, altered liver, canalicular enzymes, liver function tests, high titer of lactate dehydrogenase (LDH), and pulmonary nodules on thoracic computed tomography. Incidental finding of yeast forms within the leukocytes during a routine blood cell count highlighted the diagnosis of histoplasmosis. The patient started receiving amphotericin B but succumbed soon after. The authors emphasize the possibility of this co-infection, the diagnosis of severe infection through the finding of yeast forms within peripheral leukocytes, and for the high titer of LDH in aiding the differential diagnosis.
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Eyawo O, Hogg RS, Montaner JSG. The Holy Grail: The search for undiagnosed cases is paramount in improving the cascade of care among people living with HIV. Canadian Journal of Public Health 2013; 104:e418-9. [PMID: 24183185 DOI: 10.17269/cjph.104.4054] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 10/02/2013] [Accepted: 09/26/2013] [Indexed: 12/18/2022]
Abstract
Highly Active Antiretroviral Therapy (HAART) has transformed the nature of HIV/AIDS from an imminent death sentence to a chronic manageable condition. There is a growing interest in the potential impact of "treatment as prevention" - a notion that expanded coverage with HAART would substantially reduce morbidity and mortality from HIV, and secondarily HIV transmission at the population level. However, undiagnosed and undocumented HIV cases cannot benefit from HAART and are more likely to experience HIV-related morbidity and untimely mortality. Late diagnosis of HIV remains prevalent and represents missed opportunities for early linkage to and engagement in care. In the absence of a vaccine and cure for HIV, undiagnosed HIV cases represent the biggest challenge yet in the fight against HIV/AIDS. As such, identifying them should be a priority of HIV prevention programs.
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Kim HS, Chin BS, Shin HS. Prevalence and risk factors of low bone mineral density in Korean HIV-infected patients: impact of abacavir and zidovudine. J Korean Med Sci 2013; 28:827-32. [PMID: 23772145 PMCID: PMC3677997 DOI: 10.3346/jkms.2013.28.6.827] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Accepted: 04/09/2013] [Indexed: 11/20/2022] Open
Abstract
Low bone mineral density (BMD) is common in HIV-infected patients. We aimed to describe the prevalence of low BMD and risk factors in Korean HIV-infected patients and to assess the effects of antiretroviral therapy (ART) on BMD. We retrospectively evaluated 224 HIV infected-patients. The prevalence of osteopenia and osteoporosis were 41.5% and 12.9%. These were much higher in 53 patients aged 50 yr and older (52.8% and 34.0%). Older age, lower body mass index, and ART > 3 months were independent risk factors for low BMD. Osteoporosis was more prevalent in patients on the abacavir-based regimen for < 1 yr than ≥ 1 yr; however, it was more prevalent in patients on the zidovudine-based regimen for ≥ 1 yr than < 1 yr (P = 0.017). Osteoporosis in patients on the abacavir-based regimen was more common in the spine than in the femur (P = 0.01). Given such a high prevalence of low BMD, close monitoring of BMD for HIV-infected patients on ART is required. The different prevalence of osteoporosis over time and affected areas between two regimens suggest they may play roles in different mechanisms in bone loss.
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Girón SL, Palacio H, Mateus JC. HIV sexual risk behaviors in youth 15-24 years of age in Cali, Colombia: Do differences exist among neighborhoods? Colomb Med (Cali) 2013; 44:72-9. [PMID: 24892451 PMCID: PMC4002023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Revised: 04/05/2013] [Accepted: 02/13/2013] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION HIV/AIDS is a global health priority. About 40% of new infections occur among heterosexual youth by means of sexual contact. In Cali, district 13, 15 and 20 account for 11.5% of the prevalent cases and 18.0% of incident cases. OBJECTIVE To establish differences in risk behaviors for HIV among young people 15-24 yrs of age from two areas of Cali, Colombia. METHODS We carried out a cross-sectional study among young people between 15 and 24 yrs of age in these districts. The selection was done with a two-stage probability sampling. We estimated the prevalence of sexual relationships without condom usage, sex with multiple partners, and sex under the effects of alcohol and through logistical regression we identified the related factors. RESULTS In district 13, 15 and 20, the prevalence of unprotected sexual relationships in the last 12 months and the prevalence of sex with two or more partners was 70%; and 38% of young people had sex under the effects of alcohol. In both areas, the intention was positively related to the risk behaviors. We found socio-demographic factors, intentions, and beliefs that increase the opportunity to display these behaviors. The effect of these factors differs by district. CONCLUSIONS We observed a high prevalence of risk behaviors for HIV related to socio-demographic factors, intentions and beliefs that warrant interventions appropriate for local realities.
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Ataei B, Shirani K, Alavian SM, Ataie M. Evaluation of Knowledge and Practice of Hairdressers in Women's Beauty Salons in Isfahan About Hepatitis B, Hepatitis C, and AIDS in 2010 and 2011. HEPATITIS MONTHLY 2013; 13:e6215. [PMID: 23658593 PMCID: PMC3644795 DOI: 10.5812/hepatmon.6215] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Revised: 06/20/2012] [Accepted: 06/24/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND Blood-borne viruses such as hepatitis B, hepatitis C, and human immunodeficiency virus (HIV) have some common epidemiological characteristics, and have infected millions of people throughout the world. Patients infected by acute hepatitis or HIV infections may not be aware of the disease, and thereby cause transmission to others. During haircut, shave, or pedicure, barbers may accidentally expose to their clients' blood, transmit their own infection to them, or transmit the infection from one client to another. Thus the beauty salon staff has a potential role in expansion of infections. OBJECTIVES As being barbers and barbering are risk factors to some infectious diseases, determining the role of knowledge and awareness of barbers and hairdressers about topics related to AIDS, and hepatitis B and C is important. PATIENTS AND METHODS This cross-sectional descriptive study was performed in 2010-2011 on 281 women's beauty salons located in eleven urban districts of Isfahan town. A multistage cluster sampling was performed and knowledge assessment questionnaire accompanied by practice checklist regarding hepatitis B and C, and AIDS were completed by trained interviewers. Knowledge and practice scores were determined in 0-20 and 0-10 scales, respectively. The content validity of questionnaire was confirmed by three expert opinions and the test-retest reliability of the questionnaire was determined to be 0.83 in a pilot study on 30 participants. Data were analyzed using Pearson's correlation coefficient and one-way ANOVA test by SPSS software, version 18. RESULTS In the study, 281 hairdressers participated. There was a statistically significant relationship between education level and knowledge score of hairdressers (P < 0.001). We found a statistically significant relationship between knowledge level and job history of hairdressers according to the Pearson's correlation coefficient (P = 0.004). The results did not show any statistically significant relationship between education level and practice scores (P = 0.5). Furthermore, the job history of hairdressers and their practice score did not show a significant relationship (P = 0.77). CONCLUSIONS We obtained promising results about the knowledge and practice levels of staffs of women's beauty salons in Isfahan about AIDS, and hepatitis B and C. The target group exhibited an intermediate level of knowledge about the diseases because of important role of barbers in virus transmission; we should provide the best control, evaluation, and continuous teaching programs.
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Liu Y, Patel AA, Shaw JC, Fillman EP, Lamb PB. Gastroduodenal Cryptococcus in an AIDS Patient Presenting With Melena. Gastroenterology Res 2013; 6:26-28. [PMID: 27785222 PMCID: PMC5051116 DOI: 10.4021/gr507w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/31/2013] [Indexed: 11/09/2022] Open
Abstract
Gastrointestinal cryptococcosis is extremely rare with only a few case reports found in the literature and involvement primarily identified post-mortem. This is a case of 54-year-old man with a 20-year history of poorly controlled human immunodeficiency virus presented with constitutional symptoms along with melena. Diagnostic work up with esophagogastroduodenoscopy showed 4 irregular ulcers in the stomach notable for red-pigmented lesions within the ulcers, erythematous mucosa in the antrum and patchy friable mucosa in the duodenum. H&E staining and Mucicarmine staining showed findings consistent with C. neoformans. Blood culture and cerebrospinal fluid studies also revealed C. neoformans. Cryptococcus neoformans is an AIDS defining illness that most commonly presents as meningoencephalitis and pneumonitis. Key management principles includes: induction of antifungal therapy followed by consolidation and maintenance; management of elevated intracranial pressure and immune reconstitution inflammatory syndrome. Although the organism can infect nearly all organs, gastrointestinal involvement is rarely described. Our case highlights the fact that gastrointestinal C. neoformans infection can be associated with upper gastrointestinal symptoms and may be the initial presentation of disseminated cryptococcosis.
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Davis Pate M, Shell AT, King SR. Assessing pharmacists' perspectives of HIV and the care of HIV-infected patients in Alabama. Pharm Pract (Granada) 2012; 10:188-93. [PMID: 24155836 PMCID: PMC3780495 DOI: 10.4321/s1886-36552012000400002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Accepted: 12/06/2012] [Indexed: 11/22/2022] Open
Abstract
Objective The purpose was to assess factors potentially affecting care pharmacists
provide to HIV/AIDS patients including comfort level, confidence, education,
experience, professional competence, continuity of care and patient-provider
relationship between pharmacists and HIV-infected patients. Methods A 24-item questionnaire assessed the constructs of this study. Surveys were
distributed from October 2009 to April 2010 to pharmacists in Alabama with
varying levels of experience treating HIV-infected patients. Chi-square
tests determined whether relationships existed between responses, consisting
of how often respondents reported treating HIV-infected patients, amount of
HIV education respondents had, participants’ confidence with HIV/AIDS
knowledge and comfort level counseling HIV-infected patients about their
medications. Results Thirty-three percent of the pharmacists cared for HIV-infected patients on a
monthly basis, yet 86% do not feel very confident with their HIV/AIDS
knowledge. Forty-four percent were not comfortable counseling patients on
antiretroviral medications, and 77% would feel more comfortable with more
education. Significant, positive relationships were revealed concerning how
often respondents treat HIV-infected patients and their comfort level
counseling them (r=0.208, p<0.05). Similar relationships pertaining to
the amount of education respondents had regarding HIV, how confident they
are in their HIV/AIDS knowledge (r=0.205, p< 0.05), and their comfort
level counseling HIV-infected patients on their medications (r=0.312,
p<0.01) were found. The time spent treating HIV-infected patients and the
education respondents had pertaining to HIV/AIDS related to increased
comfort levels concerning counseling patients on their medications. Conclusions This research uncovered areas where pharmacists can improve care and
treatment for HIV-infected patients. Increasing education on HIV/AIDS and
treatment options may lead to increased comfort and confidence in
therapeutic management. Through changes in pharmacists’ perspectives and
abilities to care for their patients, the patient-provider relationship
could strengthen, potentially leading to improved medication compliance,
enhanced overall health, and a better quality of life for HIV-infected
patients.
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Abstract
Background A primary goal for the development of EHRs and EHR-related technologies should be to facilitate greater knowledge management for improving individual and community health outcomes associated with HIV / AIDS. Most of the current developments of EHR have focused on providing data for research, patient care and prioritization of healthcare provider resources in other areas. More attention should be paid to using information from EHRs to assist local, state, national, and international entities engaged in HIV / AIDS care, research and prevention strategies. Unfortunately the technology and standards for HIV-specific reporting modules are still being developed. Methods: A literature search and review supplemented by the author’s own experiences with electronic health records and HIV / AIDS prevention strategies will be used. This data was used to identify both opportunities and challenges for improving public health informatics primarily through the use of latest innovations in EHRs. Qualitative analysis and suggestions are offered for how EHRs can support knowledge management and prevention strategies associated with HIV infection. Results: EHR information, including demographics, medical history, medication and allergies, immunization status, and other vital statistics can help public health practitioners to more quickly identify at-risk populations or environments; allocate scarce resources in the most efficient way; share information about successful, evidenced-based prevention strategies; and increase longevity and quality of life. Conclusion: Local, state, and federal entities need to work more collaboratively with NGOs, community-based organizations, and the private sector to eliminate barriers to implementation including cost, interoperability, accessibility, and information security.
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Pavlova-McCalla E, Trepka MJ, Ramirez G, Niyonsenga T. Socioeconomic Status and Survival of People with Human Immunodeficiency Virus Infection before and after the Introduction of Highly Active Antiretroviral Therapy: A Systematic Literature Review. JOURNAL OF AIDS & CLINICAL RESEARCH 2012; 3:1000163. [PMID: 24575328 PMCID: PMC3933225 DOI: 10.4172/2155-6113.1000163] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Human immunodeficiency virus/acquired immunodeficiency disease syndrome-associated mortality contributes considerably to overall mortality rates among adults in the United States. The purpose of this review is to systematically examine conceptual approaches that have been used to evaluate the association between socioeconomic status of people infected with human immunodeficiency virus and their survival and summarize existing evidence regarding the association between socioeconomic status and mortality due to human immunodeficiency virus/acquired immunodeficiency disease syndrome. METHODS We systematically retrieved neighborhood and individual-level studies of acquired immunodeficiency disease syndrome-related or all-cause mortality among patients diagnosed with human immunodeficiency virus that reported original data and analyzed socioeconomic status as a predictor of mortality. RESULTS We included 21 studies (19 cohort and 2 case-control studies). Heterogeneity in both the conceptual approaches to socioeconomic status measurements and selection of variables for the adjustment of the measure of association precluded meta-analysis of the results. Six studies observing populations before the introduction of highly active antiretroviral therapy found that socioeconomic status was not associated with human immunodeficiency virus/acquired immunodeficiency disease syndrome mortality. In the post- highly active antiretroviral therapy period socioeconomic status was inconsistently associated with Human immunodeficiency virus/acquired immunodeficiency disease syndrome mortality risk in studies adjusting for highly active antiretroviral therapy use. CONCLUSION Further studies considering multilevel socioeconomic status measurements and controlling for treatment and clinical variables are needed to enhance understanding of the role of socioeconomic gradients on human immunodeficiency virus outcomes.
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Improving Access to HIV and AIDS Information Resources for Patients, Caregivers, and Clinicians: Results from the SHINE Project. Online J Public Health Inform 2012; 4:ojphi-04-2. [PMID: 23569627 PMCID: PMC3615804 DOI: 10.5210/ojphi.v4i1.3849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) remains a significant international public health challenge. The Statewide HIV/AIDS Information Network (SHINE) Project was created to improve HIV/AIDS health information use and access for health care professionals, patients, and affected communities in Indiana. OBJECTIVE Our objective was to assess the information-seeking behaviors of health care professionals and consumers who seek information on the testing, treatment, and management of HIV/AIDS and the usability of the SHINE Project's resources in meeting end user needs. The feedback was designed to help SHINE Project members improve and expand the SHINE Project's online resources. METHODS A convenience sample of health care professionals and consumers participated in a usability study. Participants were asked to complete typical HIV/AIDS information-seeking tasks using the SHINE Project website. Feedback was provided in the form of standardized questionnaire and usability "think-aloud" responses. RESULTS Thirteen participants took part in the usability study. Clinicians generally reported the site to be "very good," while consumers generally found it to be "good." Health care professionals commented that they lack access to comprehensive resources for treating patients with HIV/AIDS. They requested new electronic resources that could be integrated in clinical practice and existing information technology infrastructures. Consumers found the SHINE website and its collected information resources overwhelming and difficult to navigate. They requested simpler, multimedia-content rich resources to deliver information on HIV/AIDS testing, treatment, and disease management. CONCLUSIONS Accessibility, usability, and user education remain important challenges that public health and information specialists must address when developing and deploying interventions intended to empower consumers and support coordinated, patient-centric care.
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Kim SJ, Park SJ, Yu HG, Kim NJ, Jang HC, Oh MD. Ocular manifestations of acquired immunodeficiency syndrome in Korea. J Korean Med Sci 2012; 27:542-6. [PMID: 22563221 PMCID: PMC3342547 DOI: 10.3346/jkms.2012.27.5.542] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Accepted: 01/26/2012] [Indexed: 11/20/2022] Open
Abstract
The clinical features of HIV/AIDS-related ocular manifestations in Korean patients were investigated in this study. Data on 200 consecutive Korean patients diagnosed with AIDS who visited the Seoul National University Hospital from January 2003 to June 2008 were reviewed. Fifty-seven patients (28.5%) had ocular manifestations, and they showed significantly lower CD4+ T cell count than patients without ocular manifestations. Among them, 23 (40.3%) patients showed retinal microvasculopathy, and 22 (38.5%) patients showed cytomegalovirus (CMV) retinitis. Other manifestations included retinal vein occlusion (n = 4), herpes zoster ophthalmicus (n = 4), syphilitic uveitis (n = 2), acute retinal necrosis (n = 1), and progressive outer retinal necrosis (n = 1). The mean CD4+ lymphocyte counts of the patients with retinal microvasculopathy and cytomegalovirus retinitis were 108.5 cells/µL and 69.4 cells/µL, respectively. In conclusion, ocular manifestations including CMV retinitis are common complications in Korean patients with AIDS even in the era of highly active anti-retroviral therapy. Compared to previous reports in western countries, prevalence of CMV retinitis is relatively low and CD4+ lymphocytes count at the time of diagnosis is relatively high.
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The knowledge and attitudes of a female at-risk population towards the prevention of AIDS and sexually transmitted infections in Tehran. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2011; 16:1452-8. [PMID: 22973347 PMCID: PMC3430063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2011] [Accepted: 10/14/2011] [Indexed: 11/24/2022]
Abstract
BACKGROUND The female at-risk population represents a subgroup that is both a crucial determining factor in acquired immune deficiency syndrome (AIDS) transmission and a gap in the existing literature in Iran. The objective of this study was to evaluate the level of sex workers' knowledge towards to safe procedures of sexually transmitted infection and AIDS prevention as well as attitudes towards AIDS. METHODS A sample of 256 female sex workers working in Tehran was obtained by a variety of methods. Appropriate questions for the assessment of knowledge and attitude were developed based on previous studies. RESULTS The mean age of the subjects was 26.8 ± 6.1 years (ranging from 16 to 45). Methods of transmission were widely recognized, despite the exception that few realized oral (23.4%) and anal (44.9%) intercourse as methods of human immunodeficiency virus (HIV) transmission. Most subjects knew that AIDS currently has no cure (81.2%) and no vaccine (73.4%). Most also acknowledged that HIV is transmissible from people who do not know they are HIV positive (59.4%), proper condom use can reduce the possibility of infection (78.1%), and so can having a single sexual partner (68.8%). Of the participants, 43.4% knew that an HIV-positive person can seem perfectly healthy. CONCLUSIONS Knowledge towards sexually transmitted infections (STIs) and condom use is still inadequate, especially regarding risky behaviors such as anal sex, and attitudes are mainly negative. Identifying at-risk populations, HIV-positive sex workers, education and campaigns to change the attitudes towards AIDS should be regarded a high priority in Iran.
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Goon DT, Abaver DT, Nwobegahay JM, Iweriebor BC, Anye DN. Prevalence of intestinal parasitic infections among HIV/AIDS patients from two health institutions in Abuja, Nigeria. Afr Health Sci 2011; 11 Suppl 1:S24-7. [PMID: 22135640 DOI: 10.4314/ahs.v11i3.70066] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Intestinal parasitic infections play a vital role in the prognosis of HIV/AIDS in patients. OBJECTIVES The aim of this study was to determine the prevalence of intestinal parasitic infections (IPIs) in HIV-infected individuals in two health facilities in Abuja-Nigeria. METHODS A cross sectional study was conducted in two sites: the GEDE AIDS and Infectious Diseases Research Institute (GAIDRI), and the Human Virology Institute-General Hospital Asokoro-Abuja, Nigeria. A total of 119 subjects were recruited (85 HIV infected and 34 HIV negative). Stool specimens collected were analyzed macroscopically and microscopically for consistency and the presence of enteric parasites. RESULTS The overall prevalence rate of enteroparasites obtained in this study was 22.7% (27/119). The prevalence of intestinal parasitic infections in HIV infected patients was 24.7 %; while in HIV negative persons, it was 17.6%. However, the high rate obtained for HIV infected patients was not statistically significant (p> 0.05). CONCLUSION Although the prevalence rate of enteric parasites in HIV/AIDS patients was higher than in HIV negative individuals, this difference is not statistically significant. Even though there was no statistical difference in the two groups, parasitic infections in HIV/AIDS patients often result in debilitating illness.
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Choe PG, Park WB, Song JS, Kim NH, Song KH, Park SW, Kim HB, Kim NJ, Oh MD. Incidence of atazanavir-associated hyperbilirubinemia in Korean HIV patients: 30 months follow-up results in a population with low UDP-glucuronosyltransferase1A1*28 allele frequency. J Korean Med Sci 2010; 25:1427-30. [PMID: 20890421 PMCID: PMC2946650 DOI: 10.3346/jkms.2010.25.10.1427] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Accepted: 07/07/2010] [Indexed: 01/11/2023] Open
Abstract
Hyperbilirubinemia is frequently observed in Caucasian HIV patients treated with atazanavir. UDP-glucuronosyltransferase 1A1 polymorphism, UGT1A1*28, which is associated with atazanavir-induced hyperbilirubinemia, is less common in Asians than in Caucasians. However, little is known about the incidence of atazanavir-associated hyperbilirubinemia in Asian populations. Our objective was to investigate the incidence of and tolerability of atazanavir-associated hyperbilirubinemia in Korean HIV patients. The prevalence and cumulative incidence of atazanavir-associated hyperbilirubinemia and UGT1A1*28 allele frequency was investigated in 190 Korean HIV-infected patients treated with atazanavir 400 mg per day. The UGT1A1*28 were examined by direct sequencing of DNA from peripheral whole blood. The UGT1A1*28 allele frequency was 11%. The cumulative incidence of any grade of hyperbilirubinemia was 77%, 89%, 98%, and 100%, at 3, 12, 24, and 30 months, respectively. The cumulative incidence of severe (grade 3-4) hyperbilirubinemia was 21%, 41%, 66%, and 75%, at 3, 12, 24, and 30 months, respectively. However, the point prevalence of severe hyperbilirubinemia did not increase with time and remained around 25%. Our data suggest that atazanavir-associated hyperbilirubinemia is common but transient in a population with low UGT1A1*28 allele frequency.
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Choe PG, Park WB, Song JS, Song KH, Jeon JH, Park SW, Kim HB, Chang KH, Oh MD, Choe KW, Kim NJ. Spectrum of intracranial parenchymal lesions in patients with human immunodeficiency virus infection in the Republic of Korea. J Korean Med Sci 2010; 25:1005-10. [PMID: 20592890 PMCID: PMC2890875 DOI: 10.3346/jkms.2010.25.7.1005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Accepted: 12/30/2009] [Indexed: 11/30/2022] Open
Abstract
The incidence of specific intracranial parenchymal lesions of HIV-infected patients varies considerably between countries. In the Republic of Korea, the number of HIV-infected patients is increasing, but little is known regarding the spectrum of intracranial parenchymal lesions in these patients. The aim of the present study was to obtain this information. To identify HIV patients with intracranial parenchymal lesions, the electronic database of radiological reports for 1,167 HIV-infected patients, seen from 1999 to 2008 at the Seoul National University Hospital, were reviewed. Neuroradiologic studies were performed on 165 of these patients, and intracranial parenchymal lesions were detected in 40 (3.4%) of them. Thirty-seven were male, and median age was 41 yr (range, 26-61). At the time of the diagnosis of intracranial parenchymal lesions, median CD4(+) lymphocyte count was 40 cells/microL (range 5-560) and in 33 (82.5%) patients, it was less than 200 cells/microL. Progressive multifocal leukoencephalopathy (12 patients) is the most frequent intracranial parenchymal lesions, followed by intracranial tuberculoma (7 patients), primary central nervous system lymphoma (7 patients), intracranial cryptococcoma (4 patients), Toxoplasma encephalitis (4 patients), and disseminated non-tuberculous mycobacterial infection (3 patients).
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95
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Vallejos IC, Sánchez HE, Lagunas LF, Valdés BC, Acosta RC. Knowledge, attitudes and perceptions of nurses and nursing students towards HIV/AIDS. INVESTIGACION Y EDUCACION EN ENFERMERIA 2010; 28:345-354. [PMID: 27499563 PMCID: PMC4973513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To describe attitudes, knowledge and perceptions of nurses and nursing students towards the people who live with HIV/AIDS (PLWHA). METHODOLOGY Bibliographic study in which six electronic databases were searched using the key words: "attitude", "knowledge", "nursing", perceptions", "HIV/AIDS". Publications between 1998 and 2007 were considered. RESULTS 560 articles limited by scientific researches or ministerial reports membership were retrieved. Finally a total of 38 publications were selected, the analysis showed that the level of knowledge of nurses and nursing students about PLWHA is good and the attitudes towards HIV/AIDS have improved over time. Nurses and nursing students have been able to identify both positive and negative aspects in the PLWHA care personally and professionally because there is a more favourable perception. CONCLUSION There are few studies in Latin America and Chile that study the attitudes and knowledge of the studied population towards PLWHA. According to publications found the knowledge and attitudes have improved because the perception is more favourable.
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96
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Clauson KA, Polen HH, Joseph SA, Zapantis A. Role of the pharmacist in pre-exposure chemoprophylaxis (PrEP) therapy for HIV prevention. Pharm Pract (Granada) 2009; 7:11-8. [PMID: 25147587 PMCID: PMC4139751 DOI: 10.4321/s1886-36552009000100002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2008] [Accepted: 11/21/2008] [Indexed: 11/26/2022] Open
Abstract
With a global estimate of 2.5 million new infections of HIV occurring yearly, discovering novel methods to help stem the spread of the virus is critical. The use of antiretroviral chemoprophylaxis for preventing HIV after accidental or occupational exposure and in maternal to fetal transmission has become a widely accepted method to combat HIV. Based on this success, pre-exposure chemoprophylaxis (PrEP) is being explored in at-risk patient populations such as injecting drug users, female sex workers and men who have sex with men. This off-label and unmonitored use has created a need for education and intervention by pharmacists and other healthcare professionals. Pharmacists should educate themselves on PrEP and be prepared to counsel patients about their means of obtaining it (e.g. borrowing or sharing medications and ordering from disreputable Internet pharmacies). They should also be proactive about medication therapy management in these patients due to clinically important drug interactions with PrEP medications. Only one trial exploring the safety and efficacy of tenofovir as PrEP has been completed thus far. However, five ongoing trials are in various stages and two additional studies are scheduled for the near future. Unfortunately, studies in this arena have met with many challenges that have threatened to derail progress. Ethical controversy surrounding post-trial care of participants who seroconvert during studies, as well as concerns over emerging viral resistance and logistical site problems, have already halted several PrEP trials. Information about these early trials has already filtered down to affected individuals who are experimenting with this unproven therapy as an “evening before pill”. The potential for PrEP is promising; however, more extensive trials are necessary to establish its safety and efficacy. Pharmacists are well-positioned to play a key role in helping patients make choices about PrEP, managing their therapy, and developing policy with an eye towards the future.
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97
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Choi JY, Song YG, Kim YH, Kim CO, Kim MS, Chin BS, Han SH, Choi SH, Lee HS, Jeong SJ, Choi H, Kim JM. Factors associated with HIV-1 proviral DNA loads in patients with undetectable plasma RNA load. J Korean Med Sci 2009; 24:152-4. [PMID: 19270829 PMCID: PMC2650966 DOI: 10.3346/jkms.2009.24.1.152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2007] [Accepted: 11/11/2008] [Indexed: 12/02/2022] Open
Abstract
To evaluate factors associated with human immunodeficiency virus type 1 (HIV-1) proviral DNA load, we conducted a cross-sectional study of 36 chronically HIV-1-infected individuals with undetectable plasma viral RNA. We used real-time polymerase chain reaction to determine the number of HIV-1 proviral DNA copies per 10(6) peripheral blood mononuclear cells. The mean level of plasma viral RNA when the CD4+ T cell count was above 500 cells/microL without highly active antiretroviral therapy (HAART) was significantly associated with proviral DNA load at the time of undetectable plasma HIV RNA with HAART. Strategies to reduce the level of plasma viral RNA when patients' CD4+ T cell counts are above 500 cells/microL without HAART could help reduce HIV-1 proviral DNA load.
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98
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Lincoln DW. Reproductive health, population growth, economic development and environmental change. CIBA FOUNDATION SYMPOSIUM 2007; 175:197-212; discussion 212-4. [PMID: 8222991 DOI: 10.1002/9780470514436.ch12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
World population will increase by 1000 million, or by 20%, within 10 years. Ninety-five per cent of this increase will occur in the South, in areas that are already economically, environmentally and politically fragile. Morbidity and mortality associated with reproduction will be greater in the current decade than in any period in human history. Annually, 40-60 million pregnancies will be terminated and 5-10 million children will die within one year of birth. AIDS-related infections, e.g. tuberculosis, will undermine health care in Africa (and elsewhere) and in places AIDS-related deaths will decimate the work-force. The growth in population and associated morbidity will inhibit global economic development and spawn new problems. The key issues are migration, the spread of disease, the supply of water and the degradation of land, and fiscal policies with respect to family planning, pharmaceuticals and Third-World debt. Full education, particularly of women, and more effective family planning in the South have the power to unlock the problem. Failure will see the developed countries, with their 800 million population, swamped by the health, economic and environmental problems of the South, with its projected population of 5400 million people for the year 2000.
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Commeyras C, Rey JL, Badre-Sentenac S, Essomba-Ntsama C. Determining factors of observance of antiretroviral treatments in Cameroon during the start-up period (2000-2002). Pharm Pract (Granada) 2006; 4:117-22. [PMID: 25214897 PMCID: PMC4156843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE highlight the socioeconomic and environmental determining factors of long-term observance to antiretroviral treatments in developing countries. METHOD The regularity of antiretroviral prescriptions renewal at the central pharmacy of the Yaounde Central Hospital (Cameroon) was measured through analysing the medical and pharmaceutical files of 230 patients over the 21 month start-up period. 99 patients were also interviewed during the last six months. The determining factors were analysed according to various socio-economic criteria, linked with the longitudinal study of treatment observance. RESULTS The huge price decrease of HIV treatments during the start-up period was conducive to an increase in new treatments by a factor 5.76. In this context of an exploding demand, the paper shows that observance is firstly dependent on quality information about illness and treatment protocols, while longer term adherence is partly dependent on financial capability, and includes the strong influence of living conditions and behaviours. CONCLUSION The paper recommends the introduction of free treatment as an objective in national sector policies and the organisation of a long term following-up of patients. In the African context of poverty and actual decentralisation of healthcare, the question of the availability of human resources is profoundly enhanced.
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100
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Rosenberg PS, Gail MH. Backcalculation of flexible linear models of the human immunodeficiency virus infection curve. J R Stat Soc Ser C Appl Stat 2002; 40:269-82. [PMID: 12157988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
The authors present a regression approach to the backcalculation of flexible linear models of the HIV infection curve. They note that "because expected AIDS incidence can be expressed as a linear function of unknown parameters, regression methods may be used to obtain parameter and covariance estimates for a variety of interesting quantities, such as the expected number of people infected in previous time intervals and the projected AIDS incidence in future time intervals. We exploit these ideas to show that estimates based on maximum likelihood are, for practical purposes, equivalent to approximate estimates based on quasi-likelihood and on Poisson regression. These algorithms are readily implemented on a personal computer." These concepts are illustrated by projecting AIDS incidence in the United States up to 1993.
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