1/36. housing for people with AIDS.People with AIDS are homeless for a variety of reasons, including financial devastation, rejection based on fear of contagion or fear of the dying process, and homelessness prior to a diagnosis of AIDS. The author developed and directed the Shanti AIDS Residence Program in san francisco, the first program to provide housing for people with AIDS. This model is appropriate for single, independent people able to live cooperatively with others. It provides shared living situations for three to six people per apartment, and office staff physically maintain the houses and assure that the needs for community-based home care and other services are met. Other models are proposed for people who are physically or cognitively dependent (and require physical care or supervision in addition to housing), who are socially unable to live cooperatively with others in an unstructured living environment (e.g., active substance users or the emotionally disturbed), or who have families (e.g., mothers with dependent children or gay men who live with their lovers).- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/36. Disseminated manifestation of Kaposi's sarcoma in newly diagnosed AIDS in an african female.BACKGROUND: Kaposi's sarcomas are the most frequent malignancies in patients with AIDS and there is increasing evidence of an association with human Herpesvirus 8 (HHV-8). A reconstitution of the immune response due to different regimens of highly active antiretroviral therapy (HAART) is the most important step in treatment of Kaposi's sarcomas. Local treatment options include the topic application of alitretionin (9-cis-retinoic acid) as a gel, cryotherapy with liquid nitrogen and intralesional vinblastine, as well as local laser or low-dose X-ray treatment. A systemic chemotherapy can be taken under consideration in selected cases with clinical significant visceral lesions or aggressive sarcomatous behavior with anthracyclines, taxanes, as well as an immunomodulatory treatment with alpha Interferon. CASE REPORT: The case of an african emigrant is described. Hospitalized due to recurrent fever and diarrhea, the diagnosis of AIDS was quickly established. The physical examination revealed multiple nodular, painless skin lesions suspicious of Kaposi's sarcoma. The diagnosis was confirmed histologically, later on also in bronchial and duodenal biopsies due to the atypical subepithelial vessels with slit-like appearance and prominent endothelia. CONCLUSIONS: Cutaneous lesions in patients with dark skin colour may be unfamiliar to European physicians. In patients with hiv-infection, nodular skin lesions should lead suspicion to Kaposi's sarcoma. If this diagnosis is established, it should be clarified, if other locations (e.g.: intestine, respiratory tract) are involved, too.- - - - - - - - - - ranking = 0.33333333333333keywords = physical (Clic here for more details about this article) |
3/36. Understanding the psychodynamics of non-adherence to medical treatment in persons with hiv infection.We present this medical-psychiatric case discussion to illustrate the psychodynamic aspects of nonadherence in a woman with AIDS. Our patient sustained severe, repeated abandonment and brutal emotional, physical and sexual trauma throughout her early and later childhood and adult life. Her care was considerably complicated by the sequelae of trauma including difficulty with trust and posttraumatic stress disorder. The additional problem of hiv dementia compounded the patient's nonadherence to treatment. We present a multidisciplinary biopsychosocial approach that enabled the patient to engage in both medical and psychiatric care.- - - - - - - - - - ranking = 0.33333333333333keywords = physical (Clic here for more details about this article) |
4/36. Hyperlipidaemia a risk factor for femoral head osteonecrosis (Legg-Calv -Perthes-like disease) in children with AIDS: case report.Although treatment of children infected with hiv with protease inhibitors has improved the survival of these patients, various adverse side effects have been reported, including metabolic abnormalities, such as hyperlipidaemia. We describe a case of hip osteonecrosis in an adolescent with AIDS who was being treated with protease inhibitors. There is a possible relation with hyperlipidemia. F.M.G., white, 11 years old, AIDS A2, started to receive AZT and DDI when he was 7 years old. In April 1999, the patient had a significant increase in viral load and so the antiretroviral therapy was switched to d4T, 3TC and ritonavir. Triglyceride plasma levels reached 460mg/dl after this switch and were always above the reference value. In December 1999, the patient complained of pain in the right hip. On physical examination, he had limited movement of this joint. magnetic resonance imaging of the right hip showed flattening, deformity and fragmentation of the femoral head, compatible with osteonecrosis. Few cases of femoral head osteonecrosis have been associated with hiv infection, in the absence of the classic risk factors for osteonecrosis. Metabolic risk factors include hypertriglyceridaemia. The immunological disorders that occur in the hiv infection may predispose the patient to avascular osteonecrosis and metabolic disorders, particularly hypertriglyceridemia, while the use of protease inhibitors, may be considered an additional risk factor for osteonecrosis. Given the importance of premature diagnosis and to avoid complications of osteonecrosis, we recommend evaluation of musculoskeletal symptoms in children receiving protease inhibitors.- - - - - - - - - - ranking = 0.33333333333333keywords = physical (Clic here for more details about this article) |
5/36. female garment factory workers in cambodia: migration, sex work and hiv/AIDS.female garment factory workers in cambodia are more exposed to hiv/AIDS than previously thought. Although hiv/AIDS epidemics are fast spreading in cambodia, relatively little is known about the sexual health of women other than those perceived as commercial sex workers or married women of reproductive age. In-depth interviews with 20 unmarried female garment factory workers, who reported to have engaged in multi-partnered sex through direct or discretionary commercial sex occupations, demonstrate that they are exposed to hiv-risk created along the gradients of power. Low socioeconomic status (low education, meager factory wage and high dependency rate at their rural households) and obligations as daughters to provide for the family mainly determine their entry into sex work. At the location of sex work, they are subjected to physical violence, alcohol and drug use, both self-taken and forced, and receive meager wages. In a society where women are expected to be virtuous and obedient to parents and husbands, these workers are motivated to identify male sex partners in paid sex as "sweethearts" rather than "guests." These factors contribute to low consistency of condom use. This paper demonstrates the complex interrelationships between power, cultural definitions of intimacy and economic dependency, which structure sexual relationships and the risk of hiv/AIDS.- - - - - - - - - - ranking = 0.33333333333333keywords = physical (Clic here for more details about this article) |
6/36. Hemiparesis in hiv infection. rehabilitation approach.persons with acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (hiv) infection demonstrate a wide array of central nervous system impairments and may be at a significantly increased risk for cerebrovascular disease. Cerebrovascular disease can be the first manifestation of hiv infection and may be associated with a treatable etiology. Anticipating more referrals for hiv-related physical disability, we detail the rehabilitation management of three persons with hiv infection and hemiparesis. Onset of hemiparesis ranged from just before to 24 months after an AIDS-defining illness. No specific underlying etiology was identified in two of three patients, consistent with previous observations. rehabilitation interventions included lower and upper extremity orthoses, assistive devices to aid gait and activities of daily living, therapeutic exercise and use of antispasticity medication. All patients made at least mild, temporary gains in functional status. survival ranged from 3 to >6 months from initial contact with rehabilitation services. Neurologic and nonneurologic considerations in the rehabilitation of persons with hiv infection are discussed. We conclude that selected individuals with hiv infection and hemiparesis can benefit from rehabilitation intervention. hiv infection should be considered in any young adult presenting with stroke.- - - - - - - - - - ranking = 0.33333333333333keywords = physical (Clic here for more details about this article) |
7/36. Understanding the experience of hiv/AIDS for women: implications for occupational therapists.BACKGROUND: Within the past few years, hiv/AIDS has shifted from being an acute, palliative disease to one that is more chronic and episodic in nature. This shift has major implications for the role of occupational therapy in women's lives. Very few studies, however, have examined the perspective of women living with hiv/AIDS from an occupational therapy perspective. PURPOSE: This qualitative study was designed to examine the experiences of five women living with hiv/AIDS in Southern ontario and to begin to explore the implications of these findings for occupational therapy. METHOD: Through the implementation of five in-depth interviews, a phenomenological approach was used to explore the lived experience of women with hiv/AIDS. RESULTS: Four main themes emerged: fearing disclosure, experiencing challenges (physical and psychological), having supportive networks, and coping positively with being hiv positive (spirituality and opportunity for living and learning). PRACTICE IMPLICATIONS: There are several potential roles for occupational therapy in working with women who are living with hiv/AIDS More studies need to be pursued in this area of rehabilitation.- - - - - - - - - - ranking = 0.33333333333333keywords = physical (Clic here for more details about this article) |
8/36. Pharyngeal ulceration in AIDS patients secondary to cytomegalovirus infection.cytomegalovirus (CMV) infections in patients with acquired immunodeficiency syndrome are common and may present as retinitis, encephalitis, esophagitis, gastritis, enterocolitis, adrenalitis, or pneumonitis. Three patients are presented with pharyngeal ulcerations secondary to CMV. Similar cases have not been previously described in the literature. Symptoms, physical findings, and the treatment of this clinical entity are discussed. Although pharyngeal CMV ulcers are not life-threatening, they may herald multisystemic CMV infection that may require prompt antiviral chemotherapy.- - - - - - - - - - ranking = 0.33333333333333keywords = physical (Clic here for more details about this article) |
9/36. The use of video tape in teaching how psychological factors influence nutritional status in chronic/terminal illness.The medical students of louisiana State University Medical School in new orleans are required to take a clinical nutrition course in their senior year. In 1989, audio-visual media were used to introduce the students to the ways that the psychological aspects of chronic/terminal illness can influence nutritional status. In order to illustrate this topic, a patient with acquired immune deficiency syndrome (AIDS) was interviewed by a psychiatrist, internist, and a dietitian over several weeks. The interviews were videotaped and the videotape was edited to 25 minutes to address specific areas including psychiatric symptomatology, coping with illness, attitude towards treatment, diet and nutritional status, and results of the anthropometric and clinical exams. During the nutrition course, the videotape was presented to the students with subsequent discussion facilitated by the psychiatrist. The students agreed the subject was favorably presented and had increased their understanding of psychological factors in physical illness. The pre- and post-film examinations suggested the students were already aware of many of the psychological issues of chronic/terminal illness. The videotaped interview of a real person diagnosed with a chronic/terminal illness was found to be useful in introducing a difficult subject within a limited course schedule.- - - - - - - - - - ranking = 0.33333333333333keywords = physical (Clic here for more details about this article) |
10/36. rehabilitation of neurologic disability related to human immunodeficiency virus.acquired immunodeficiency syndrome (AIDS) is globally fatal; before death, it often causes a multitude of medical complications leading to significant physical impairment and functional loss. Specifically, the neuropathology associated with AIDS can be diverse, and it ranges from inconsequential cerebrovascular insults to rapidly progressive neuronosis. Moreover, physical impairments may present any time during the course of the disease and even before knowledge of seropositivity. We present three patients infected with human immunodeficiency virus (hiv), each with a different form of neuropathology, who were treated by rehabilitative services and who gained reasonable functional benefits within moderate time periods. The growing number of hiv-infected persons with physical debilitation mandates a rational, knowledgeable approach to rehabilitation intervention. This article highlights the importance of a thorough understanding of the neurologic complications of AIDS in setting realistic goals and in improving the quality of life for these individuals.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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