1/93. Striae formation in two HIV-positive persons receiving protease inhibitors.Steroidal side effects such as "buffalo hump" and visceral abdominal fat accumulation have been reported in association with protease inhibitors. We report two cases of severe disfiguring striae formation in patients with HIV who recently started indinavir therapy. These changes occurred within 3 months of starting treatment.- - - - - - - - - - ranking = 1keywords = person (Clic here for more details about this article) |
2/93. Transverse leukonychia with systemic infection.Transverse white nail bands (leukonychia) have been described in association with systemic illnesses and exposure to toxins, and medications. We describe the occurrence of transverse nail bands in two patients following acute systemic illnesses. In the first case, transverse white nail bands developed in a 30-year-old human immunodeficiency virus-positive man following acute pulmonary tuberculosis. In the second case, transverse white nail bands were noted in an 80-year-old patient following streptococcus intermedius empyema.- - - - - - - - - - ranking = 0.013489148044999keywords = illness (Clic here for more details about this article) |
3/93. Psychosis and nonadherence in an HIV-seropositive patient.While adherence to antiretroviral therapy is of paramount importance in the treatment of HIV-infected patients, optimal adherence can be challenging to achieve. Furthermore, the presence of comorbid psychiatric illness can potentially compromise treatment adherence. This Case Report highlights the difficulties encountered in the care and treatment adherence of an HIV-seropositive patient who presented with psychotic symptoms. Treatment, ethical, and legal issues are discussed.- - - - - - - - - - ranking = 0.0067445740224997keywords = illness (Clic here for more details about this article) |
4/93. Cutaneous dendritic cells are main targets in acute hiv-1-infection.Acute human immunodeficiency virus (HIV) infection is a transient illness that typically presents with mucocutaneous and constitutional symptoms. It is soon followed by seroconversion with the detection of anti-hiv antibodies in the peripheral blood. To better understand the pathogenetic events leading to this clinical picture, we sought to investigate the (immuno)histologic features of the skin rash occurring in an acutely infected person. A skin biopsy of an acutely infected person was investigated histologically and immunohistologically using paraffin-embedded tissue sections. Interface dermatitis with pronounced vacuolization of the basal keratinocytes was a prominent histological finding. The inflammatory infiltrate was composed of CD3 /CD8 T cells with coexpression of Granzyme B7 and TIA-1, and CD68 histiocytes/dendritic cells. CD1a intraepidermal langerhans cells (LC) were significantly decreased and individual LC coexpressed HIV-p24 antigens as evidenced in double labeling experiments. HIV-infected LC were demonstrated in close apposition to cytotoxic T cells. This study provides the first definitive evidence for infection of LC at extramucosal sites in this very early stage of disease. Our findings emphasize the critical role of dendritic cells as a virus reservoir and the skin as a major site of HIV replication during the course of the disease.- - - - - - - - - - ranking = 0.5067445740225keywords = person, illness (Clic here for more details about this article) |
5/93. Five cases of melanoma in HIV positive patients.BACKGROUND: Kaposi's sarcoma, high grade B-cell non-Hodgkin lymphoma and invasive carcinoma of the cervix are all AIDS-defining illnesses according to the CDC staging criteria classification. A number of other malignancies, not traditionally associated with HIV infection, such as Hodgkin's disease, cancers of the rectum, anus, and germ-cell tumours, appear to occur more often than would be expected in these patients. Malignant cutaneous lesions, including basal cell, squamous-cell carcinomas, bowen's disease, and cutaneous melanoma (CM) have been less often reported. patients AND methods: We retrospectively evaluated the clinical data of 5 HIV seropositive patients and CM observed at the "M. Bufalini" Hospital, Cesena, italy from 1994 to 2000. RESULTS: All the 5 subjects had a history of intense sun exposure and sunburns. Four patients reported homosexuality as their risk factor for HIV disease. Reviewing the international literature on the subject HIV infected homosexuals appear the group at higher risk of developing CMM, accounting for 80% of cases. CONCLUSION: As patients' life expectancy appears to be prolonged after the advent of the HAART therapy, skin cancers will probably become more frequent in the near future. Clinicians should keep close medical surveillance to promptly diagnose new cases of melanoma and non-melanoma skin cancers and advise their HIV-infected patients on the risk of prolonged sun exposure and severe sun burns for the development of skin cancers.- - - - - - - - - - ranking = 0.0067445740224997keywords = illness (Clic here for more details about this article) |
6/93. Atypical presentation of HIV seroconversion illness in a young woman.Early detection and counselling of HIV-infected individuals can have an impact on prevention of HIV transmission. We describe an atypical presentation of an HIV seroconversion illness in a woman.- - - - - - - - - - ranking = 0.033722870112498keywords = illness (Clic here for more details about this article) |
7/93. Successful iterative drainage and partial hepatectomy for pyogenic liver abscess in a HIV seropositive patient.The case of cryptogenic escherichia coli pyogenic liver abscess in a 59-year-old Human Immunodeficiency Virus (HIV) seropositive man is reported. The initial treatment was a percutaneous drainage. As the abscess did not reduce in size, surgical drainage was planned but during surgery a necrosectomy had to be performed resulting in a partial hepatectomy. After nine months of amoxicillin-clavulanic acid treatment, drainage and highly active antiretroviral therapy, the patient recovered completely. It is expected that because of highly active antiretroviral therapy, mortality rates of surgical interventions in patients with HIV infection will decrease. Because of the increased life expectancy in persons with HIV infection, the criteria for considering surgical interventions in these patients should be broadened.- - - - - - - - - - ranking = 0.25keywords = person (Clic here for more details about this article) |
8/93. 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 = 1keywords = person (Clic here for more details about this article) |
9/93. Prolonged hepatitis A infection in an hiv-1 seropositive patient.hepatitis a virus (HAV) is a worldwide disease; in most cases, it causes an acute self-limited illness that does not lead to a chronic state. The course of HAV viremia in a homosexual male with human immunodeficiency virus type 1 (hiv-1) and the correlation between HIV and HAV viral load, alanine aminotranferase (ALT) level, and CD4( ) lymphocyte count were investigated during the course of the infection. HAV rna was detected quantitatively up to 256 days after clinical onset. To our knowledge, this specific case is the first report of a prolonged infection with hepatitis A in a male with hiv-1. The ALT levels decreased gradually; however, 286 days after clinical onset of hepatitis, ALT levels were three times higher than normal values. HIV viral load was not affected by the infection with HAV and CD4( ) cell count was stable during the course of the co-infection. The duration and the high-titer viremia of hepatitis a virus in an immunodeficient patient constitute a serious risk of the spread of hepatitis A within this population. As inactivated HAV vaccine is safe in HIV-positive subjects, it would be wise to establish a strategy of preventive vaccination in this high-risk group.- - - - - - - - - - ranking = 0.0067445740224997keywords = illness (Clic here for more details about this article) |
10/93. Addressing the spiritual needs of a drug user living with human immunodeficiency virus: a case study.OBJECTIVES: To describe an application of Spiritual Self-Schema Therapy (3-S) with a human immunodeficiency virus (HIV)-seropositive, injection drug-using individual. INTERVENTION: 3-S is a structured and readily administered therapy for integrating a spiritual dimension into addiction treatments for HIV-positive drug users. It posits the existence of many potential "selves," salient among which are the "addict" self and the "spiritual" self. The central strategy of 3-S is to "deactivate" the addict self and "activate" the spiritual self. Techniques to achieve this shift are discussed. RESULTS: Over the course of treatment, this patient was able to use 3-S therapy to shift her dominant sense of self from that of an addict to a spiritual person and reported that this increased feelings of hope and the sense of control. CONCLUSION: A spiritually based therapy appears to help injection drug users with HIV infection and warrants further investigation.- - - - - - - - - - ranking = 0.25keywords = person (Clic here for more details about this article) |
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