1/24. Diffuse, intense lung uptake on a bone scan: a case report.PURPOSE: Clinical and scintigraphic findings are described in a patient with unexpected diffuse lung uptake on bone scan after a heroin overdose. methods: The patient's Tc-99m MDP bone scan is reviewed along with the pertinent clinical history and laboratory findings. RESULTS: Marked diffuse and symmetric lung uptake is present on bone scintigraphy in a patient with a history of acute renal failure and a markedly elevated calcium-phosphate product but normal renal function and laboratory values at the time of the examination. CONCLUSIONS: The incidental observation of metastatic calcification by bone scintigraphy is important, because it may aid in the diagnosis of a previously unsuggested elevated calcium-phosphate product, renal failure, or both. Furthermore, the intensity of tracer localization on bone tracer-specific imaging may help evaluate the activity of the metastatic calcification process.- - - - - - - - - - ranking = 1keywords = aid (Clic here for more details about this article) |
2/24. Hepatitis after intravenous buprenorphine misuse in heroin addicts.BACKGROUND: Sublingual buprenorphine is used as a substitution drug in heroin addicts. Although buprenorphine inhibits mitochondrial function at high concentrations in experimental animals, these effects should not occur after therapeutic sublingual doses, which give very low plasma concentrations. case reports: We report four cases of former heroin addicts infected with hepatitis c virus and placed on substitution therapy with buprenorphine. These patients exhibited a marked increase in serum alanine amino transferase (30-, 37-, 13- and 50-times the upper limit of normal, respectively) after injecting buprenorphine intravenously and three of them also became jaundiced. Interruption of buprenorphine injections was associated with prompt recovery, even though two of these patients continued buprenorphine by the sublingual route. A fifth patient carrying the hepatitis c and human immunodeficiency viruses, developed jaundice and asterixis with panlobular liver necrosis and microvesicular steatosis after using sublingual buprenorphine and small doses of paracetamol and aspirin. CONCLUSIONS: Although buprenorphine hepatitis is most uncommon even after intravenous misuse, addicts placed on buprenorphine substitution should be repeatedly warned not to use it intravenously. Higher drug concentrations could trigger hepatitis in a few intravenous users, possibly those whose mitochondrial function is already impaired by viral infections and other factors.- - - - - - - - - - ranking = 15.864452734113keywords = immunodeficiency (Clic here for more details about this article) |
3/24. Prevention of suicide by naltrexone in a recently detoxified heroin addict.This case describes a heroin addict who was participating in a placebo-controlled randomized trial of naltrexone as an aid to relapse prevention. The patient tried to commit suicide by taking a heroin overdose after learning that he was hiv-positive. He was on naltrexone at the time and, as a result, survived what would probably have been a fatal overdose. This case demonstrates that naltrexone can have immediate as well as long-term positive effects in persons who are attempting to recover from heroin addiction.- - - - - - - - - - ranking = 1keywords = aid (Clic here for more details about this article) |
4/24. hiv, heroin and heterosexual relations.This ethnographic study describes part of the social context in which heterosexual transmission of the human immunodeficiency virus (hiv) may be taking place. Based on interviews with sex partners of intravenous (IV) drug users in an urban, African American community of the united states, the study documents the personal experience of 35 men and women to show how living with one's own and/or one's partner's heroin habit may structure one's response to public health information and one's possibility of becoming infected with hiv. As described by sex partners of intravenous drug users, people who use heroin habitually are drawn into social networks that are loosely organized according to their preferred route of drug administration, i.e. 'shooters' (intravenous) and 'tooters' (intranasal), both of which tend to exclude 'squares' (non-use). Social divisions such as these may slow rates of hiv transmission to those outside the drug life. But nevertheless, as sex partners explain, there are many types of social and sexual exchanges taking place among shooters, tooters and squares, including but not limited to the exchange of bodily fluids. Ethnography analyzes discursive representations of such exchanges, filling in and questioning the empty categories of epidemiological prediction. How does risky behavior actually figure in the lives of individuals who happen to fall in the category of 'sex partner'? How is sexual behavior shaped by drug use behavior? Being sexually involved with an IV drug user for some years alters a person's relative position betwixt and between the drug subculture, on the one hand, and mainstream pursuits of family, work and church, on the other. Differences in personal need and group identity create conflicts. Couples in long-term relationships develop rules to manage these. But in which terms will they interpret and negotiate the new threat of AIDS? If the strategic aspect of discursive representations of experience is taken into account, and if discursive representations are interpreted within appropriate social and historical contexts, they can provide a rich source of material for understanding the social impact of the AIDS epidemic. Without this discursive dimension, analytic power to interpret seroprevalence data cross-culturally would be lacking. In addition, and independently of the problem of interpreting seroprevalence data, ethnographic analysis links local, culturally-specific meanings through which AIDS is interpreted to our understanding of AIDS as a global phenomena.- - - - - - - - - - ranking = 15.864452734113keywords = immunodeficiency (Clic here for more details about this article) |
5/24. methadone maintenance program for AIDS-affected opiate addicts.To slow the spread of AIDS, it may be important for substance abuse treatment programs to give priority admission to patients who are hiv-infected and infectious. A new program is described that provides methadone maintenance treatment to opiate addicts who are "AIDS affected"--heroin addicts diagnosed with AIDS, aids-related complex (ARC), or other significant symptoms of hiv infection. The program aims to protect the health of patients and to protect the general public by slowing the spread of the human immunodeficiency virus (hiv). This article describes the program's history and goals, its referral and patient admission process, methods of assessment and treatment planning, medical care, counseling procedures, tolerance for misbehavior, philosophy toward eventual detoxification, and procedures that maintain confidentiality.- - - - - - - - - - ranking = 15.864452734113keywords = immunodeficiency (Clic here for more details about this article) |
6/24. Reactive perforating collagenosis in a setting of double disaster: acquired immunodeficiency syndrome and end-stage renal disease.We report reactive perforating collagenosis in an intravenous heroin abuser with acquired immunodeficiency syndrome and end-stage renal disease. The literature on perforating disorders in patients with acquired immunodeficiency syndrome and the pathogenesis of reactive perforating collagenosis in this setting is reviewed.- - - - - - - - - - ranking = 656.37182279276keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
7/24. peritoneal dialysis-associated tuberculous peritonitis in an intravenous drug user with acquired immunodeficiency syndrome.A rare case of tuberculous peritonitis in a continuous ambulatory peritoneal dialysis (CAPD) patient who has multiple risk factors for extrapulmonary disease due to mycobacterium tuberculosis is presented. This patient' acute course was atypical with a predominance of neutrophils and low levels of protein in the peritoneal fluid. Obtaining the diagnosis of tuberculous peritonitis by acid-fast smear was also unusual, probably facilitated by centrifugation of large amounts of fluid. The patient was successfully treated without catheter removal. Tuberculosis should be considered in patients with culture-negative CAPD peritonitis.- - - - - - - - - - ranking = 437.58121519517keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
8/24. Disseminated talc granulomatosis. An unusual finding in a patient with acquired immunodeficiency syndrome and fatal cytomegalovirus infection.The association of disseminated magnesium silicate talc granulomatosis and acquired immunodeficiency syndrome is reported in a male homosexual who used intravenous drugs and who died of overwhelming cytomegalovirus (CMV) infection. autopsy findings included widespread deposition of talc crystals in the lungs, liver, lymph nodes, bone marrow, and spleen. Typical CMV inclusions were seen in the lungs, kidneys, adrenal glands, gastrointestinal tract, and right eye. There was no evidence of malignancy. Analysis of peripheral blood neutrophil function revealed impaired chemotaxis and chemokinesis, but opsonophagocytosis had remained normal. The CMV infection in the small bowel was extensive and resulted in severe destruction of the muscularis propria and neural plexi, leading to marked dilatation and persistent diarrhea. The terminal course was marked by intractable hypotension, pneumonitis, and malnutrition, which could be attributed respectively to CMV involvement of the adrenal glands, lungs, and small bowel. The etiology and possible role of systemic talc granulomatosis in the development of immunosuppressive illness is reported herein.- - - - - - - - - - ranking = 546.97651899396keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
9/24. Hodgkin's disease in hiv-infected patients.Eight patients with Hodgkin's disease who were seropositive to human immunodeficiency virus (hiv), 6 of them being heroin addicts and one a homosexual, were studied. Histological examination showed 4 cases of lymphocytic depletion, 2 cases of mixed cellularity, 1 nodular sclerosis, and one not classifiable. There were five cases of stage IV-B and 3 IIIs-B. The response to treatment was poor, with disproportionate cytopenia and severe infectious complications. We suggest that the atypical nature of Hodgkin's disease in patients who are seropositive for hiv might be considered to be a part of the acquired immunodeficiency syndrome (AIDS).- - - - - - - - - - ranking = 15.864452734113keywords = immunodeficiency (Clic here for more details about this article) |
10/24. Vertebral arch tuberculosis in two human immunodeficiency virus-seropositive heroin addicts.We studied two cases of disseminated tuberculosis with vertebral arch involvement in drug addicts seropositive for human immunodeficiency virus. The first patient developed a paraplegia while he was recovering from a meningeal tuberculosis. On the abdominal plain roentgenogram, the right transverse process of L-2 was absent, and a computed tomographic scan revealed destruction of the right vertebral arch together with a collection in the paravertebral area. The second patient had miliary tuberculosis and complained of lumbar pain. The radiologic findings were similar to those in the first case, but at the L-4 level.- - - - - - - - - - ranking = 79.322263670566keywords = immunodeficiency (Clic here for more details about this article) |
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