1/12. Stories of AIDS outreach and case management: context and activities.research has shown that injection drug users (IDUs) are now at greater risk for contracting HIV infection. Studies also show that seroincidence has begun to decrease among IDUs in a number of cities due to risk-reduction interventions. One important intervention is the use of indigenous outreach workers, shown to be an effective method in reducing HIV risk behavior and promoting preventive actions among IDUs in various settings. This study explores continuities and changes in the activities of outreach workers and in their changing role as case managers in the long-standing Community Outreach Intervention Project in chicago. It examines their efforts to change risk behaviors and improve the health and living conditions of IDUs. This research is based on outreach and case-worker perspectives and related background data gathered from 10 outreach workers and the four ethnographers that supervise the project. Outreach and case workers describe the diverse populations and contexts in which they operate and the growing complexity and depth of the issues they face, especially in working with HIV and AIDS-afflicted clients. These descriptions demonstrate the important role "indigenous" outreach and case workers play in engaging out-of-treatment IDUs, supporting meaningful changes in their lives, and responding to their particular and emerging needs.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
2/12. cocaine-induced torsades de pointes in idiopathic long Q-T syndrome.torsades de pointes is a ventricular tachycardia characterized by the QRS complexes of changing amplitude that appear to twist around an isoelectric line. It usually precipitates in the setting of underlying Q-T interval prolongation, which has both congenital and acquired causes. The common acquired causes of torsades precipitation are medications, electrolyte imbalance, and severe bradycardia. This report presents a case of torsades de pointes that was precipitated by substance abuse in a patient with idiopathic long Q-T syndrome and required several treatment modalities.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
3/12. streptococcus milleri and complex groin abscesses in intravenous drug abusers.Intravenous drug abuse is an increasing problem. Septic complications occur frequently at the injection site, especially in the groin where large abscesses around the femoral vessels can threaten life or limb. We report four patients with extensive or complex groin abscesses following attempted self-injection into the femoral vein. streptococcus milleri was cultured from all of these abscesses and prompted a review of the isolation of this organism in this hospital.- - - - - - - - - - ranking = 5keywords = complex (Clic here for more details about this article) |
4/12. aids-related complex treated by antiviral drugs and allogeneic bone marrow transplantation following conditioning protocol with busulphan, cyclophosphamide and cyclosporin.A 26-year-old man with aids-related complex (ARC) was treated with high-dose busulphan and cyclophosphamide, followed by allogeneic bone marrow transplantation. For 3 months before transplantation he received a combination of four drugs considered active against human immunodeficiency virus (HIV) to reduce the viral burden: zidovudine, acyloguanosine, fusidic acid and phenylidantoin. Although in reduced doses in coincidence with marrow engraftment, zidovudine therapy was scheduled after transplantation in order to protect donor cells from infection with HIV. Engraftment rapidly occurred and was documented by cytogenetic analyses. The post-transplant course was characterized by severe acute GvHD with irreversible hepatorenal failure. The patient died on day 48 after transplantation. polymerase chain reaction analyses for detecting HIV dna showed the persistence of positivity at day 30 and 45 after transplantation. antibodies to specific HIV proteins evaluated with Western blot testing also persisted at days 21 and 35 after transplantation. Circulating immunocomplexes disappeared on day 31, and an increase in the CD4/CD8 ratio occurred. The short survival of the patient, affected by chronic hepatitis too, does not allow final conclusions about the role of BMT in HIV disease.- - - - - - - - - - ranking = 6keywords = complex (Clic here for more details about this article) |
5/12. A new role for pediatric nurses: teaching teen drug users how to sterilize their equipment for prevention of infectious disease; a course outline.This article discusses a sensitive issue that is complex and provocative, and will undoubtedly stimulate a variety of opinions. What do you think? Post your comments about this topic on the pediatric nursing Web site and read what others have to say as well. Visit our homepage at www.pediatricnursing.net and click on "Discussion". The opinions and assertions contained herein are the private views of the contributors and do not necessarily reflect the views of pediatric nursing Journal or the publisher.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
6/12. hiv-1 associated cognitive/motor complex in an injecting drug user.The clinical and social consequences of aids dementia complex/hiv-1 associated cognitive/motor complex (ADC/HACC) in drug users have not been well documented. The value of prospective serial neuropsychological, neuroradiological and neurophysiological measurements to assist diagnosis of ADC/HACC in patients with premorbid personality disorder and intercurrent drug use is demonstrated. The psychosocial problems resulting from ADC/HACC with respect to community care and the location of hospitalization is considered. The relevance of the 1984 mental health Act (scotland) with regard to drug users with ADC/HACC is discussed.- - - - - - - - - - ranking = 6keywords = complex (Clic here for more details about this article) |
7/12. salmonella meningitis and infection with HIV.patients infected with HIV demonstrate increased susceptibility to serious infections with non-typhoidal salmonellae. However, no cases of salmonella meningitis have been reported in this population. We now report three cases of salmonella meningitis which occurred in a population of 1800 patients with AIDS or aids-related complex at our hospitals. The incidence of meningitis complicating salmonella infection in our HIV-infected population appears to be much higher than that reported in non-AIDS patients (7.5 versus 0.15%). All had cerebrospinal fluid parameters consistent with bacterial meningitis, and two of three revealed organisms on cerebrospinal fluid Gram stain. Two presented with a fulminant illness and died despite therapy; the third developed a brain abscess associated with a relapse of meningitis. salmonella meningitis should be considered as a cause of acute neurological deterioration in patients at risk for HIV-related disease. Relapses may occur, and mortality is high.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
8/12. association of thrombotic thrombocytopenic purpura and human immunodeficiency virus infection.A 35 year-old HIV-positive male intravenous drug abuser developed thrombotic thrombocytopenic purpura (TTP) during the course of recto-sigmoiditis secondary to shigella flexneri. Complete remission was achieved by aggressive treatment of a combination of plasma exchange, fresh frozen plasma infusion, continuous prostacyclin perfusion, p.o. administered aspirin-dipyridamol and intravenous injections of vincristine. During acute microangiopathy, an acquired type II von Willebrand disease was diagnosed. TTP is a newly-recognized hematologic manifestation of hiv-1 infection; endothelial damage by endotoxin during course of infection or by high serum levels of circulating immune complexes may be a causative mechanism of microangiopathy causing hemolysis and platelet consumption.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
9/12. AIDS peripheral neuropathy.A young male IV drug abuser with multiple AIDS risk factors and positive HIV serology presented with acute onset of painful urinary retention as a result of a parasympathetic mononeuropathy. Because no other explanation could be found for his illness, despite a careful search for the most likely etiologic agents, the authors propose that his symptom complex may have resulted from infection with the AIDS virus. A review of the current literature relevant to the peripheral neuropathy associated with AIDS is presented.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
10/12. Cryopreserved homografts in aortic and mitral prosthetic endocarditis: expanding the use of biological tissues in complex cardiac infections.The case of a 27-year-old male heroin addict suffering from mitral and aortic prosthetic valve endocarditis is presented. Double valve re-replacement was performed using cryopreserved aortic homografts. Aortic root replacement with coronary re-implantation and intra-atrial valve implantation for mitral valve replacement were the techniques used. Despite the fatal outcome of this case, it clearly illustrates the possibilities of expanding the indications for combined complex replacement of heart valves by using fully biological tissue of human origin.- - - - - - - - - - ranking = 5keywords = complex (Clic here for more details about this article) |
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