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21.
Pilot study to enhance HIV care using needle exchange-based health services for out-of-treatment injecting drug users 总被引:2,自引:0,他引:2
Altice Frederick L. Springer Sandra Buitrago Marta Hunt David P. Friedland Gerald H. 《Journal of urban health》2003,80(3):416-427
The introduction of highly active antiretroviral therapy (HAART) has resulted in marked reductions in mortality and acquired
immunodeficiency syndrome (AIDS) incidence across all risk groups; however, the proportionate decrease among injecting drug
users (IDUs) has been less impressive. Much of the disparity in benefit to IDUs has been a consequence of decreased access
to and receipt of potent antiretroviral combinations. Strategies to increase access to and utilization of HAART have included
entry into drug treatment and abstinence. Unfortunately, as few as 15%–20% of active drug users in the United States, and
in many other countries, are in drug treatment at any one time. We report a pilot project among out-of-drug treatment IDUs
infected with human immunodeficiency virus (HIV); HIV therapy was successfully provided to active heroin injectors using the
Community Health Care Van (CHCV) at sites of needle exchange. Subjects were willing to initiate, but were not receiving, recommended
HIV therapy and were not interested in formal drug treatment. Antiretroviral therapy regimens were selected and linked to
heroin injection timing. Weekly visits were scheduled by CHCV staff to assess adverse side effects and encourage adherence.
Of the 13 participants, the mean baseline HIV-1 RNA level and CD4 lymphocyte count were 162,369 (log 5.21) copies per milliliter
and 265 cells per milliliter, respectively. By 6 months, the proportion whose HIV-1 RNA was below the limits of detection
(<400 copies/mL) was 85% (N=11); 77% (N=10) had nondetectable levels by 9 months. By 12 months, 54% (N=7) had a persistently
nondetectable viral load, and the net increase in CD4 lymphocyte count was 150 cells per milliliter. As an additional and
unintended benefit of this pilot project, 9 (69%) subjects chose to enter drug treatment after achieving a nondetectable viral
load. Entry into drug treatment was associated with durability of viral suppression. This small pilot study suggests that
health services based on needle exchange may enhance access to HAART among out-of-treatment HIV-infected IDUs. In addition,
it demonstrates that this population can benefit from this therapy with the support of a nontraditional, community-based health
intervention. 相似文献
22.
L. Guillermo Palacio Ivan Jimnez H. Hugo Garcia Marta E. Jimnez Jorge L. Snchez John Noh IlLisa Ahn Ofelia Mora Margarita Giraldo Victor C. W. Tsang 《Epilepsia》1998,39(12):1334-1339
Summary: Purpose: A prospective series of 643 persons with epilepsy attending a reference neurologic center in Medellin, Colombia, was examined by computed tomography (CT scan) or serology or both with the enzyme-linked immunoelectrotransfer blot assay (EITB) to assess the prevalence of Taenia solium cysticercosis. Methods: All presenting patients were consecutively enrolled in the study. Five hundred forty-six persons underwent cerebral CT scans; 376 of them also had serum EITB performed. Results: Prevalence of neurocys@ercosis by CT scan was 13.92%. Overall prevalence of T. solium antibodies with EITB was 9.82%, but for those with late-onset epilepsy (onset after age 30 years), prevalence increased to 17.5% and 19% for those who originated from outside urban Medellin. Seroprevalence in individuals with mixed lesions (cysts and calcifications) was 88.2% and 64.10% in those with live cysts. Conversely, only 2.72% of persons with CT findings not related to neurocysticercosis had positive EITB tests. Conclusions: Our study shows that an important proportion of individuals with epilepsy have radiologic or serologic evidence of T. solium infection, suggesting that neurocysticercosis is an important etiology for epilepsy in Colombia. 相似文献
23.
24.
Magí Farré María-Teresa Terán Pere N. Roset Marta Mas Marta Torrens J. Camí 《Psychopharmacology》1998,140(4):486-495
Abuse liability and acute subjective and psychomotor effects of flunitrazepam were assessed in ten methadone-maintained males
with history of benzodiazepine and alcohol use, who voluntarily participated in a double-blind, controlled, cross-over, randomized
clinical trial. There were six experimental sessions in which a single oral dose of flunitrazepam 1, 2, and 4 mg; triazolam
0.5 and 0.75 mg; and placebo was given. Evaluations included physiological measures; psychomotor performance tasks (simple
reaction time, Digit Symbol Substitution Test, balance task, Maddox-wing device); and self-administered subjective effects
questionnaires [Addiction Research Center Inventory (ARCI), Profile of Mood States (POMS), a series of visual analog scales
(VAS)]. All drugs but flunitrazepam 1 mg caused an impairment of psychomotor tasks. Effects were more evident with the highest
doses of both drugs. Only flunitrazepam 4 mg produced a significant decrease in balance time. Triazolam 0.75 mg induced increases
in sedation measured by ARCI-PCAG, depression in POMS, and VAS-drowsiness scores. Flunitrazepam 4 mg caused euphoria-related
effects as measured by increases in ARCI-MBG and “high” scores in the VAS. Our findings of flunitrazepam-induced euphoria
in methadone-maintained subjects together with epidemiological evidence of flunitrazepam abuse by opioid dependents, suggest
that it may be included in the group of benzodiazepines with a relatively high abuse potential.
Received: 13 February 1998/Final version: 1 May 1998 相似文献
25.
Marta Zakrzewska 《Archives of environmental contamination and toxicology》1988,17(3):365-371
Female bank voles (Clethnonomys glareolus Schreber, 1780) were given lead-contaminated food (2.5, 60, 380, and 730 g g–1 of lead) after giving birth to litters. The concentrations of lead in bodies of young voles were determined after 5th, 10th, 15th, and 20th days of life. The concentrations of lead in the offspring increased with elevation of lead level in the diet of mothers. Lead accumulation became remarkable after 15th day, particularly in the bodies of the young born to mothers given 380 and 730 g g–1 of dietary lead. The adverse effect of lead on the growth of young voles (declining weight increments) was observed in groups receiving highly contaminated food. The mortality among the young was also monitored. It occurred in whole litters as well as individuals and attained the highest values in groups given 730 g g–1 of dietary lead. 相似文献
26.
Wilson disease: novel mutations in the ATP7B gene and clinical correlation in Brazilian patients 总被引:1,自引:0,他引:1
Deguti MM Genschel J Cancado EL Barbosa ER Bochow B Mucenic M Porta G Lochs H Carrilho FJ Schmidt HH 《Human mutation》2004,23(4):398
Wilson disease (WD) is a rare inherited autosomal recessive disorder caused by a defect in a metal transporting P-type ATPase, resulting in copper overload in various tissues and cells. The aim was to assess both the phenotype in Brazilian WD patients and the corresponding ATP7B genotype. Sixty subjects belonging to 46 pedigrees diagnosed as WD were included in this study. Direct sequencing of all 21 exons within ATP7B and their flanking introns was performed. Demographic, clinical, laboratory and histopathological data at the time of diagnosis were obtained. We identified twenty-five mutations, twelve of them reported for the first time. The c.3402delC mutation had the highest allelic frequency (30.8%), followed by the c.2123T>C (p.L708P) (16.7%). Exons 8 and 15 were the site of 62.5% of the mutations. The common European mutation c.3207C>A (p.H1069Q) was not present at all. Phenotype varied greatly among individuals with the same ATP7B genotype. Our data confirm the heterogeneity of ATP7B genotype in Brazilian WD patients. The mutational spectrum is compatible with the Brazilian history of Mediterranean immigration; however, new mutations, and different frequencies and phenotype associated with the previously known mutations characterize this population. Exons 8 and 15 should be preferentially screened in WD cases from Brazil. Phenotype variation among subjects with the same ATP7B genotype suggests that modifying factors play an additional role in the pathogenesis of WD. 相似文献
27.
Recent research has shown that pseudowords created by transposing letters are very effective for activating the lexical representation of their base words (e.g., relovution activates REVOLUTION). Furthermore, pseudoword transpositions of consonants are more similar to their corresponding base words than the transposition of vowels. We report one experiment using pseudowords created by the transposition of two consonants, two vowels, and their corresponding control conditions (i.e., the replacement of two consonants or two vowels) in a lexical decision task while Event Related Potentials (ERPs) were recorded. The results showed a modulation of the amplitude of the N400 component as a function of the type of pseudoword (transposed-letter versus replacement letter pseudowords), and this modulation was different for transposed consonants and vowels. These results suggest that consonants and vowels play a different role during word processing. 相似文献
28.
Thi Thu Ha Hoang Carina Bengtsson Dac Cam Phung Mikael Srberg Marta Granstrm 《Clinical and Vaccine Immunology : CVI》2005,12(1):81-85
Helicobacter pylori-associated diseases, such as peptic ulcer and gastric cancer, are common in Vietnam, but the prevalence of the infection is largely unknown. A validated enzyme-linked immunosorbent assay was used for seroepidemiology with 971 samples from the general population, ages 0 to 88 years, with 546 samples from an urban population (Hanoi), and with 425 samples from a poor, rural province (Hatay). The overall seroprevalence of the infection was 746 per 1,000, with a prevalence of 788 per 1,000 in Hanoi and 692 per 1,000 in Hatay (P = 0.0007). The risk for infection in the rural area of Hatay was 40% lower than in the urban population of Hanoi, with the odds ratio being 0.59 (95% confidence interval, 0.43 to 0.81). The study shows that the prevalence of H. pylori infection is high in Vietnam and especially high in a large urban area, such as the city of Hanoi. 相似文献
29.
Moreno Sabater A Moreno M Moreno FJ Eguiluz C van Rooijen N Benito A 《Parasitology research》2005,95(2):97-105
The main objective of this study was to determine whether a chemical immunomodulation protocol could reduce the resistance of NOD/LtSz-SCID mice to Plasmodium falciparum infection and provide an improved mouse model for screening the antimalarial activity of new compounds. This model was compared with the presently used immunodeficient Beige/Nude/Xid (BNX) mouse model, using the same protocol, in terms of percentage of infected mice, parasite development, leukocyte response and phagocytosis of P. falciparum infected cells in various organs. Our results show that the combination of the chemical immune modulation protocol with the genetic background of NOD/LtSz-SCID mice results in the development of long-lasting P. falciparum infection in a high percentage of mice. A comparison of the results obtained in the histological study for both mouse models suggests that the higher rate of success in NOD/LtSz-SCID mice could be related to the reduced macrophage recruitment developed in different tissues to remove the parasite from blood. 相似文献