HIV AIDS

SYDNEY -- Investigators remain puzzled about why a supposedly safe anti-HIV microbicidal gel turned out to increase the risk of HIV in women who used it.

SYDNEY -- Making circumcision widely available to adult men in regions of the world where HIV infection is highly prevalent will save millions of lives and should be undertaken immediately, researchers urged here.

SYDNEY -- Starting antiretroviral therapy in the first 12 weeks of life markedly reduces mortality for infants born with HIV infection.

SYDNEY -- An investigational HIV drug that blocks the virus from entering its target cells "isn't ready for prime time" in the treatment of newly diagnosed patients, a researcher said here.

SYDNEY -- A screening test can identify patients at risk of suffering a dangerous hypersensitivity reaction to abacavir (Ziagen), a mainstay in the treatment of HIV.

SYDNEY -- A combination of two new HIV drugs can reduce the virus to undetectable levels even in patients with a highly resistant strain, according to two studies presented here.

SYDNEY -- Malignancies still plague a major study of the investigational HIV drug vicriviroc, which blocks one of the pathways the virus uses to enter target cells, a researcher said here.

SYDNEY -- As the long-term prognosis for patients with HIV improves, it becomes more important to assess the patient's risk for cardiovascular disease and other health issues, researchers suggested here.

SYDNEY -- In patients who have both HIV and tuberculosis, doctors can use a relatively low dose of nevirapine (Viramune) in combination with rifampin (Rifadin), researchers said here.

SYDNEY -- The novel integrase inhibitor raltegravir was as effective initial therapy as the standard treatment, a researcher said here.

SYDNEY -- New compounds that seek ways to disrupt mechanisms of the HIV life cycle were outlined here, reflecting an expanding investigative antiviral pipeline

SYDNEY -- A novel HIV drug aimed at barring entry of the virus into the cell was safe and had a long half-life in an early trial, lowering viral load for up to two weeks after treatment stopped, a researcher said here.

SYDNEY -- HIV vaccine research is poised to take a step into the unknown -- the use of live but attenuated viruses to create immunity.

SYDNEY -- Doctors and patients should not be content with keeping human immunodeficiency virus (HIV) at low levels, but should seek to optimize treatment to suppress virus to undetectable levels.

SYDNEY -- Tuberculosis and HIV therapy can take place at the same time without the risk of long-term HIV treatment failure, researchers said here.

SYDNEY -- The pendulum of HIV treatment is starting to swing -- once again -- toward the "hit early, hit hard" theory.

TAIPEI, Taiwan -- Older patients prone to falling can have significantly better lives if they undergo a structured exercise programs, investigators here reported.

abstract: Tuberculous pericarditis, while relatively rare in the United States, is an important cause of pericardial disease in countries where tuberculosis is prevalent. Patients are most likely to present with chronic disease--effusive and/or constrictive. Those with effusive pericarditis often present with tamponade. Patients with constrictive pericarditis exhibit features of systemic and pulmonary venous congestion. An elevated level of adenosine deaminase in pericardial fluid is a good marker for tuberculosis. The presence of granulomas or case-ation necrosis in pericardial tissue confirms the diagnosis. If treatment of effusive tuberculous pericarditis is delayed, constrictive or effusive-constrictive disease usually develops, resulting in a high mortality risk. In addition to a standard antituberculosis regimen, treatment of tuberculous pericarditis may include adjuvant therapy with corticosteroids, pericardiocentesis, and/or pericardiectomy. (J Respir Dis. 2007;28(7):278-282)

Given the dramatic advances in antimicrobials since penicillin was introduced, why has the mortality rate associated with community-acquired pneumonia (CAP) remained essentially unchanged? Inadequate application of practice guidelines may be the chief reason, according to a committee from the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS).1

Acute invasive fungal rhinosinus- itis occurs predominantly in immunocompromised patients, such as those with neutropenia and transplant recipients. The diagnosis requires biopsy, but permanent section can be time-consuming and result in a delay in treatment. Ghadiali and colleagues conducted a study to evaluate the accuracy of frozen-section biopsy in this setting.

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The diagnostic criteria for major depression are anhedonia, depressed mood, feelings of worthlessness or inappropriate guilt, inability to concentrate, fatigue, insomnia or hypersomnia, psychomotor agitation or retardation, significant weight loss or gain, and recurrent thoughts of death or suicide. Five or more of these symptoms must be present for at least 2 weeks, and one of them must be anhedonia or depressed mood. Conditions that can present with depression include dysthymia, bipolar disorder, cyclothymia, and adjustment disorder. Depression may also result from substance abuse or from the physiological conditions associated with a medical disorder, such as spinal or head injury, AIDS, or cancer.

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BALTIMORE -- A needle stick injures more than four of every five surgical residents during their training, researchers here said, and about half of the incidents go unreported.