37 research outputs found

    HIV-associated neurosyphilis: Report of a fatal case due to fear of work-place stigma

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    Syphilis and HIV infection are two STI diseases that have bidirectional influence on the clinical course of each other. There is a high risk of neurological extension if syphilis is not diagnosed early or if the patient has a co-infection with HIV. Both diseases have stigma associated with them and could affect the compliance to treatment, as was the case with this young employee of the medical department of a Nigerian tertiary hospital. He was diagnosed with HIV/ neurosyphilis co-infection and responded to penicillin therapy, but the fear of stigma at his workplace has made him to abandon hospital treatment for unorthodox therapy, which unfortunately cost him his life.Syphilis et infection par le VIH sont deux maladies qui ont des STI bidirectionnel infl uence sur l\u2019\ue9volution clinique de l\u2019autre. Il ya un risque \ue9lev\ue9 de troubles neurologiques extension si la syphilis n\u2019est pas diagnostiqu\ue9 \ue0 un stade pr\ue9coce ou si le patient a une co-infection avec le VIH. Les deux maladies sont les stigmatiser et pourrait infl uer sur la conformit\ue9 du traitement, comme ce fut le cas avec ce jeune personnel m\ue9dical d\u2019un h\uf4pital tertiaire nig\ue9riane. Il a re\ue7u un diagnostic de neurosyphilis et a r\ue9pondu \ue0 la th\ue9rapie de p\ue9nicilline, mais la peur de la stigmatisation \ue0 son lieu de travail a fait de lui \ue0 renoncer \ue0 l\u2019h\uf4pital pour un traitement de th\ue9rapie peu orthodoxe qui, malheureusement, lui a co\ufbt\ue9 la vie

    Risk factors for default from tuberculosis treatment in HIV-infected individuals in the state of Pernambuco, Brazil: a prospective cohort study

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    BACKGROUND: Concomitant treatment of Human Immunodeficiency Virus (HIV) infection and tuberculosis (TB) presents a series of challenges for treatment compliance for both providers and patients. We carried out this study to identify risk factors for default from TB treatment in people living with HIV. METHODS: We conducted a cohort study to monitor HIV/TB co-infected subjects in Pernambuco, Brazil, on a monthly basis, until completion or default of treatment for TB. Logistic regression was used to calculate crude and adjusted odds ratios, 95% confidence intervals and P-values. RESULTS: From a cohort of 2310 HIV subjects, 390 individuals (16.9%) who had started treatment after a diagnosis of TB were selected, and data on 273 individuals who completed or defaulted on treatment for TB were analyzed. The default rate was 21.7% and the following risk factors were identified: male gender, smoking and CD4 T-cell count less than 200 cells/mm3. Age over 29 years, complete or incomplete secondary or university education and the use of highly active antiretroviral therapy (HAART) were identified as protective factors for the outcome. CONCLUSION: The results point to the need for more specific actions, aiming to reduce the default from TB treatment in males, younger adults with low education, smokers and people with CD4 T-cell counts < 200 cells/mm3. Default was less likely to occur in patients under HAART, reinforcing the strategy of early initiation of HAART in individuals with TB

    The association between alcohol use, alcohol use disorders and tuberculosis (TB). A systematic review

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    <p>Abstract</p> <p>Background</p> <p>In 2004, tuberculosis (TB) was responsible for 2.5% of global mortality (among men 3.1%; among women 1.8%) and 2.2% of global burden of disease (men 2.7%; women 1.7%). The present work portrays accumulated evidence on the association between alcohol consumption and TB with the aim to clarify the nature of the relationship.</p> <p>Methods</p> <p>A systematic review of existing scientific data on the association between alcohol consumption and TB, and on studies relevant for clarification of causality was undertaken.</p> <p>Results</p> <p>There is a strong association between heavy alcohol use/alcohol use disorders (AUD) and TB. A meta-analysis on the risk of TB for these factors yielded a pooled relative risk of 2.94 (95% CI: 1.89-4.59). Numerous studies show pathogenic impact of alcohol on the immune system causing susceptibility to TB among heavy drinkers. In addition, there are potential social pathways linking AUD and TB. Heavy alcohol use strongly influences both the incidence and the outcome of the disease and was found to be linked to altered pharmacokinetics of medicines used in treatment of TB, social marginalization and drift, higher rate of re-infection, higher rate of treatment defaults and development of drug-resistant forms of TB. Based on the available data, about 10% of the TB cases globally were estimated to be attributable to alcohol.</p> <p>Conclusion</p> <p>The epidemiological and other evidence presented indicates that heavy alcohol use/AUD constitute a risk factor for incidence and re-infection of TB. Consequences for prevention and clinical interventions are discussed.</p

    HIV-associated neurosyphilis: Report of a fatal case due to fear of work-place stigma

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    Syphilis and HIV infection are two STI diseases that have bidirectional influence on the clinical course of each other. There is a high risk of neurological extension if syphilis is not diagnosed early or if the patient has a co-infection with HIV. Both diseases have stigma associated with them and could affect the compliance to treatment, as was the case with this young employee of the medical department of a Nigerian tertiary hospital. He was diagnosed with HIV/ neurosyphilis co-infection and responded to penicillin therapy, but the fear of stigma at his workplace has made him to abandon hospital treatment for unorthodox therapy, which unfortunately cost him his life.Syphilis et infection par le VIH sont deux maladies qui ont des STI bidirectionnel infl uence sur l’évolution clinique de l’autre. Il ya un risque élevé de troubles neurologiques extension si la syphilis n’est pas diagnostiqué à un stade précoce ou si le patient a une co-infection avec le VIH. Les deux maladies sont les stigmatiser et pourrait infl uer sur la conformité du traitement, comme ce fut le cas avec ce jeune personnel médical d’un hôpital tertiaire nigériane. Il a reçu un diagnostic de neurosyphilis et a répondu à la thérapie de pénicilline, mais la peur de la stigmatisation à son lieu de travail a fait de lui à renoncer à l’hôpital pour un traitement de thérapie peu orthodoxe qui, malheureusement, lui a coûté la vie

    Effect Of Artesunate On The Nissl Bodies Of The Cerebellum Of Wistar Rats

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    The study was to assess the effect of the administration of different doses of artesunate on the Nissl bodies of the cerebellum of Wistar rats. Twenty adult albino Wistar rats weighing between 160-180g were equally assigned into four groups (A, B, C and D). Group A served as the control that received distilled water, while groups B, C and D were the experimental groups. Groups B and C received 2.86mg/kg and 5.71mg/kg of artesunate respectively for three days, while group D received 2.86mg/kg of artesunate for six days. Twelve hours after the last administration the animals were sacrificed. There was reduced staining intensity of Nisslbodies in groups B, C and D compared to the control. The reduction in staining was more in groups C and D especially in the granular and Purkinje cortical layers. These results revealed that artesunate cause reducedNissl bodies of the cerebellum of Wistar rats, and these reductions were dose and time dependent
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