Circulating interferon-alpha levels and hypertriglyceridemia in the acquired immunodeficiency syndrome
Article Abstract:
Infections are often complicated by disturbances in metabolism, possibly resulting from the actions of cytokines, which are modulators, or regulators, of the immune system. AIDS is often associated with hypertriglyceridemia, or abnormally high levels of triglycerides, and wasting of tissue. Increased blood levels of cytokines have been detected in AIDS patients. The relation of blood levels of cytokines to lipid levels and wasting was assessed in 45 patients with AIDS, 13 patients infected with human immunodeficiency virus (HIV), and 17 subjects without HIV disease. The levels of triglyceride, cholesterol, and the cytokines interferon, tumor necrosis factor (TNF), and interleukin-1 were measured. Interferon-alpha was detected in 84 percent of AIDS patients and three HIV-infected patients, but in no patients without HIV disease. In addition, interferon-alpha levels were correlated with blood levels of triglycerides in patients with HIV disease, but not with blood cholesterol levels. TNF levels were detectable in only 11 percent of AIDS patients and were similar in prevalence to those of subjects without HIV disease. Interleukin-1 was not detected. TNF levels were not correlated with blood triglyceride levels. Tissue wasting did not appear to be related to levels of interferon-alpha or TNF. These findings suggest that increased levels of interferon-alpha, which regulates lipid (fat) metabolism, may contribute to the development of hypertriglyceridemia associated with AIDS. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Psychotropic drug prescribing for hospitalized patients with acquired immunodeficiency syndrome
Article Abstract:
The prescribing practices associated with psychotropic drug treatment of hospitalized AIDS patients was assessed. The study involved 151 patients with an average age of 37 years, who were hospitalized for an average of 13 days. The patients' medical charts were reviewed for demographic characteristics, duration of hospital stay, diagnosis, psychiatric history, and mental status on admission. The reasons for prescribing psychotropic drugs, the daily dose and duration of drug treatment, and side effects were also assessed. Psychoactive agents were prescribed for 89 percent of the patients, with anxiolytics, or anxiety-reducing drugs, accounting for 49 percent of prescriptions, and hypnotics, such as sedatives, accounting for 43 percent. Benzodiazepines were the most frequently prescribed psychotropic drugs. Psychotropic agents were used to manage insomnia in 39 percent of cases; psychologic distress in 20 percent; and nausea in 16 percent. The doses were moderate for anxiolytic and antipsychotic agents and low for antidepressants. These findings suggest that AIDS patients have an increased likelihood of being treated with psychotropic drugs, most often anxiolytic or hypnotics. Anxiolytics are used to manage various conditions, such as antibiotic-related nausea, whereas antidepressants and antipsychotics are rarely prescribed. Psychiatric problems underlying insomnia or mood change should be examined in order to use the most appropriate therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Transient acquired factor X deficiency: report of the use of activated clotting concentrate to control a life-threatening hemorrhage
Article Abstract:
A case is reported of a 74-year-old woman who had a massive hematoma (collection of blood) in the anterior (front) of the neck. There was no prior history of abnormal bleeding in the patient or in her family. On the basis of coagulation studies, a diagnosis of factor X deficiency was made. Factor X is a substance found in normal serum; its absence results in a tendency toward bleeding. The patient was treated with fresh frozen plasma. However, eight hours following treatment, her condition worsened; the hematoma increased in size causing a deviation of the trachea (windpipe) and moderately compromising her airway. The patient was then treated with Konyne, a drug which encourages clotting, but the hematoma continued to increase in size. She was then given Autoplex T, a drug which is an activated clotting factor. After two doses of Autoplex T within a 12-hour period, Konyne was resumed. The patient's symptoms improved over the next four days and the Konyne dosage was reduced. Symptoms continued to improve and upon clinic visits on days 11 and 27, the patient's hematoma had disappeared and her factor X levels were normal. The authors conclude that when bleeding is not controlled by the administration of Konyne, the use of Autoplex T should be promptly considered.
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1989
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