Is it time for a comprehensive AIDS medical center?
Article Abstract:
The establishment of an AIDS medical center was proposed as an approach to fighting the human immunodeficiency virus epidemic. (Human immunodeficiency virus, or HIV, is the AIDS virus.) However, when such as institution was set up in Texas, it was perceived as a modern type of leper colony and failed soon after its opening. The creation of an AIDS medical center should be reconsidered, because technologies to diagnose and treat HIV disease have improved and social attitudes toward HIV-infected patients have changed favorably. Improved diagnosis and treatment of AIDS have resulted in an increased number of surviving HIV-infected persons (with or without symptoms). An AIDS medical center would serve as a basic and clinical research center, providing the most effective treatment available for AIDS; a social services center for AIDS patients and their families; and an information and resource center for all aspects of this disease. The AIDS center would function primarily on an outpatient basis and consist of permanent medical and research staff and rotating medical staff from the surrounding community. Cancer institutes and great public hospitals, established to provide care for the poor and socially disenfranchised, serve as appropriate models for an AIDS medical center. A facility for patients with AIDS would be beneficial in enhancing and coordinating research, providing education about AIDS, coordinating both social and medical services for HIV-positive patients, and providing leadership in fighting HIV and AIDS. The main concerns over establishing an AIDS hospital are related to the high costs of patient care and treatment, research, and hospital operation; the social stigma created by an AIDS medical center; the reluctance of local residents to have an AIDS hospital in their community; and the questionable need for such an institution when AIDS patients can obtain care in the current health care system. Although the establishment of an AIDS medical center would not solve all the problems of HIV disease, it provides the opportunity for society to respond to the painful and persistent problem of 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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Aortoesophageal fistula: a comprehensive review of the literature
Article Abstract:
Bleeding from the upper digestive tract occurs in around 1.5 per 1,000 patients every year. Aortoesophageal fistula (AEF), an abnormal connection between the esophagus and the main systemic artery, is a relatively uncommon cause of this bleeding, occurring in fewer than 3.5 percent of all cases. The blood from the aorta is bright red, and this differentiates AEF from other causes of hematemesis (vomiting of blood). AEF is frequently characterized by a history of chest pain, a signal hemorrhage or sentinel bleed, followed hours or days later by massive bleeding. AEF is chiefly caused by aortic aneurysms (local ballooning of the vessel due to thinning of its wall), ingestion of foreign bodies, or tumors of the esophagus, but may also be due to surgical complications, tuberculosis, defective structure, atherosclerosis, or instruments, among others. The literature on AEF was reviewed, and the features of AEF associated with aneurysms, foreign bodies, and esophageal cancer, as well as other common causes, are discussed. Rapid diagnosis is important, but no single procedure is sufficient by itself. X-ray, aortography (X-rays with contrast dye), esophagoscopy (viewing the esophagus directly with an optical instrument), or barium esophagraphy are among the more common and useful techniques. Surgery is essential for survival of AEF, and techniques used during surgery are reviewed. (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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