How strictly do dialysis patients want their advance directives followed?

Article Abstract:

A survey of 150 dialysis patients found that only 39% would want doctors to follow their advance directive without deviation should they become mentally incompetent. Thirty-one percent would give their doctors 'complete leeway' to override their advance directive. Most of the patients who would grant doctors this authority wanted their physicians to consider pain or suffering, quality of life, possible new treatments, indignity caused by treatment and the financial impact of treatment on their families as factors in the decision to override the advance directive. Although the implication behind advance directives is that they be strictly followed, this may not always be in the patient's best interests. Many patients may want their health-care provider to override their advance directive.

Planning, Usage, Advance directives (Medicine), Dialysis, Dialysis (Chemical process)

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Stress-Induced Immunomodulation: Implications for Infectious Diseases?

Article Abstract:

There is considerable evidence that psychological stress can affect the immune system. This can occur because of links between the central nervous system, the endocrine system and the immune system. Part of the immune response depends on chemicals called cytokines, which are messenger molecules released by certain immune cells. The cytokines in turn are involved in inflammatory responses. The production of cytokines can be affected by stress hormones. Animal models show that stress can increased the risk of infectious disease because psychological stress can inhibit the immune response to infectious agents.

Psychological aspects, Physiological aspects, Stress (Psychology), Immunity, Immunity (Physiology)

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Postexposure Prophylaxis After Nonoccupational HIV Exposure: Clinical, Ethical, and Policy Considerations

Article Abstract:

Physicians may want to offer drugs to prevent HIV infection in some people who have been exposed to the virus. These drugs have been very effective in preventing HIV infection in health care workers who are exposed to the virus while performing their duties. Since the risk of acquiring the virus can be just as high via sex and intravenous drug use, people in these risk groups may want the drugs. However, it may be best to offer the drugs in areas with the highest concentration of HIV patients.

HIV infection, HIV infections, Antiviral agents

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