scholarly journals Management of Depression and Related Neuropsychiatric Symptoms Associated with HIV/AIDS and Antiretroviral Therapy

2001 ◽  
Vol 12 (suppl c) ◽  
pp. 9C-19C ◽  
Author(s):  
Mark Halman
Keyword(s):  
Antiretroviral Therapy ◽  
Major Depression ◽  
Depressed Mood ◽  
Negative Impact ◽  
Neuropsychiatric Symptoms ◽  
Significant Risk ◽  
Psychiatric Evaluation ◽  
Medical Illness ◽  
Wide Range ◽  
Hiv Aids

Persons with HIV/AIDS may experience a wide range of neuropsychiatric symptoms, including depressed mood, anxiety, irritability, suicidal ideation, agitation and insomnia. These symptoms may be related to psychosocial stressors, biological diathesis to psychiatric syndromes, HIV-related medical illness and/or the medications used in the treatment of HIV/AIDS. Depressed mood is the most common neuropsychiatric complaint in persons with HIV/AIDS seeking psychiatric evaluation. Prevalence rates of major depression in persons with HIV/AIDS have been reported to range between 22% and 45%. Despite the high prevalence, major depression remains underdiagnosed in patients with HIV/AIDS. Depression has a significant impact on quality of life, has a negative impact on antiretroviral adherence and is a significant risk factor for suicide. With the advent of highly active antiretroviral therapy, HIV/AIDS has evolved into a chronic, manageable illness. The management of mental health concerns and neuropsychiatric symptoms has, therefore, become an integral part of comprehensive HIV/AIDS care. Clinical experience to date suggests that psychiatric syndromes in persons with HIV/AIDS and treatment-emergent neuropsychiatric side effects related to antiretroviral medications can be successfully managed using standard psychiatric interventions. The present article focuses on the treatment and management of major depression, including the choice of antidepressants and potential drug interaction considerations. Management of related symptoms of agitation and sleep disturbances are also reviewed.

scholarly journals Management of Depression Associated with HIV/AIDS and Antiretrovial Therapy

2006 ◽  
Vol 17 (suppl d) ◽  
pp. 5D-9D
Author(s):  
Mark Halman
Keyword(s):  
Major Depression ◽  
Psychiatric Symptoms ◽  
Social Withdrawal ◽  
Case Reports ◽  
Meta Analysis ◽  
Neuropsychiatric Symptoms ◽  
Medical Illness ◽  
Open Label ◽  
Antiretroviral Adherence ◽  
Hiv Aids

Depressed mood is a common psychiatric complaint in persons with HIV/AIDS, with a meta-analysis indicating that the rates of depression within this group may be as high as double that of the general population. Depression may result from a biological diathesis to mood disorders, a physiological reaction to a medical illness or its treatment, and/or a psychological reaction to challenging life circumstances. Associated symptoms include sleep, energy and appetite disturbances; social withdrawal; diminished capacity to experience pleasure; diminished concentration; feelings of worthlessness, shame and guilt; and recurrent thoughts of death, including suicidal ideation. The emotionally and physically painful state of major depression is associated with decreased antiretroviral adherence and poorer HIV/AIDS disease outcomes. Neuropsychiatric symptoms have been reported with several of the medications taken by patients with HIV/AIDS, including lamivudine, zidovudine, interferon and, most notably, efavirenz. However, data from several sources demonstrate that neuropsychiatric symptoms associated with efavirenz use are generally transient, with onset early after treatment initiation, peaking after one week and decreasing over the first one to four months of treatment. Recent comparative studies have not found elevated incident rates of major depression in patients treated with efavirenz, but they have confirmed the typical neuropsychiatric symptoms reported in earlier open-label studies and case reports. Becoming skilled in the management of depression and psychiatric symptoms is integral to the provision of comprehensive care for patients with HIV/AIDS.

scholarly journals Low body mass index increases risk of anemia in patients with HIV-AIDS receiving antiretroviral therapy

2017 ◽  
Vol 36 (3) ◽  
pp. 221
Author(s):  
Mirna Widiyanti ◽  
Reynold Ubra ◽  
Eva Fitriana
Keyword(s):  
Body Mass Index ◽  
Logistic Regression ◽  
Risk Factor ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Body Mass ◽  
Significant Risk ◽  
Severe Anemia ◽  
Low Body Mass Index ◽  
Hiv Aids

Background<br />In acquired immunodeficiency syndrome (AIDS) cases, cytopenias of all major blood cell lines were increasingly recognized in patients with HIV infection. Anemia commonly occurs during HIV infection and has been associated with increased progression to AIDS and decreased survival. The aim of this study was to determine the prevalence of anemia and associated risk factors in adults with HIV-AIDS receiving antiretroviral therapy (ART). <br /><br />Methods<br />A cross sectional study was conducted involving 90 adults with HIV-AIDS. Sociodemographic data were collected using a questionnaire. In all patients, CD4+ lymphocyte counts were performed by means of a PIMA analyzer, while hemoglobin was determined using a Sysmex hematology analyzer. The WHO cutoff value of hemoglobin was adjusted to altitude to define anemia. Mild to moderate anemia was defined as hemoglobin 8-13 g/dL for men and 8-12 g/dL for women. Severe anemia was defined as hemoglobin 8 g/dL. Data was analyzed by using logistic regression test.<br /><br />Results<br />There were 90 subjects with HIV-AIDS in this study. Anemia was found in 50 subjects (55.6%), consisting of 12.2% with mild anemia and 43.4% with moderate to severe anemia. Multiple logistic regression showed that an important risk factor for anemia was low body mass index (BMI) between &lt;17-18.5 (OR=4.20; 95% CI=1.23-14.36). However, the CD4 &lt;350 cells/mm3 was not a significant risk factor for anemia (OR=1.03; 95% CI=0.21-5.04).<br /><br />Conclusions<br />Low BMI increases the risk of anemia in subjects with HIV receiving ART. Better screening for anemia and infectious diseases, and modified harm reduction strategy for injection drug users are primary needs in HIV patients.

Dukungan sosial dan kualitas hidup orang dengan HIV/AIDS

2017 ◽  
Vol 33 (3) ◽  
pp. 147
Author(s):  
Mardia Mardia ◽  
Riris Andono Ahmad ◽  
Bambang Sigit Riyanto
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Antiretroviral Therapy ◽  
Social Life ◽  
Opportunistic Infections ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Criteria For Diagnosis ◽  
Hiv Aids

Purpose: This study aimed to determine the quality of life among people living with HIV/AIDS based on the criteria for diagnosis and other factors.Methods: This study was conducted in the VCT clinic hospital of Dr. Moewardi. The population was HIV-positive patients with antiretroviral therapy. Data collection conducted through medical records and interview to patients. Results: Out of a total of 89 respondents, 66.29% were males and 71.91% were aged between 26-45 years. We found significant correlations for diagnosis of HIV/AIDS, opportunistic infections, time since HIV diagnosis, duration of ARV therapy, social support, modes of transport, sex, age, and marital status with the quality of life. Multivariate analysis obtained by each variable showed the strongest association with the quality of life was time since diagnosis, social support and duration of ARV therapy. Conclusion: The quality of life was better for those who have been diagnosed with HIV/AIDS ≥ 32 months, with social support, and who have been undergoing antiretroviral therapy ≥ 29 months. Improved counseling in the early days of ARV therapy is necessary to always maintain the treatment and provide support for their social life.

scholarly journals Treatment patterns and appropriateness of antipsychotic prescriptions in patients with schizophrenia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Verónica Gamón ◽  
Isabel Hurtado ◽  
José Salazar-Fraile ◽  
Gabriel Sanfélix-Gimeno
Keyword(s):  
Negative Impact ◽  
Current Treatment ◽  
Treatment Patterns ◽  
Mental Condition ◽  
Comorbid Condition ◽  
Concomitant Treatment ◽  
Antipsychotic Medications ◽  
Wide Range ◽  
Schizophrenic Patients ◽  
High Level

AbstractSchizophrenia is a chronic mental condition presenting a wide range of symptoms. Although it has a low prevalence compared to other mental conditions, it has a negative impact on social and occupational functions. This study aimed to assess the appropriateness of antipsychotic medications administered to schizophrenic patients and describe current treatment patterns for schizophrenia. A retrospective cohort study was conducted in all patients over the age of 15 with an active diagnosis of schizophrenia and treated with antipsychotics between 2008 and 2013 in the Valencia region. A total of 19,718 patients were eligible for inclusion. The main outcome assessed was inappropriateness of the pharmacotherapeutic management, including polypharmacy use. Altogether, 30.4% of patients received antipsychotic polypharmacy, and 6.8% were prescribed three or more antipsychotics. Overdosage affected 318 individuals (1.6%), and 21.5% used concomitant psychotropics without an associated psychiatric diagnosis. Women and people with a comorbid condition like anxiety or depression were less likely to receive antipsychotic polypharmacy. In contrast, increased polypharmacy was associated with concomitant treatment with other psychoactive drugs, and only in user on maintenance therapy, with more visits to the mental health hospital. Overall, we observed a high level of inappropriateness in antipsychotic prescriptions. Greater adherence to guidelines could maximize the benefits of antipsychotic medications while minimizing risk of adverse effects.

scholarly journals Production of Microfibrillated Cellulose from Fast-Growing Poplar and Olive Tree Pruning by Physical Pretreatment

2021 ◽  
Vol 11 (14) ◽  
pp. 6445
Author(s):  
David Ibarra ◽  
Raquel Martín-Sampedro ◽  
Bernd Wicklein ◽  
Úrsula Fillat ◽  
María E. Eugenio
Keyword(s):  
Negative Impact ◽  
Raw Materials ◽  
Olive Tree ◽  
Barrier Properties ◽  
Microfibrillated Cellulose ◽  
Mechanical Resistance ◽  
Fast Growing ◽  
Wide Range ◽  
Pfi Refining ◽  
Tree Pruning

Motivated by the negative impact of fossil fuel consumption on the environment, the need arises to produce materials and energy from renewable sources. Cellulose, the main biopolymer on Earth, plays a key role in this context, serving as a platform for the development of biofuels, chemicals and novel materials. Among the latter, micro- and nanocellulose have been receiving increasing attention in the last few years. Their many attractive properties, i.e., thermal stability, high mechanical resistance, barrier properties, lightweight, optical transparency and ease of chemical modification, allow their use in a wide range of applications, such as paper or polymer reinforcement, packaging, construction, membranes, bioplastics, bioengineering, optics and electronics. In view of the increasing demand for traditional wood pulp (e.g., obtained from eucalypt, birch, pine, spruce) for micro/nanocellulose production, dedicated crops and agricultural residues can be interesting as raw materials for this purpose. This work aims at achieving microfibrillated cellulose production from fast-growing poplar and olive tree pruning using physical pretreatment (PFI refining) before the microfibrillation stage. Both raw materials yielded microfibrillated cellulose with similar properties to that obtained from a commercial industrial eucalypt pulp, producing films with high mechanical properties and low wettability. According to these properties, different applications for cellulose microfibers suspensions and films are discussed.

scholarly journals Overview of the Genetic Diversity of African Macrotermes (Termitidae: Macrotermitinae) and Implications for Taxonomy, Ecology and Food Science

Insects ◽  
2021 ◽  
Vol 12 (6) ◽  
pp. 518
Author(s):  
Bronwyn Egan ◽  
Zwannda Nethavhani ◽  
Barbara van Asch
Keyword(s):  
Negative Impact ◽  
Phylogenetic Reconstruction ◽  
Morphological Characters ◽  
Food Science ◽  
Cryptic Diversity ◽  
African Species ◽  
Genetic Groups ◽  
Wide Range ◽  
Coi Sequences ◽  
High Level

Macrotermes termites play important ecological roles and are consumed by many communities as a delicacy and dietary complement throughout Africa. However, lack of reliable morphological characters has hampered studies of Macrotermes diversity in a wide range of scientific fields including ecology, phylogenetics and food science. In order to place our preliminary assessment of the diversity of Macrotermes in South Africa in context, we analysed a comprehensive dataset of COI sequences for African species including new and publicly available data. Phylogenetic reconstruction and estimates of genetic divergence showed a high level of incongruity between species names and genetic groups, as well as several instances of cryptic diversity. We identified three main clades and 17 genetic groups in the dataset. We propose that this structure be used as a background for future surveys of Macrotermes diversity in Africa, thus mitigating the negative impact of the present taxonomic uncertainties in the genus. The new specimens collected in Limpopo fell into four distinct genetic groups, suggesting that the region harbours remarkable Macrotermes diversity relative to other African regions surveyed in previous studies. This work shows that African Macrotermes have been understudied across the continent, and that the genus contains cryptic diversity undetectable by classic taxonomy. Furthermore, these results may inform future taxonomic revisions in Macrotermes, thus contributing to advances in termitology.

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