Symptoms Associated with HIV and AIDS

2010 ◽  
Author(s):  
Harold W. Goforth ◽  
Mary Ann Cohen
Keyword(s):  
Hepatitis C ◽  
Opportunistic Infections ◽  
Evidence Base ◽  
Chronic Illnesses ◽  
Hiv And Aids ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Specific Symptom ◽  
Viral Loads ◽  
End Stage

Many persons with HIV and AIDS have symptoms that are unrelated to underlying psychiatric disorders but may masquerade as such. These symptoms may include insomnia, fatigue, nausea, or other troubling symptoms, and often result in suffering for patients, their families, and loved ones. The symptoms are common throughout the course of HIV and AIDS, from onset of infection to late-stage and end-stage AIDS. They need to be addressed whenever they occur and not only as part of end-of-life care. We present protocols to ameliorate or eliminate these symptoms and alleviate suffering. Fatigue is one of the most prevalent but underreported and undertreated aspects of HIV disease. The prevalence of fatigue in an HIV population has been estimated to affect at least 50% of seropositive individuals (Breitbart et al., 1998) and may affect up to 80% of the population. Darko and colleagues (1992) found that HIV-seropositive individuals were more fatigued, required more sleep and daytime naps, and showed less alert morning functioning than did persons who are HIV-seronegative. While the symptom of fatigue may fluctuate with increasing viral loads, there is no evidence base for a consistent correlation between fatigue and viral load. Fatigue is a pseudo-specific symptom common to a variety of disabilities found in an HIV population, and it has been linked to a variety of other AIDS-related disabilities including pain, anemia, impaired physical function, psychological distress, and depression. Hormonal alterations, such as those in testosterone and thyroxin, that occur in the context of HIV infection are also common in this group. While these findings are further discussed in Chapter 10, it is worth noting here that they can contribute substantially to tiredness and fatigue in this population. Other sources of fatigue include multimorbid chronic illnesses (opportunistic infections and cancers, chronic renal insufficiency, hepatitis C and other hepatic illnesses, and chronic obstructive pulmonary disease [COPD]) and some of their treatments (notably interferon/ribavirin for hepatitis C and cancer chemotherapy). Substances such as recreational drugs, nicotine, and caffeine are also factors in HIV-related fatigue.

Chronic obstructive pulmonary disease

2017 ◽  
Author(s):  
Amina Jaffer ◽  
Anant Patel ◽  
John Hurst
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Phenotypic Variability ◽  
Evidence Base ◽  
Future Research ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Potential Benefits ◽  
Learning Points

This chapter discusses the case of a 70-year-old man with his first presentation of chronic obstructive pulmonary disease. This case is used as a basis to explore and describe the diagnosis, investigation, and management of this condition. The chapter includes the evidence base and relative guidelines that support current practice, as well as highlighting useful learning points and providing expert opinion. The role of lung volume reduction surgery is discussed, and its potential benefits in selected patients highlighted. Phenotypic variability within chronic obstructive pulmonary disease is increasingly recognized, and this is discussed, including the implications on current management and future research.

Case Discussions in Advanced Care Planning

2020 ◽  
pp. 104990912094849
Author(s):  
Regine Krechowicz ◽  
Melini Gupta ◽  
Valerie Gratton ◽  
Carly Hickey ◽  
Laura H. Thompson ◽  
...  
Keyword(s):  
Life Experience ◽  
Chronic Obstructive ◽  
Care Planning ◽  
Advanced Care Planning ◽  
Obstructive Pulmonary Disease ◽  
Case Discussions ◽  
End Stage ◽  
Valuable Role

Background: Advanced care planning (ACP) provides an opportunity for individuals to explore and document their values concerning medical care decisions prior to an acute event. This manuscript explores the value of ACP and compares and contrasts 2 ACP models currently in practice. Methods: This hypothetical case describes an elderly, frail patient with end-stage chronic obstructive pulmonary disease who is also a high user of health care resources. A new palliative care-led outpatient ACP clinic model is described using this example. Results: Using the ACP clinic model in this case reveals how different a patient’s end of life experience may be when proper, proactive planning measures are in place. With proper education and discussion around this patient and family’s wishes pertaining to the end of his life, this man was able to change his plan of care from aggressive resuscitation treatment in hospital to a peaceful palliative experience at home. Conclusions: In this case description, the valuable role of ACP in preserving quality of life for patients, increasing satisfaction with care, and decreasing distress among family members during a medical event is demonstrated.

scholarly journals Residuos peligrosos hospitalarios en casa: una amenaza emergente.

2016 ◽  
Vol 13 (1) ◽  
pp. 87
Author(s):  
Luz Divia Mejía-Reales ◽  
Lilibeth Romero-Mendoza ◽  
Viadcy Lineth Beltrán-Quintero
Keyword(s):  
Chronic Illnesses ◽  
Chronic Obstructive ◽  
Hospital Waste ◽  
Obstructive Pulmonary Disease ◽  
Whole Process ◽  
Enfermedad Pulmonar Obstructiva Crónica ◽  
Hospital Wastes ◽  
Middle Strata ◽  
The Impact ◽  
The City

Objetivo: describir el manejo de residuos peligrosos hospitalarios generados en los domicilios por usuarios con enfermedades crónicas de  una institución prestadora de servicios de salud en la ciudad de  Valledupar, Colombia. Materiales y Métodos: estudio de enfoque cuantitativo, la muestra estuvo conformada por 85 usuarios con enfermedades crónicas que cumplieran con los criterios de inclusión, a quienes se les aplicó un cuestionario sobre manejo de residuos peligrosos hospitalarios en casa. Resultados: la población encuestada  estuvo expuesta a riesgos relacionados con el manejo de  agujas un 40% de los diabéticos, el 55% de quienes padecen enfermedad renal, en contacto con  líquido peritoneal, y los usuarios con enfermedad pulmonar obstructiva crónica 36% presentaron  reacciones anafilácticas. Además se encontró que el 66% de la población no tiene conocimientos acerca del manejo de estos residuos, cuál es el almacenamiento,  recolección, transporte, tratamiento y/o disposición final de los mismos. Conclusión: el estudio reveló que existe una  problemática relacionada con el proceso  integral de los residuos peligrosos hospitalarios, debido a que la población generadora de estos pertenecen a estratos medios - bajos y asumir la totalidad de los gastos generados es poco viable, además no está capacitada adecuadamente, por tal razón resultó pertinente la elaboración de un manual para el manejo de residuos peligrosos hospitalarios generados en casa, para instruir  sobre actividades que  realizan estos usuarios, buscando disminuir el impacto en la salud y el ambiente derivados de la producción de estos desechos.PALABRAS CLAVE: atención domiciliaria de salud, residuos sanitarios, riesgo. Hazardous hospital wastes in the home: an emerging threatABSTRACTObjective: to describe the management of hazardous hospital waste generated in households by users with chronic diseases from one institution providing health services in the city of Valledupar, Colombia. Materials and Methods: study of quantitative approach, the sample consisted of 85 users with chronic illnesses that met the inclusion criteria, who were given a questionnaire on management of hazardous hospital waste in the home. Results: the survey population was exposed to risks associated with needle handling 40% of diabetics, 55% of those with kidney disease, contact with peritoneal fluid, and users with chronic obstructive pulmonary disease, 36% had anaphylactic reactions . It was also found that 66% of the population had no knowledge about handling these wastes, which involves storage, collection, transportation, treatment and / or disposal thereof. Conclusion: the study revealed that there is a problem related to the whole process of hazardous hospital waste, because the generating population of residues belong to middle strata - low and assuming all of the costs incurred is unfeasible, then there is  inadequate training for this reason it was relevant to develop a manual for the management of hazardous hospital waste generated in the home, to educate on activities carried out by these users, seeking to reduce the impact on health and the environment from the production of these wastes .KEYWORDS: home nursing, medical waste, risk. Resíduos hospitalares perigosos em casa: uma ameaça emergenteRESUMOObjetivo: descrever a gestão de resíduos hospitalares perigosos produzidos pelo sector doméstico por usuários com doenças crônicas de uma instituição que presta serviços de saúde na cidade de Valledupar, Colômbia. Materiais e Métodos: estudo de abordagem quantitativa, a amostra foi composta por 85 usuários com doenças crônicas que preencheram os critérios de inclusão, que foram aplicados um questionário sobre gestão de resíduos hospitalares perigosos em casa. Resultados: a população do estudo foi exposto a riscos associados com a manipulação de agulha 40% dos diabéticos, 55% das pessoas com doença renal, entre em contato com o fluido peritoneal, e os usuários com doença pulmonar obstrutiva crônica, 36% tiveram reações anafiláticas . Constatou-se também que 66% da população não tem conhecimento sobre o manuseio desses resíduos, que é o armazenamento, coleta, transporte, tratamento e / ou eliminação dos mesmos. Conclusão: O estudo revelou que existe um problema relacionado a todo o processo de resíduos hospitalares perigosos, porque a população de geração de resíduos pertencem a estratos médios - baixo e assumir todos os custos incorridos é inviável, então não há nenhuma treinados adequadamente por este motivo foi relevante o desenvolvimento de um manual para a gestão de resíduos hospitalares perigosos gerados em casa, para instruir sobre as actividades realizadas por estes utilizadores, procurando reduzir o impacto sobre a saúde eo ambiente decorrentes da produção destes resíduos .PALAVRAS-CHAVE: assistência domicilar, resíduos de serviços de saúde,  risco. 

scholarly journals The patients with severe Chronic Obstructive Pulmonary Disease and chronic respiratory insufficiency

2016 ◽  
Vol 67 (3) ◽  
Author(s):  
N. Ambrosino ◽  
M. Di Giorgio ◽  
A. Di Paco
Keyword(s):  
Exercise Capacity ◽  
Chronic Obstructive Lung Disease ◽  
Supplemental Oxygen ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Chronic Respiratory Insufficiency ◽  
Global Initiative ◽  
End Stage

Caring for patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages III and IV with chronic respiratory failure is difficult independent of whether the target is survival or quality of life (QOL). The role of inhaled drug therapy in this specific set of very severe COPD patients has not previously been assessed. The only drug able to prolong survival in these patients is long term oxygen therapy, whereas there is little evidence to indicate long term domiciliary mechanical ventilation in the routine management of stable hypercapnic patients. Supplemental oxygen during exercise reduces exercise breathlessness and improves exercise capacity of the hypoxaemic patient. Pulmonary rehabilitation including nutritional supplementation is a significant component of therapy, even in these severe patients. Relief of dyspnoea with drugs such as morphine should not be denied to severely disabled patients who share poor QOL with cancer patients. Non-invasive ventilation has been used as a palliative treatment to reduce dyspnoea. Lung Volume Reduction Surgery may improve mortality, exercise capacity, and QOL in selected patients, but is associated with significant morbidity and an early mortality rate in the most severe patients. Lung transplantation is a final step in end-stage patients, but short- and long-term outcomes remain significantly inferior in relation to other “solid” organs recipients.

Medical Management Considerations for Patients With Lung Transplantation

2001 ◽  
Vol 14 (4) ◽  
pp. 258-276 ◽  
Author(s):  
Robert E. Dupuis ◽  
David J. Taber ◽  
Amy L. Fann ◽  
Kevin P. Lumbert
Keyword(s):  
Lung Transplantation ◽  
Immunosuppressive Agents ◽  
Chronic Obstructive ◽  
Drug Induced ◽  
Obstructive Pulmonary Disease ◽  
Drug Regimens ◽  
Short And Long Term ◽  
End Stage

Lung transplantation has become an accepted modality for the treatment of end-stage lung disease. Adult and pediatric patients with a variety of lung diseases, including cystic fibrosis, chronic obstructive pulmonary disease, and idiopathic pulmonary fibrosis are candidates for lung transplantation. Lung transplantation can extend survival and improve quality of life for these patients. With the introduction of new immunosuppressive agents and enhanced surgical and medical care, both short- and long-term morbidity and mortality in these populations, although not as good as other transplant types, are improving. After lung transplantation, recipients continue to face a number of obstacles including post-operative complications, complex drug regimens, drug-induced toxicities, infection, and rejection. An understanding of the management and monitoring issues after lung transplantation is the focus of this review.

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