HIV-related diarrhea and outcome measures.

This article highlights the primary causes of HIV-related diarrhea. This article also reviews and evaluates available stool outcome measures frequently used in gastrointestinal studies examining fecal outcomes. Discussion focuses on instruments, scales, and other quantitative measures to assess stool outcomes. A discussion of the advantages and limitations of each instrument is included.

Diarrhea and wasting conference summary.

With the advancement of the therapeutic management of the human immunodeficiency virus (HIV), changes in the manifestation and clinical presentation of the disease are also evident. Clinicians and patients are continually challenged by these changes because frequently they are the first individuals to encounter them. Thus, clinical questions raised by clinicians/practitioners can often guide the endeavor of researchers. In this summation, the authors, a research scientist and clinician, highlight the main themes of the current state of the science of diarrhea and wasting presented at the 12th Annual Association for Nurses in AIDS Care conference. The experiences of both authors will hopefully provide greater insight into the current state of diarrhea and wasting in HIV.

HIV and diarrhea in the era of HAART: 1998 New York State hospitalizations.

BACKGROUND: This study reflects an attempt to identify the causes of diarrheal illness in hospitalized HIV patients in light of therapeutic advancements in HIV management. METHODS: The study identifies the various etiologies associated with diarrhea among HIV patients hospitalized in New York State in 1998. Data for this study were extracted from the New York State Department of Health Statewide Planning and Research Cooperative System. Pathogens recognized to cause diarrhea in persons with HIV and general codes identifying diarrhea were examined by using the principal and all secondary diagnoses based on the International Classification of Diseases 9th Revision Clinical Modification codes. RESULTS: Based on the Statewide Planning and Research Cooperative System data set, more than 15,000 patients with HIV were hospitalized in 1998. Among the HIV patients hospitalized, 2.8% were admitted with a diarrheal diagnosis. The following diagnoses occurred the most frequently among HIV patients hospitalized with a diarrheal illness: Clostridium difficile (51.3%), other protozoal diseases (18.1%), and other organisms, not elsewhere specified (11.7%). CONCLUSIONS: In the era of highly active antiretroviral therapy, diarrhea is still an occurring symptom in HIV patients. Despite the relatively small percentage of hospitalizations attributed to diarrhea, clinicians must remember that even "mild" to "moderate" diarrhea can have a debilitating impact among persons with the symptom.

A symptom review: nausea and vomiting in HIV.

Nausea and vomiting are symptoms often experienced by individuals with HIV disease. The etiologies are multifactorial, yet the symptoms have not been well studied in HIV research. Interventions currently used are adapted from the oncology setting and remain to be tested on patients with HIV. The purpose of this article is to review and discuss the symptoms of nausea and vomiting and to emphasize the need for research in this area.

Diarrhea and human immunodeficiency virus: Western and Eastern perspectives [corrected].

Sixty percent of patients with human immunodeficiency virus (HIV) in the United States and 90% throughout the world will have diarrhea at some point in their illness. This article provides an introductory exploration and discussion of Western and Eastern perspectives of chronic diarrhea in patients with HIV. Western etiologies and treatment approaches, as well as Eastern views from traditional Chinese medicine pathogenesis and treatment principles involving acupuncture and moxibustion are presented. Whereas their interpretations of the causes of diarrhea are different, both the East and West have something to offer patients with this distressing symptom. Further exploration and clinical research is needed in this area.

Squamous cell cervical lesions in women with and without AIDS. Biochemical risk factors, prevention, and policy.

Worldwide, squamous cell cervical cancer and intraepithelial lesions (SIL) are a major source of morbidity and mortality. Compared to women in general, women with human immunodeficiency syndromes (HIV) are at higher risk of developing SIL. With the HIV epidemic escalating among women, prevalence, morbidity, and mortality related to SIL are likely to increase unless adequate prevention and detection programs are mounted. Consequently, this article provides background information for the design of such programs, focusing on selected biochemical risk factors and natural history of SIL in women infected with HIV (HIV+) and women in general (HIV-). Current screening policies are described, and implications for nursing research and policy are discussed.

Symptomatology in HIV-seropositive women.

The number of reported AIDS cases in women rose to 12.8% of all reported cases in 1991. Nurses caring for HIV-infected women must be aware of the clinical issues as well as emotional and practical problems posed by HIV infection in order to design a plan of care that addresses patients' specific needs.

Diarrhea in acquired immune deficiency syndrome (AIDS).

Diarrhea is a common manifestation of HIV disease which most nurses will find themselves confronting at some point. It can be extremely debilitating, as well as causing psychological distress to patients. Treatment depends on etiology; it may be successful if the diarrhea is caused by a specific enteric pathogen or a specific medication the patient is taking. However, often the diarrhea cannot be resolved and treatment must be by supportive measures. Management has three components: diet, anti-diarrheal agents, and skin care. A multidisciplinary team provides the most effective approach for managing these complex, difficult cases.