ABSTRACT
The use of complementary and alternative medicine (CAM) therapies is widespread in many chronic illnesses, including human immunodeficiency virus (HIV) infection. The objective of this study was to determine the impact of increasingly effective antiretroviral therapy on the use of CAM in an HIV-positive patient population. A written survey was given to 191 HIV-positive outpatients. Participation was voluntary and anonymous. One hundred twenty-eight patients (67%) used CAM at some time to control HIV and 76 (40%) of the patients were currently using CAM. The major forms of CAM used were exercise (43%), lifestyle changes (38%), dietary supplements (37%), counseling (27%), herbal medications (26%), megavitamins (24%), and prayer therapy (24%). One hundred forty-one patients (74%) used a protease inhibitor medication, 28 (15%) used a protease inhibitor sparing regime, and 22 (11%) had no current or prior antiretroviral use. Eighty-two (43%) patients indicated that their doctor knew they used CAM and 56 patients (29%) received their information about CAM from a doctor or other health care professional. Of 128 patients who used CAM, 90 (70%) felt CAM improved their quality of life. Income of $15,000 or more per year and discontinuation of medications by patients for any reason in the past were the best predicators of CAM use for patients in general and also those on protease inhibitor therapy. CD(4) count, educational status, year of HIV diagnosis, and martial status were not effective predictors of CAM use. Use of CAM remains widespread among patients with HIV infection even with the availability of effective, yet noncurative antiretroviral therapy and does not correlate with type of antiretroviral therapy used or clinical status.
Subject(s)
Complementary Therapies/statistics & numerical data , HIV Infections/psychology , HIV Infections/therapy , Patient Acceptance of Health Care/psychology , Adult , Ambulatory Care/statistics & numerical data , Anti-HIV Agents/supply & distribution , Anti-HIV Agents/therapeutic use , CD4 Lymphocyte Count , Drug Utilization , Educational Status , Female , HIV Infections/immunology , HIV Protease Inhibitors/supply & distribution , HIV Protease Inhibitors/therapeutic use , Humans , Illinois , Male , Ohio , Patient Acceptance of Health Care/statistics & numerical data , Predictive Value of Tests , Quality of Life , Surveys and Questionnaires , Viral LoadABSTRACT
We evaluated 28 patients with dry-eye syndrome in the setting of either primary or secondary Sjogren's syndrome, with topical Healon tears. In 26 of the 28 patients, we noted both subjective and objective improvement characterized by decreased itching, burning and foreign body sensation, decreased mucus stranding and Rose-Bengal staining of the cornea and conjunctiva, and increased corneal luster and tear break-up time.
Subject(s)
Hyaluronic Acid/therapeutic use , Lacrimal Apparatus Diseases/drug therapy , Sjogren's Syndrome/drug therapy , Tears/metabolism , Administration, Topical , Adult , Aged , Animals , Chickens , Female , Humans , Hyaluronic Acid/administration & dosage , Male , Middle Aged , Tears/drug effectsABSTRACT
An early stage of Leber's congenital amaurosis, characterized by white spots or lines in the fundus, occurred in two children. Light microscopic examination of eyes obtained from one child, a 16-month-old Japanese girl, revealed subretinal deposits corresponding to the white spots and lines in the fundus deposits. Light and electron microscopic examination of the eye showed distinctive changes in the outer retinal layers and choroid, while the inner retinal layers were nearly normal. Characteristic early lesions of congenital amaurosis appeared to be produced by deposits consisting of loose outer segments and apical processes of the pigmental epithelial cell and macrophages. Undifferentiation in the nuclei of the photoreceptor cell, the inner segment, the pigment epithelial cell, and the choriocapillaris were likely characteristics of the early changes of congenital amaurosis.
