ABSTRACT
The purpose of this paper was to evaluate the prevalence of HIV infection and AIDS in Argentina, to study the dynamics of the spread of HIV and to predict the future course by means of an epidemic model. The model was constructed using differential equations to describe the interactions between members of the various groups at risk. The functional form of the solutions was used in a back calculation procedure using data from cohort studies which were done in other countries (U.S.A. and France) together with data of AIDS cases reported to the National AIDS Program, to determine the time evolution of HIV-infection in each of the groups at risk defined. Results show that HIV was introduced in Argentina during the early 80's and affected persons of the homosexual/bisexual group in a first stage. In April 1990 it was estimated that there were a total of 34,131 HIV-infected persons. Intravenous drug users (IVDU) represented 39.5%, homosexual/bisexual men 47.6% and heterosexual adults 11%. It is estimated that in December 1992 there will be 107,946 HIV-infected persons where heterosexuals contribute with more than 20% of that value. AIDS cases predicted for the same period are 4130, with 1958 among homosexual/bisexual, 1483 among IVDU, 449 in heterosexual adults, 153 in children under 4 years old and 87 among hemophiliacs or patients with blood coagulation disorders. By the end of 1994 the model predicts more than 200,000 HIV infected persons with an important proportion of heterosexual adults and more than 12,000 AIDS cases. The values of this period must be considered as a future possible scenario if the present spread conditions are preserved. Infection among heterosexual adults is at the present time in a first and exponential phase of spread and dominated by transmission from IVDU group and bisexual men. It is concluded that the future course of AIDS epidemic in Argentina may be particularly influenced by changes in the heterosexual behavior particularly in those with a higher degree of exposure to HIV-infection
Subject(s)
Humans , Male , Female , Acquired Immunodeficiency Syndrome/epidemiology , Disease Outbreaks , HIV Infections/epidemiology , Models, Theoretical , Adult , Argentina/epidemiology , Blood Coagulation Disorders/epidemiology , Blood Transfusion/adverse effects , Child, Preschool , Cohort Studies , Comorbidity , Health Planning , Hemophilia A/epidemiology , HIV Infections/transmission , HIV Seroprevalence , Infant , Infant, Newborn , PregnancyABSTRACT
The purpose of this paper was to evaluate the prevalence of HIV infection and AIDS in Argentina, to study the dynamics of the spread of HIV and to predict the future course by means of an epidemic model. The model was constructed using differential equations to describe the interactions between members of the various groups at risk. The functional form of the solutions was used in a back calculation procedure using data from cohort studies which were done in other countries (U.S.A. and France) together with data of AIDS cases reported to the National AIDS Program, to determine the time evolution of HIV-infection in each of the groups at risk defined. Results show that HIV was introduced in Argentina during the early 80s and affected persons of the homosexual/bisexual group in a first stage. In April 1990 it was estimated that there were a total of 34,131 HIV-infected persons. Intravenous drug users (IVDU) represented 39.5%, homosexual/bisexual men 47.6% and heterosexual adults 11%. It is estimated that in December 1992 there will be 107,946 HIV-infected persons where heterosexuals contribute with more than 20% of that value. AIDS cases predicted for the same period are 4130, with 1958 among homosexual/bisexual, 1483 among IVDU, 449 in heterosexual adults, 153 in children under 4 years old and 87 among hemophiliacs or patients with blood coagulation disorders. By the end of 1994 the model predicts more than 200,000 HIV infected persons with an important proportion of heterosexual adults and more than 12,000 AIDS cases. The values of this period must be considered as a future possible scenario if the present spread conditions are preserved. Infection among heterosexual adults is at the present time in a first and exponential phase of spread and dominated by transmission from IVDU group and bisexual men. It is concluded that the future course of AIDS epidemic in Argentina may be particularly influenced by changes in the heterosexual behavior particularly in those with a higher degree of exposure to HIV-infection (Au)
Subject(s)
Humans , Male , Female , Acquired Immunodeficiency Syndrome/epidemiology , Disease Outbreaks , HIV Infections/epidemiology , Models, Theoretical , Adult , Argentina/epidemiology , Blood Coagulation Disorders/epidemiology , Blood Transfusion/adverse effects , Child, Preschool , Cohort Studies , Comorbidity , Health Planning , Hemophilia A/epidemiology , HIV Infections/transmission , HIV Seroprevalence , Infant , Infant, Newborn , PregnancyABSTRACT
The purpose of this paper was to evaluate the prevalence of HIV infection and AIDS in Argentina, to study the dynamics of the spread of HIV and to predict the future course by means of an epidemic model. The model was constructed using differential equations to describe the interactions between members of the various groups at risk. The functional form of the solutions was used in a back calculation procedure using data from cohort studies which were done in other countries (U.S.A. and France) together with data of AIDS cases reported to the National AIDS Program, to determine the time evolution of HIV-infection in each of the groups at risk defined. Results show that HIV was introduced in Argentina during the early 80's and affected persons of the homosexual/bisexual group in a first stage. In April 1990 it was estimated that there were a total of 34,131 HIV-infected persons. Intravenous drug users (IVDU) represented 39.5%, homosexual/bisexual men 47.6% and heterosexual adults 11%. It is estimated that in December 1992 there will be 107,946 HIV-infected persons where heterosexuals contribute with more than 20% of that value. AIDS cases predicted for the same period are 4130, with 1958 among homosexual/bisexual, 1483 among IVDU, 449 in heterosexual adults, 153 in children under 4 years old and 87 among hemophiliacs or patients with blood coagulation disorders. By the end of 1994 the model predicts more than 200,000 HIV infected persons with an important proportion of heterosexual adults and more than 12,000 AIDS cases. The values of this period must be considered as a future possible scenario if the present spread conditions are preserved. Infection among heterosexual adults is at the present time in a first and exponential phase of spread and dominated by transmission from IVDU group and bisexual men. It is concluded that the future course of AIDS epidemic in Argentina may be particularly influenced by changes in the heterosexual behavior particularly in those with a higher degree of exposure to HIV-infection.
Subject(s)
Acquired Immunodeficiency Syndrome/epidemiology , Disease Outbreaks , HIV Infections/epidemiology , Models, Theoretical , Adult , Argentina/epidemiology , Blood Coagulation Disorders/epidemiology , Child, Preschool , Cohort Studies , Comorbidity , Female , HIV Infections/transmission , HIV Seroprevalence , Health Planning , Hemophilia A/epidemiology , Humans , Infant , Infant, Newborn , Male , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Risk Factors , Sexual Behavior/statistics & numerical data , Substance Abuse, Intravenous/epidemiology , Time Factors , Transfusion ReactionABSTRACT
The purpose of this paper was to evaluate the prevalence of HIV infection and AIDS in Argentina, to study the dynamics of the spread of HIV and to predict the future course by means of an epidemic model. The model was constructed using differential equations to describe the interactions between members of the various groups at risk. The functional form of the solutions was used in a back calculation procedure using data from cohort studies which were done in other countries (U.S.A. and France) together with data of AIDS cases reported to the National AIDS Program, to determine the time evolution of HIV-infection in each of the groups at risk defined. Results show that HIV was introduced in Argentina during the early 80s and affected persons of the homosexual/bisexual group in a first stage. In April 1990 it was estimated that there were a total of 34,131 HIV-infected persons. Intravenous drug users (IVDU) represented 39.5
, homosexual/bisexual men 47.6
and heterosexual adults 11
. It is estimated that in December 1992 there will be 107,946 HIV-infected persons where heterosexuals contribute with more than 20
of that value. AIDS cases predicted for the same period are 4130, with 1958 among homosexual/bisexual, 1483 among IVDU, 449 in heterosexual adults, 153 in children under 4 years old and 87 among hemophiliacs or patients with blood coagulation disorders. By the end of 1994 the model predicts more than 200,000 HIV infected persons with an important proportion of heterosexual adults and more than 12,000 AIDS cases. The values of this period must be considered as a future possible scenario if the present spread conditions are preserved. Infection among heterosexual adults is at the present time in a first and exponential phase of spread and dominated by transmission from IVDU group and bisexual men. It is concluded that the future course of AIDS epidemic in Argentina may be particularly influenced by changes in the heterosexual behavior particularly in those with a higher degree of exposure to HIV-infection.
ABSTRACT
The purpose of this paper was to evaluate the prevalence of HIV infection and AIDS in Argentina, to study the dynamics of the spread of HIV and to predict the future course by means of an epidemic model. The model was constructed using differential equations to describe the interactions between members of the various groups at risk. The functional form of the solutions was used in a back calculation procedure using data from cohort studies which were done in other countries (U.S.A. and France) together with data of AIDS cases reported to the National AIDS Program, to determine the time evolution of HIV-infection in each of the groups at risk defined. Results show that HIV was introduced in Argentina during the early 80s and affected persons of the homosexual/bisexual group in a first stage. In April 1990 it was estimated that there were a total of 34,131 HIV-infected persons. Intravenous drug users (IVDU) represented 39.5
, homosexual/bisexual men 47.6
and heterosexual adults 11
. It is estimated that in December 1992 there will be 107,946 HIV-infected persons where heterosexuals contribute with more than 20
of that value. AIDS cases predicted for the same period are 4130, with 1958 among homosexual/bisexual, 1483 among IVDU, 449 in heterosexual adults, 153 in children under 4 years old and 87 among hemophiliacs or patients with blood coagulation disorders. By the end of 1994 the model predicts more than 200,000 HIV infected persons with an important proportion of heterosexual adults and more than 12,000 AIDS cases. The values of this period must be considered as a future possible scenario if the present spread conditions are preserved. Infection among heterosexual adults is at the present time in a first and exponential phase of spread and dominated by transmission from IVDU group and bisexual men. It is concluded that the future course of AIDS epidemic in Argentina may be particularly influenced by changes in the heterosexual behavior particularly in those with a higher degree of exposure to HIV-infection.
ABSTRACT
Carotid endarterectomy has been used increasingly in the management of cerebrovascular disease. However, morbidity and mortality statistics for this procedure have caused criticism. The authors believe neurologic and medical complications can be reduced with the use of regional anesthesia for carotid endarterectomy.
Subject(s)
Arteriosclerosis/surgery , Carotid Artery Diseases/surgery , Cervical Plexus , Endarterectomy/methods , Nerve Block , Carotid Artery, Internal , HumansABSTRACT
A combination epidural technique using local anesthetics intraoperatively and morphine postoperatively is shown to offer many advantages. These benefits include inhibition of the surgical stress response, decreased cardiorespiratory depression, decreased blood loss, decreased intubation and pulmonary infection, decreased thromboembolism, decreased hyperglycemic and hypertensive response, nitrogen sparing, a stable resting metabolic rate, prevention of immunosuppression, simplification of cerebral status monitoring, and earlier ambulation and hospital discharge. The main disadvantage in patients undergoing vascular procedures is the risk of epidural hematoma. A review of the literature confirms the extreme rarity of this risk and, in view of the emerging benefits, argues for reconsideration of epidural technique in vascular patients. The addition of epidural morphine to this combined technique affords a postoperative pain-free continuum unmatched by any other method. This significantly decreased pain stress in cardiac patients increases safety and comfort. In conclusion, epidural anesthesia and postoperative epidural narcotics provide a safe and reliable method of management for patients undergoing vascular procedures.
Subject(s)
Anesthesia, Epidural , Morphine/therapeutic use , Pain, Postoperative/drug therapy , Vascular Surgical Procedures , Anesthetics, Local , Humans , Injections, Epidural , Intraoperative Care , Morphine/administration & dosageABSTRACT
In summary, the clinical goal in regional anesthesia for hand surgery is to constantly approach the ideal of a well-conducted, smooth, "balanced regional technique." This begins with the preoperative interview, assurance, and preoperative sedation (po). In the operating room, monitoring (EKG, BP) and safety measures (IV port, nasal oxygen) precede the regional technique. The block is performed with asepsis, minimal "needling," and correct dosages. The complement to neural blockade anxiolytic medication is titrated, thus the balance of IV sedation and regional block is achieved. The patient's symptoms, vital signs, and general comfort should be attended to during the hand surgery. Monitoring is continued in the recovery room, where special attention is given to positioning, cushioning of pressure areas, dressing, analgesia, and specific physical rehabilitation exercises. With a "balanced regional technique," the patient becomes an early participant in his or her own postoperative care and result. This balanced technique reduces the patient's overall operative risk and maximizes the surgical result.