African Kaposi's sarcoma in the light of global AIDS: antiblackness and viral visibility.

Drawing on the theoretical frameworks of antiblackness and intersectionality and the concept of viral visibility, this essay attends to the considerable archive of research about endemic Kaposi's sarcoma (KS) in sub-Saharan Africa accrued during the mid-20th century. This body of data was inexplicably overlooked in Western research into KS during the first decade of the AIDS epidemic, during which period European and Mediterranean KS cases were most often cited as precedents despite the volume of African data available. This paper returns to the research on KS conducted in Africa during the colonial and postcolonial period to consider visibility, racial erasure, and discourses of global epidemiology, suggesting that the dynamics of medical research on HIV/AIDS have proceeded according to a tacit paradigm of antiblackness manifest in multiple exclusions of Africa from global health agendas--most recently the exclusion of the region from antiretroviral (ARV) drug therapy during the first decades of the treatment's availability. During that decade KS all but disappeared among people with access to ARV therapy while KS became even more prevalent in sub-Saharan Africa, escalating along with HIV.

Trends in AIDS-defining opportunistic illnesses incidence over 25 years in Rio de Janeiro, Brazil.

OBJECTIVES: To assess the temporal trends in incidence of AIDS-defining opportunistic illnesses in an urban cohort of a middle-income country. METHODS: HIV infected patients aged ≥ 18 years at cohort entry were included in this analysis. We calculated incidence rates per 1000 persons-years of observation for the first opportunistic illness presented after cohort enrollment, from 1987 to 2012. Trends for overall and specific opportunistic illnesses were tested and incidence rate ratios for the most recent calendar period were calculated as the ratio between the incidence rate observed in the most recent period of the study (2009-2012) and the incidence rate observed in first period of the study (1987-1990). RESULTS: Overall, 3378 patients were included in this analysis; of which 1119 (33%) patients presented an opportunistic illness during follow up. Incidence rates of all opportunistic illnesses decreased over time, and the overall opportunistic illness incidence rates fell from 295.4/1000 persons-years in 1987-1990 to 34.6/1000 persons-years in 2009-2012. Tuberculosis, esophageal candidiasis, cerebral toxoplasmosis and Pneumocystis jirovecii pneumonia were the most incident opportunistic illnesses in the cohort. Tuberculosis had the highest incidence rate in the study period. The peak in tuberculosis incidence occurred in 1991-1993 (80.8/1000 persons-years). Cerebral toxoplasmosis was the third most incident opportunistic illness in the study, with a peak of incidence of 43.6/1000 persons-year in 1987-1990. CONCLUSIONS: All opportunistic illnesses incidence rates decreased over the years but they still occur in an unacceptable frequency. Tuberculosis co-infection among HIV-infected persists as an important challenge for health care professionals and policy makers in our setting. Impressively high rates of cerebral toxoplasmosis were found suggesting that its incidence among HIV-infected is linked to the high prevalence of Toxoplasma gondii infection in the general population.

[Sexually transmitted diseases: the impact of stigma and taboo on current medical care]. / Sexuell übertragbare Krankheiten: Die Bedeutung von Stigma und Tabu für die Versorgungsrealität.

Sexually transmitted diseases (STD) are probably the most tabooed diseases we know. The many taboos and the related stigmata shape patients' lives and significantly influence health care policies, medical research, and current problems in medical ethics. To better understand these complex influences, the still powerful taboos and related metaphors associated with illness and disease are analyzed within their cultural and historical background and concerning the actual impact on patient care and research. It becomes obvious that research and health care policies cannot be satisfyingly successful in helping people affected by STDs as long as these "nonscientific" factors are not taken into account.

The new epidemic.

Editor's note: From its first issue in 1900 through to the present day, AJN has unparalleled archives detailing nurses' work and lives over the last century. These articles not only chronicle nursing's growth as a profession within the context of the events of the day, but they also reveal prevailing societal attitudes about women, health care, and human rights. Today's nursing school curricula rarely include nursing's history, but it's a history worth knowing. To this end, From the AJN Archives will be a frequent column, containing articles selected to fit today's topics and times.This month's article, from the November 1982 issue, is the first AJN article published on AIDS. It was early in the epidemic; only 608 cases of Kaposi's sarcoma and opportunistic infections had been reported to the Centers for Disease Control and Prevention-a mere trickle in the flood that was to come. Reading it now, aware of all we've learned since, we have a sense of how much we were fumbling around in the dark in those early days, searching for a cause and a cure, often going in wrong directions. The closest we had come to the true nature of the syndrome was an understanding that "life-style factors seem to be involved and the agent appears to be infectious." To read the complete article from our archives, go to http://bit.ly/1iswhZe.

Retrospective study of Pneumocystis pneumonia over half a century in mainland China.

A retrospective study was performed on case reports of Pneumocystis pneumonia (PCP) from 1959 to 2009 in mainland China. The epidemiological characteristics of PCP over half a century were investigated over two time spans. The first was from 1959, when the first incidence of PCP was reported, to 1984, before the emergence of AIDS in mainland China. The second was from 1985, when the first AIDS case was reported in mainland China, to the end of 2009. A total of 2351 PCP cases were reported during these two time spans, covering a 51-year period. Only seven PCP cases were reported during the first time span. Six were diagnosed by autopsy, accordingly without treatment, whilst the other was diagnosed by open lung biopsy in a living patient who eventually recovered following treatment with sulfadiazine and pyrimethamine. The other 2344 PCP cases were reported during the second time span (1985-2009) from 21 provinces, four municipalities and three autonomous regions. Among the 2344 PCP cases, 70.22 % (1646/2344) were identified together with human immunodeficiency virus (HIV) infection or were in AIDS patients. The remaining 698 non-HIV-infected patients had undergone organ transplantation, had other underlying diseases such as malignancy or hypoimmunity, or had undetermined diagnosis. The results of statistical analysis indicated that AIDS was the most common underlying disease of PCP for patients <1 year and >14 years. For patients aged between 1 and 14 years, haematological malignancy was the most common underlying disease. The trend of the underlying diseases changed with time, showing that the number of PCP patients afflicted by HIV/AIDS increased dramatically, reaching almost threefold during the most recent 5 years compared with the level of the previous 10 years. The number of patients undergoing organ transplantation or with other underlying diseases rose constantly, but the number of malignancies tended to decline from 1995-2004 to 2005-2009. During the second time span (1995-2009), most of the patients (97.61 %) were diagnosed alive and only 56 cases (2.39 %) were identified by autopsy. The mortality of PCP patients treated with anti-Pneumocystis drugs was 14.61 % for those with HIV/AIDS and 15.84 % for those without HIV/AIDS. For the PCP patients without anti-Pneumocystis treatment, all (100 %) of the HIV/AIDS-associated PCP patients died, whilst 13.79 % (4/29) of non-HIV-infected PCP patients survived. These data from epidemiological investigation of PCP in China over a period of half a century may provide useful information for prevention and the development of treatment of PCP.

Toxoplasmosis: A history of clinical observations.

It has been 100 years since Toxoplasma gondii was initially described in Tunis by Nicolle and Manceaux (1908) in the tissues of the gundi (Ctenodoactylus gundi) and in Brazil by Splendore (1908) in the tissues of a rabbit. Toxoplasma gondii is a ubiquitous, Apicomplexan parasite of warm-blooded animals that can cause several clinical syndromes including encephalitis, chorioretinitis, congenital infection and neonatal mortality. Fifteen years after the description of T. gondii by Nicolle and Manceaux a fatal case of toxoplasmosis in a child was reported by Janku. In 1939 Wolf, Cowen and Paige were the first to conclusively identify T. gondii as a cause of human disease. This review examines the clinical manifestations of infection with T. gondii and the history of the discovery of these manifestations.

Relato histórico de la infectología española / History of Infectious Diseases in Spain

En el presente manuscrito se hace un breve resumen de lo que ha sido la historia de la infectología en España. Se consideran cuatro secciones referidas, en primer lugar, a los orígenes de una especialidad fruto de la necesidad de contar con expertos que dieran solución de una forma práctica y moderna a los diferentes problemas planteados por los pacientes con enfermedades infecciosas. En segundo lugar, la aparición del sida al comienzo de los años ochenta dio lugar a un enorme florecimiento en el campo de las enfermedades infecciosas, que trajo consigo la creación de unidades específicas dedicadas no sólo al control de los problemas asociados directamente con la infección por el virus de la inmunodeficiencia humana, sino al tratamiento de las infecciones oportunistas con comitantes. En tercer lugar, en estos últimos años ha despuntado de forma alarmante el problema de la infección nosocomial, problema de plena actualidad que obliga a la presencia de infectólogos expertos en este campo. Finalmente, la emigración y los viajes han requerido de los especialistas en enfermedades infecciosas una formación especial en salud internacional, lo que acrecienta la importancia de la disciplina de infectología (AU)

This paper includes a brief summary of the clinical historyof the diagnosis and treatment of infectious diseases in Spain. Firstly, the origins of a specialty arising from the need for specialists to attend to, in a practical and modern form, the different health problems of patients affected by infectious diseases, are described. Secondly, the appearance of AIDS, at the beginning of the 1980’s, prompted the creation of specific units dedicated to the care of problems associated with human immunodeficiency virus (HIV) infection and the concomitant opportunistic infections arising from the immunodeficiency arising from the HIV infection. Thirdly, in the last decades and even today, nosocomial infections have appeared as an alarming problem, needing the presence of specialist physicians in this field. Finally, emigration and international travel require specialists ininfectious diseases with specific expertise in international health, once more highlighting the importance of the specialty of Infectious Diseases (AU)

[History of the infectious disease specialty in Spain]. / Relato histórico de la infectología española.

This paper includes a brief summary of the clinical history of the diagnosis and treatment of infectious diseases in Spain. Firstly, the origins of a specialty arising from the need for specialists to attend to, in a practical and modern form, the different health problems of patients affected by infectious diseases, are described. Secondly, the appearance of AIDS, at the beginning of the 1980's, prompted the creation of specific units dedicated to the care of problems associated with human immunodeficiency virus (HIV) infection and the concomitant opportunistic infections arising from the immunodeficiency arising from the HIV infection. Thirdly, in the last decades and even today, nosocomial infections have appeared as an alarming problem, needing the presence of specialist physicians in this field. Finally, emigration and international travel require specialists in infectious diseases with specific expertise in international health, once more highlighting the importance of the specialty of Infectious Diseases.

Fatores imunogenéticos envolvidos na progressäo para a AIDS / Immunogenetic factors involved in the progression to AIDS

A síndrome da Imunodeficiência Adquirida - AIDS - é uma doença caracterizada pela progressäo para graves infecçöes oportunistas e neoplasias resultantes da progressiva imunossupressäo adquirida após a infecçäo pelo HIV. A variedade de padröes temporais para iniciaçäo e progressäo para a AIDS leva-nos à hipótese da existência de vários fatores desencadeadores da doença

Microbiota fúngica conjuntival: estudo comparativo entre pacientes com AIDS, pacientes infectados pelo HIV e pacientes HIV-negativos antes da era do HAART / Fungal microbiota: comparative study between patients with acquired immuno-deficiency syndrome, patients infected with human immunodeficieny virus and immunocompetent individuals before the HAART era

Foi pesquiasda a presença de fungos na conjuntiva ocular de 23 pacientes com AIDS, 24 pacientes infectados pelo HIV, ambos de controle ambulatoraial e 48 indivíduos HIV negativos, durante um ano, nos meses de fevereiro, abril, julho e outubro. O fungo mais isolado foi Penicillium sp, seguido de Aspergillus sp, Candida sp e Rhodotorula sp. Embora sem diferença significante, em todas as coletas foi verificados um crescimento maior de fungos na conjuntiva dos portadores de AIDS, seguido pelo grupo infectado pelo HIV e em menor número nos individuos HIV-negativos