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1.
Anim Reprod Sci ; 79(1-2): 17-32, 2003 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-12853176

RESUMO

Prostaglandin F(2alpha) is used in dairy herd management because of its luteolytic properties and for its direct effect on the myometrium in cows diagnosed with endometritis. Prostaglandin E(2) has a contractile effect on the bovine uterus. In human medicine, prostaglandin E(2) is routinely used to maintain labor and to ripen the cervix. We hypothesized, that a combination of prostaglandin F(2alpha) and prostaglandin E(2) would provoke a long-lasting increase in intrauterine pressure (IUP) and uterine motility as compared to either prostaglandin group. Intrauterine pressure was recorded during the diestrus of eight lactating dairy cows using a transcervically placed intraluminal pressure microtransducer. After recording of physiologic uterine motility for 30min, prostaglandins (DL-cloprostenol, PGE(2), PGE(2) in combination with D-cloprostenol) or placebo were administered, followed by a 2h recording period. Significant differences were found for the area under the curve, the mean amplitude and the intrauterine pressure, whereas the number of pressure waves did not differ significantly among treatments. Peak values for area under the curve and mean amplitude were found during the first 15min for the combination of PGE(2) and D-cloprostenol. During the last 15min of the recording session, area under the curve and mean amplitude were increased only for the combination of PGE(2) and D-cloprostenol as compared to placebo. Although PGF(2alpha) and PGE(2) provoke an increase in intrauterine pressure, only their combination guarantees a significant effect over a 2h recording period.


Assuntos
Bovinos/fisiologia , Cloprostenol/farmacologia , Diestro , Dinoprostona/farmacologia , Útero/efeitos dos fármacos , Útero/fisiologia , Animais , Cloprostenol/administração & dosagem , Dinoprostona/administração & dosagem , Dinoprostona/efeitos adversos , Feminino , Placebos , Pressão , Progesterona/sangue , Contração Uterina/efeitos dos fármacos
2.
Reprod Domest Anim ; 38(1): 41-9, 2003 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-12535328

RESUMO

This study aimed to assess the effect of ketone body status early postpartum on time empty in 74 multiparous dairy cows under field conditions. Animals were equally distributed across eight farms and were controlled by the same herd-fertility-monitoring programme. Cows were visited twice antepartum and six times postpartum at weekly intervals between 0530 and 0830 a.m. On these occasions, body condition scores and milk yields were measured, blood and milk samples were taken, cows were gynaecologically examined, and parameters of reproduction were recorded. Cows with a time empty of less or more than 80 days were classified as early and late conceiving cows (EC and LC, respectively). A time empty of 80 days results in calving-to-calving intervals of 1 year and classification based on this threshold value resulted in groups of equal size and equal distribution of EC and LC within farms. Ketone bodies measured were beta-hydroxybutyrate in blood and acetoacetate and acetone in blood and milk. Blood and milk ketone body concentrations, as well as the ratios of acetoacetate and acetone to beta-hydroxybutyrate, over the first 6 weeks postpartum were higher in LC than in EC, whereas plasma glucose and non-esterified fatty acids and milk fat, protein and urea concentrations did not exhibit clear differences between groups. Ketone body concentrations were as good predictors of time empty as ketone body ratios and might have practical impact in herd-fertility-monitoring programmes.


Assuntos
Bovinos/fisiologia , Corpos Cetônicos/análise , Leite/química , Período Pós-Parto/fisiologia , Acetoacetatos/análise , Acetoacetatos/sangue , Acetona/análise , Acetona/sangue , Animais , Glicemia/análise , Ácidos Graxos não Esterificados/análise , Feminino , Nível de Saúde , Hidroxibutiratos/análise , Hidroxibutiratos/sangue , Corpos Cetônicos/sangue , Lactação , Leite/metabolismo , Proteínas do Leite/análise , Gravidez , Fatores de Tempo
3.
J Vet Med A Physiol Pathol Clin Med ; 49(9): 455-60, 2002 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-12489867

RESUMO

Relationships between body condition scores (BCS), metabolic profiles and endocrine traits were investigated in 53 healthy Red Holstein cows. Cows were categorized into groups based on BCS ante-partum (a.p.: >3.25 or < 3.25) and on BCS losses during the first 8 weeks after calving (ABCS8 > 0.75 or < or = 0.75). Blood samples were collected 1 week before calving and every 2 weeks post-partum (p.p.). Cows with BCS a.p. >3.25 and deltaBCS < or = 0.75 were oldest and cows with BCS a.p. < or = 3.25 and deltaBCS < or = 0.75 were youngest. Cows with BCS > 3.25 a.p. and that lost > 0.75 BCS in the first 2 months of lactation exhibited signs of subclinical ketosis. If statistically adjusted for the effect of lactation number, average milk yield within the first 8 weeks p.p. and milk fat concentrations were similar between BCS groups, whereas milk protein concentrations differed significantly between BCS groups. Significant differences between groups were observed for blood plasma glucose, bilirubin, beta-hydroxybutyrate, non-esterified fatty acids and insulin concentrations. No differences were seen for albumin, urea, insulin-like growth factor-1, and 3.5.3'-triiodothyronine concentrations and for plasma activities of glutamate-oxalacetate transaminase, gamma-glutamyltransferase and glutamate dehydrogenase. There was a good agreement between BCS and profiles of metabolites and hormones related to energy metabolism in clinically healthy cows. Cows in good body condition a.p. had greater risks of metabolic problems because of excessive mobilization of body reserves. However, the metabolic status was best in cows with a BCS > 3.25 a.p.. if they did not lose much body condition p.p.


Assuntos
Bovinos/metabolismo , Sistema Endócrino , Metabolismo Energético , Lactação , Condicionamento Físico Animal , Prenhez/metabolismo , Ácido 3-Hidroxibutírico/sangue , Animais , Bilirrubina/sangue , Glicemia/metabolismo , Estudos de Coortes , Indústria de Laticínios , Ácidos Graxos não Esterificados/sangue , Feminino , Insulina/sangue , Período Pós-Parto , Gravidez , Valores de Referência
4.
Anim Reprod Sci ; 70(3-4): 171-80, 2002 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-11943487

RESUMO

Myometrial smooth muscle strips were collected from slaughtered cows in estrus and diestrus. Longitudinal and circular smooth muscle strips were mounted in organ baths and after equilibration time and 2g preload, their physiologic contractility was recorded for 3h. Area under the curve (AUC), mean amplitude (MA) and frequency of contractions (F) were studied. Differences between cycle phases, between muscle layers and over the recorded time period were statistically evaluated. In the cow, physiologic contractility patterns (measured as AUC and MA) of circular versus longitudinal myometrial strips are always different during the 3h recording. Significant differences between estrus versus diestrus are only found for circular layers, but not for longitudinal layers. Significant differences over time are only found for longitudinal layers.


Assuntos
Bovinos/fisiologia , Diestro/fisiologia , Estro/fisiologia , Contração Uterina , Animais , Estradiol/sangue , Feminino , Técnicas In Vitro , Músculo Liso/fisiologia , Miométrio/fisiologia , Progesterona/sangue
5.
Theriogenology ; 56(2): 199-210, 2001 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-11480613

RESUMO

Bovine viral diarrhea virus is a major cattle pathogen with a worldwide distribution. Animals may be infected with BVD virus transiently or persistently. Transient infection leads to protective immunity. Persistent infection is unique because it is associated with an immunotolerance that is specific to the infecting strain of BVD virus. Persistent infection results from viral invasion of fetuses between the second and fourth month of development. Such animals are of prime importance in the epidemiology of BVD because they shed large amounts of virus, and thus serve as a constant source of infection for non-immune animals. Infection of pregnant animals during the first two months of gestation may result in an increased rate of return to estrus. Animals infected in the period of five months to birth may abort or give birth to calves with malformations. The effects of BVD virus on fertility and gestation are well documented from experimental infection. However, much less is known of the extent of losses under field conditions. The main reason for this may be the multitude of other causes of increased return rates and gestation failures. In addition, the incidence of infection with BVD virus may vary over time and depends on management practices. In this study, we investigated the impact of BVD virus on gestation failures under field conditions in a large cattle-breeding area of Switzerland, where no specific measures to control BVD are in effect. Our approach consisted of relating seroconversions to BVD virus with the rate of return to estrus, abortion, and birth of calves with apparent malformations. These parameters of fertility were compared to those of animals immune to BVDV infection due to previous exposure to the virus and animals without seroconversion. Our data show that infection with BVD virus during the first 45 days of gestation did not influence the rate of return to estrus. By contrast, we observed a statistically significant increase in the abortion rate in mid-term gestation (Days 46 to 210) while no such effect was observed in the later stages of gestation. No clinically manifest malformations were observed in the offspring of animals that had seroconverted to BVD virus. In our study population the prevalence of BVDV antibody positive cattle varied only slightly between 78% and 80% over the period of observation. Our data showed that 7% (CI: 2.4-14%) of fetal deaths may be attributable to infection with BVD virus.


Assuntos
Doença das Mucosas por Vírus da Diarreia Viral Bovina/complicações , Indústria de Laticínios , Morte Fetal/veterinária , Infertilidade Feminina/veterinária , Complicações Infecciosas na Gravidez/veterinária , Animais , Anticorpos Antivirais/análise , Bovinos , Vírus da Diarreia Viral Bovina , Feminino , Morte Fetal/etiologia , Morte Fetal/virologia , Infertilidade Feminina/etiologia , Gravidez , Complicações Infecciosas na Gravidez/etiologia
6.
Theriogenology ; 54(5): 685-701, 2000 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-11101031

RESUMO

The effect of ketone body status on occurrence of first ovulation during early lactation was assessed in 84 multiparous dairy cows under field conditions. Animals were equally distributed across 8 farms and were controlled by the same herd fertility monitoring program. Cows were visited twice antepartum and 6 times postpartum at weekly intervals between 5:30 and 8:30 AM. On these occasions, body condition scores and milk yields were measured, blood and milk samples were taken, cows were gynecologically examined, and parameters of reproduction were determined. The onset of first ovulation was specified by milk progesterone determination and rectal palpation. Cows starting postpartum ovarian cyclicity within or after 30 d were classified as early and late responders (ER and LR, respectively). Resumption of the estrous cycle within 30 d postpartum is considered optimal under practical conditions, and classification based on this threshold value resulted in groups of equal size and equal distribution of ER + LR cows within farms. Ketone bodies measured were beta-hydroxybutyrate in serum and acetoacetate and acetone in serum and milk. Blood serum and milk ketone body concentrations during the first 6 wk of lactation were higher in LR than in ER, whereas plasma glucose and nonesterified fatty acid and milk fat, protein and urea concentrations did not differ between groups. Maximal concentrations of ketone bodies from parturition to first ovulation were better predictors of the onset of the estrous cycle than mean or minimal concentrations over the same period. Milk acetone and serum beta-hydroxybutyrate concentrations provided the most reliable information with regard to resumption of ovarian activity of all ketone bodies.


Assuntos
Bovinos/fisiologia , Corpos Cetônicos/biossíntese , Leite/metabolismo , Ovulação/fisiologia , Ácido 3-Hidroxibutírico/análise , Ácido 3-Hidroxibutírico/sangue , Acetoacetatos/análise , Acetoacetatos/sangue , Acetona/análise , Acetona/sangue , Animais , Glicemia/análise , Ensaio de Imunoadsorção Enzimática/veterinária , Ácidos Graxos/sangue , Feminino , Corpos Cetônicos/análise , Corpos Cetônicos/sangue , Lactação , Leite/química , Proteínas do Leite/análise , Período Pós-Parto , Progesterona/análise , Ureia/análise
7.
Theriogenology ; 54(2): 291-303, 2000 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-11003309

RESUMO

Studies in human medicine proved the important role of prostaglandin E2, which stimulates uterine contractions in vivo and in vitro and has been extensively used to ripen the cervix around labor. We wanted to demonstrate that increasing the dosage of prostaglandin E2 (1.25 mg, 2.5 mg, 5 mg and 10 mg) provokes an increase in intrauterine pressure and uterine motility in cattle. Five healthy, lactating dairy cows were used as experimental animals for this study. Intrauterine pressure was recorded during the diestrus phase (1 recording per cow and diestrus phase) by means of a transcervically placed intraluminal pressure microtransducer. Physiologic uterine motility was recorded for 30 min, then placebo or one of the prostaglandin E2- dosages was administered through an indwelling catheter in the jugular vein, followed by a 2-h recording period (eight 15-min periods). Area under the curve (AUC), mean amplitude, frequency of pressure waves and intrauterine pressure were analyzed. Furthermore, we recorded protocols for monitoring heart and respiratory rates and side effects at 9 given examination times. Significant differences were found for the AUC, the mean amplitude and the intrauterine pressure (P < or = 0.05), whereas the number of pressure waves per 15 min did not differ significantly among treatments. Peak values for AUC, mean amplitude and intrauterine pressure were found during the first 15 min after administration of 10 mg of prostaglandin E2. Dose-effect curves showed that the 2.5 mg dosage provided the optimal ratio between myometrial stimulation and undesirable side-effects.


Assuntos
Bovinos/fisiologia , Dinoprostona/fisiologia , Útero/fisiologia , Animais , Área Sob a Curva , Diestro/fisiologia , Dinoprostona/administração & dosagem , Relação Dose-Resposta a Droga , Feminino , Frequência Cardíaca , Processamento de Imagem Assistida por Computador , Técnicas Imunoenzimáticas/veterinária , Análise dos Mínimos Quadrados , Análise Multivariada , Projetos Piloto , Pressão , Progesterona/sangue , Estatísticas não Paramétricas , Transdutores de Pressão/veterinária , Útero/efeitos dos fármacos
8.
J Vet Med A Physiol Pathol Clin Med ; 47(10): 609-15, 2000 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11199209

RESUMO

Data from 3276 cows with 6598 lactations in 85 herds participating in a herd health monitoring programme were selected for an observational study. Cases of endometritis were diagnosed based on a clinical examination after 21 days postpartum. The cases were grouped by the severity of endometritis (mild, severe) and by the treatment performed (intrauterine infusion, prostaglandin injection, no treatment). The conception rates and the calving-to-conception intervals of these groups were compared statistically. Conception rate was lower in cows with severe endometritis compared to cows with mild endometritis while it did not differ between treatment groups. In cows with mild endometritis a significantly longer calving-to-conception interval was observed if intrauterine infusions were performed compared to the other two treatment options. The occurrence of other fertility problems during the same service period had a significant effect on conception rate and calving-to-conception intervals. In cows with severe endometritis intrauterine or prostaglandin treatments appeared to be beneficial, whereas intrauterine infusions in cows with slight endometritis had a negative effect on reproductive efficiency.


Assuntos
Doenças dos Bovinos/fisiopatologia , Endometrite/veterinária , Fertilidade , Prostaglandinas/administração & dosagem , Animais , Anti-Infecciosos/administração & dosagem , Bovinos , Doenças dos Bovinos/tratamento farmacológico , Endometrite/tratamento farmacológico , Endometrite/fisiopatologia , Feminino , Gravidez , Taxa de Gravidez , Estudos Retrospectivos
9.
Zentralbl Veterinarmed A ; 46(6): 345-52, 1999 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10481613

RESUMO

Prostaglandins are commonly used in herd management for their luteolytic properties; however, prostaglandins also have a direct contractile effect on the myometrium. We hypothesized that different dosages (0.15 and 0.3 mg) of d-cloprostenol, a synthetical prostaglandin F2 alpha preparation, would differ as to their contractile effects on the uterus. Intrauterine pressure was recorded during dioestrus of lactating dairy cows, using a transcervically placed intraluminal pressure microtransducer. After recording of physiological uterine motility for 30 min, a placebo or d-cloprostenol at one of the two different dosages was administered intramuscularly, followed by a 2-h recording period. Significant differences were found for the area under the curve (P < or = 0.05) and mean amplitude (P < or = 0.05), whereas the number of spikes per 15 min and the baseline pressure during the last 3 min of every 15-min period did not differ significantly among treatments. Peak values for area under the curve and mean amplitude were found between 15 and 30 min after administration of the lower dosage of d-cloprostenol, and between 75 and 90 min after administration of the higher dosage. Using the higher dosage of d-cloprostenol, a steady plateau from 15 to 30 min after administration until the end of the recording session was obtained. Thus, double the luteolytic dose of the d-cloprostenol preparation gives a significantly better reaction in terms of uterine contractility than the single dose.


Assuntos
Bovinos/fisiologia , Cloprostenol/farmacologia , Útero/efeitos dos fármacos , Animais , Cloprostenol/administração & dosagem , Diestro/efeitos dos fármacos , Diestro/fisiologia , Feminino , Lactação/efeitos dos fármacos , Lactação/fisiologia , Estudos Prospectivos , Distribuição Aleatória , Estereoisomerismo , Contração Uterina/efeitos dos fármacos , Útero/fisiologia
10.
Theriogenology ; 50(3): 445-55, 1998 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10732137

RESUMO

Prostaglandins are widely used in herd management due to their luteolytic properties. They have also a direct effect on the myometrium. We hypothesized, that dissimilar prostaglandin preparations would differ as to their contractile effect. Intrauterine pressure was recorded during the diestrus of lactating dairy cows using a transcervically placed intraluminal pressure microtransducer. After recording physiologic uterine motility for 30 min, prostaglandins (dinoprost, DL-cloprostenol, D-cloprostenol) or a placebo was administered intramuscularly, followed by a 2-h recording period. Significant differences were found for the area under the curve (P < or = 0.05) and mean amplitude (P < or = 0.05), whereas the number of spikes per 15 min and the baseline pressure during the last 3 min of every recording period did not differ significantly among treatments. Peak values for area under the curve and mean amplitude were found between 15 and 30 min after administration of DL-cloprostenol, while dinoprost yielded the steadiest plateau from this period until the end of the recording session. These results contrast with those of earlier studies comparing prostaglandins after intravenous administration.


Assuntos
Bovinos/fisiologia , Eletromiografia , Prostaglandinas/farmacologia , Útero/efeitos dos fármacos , Animais , Cloprostenol/farmacologia , Dinoprosta/farmacologia , Feminino , Pressão , Progesterona/sangue , Útero/fisiologia
11.
Schweiz Arch Tierheilkd ; 139(7): 303-7, 1997.
Artigo em Alemão | MEDLINE | ID: mdl-9281060

RESUMO

In a retrospective study the gestation lengths of two groups, each consisting of 193 "Freiberger" mares, were compared. The mares of the first group were bred by a donkey, those of the second group by a stallion of the "Freiberger" breed. On average, the gestation length of mares with "Freiberger" foals lasted 336.5 days, and that of mares with mule foals 343.1 days. The difference between both groups was significant (p < 0.001). The shortest and longest observed gestation length of mares with "Freiberger" foals was 307 and 361 days, and that of mares with mule foals 315 and 369 days, respectively. Additionally, we examined if the stallion, the mare, the age of the mare, the sex of the foal and the time of mating during the breeding season influenced gestation length of mares with mule foals and if the age of the mare, the sex of the foal and the time of breeding influenced gestation length of mares with "Freiberger" foals. The time of breeding and the mare had a significant (p < 0.05) influence on gestation length.


Assuntos
Equidae/fisiologia , Cavalos/fisiologia , Hibridização Genética/fisiologia , Prenhez/fisiologia , Fatores Etários , Animais , Cruzamento , Feminino , Masculino , Gravidez , Estudos Retrospectivos , Fatores Sexuais , Fatores de Tempo
12.
Theriogenology ; 44(2): 233-46, 1995 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-16727723

RESUMO

We investigated morphometrically and densitometrically LH, FSH, PRL, and ACTH cells in pituitary glands in cows with follicular cysts and normal animals. Three groups were considered: cows in diestrus, cows in periestrus and cows with follicular cysts. The periestrous group was obtained by merging pro- and metaestrous groups, since the two did not differ when evaluated separately. The attribution to groups was confirmed by plasma progesterone measurements and by postmortem examination of the ovaries. After immunocytochemical labeling the pituitary cells were counted, and their area and total immunoreactivity were measured. The results suggest hypofunction of the LH cells (P < 0.05) and hyperfunction of the ACTH cells (P < 0.05) from the cows of the follicular cyst group. The FSH and PRL cells were similar in the three groups. These changes are consistent with the reduced LH release reported by most authors in cows with follicular cysts and should be relevant to the pathogenesis of the bovine follicular cysts. The subnormal activity of LH cells might be secondary to the activation of the ACTH cells.

13.
Schweiz Arch Tierheilkd ; 133(8): 365-9, 1991.
Artigo em Alemão | MEDLINE | ID: mdl-1962179

RESUMO

Eighty-one cows with ovarian cysts were treated with one group receiving 1500 IU HCG/150 mg progesterone and the other group receiving 5000 IU HCG/300 mg progesterone. A second examination was performed two weeks later. Milk progesterone levels were determined both initially and at the follow-up examination. No significant relationships were observed between firmness of the wall of the cysts as well as other clinical signs and the progesterone values. The examination two weeks later revealed similar findings for both treatments with a great variability within the groups. Normal ovarian activity was observed in slightly more than half of the animals. The discussion of the findings also considers the high tendency of ovarian cysts for spontaneous regression.


Assuntos
Doenças dos Bovinos/tratamento farmacológico , Gonadotropina Coriônica/uso terapêutico , Cistos Ovarianos/veterinária , Progesterona/uso terapêutico , Animais , Bovinos , Quimioterapia Combinada , Feminino , Cistos Ovarianos/tratamento farmacológico
15.
Schweiz Arch Tierheilkd ; 132(7): 353-64, 1990.
Artigo em Alemão | MEDLINE | ID: mdl-2218470

RESUMO

32 young and healthy cows each received a single intrauterine treatment with one of the following solutions: Lugol's solution, Vetedine, Lorasol, Lotagen, Aureomycin, and normal saline solution as a control. Endometrial biopsies were taken immediately before application and at days 1, 3, 6, 10, 15, 20 and 30 thereafter. On day 1, degenerative and inflammatory reactions could already be observed in all groups, with the exception of the control group. The intensity of the lesions varied, not only between treatment groups but also to a lesser extent between individuals within groups. Degeneration and inflammatory reaction found in the subepithelial stromal tissues were more distinct than those seen in the epithelia. Lorasol caused the most severe degenerative changes, regarding the depth of degeneration into the tissue, as well as the intensity of the inflammatory reaction. Lugol's solution also showed a high degree of change, followed by Lotagen and Vetedine showing moderate change, respectively. Reaction to the antibiotic treatment with Aureomycin was only slight. The regeneration time of these lesions was proportional to the intensity of the induced changes, amounting to 10-15 days for Lorasol and 3-6 days for Aureomycin, respectively. The clinical significance of these findings is discussed.


Assuntos
Anti-Infecciosos/toxicidade , Doenças dos Bovinos/induzido quimicamente , Endometrite/veterinária , Endométrio/efeitos dos fármacos , Animais , Bovinos , Clortetraciclina/toxicidade , Cresóis/toxicidade , Combinação de Medicamentos , Endometrite/induzido quimicamente , Feminino , Formaldeído/toxicidade , Iodetos/toxicidade
16.
Psychother Psychosom Med Psychol ; 39(11): 381-9, 1989 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-2587688

RESUMO

After an average observation time of 12 months we can confirm that methadone substitution on an outpatient basis has proved significantly useful for a majority of chronically intravenously opiate-dependent HIV-infected patients of the stages CDC IV or WR 3-6 if methadone is given under controlled conditions, the improvement consisting in an amelioration of certain medical and psychosocial parameters. In 25 out of 30 patients methadone substitution resulted in termination of the previously existing intravenous heroin addiction. In the further course of treatment one of these 25 patients could then be induced to undergo a methadone withdrawal course followed by long-term withdrawal therapy. Since the patients were no longer dependent on heroin, they were no longer compelled to procure it under all circumstances, so that crime and prostitution connected with the pressure to obtain heroin by all means were now superfluous. This provided the most important prerequisites for medical and social care for the patients. The decisive factors determining the effectivity of substitution and hence a successful stabilisation are the integration of the patient in a network of care including the family doctor, outpatient HIV care by a relevant clinic, drug advice centre of AIDS help, and a Public Health Office. This also guarantees that the patients act responsibly in respect of their AIDS infection. In very few patients the permanent success of the treatment was at high risk due to unsatisfactory social care, lack of social security measures, progression of the underlying disease, a too low methadone dosage level, and partnership conflicts.


Assuntos
Infecções por HIV/prevenção & controle , Dependência de Heroína/reabilitação , Metadona/uso terapêutico , Ajustamento Social , Abuso de Substâncias por Via Intravenosa/reabilitação , Adulto , Feminino , Seguimentos , Infecções por HIV/transmissão , Humanos , Masculino , Estudos Prospectivos , Fatores de Risco
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