Treatment of anemia in patients with HIV infection, Part 1: The need for adequate guidelines.

Anemia in HIV-infected individuals, still a common hematologic complication in the highly active antiretroviral therapy (HAART) era, is associated with shortened survival, increases in the rate of disease progression, and reduction in quality of life. Based on a thorough review of the literature, guidelines were developed for the assessment, diagnosis, monitoring, and treatment of anemia in patients with HIV/AIDS by a consensus committee consisting of nurses from academia and clinical practice. A major goal of this committee is to increase awareness within the nursing community of the prevalence of anemia in HIV-infected patients and its impact on their lives. Anemia developed in close to 90% of HIV-infected patients before the introduction of HAART, and it is still found in up to 46% of patients in the HAART era. Another goal is to encourage screening for anemia and the adaptation of a proposed classification system of anemia based on a graded decrease in hemoglobin levels.

Evaluating alternative treatments for HIV infection.

Complementary and alternative medicine (CAM) offers views of disease and its treatment that may not compatible with western medicine. In this review of CAM, the authors provide a strategy by which to evaluate CAM in advanced nursing practice. The strategy is shaped by critiques of how to study CAM in light of the relationships that nurses share with their patients. Expert nursing knowledge of HIV-infected patients, in combination with acquired understandings of CAM, offer nurses additional interventions to use in the management of HIV-related symptoms.

Pre- and posthemodialysis measures of serum albumin levels.

OBJECTIVE: To determine whether there was a difference between pre- and posthemodialysis serum albumin levels and, if so, whether that difference correlated with the amount of fluid removed during treatment. DESIGN: This descriptive study used a comparative data analysis strategy. SAMPLE/SETTING: 287 paired measurements of pre- and post-hemodialysis serum albumin levels were collected from 46 patients in a midwestern hemodialysis center. METHODS: Pre- and posthemodialysis serum albumin levels were obtained using the bromcresol green method. RESULTS: The pretreatment mean for serum albumin levels was 3.875 gm/dL (SD .4) and the posttreatment mean was 4.273 gm/dL (SD .599), significant at p < 0.0001. The amount of fluid removed during treatment was strongly correlated with the difference between pre- and posttreatment albumin levels (R = .6149; p < 0.0001). When data were sub-divided into three groups according to the amount of fluid removed during treatment, the mean differences between pre- and post hemodialysis albumin were significant at p < 0.0001. CONCLUSION: The strong correlation with fluid removed during hemodialysis suggests that fluid overload may be responsible for the significantly higher posttreatment albumin values in most patients.

Complementary and alternative medicine and HIV/AIDS. Part II: Selected literature review.

People with HIV/AIDS are using complementary and alternative medicine (CAM) to improve general health, prevent opportunistic infections, treat symptoms, and reduce side effects from biomedical treatments. This paper reviews the research and narrative literature on CAM use in people with HIV/AIDS and covers (1) nutrition; (2) exercise; (3) traditional and ethno-medicine; (4) miscellaneous products; and (5) psychosocial interventions.

Complementary and alternative medicine and HIV/AIDS. Part I: Issues and context.

This paper reviews the definitions of complementary and alternative medicine (CAM) and adopts the definition, "Complementary and alternative medicine is defined through a social process as those practices that do not form part of the dominant system for managing health and disease" (Jonas, 1996, p.1). The authors review the literature on CAM usage in the general and HIV/AIDS populations, and the impact of CAM on modern Western medicine and the allied health professions. Host-virus factors in HIV/AIDS are examined from the perspectives of both Western medicine and complementary and alternative medicine. Methodological issues and the historical argument over the relative importance of host and microbe are explored in relation to HIV/AIDS and the CAM and Western approaches to HIV/AIDS care.

Mechanical failure of OmniPhase penile prosthesis.

We report a case of mechanical failure due to cable breakage in both cylinders of an OmniPhase penile prosthesis. The failure occurred six weeks after implantation and was manifested by inability to activate the device. X-ray films showed cable fracture at the point of insertion into the activator mechanism bilaterally. This failure appears to be an isolated episode, and the prosthesis has been successfully replaced with a similar device.