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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”

 


AIDS/HIV & Hepatitis:
Miscellaneous Articles

Main topics can be found within the left column; sub-topics and/or research reports can be found near the bottom of this page.  Thank you

 

 

 

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"Our nation has been in the fight against HIV/AIDS for over 20 years now. The government pours millions of dollars into care, treatment and prevention. Why are there still so many Black people becoming infected and dying from this virus? We know from reports that there are health disparities between communities of color and the white population. We also know that in communities of color there is an inherited mistrust of the system. Do these reasons equate to the disproportionate amount of black people infected by this disease? Yes, they do play a part, but only a part. African Americans have other obstacles, which put them on the frontline of this virus.

Many people in Black communities are under the misguided perception that AIDS is a disease that only affects the gay population and those people who misuse drugs. In the 1980s, the gay and lesbian community did a great job of putting a face on this horrific virus, and should be commended. They refused to let their brothers die in silence. Now the time has long passed for the other faces of AIDS to be brought to the forefront. Black communities around the country need to rise up and refuse to perish without a fight. We should not pass silently into the night.

Many of those who lose the battle to AIDS in the Black community are not counted as those who have fallen to this virus. Cancer, pneumonia, or heart attacks are causes of death that we tell our family and friends. Those who are infected still fear letting others know on the chance they may be ostracized from family, friends, and the community at large. Many continue to die alone with no one to hold their hands or wipe their brows. Far too many do not seek care fearing that family and neighbors will discover the secret. Still others do not test, wrongly believing that ignorance is bliss. Shame is robbing our community of its lifeline and its future.

Even our churches, which have been a bastion of support in the Black community for many worthy causes, have not risen to this fight in appropriate numbers. Ministers continue to blame those who are infected for being immoral and sinners. How sad it is that some of our churches take this view. Some of our politicians are saying teach abstinence-only in our schools. Abstinence-only has been taught for many years and we still have a problem in this country with teen pregnancy. We cannot allow our children to die using antiquated solutions, which have never proven effective. If we do not become educated about this disease, if we do not drag AIDS out of the shadows where it has been able to fester and grow in our communities, then we will perish. The shame and ignorance surrounding AIDS in Black America could lead to the demise of us all.

We are in a burning building and only a few are shouting for all of us to get out." Dying in Silence-African Americans

ADDITIONAL ARTICLES:

Document Name & Link to Document

Description

File Size /pdf

HARMLESS VIRUS ASSOCIATED WITH LONGER LIFE FOR SOME HIV-POSITIVE MEN

Scientists have shown that an apparently harmless virus is associated with longer life for HIV-positive men, but only when it infects them for many years.

 

HEALTH AND HEALTH CARE OF Southeast Asian American Elders While Southeast Asian refugees and immigrants have the Vietnam War, refugee experiences and acculturation issues in common, there is wide diversity within and across the ethnic groups that comprise the Southeast Asian population. These include: degree of Westernization and acculturation, education and literacy in the home country; migration history; social class and social backgrounds; English and other linguistic skills; social supports; age at immigration, and years in the United States.  
HEALTHCARE WORKERS: PROTECTING THOSE WHO PROTECT OUR HEALTH Healthcare-worker protection has lagged behind that afforded other workers with similarly increased risks. Possible explanations for the delay in focusing on occupational hazards faced by healthcare workers are many and likely include the focus of curative rather than preventive medicine in the hospital environment; the focus on patient health over worker health; and the focus within occupational health on traditionally male occupations and hazards rather than female workers.  
Health Emergency 1999: The Spread of Drug-Related AIDS and Other Deadly Diseases Among African Americans and Latinos This powerful report brings home the severity of the problem of AIDS spread through dirty needles. It makes me angry! We have got to be about preventing disease! We have better drugs, but we still donít have a vaccine or a cure for this disease. We have watched people die from this disease; now they must learn how to live with HIV/AIDS. But why canít we help prevent this disease by providing clean needles? We do not allow people to get the clean needles that would reduce the spread of HIV disease, yet we spend $155,000 or more for each person who develops AIDS to take care of them, to watch them die. That makes no sense! We have got to be about preventing problems, not fixing things after they are broken.  
Health, Wealth, and Welfare New evidence coupled with a wider perspective suggest sizable economic returns to better health 301 kb pdf
Hepatitis B Virus infection: A comprehensive immunization strategy to eliminate transmission in the US-Draft  (Large paper-increase download time) This document updates the immunization strategy to eliminate hepatitis B virus transmission in the US, which was published in 1991 and expanded in 1995.  The document also updates technical information on HBV vaccination of infants, children, adolescents, and adults. 2209 kb pdf

Hepatitis C and diabetes: two rising epidemics

An association between HCV infection and Diabetes Mellitus has been observed since a 1994 study by Allison and colleagues. In this study of 100 patients with cirrhosis, 50% of those with hepatitis C-related cirrhosis had diabetes, compared with only 9% of patients with cirrhosis unrelated to hepatitis C.

 

Hepatitis C-a guide to understanding Hepatitis C

A history of the disease progression and current treatments that is available.

276 kb pdf

Hepatitis C Primer for HIV Care Providers PowerPoint Presentation 263 kb

Hepatitis C Symptom Emergencies

The side effects associated with medications for hepatitis C treatment can cause a range of side effects, from mild to severe and life threatening. In this article we review some of the most serious side effects, those that may require immediate medical attention.

 

Hepatitis C virus replication seen in patients with apparent viral clearance Hepatitis C virus (HCV) can persist and replicate in the livers of patients who have apparently cleared the virus from their blood after antiviral therapy, according to a report in the November 15th issue of Clinical Infectious Diseases.  

HIV lessons used in Hepatitis C treatment

Drug companies are beginning to test drugs that interfere with enzymes that hepatitis C virus needs to replicate, like protease and polymerase;

 

Hepatitis C viral load ultrasensitive testing

The information below (the TMA study I reported toy you that was presented here at AASLD) compared a highly sensitive TMA qualitative test to LabCorp/NGI's highly sensitive quantitative test (apples/oranges) Our Hepatitis C Virus quantitative test (Hepatitis C Virus SuperQuant) has a sensitivity of 100 copies / 39 IU's w/ a dynamic range to 5 million copies / 2 million IUs.

 

Healthcare workers fair poorly in AIDS quiz

A quiz among health care workers at a Durban hospital had exposed "substantial gaps" in their knowledge of HIV/Aids, delegates to a conference on the disease heard on Monday.

 

Health spending growing faster than economy

For the first time in almost a decade, federal health economists reported January 8, health expenditures outpaced the growth of the economy.

 

Helping Teens Ward Off STD's

Screening, education are key to combatting sexually transmitted diseases, study says

 

Henry E Sigerist Medical Historian & Social Visionary

Sigerist now emerged as a major spokesman for "compulsory health insurance" and was much sought after as a lecturer, popular author, and radio commentator

 

Hepatitis B booster vaccination for Healthcare workers

The findings suggest that booster shots are the best way to keep immunity stable, especially for the at-risk healthcare workers

 

Hepatitis B Vaccine Brand Changed

The CDC considers both Engerix-B® and Recombivax HB® to be safe and effective in the prevention of hepatitis B infections. The immune response using one or two doses of a vaccine, followed by one or more subsequent doses from a different manufacturer, has been demonstrated to be comparable to a full vaccination series with a single product.

 

Her Own STD Barrier

"Women deserve more options than begging their husbands to use a condom," says Sharon Hillier,

 

High-Income Americans Opt Out of High-Cost Health Insurance

As health insurance premiums continue to rise, more and more people are opting to take their chances and go without. Of the 41 million Americans currently uninsured, the largest portion is made up of the working poor, but those with high-incomes are quickly joining in, as growth in uninsured wealthy and poor rose almost equally last year.

 

HIV Vaccines: Could Vaccine Alter Course of HIV Disease?

The new data identify stage-independent predictors of disease progression. Examination of these predictors in AIDS- vaccine recipients with breakthrough HIV infection should indicate whether the vaccine can change the course of disease.

 

HIV/AIDS: Epidemic Update 1991-2005 The development of new knowledge from HIV-related research also has helped to clarify aspects of the human immune response, behavioral interventions, public health strategies, and social and ethical approaches that contribute to the understanding and management of other diseases and health conditions. Healthcare professionals will continue to play a major and significant role in preventing the spread of HIV infection and in caring for those who are infected or affected by HIV  
HIV/AIDS in Dental Care A case-based self-study module for dental health care personnel 533 kb pdf
How Effective Street Drug Testing Is? In developed countries, it is widely agreed that the democratic public policies should be evidence-based. Evidence-based policy has been defined as an “approach that helps people make well informed decisions about policies, programs and projects by putting the best available evidence from research at the heart of policy development and implementation. This approach stands in contrast to opinion-based policy, which relies heavily on either the selective use of evidence (e.g. on single studies irrespective of quality) or on the untested views of individuals or groups, often inspired by ideological standpoints, prejudices, or speculative conjecture.” Pdf 88 kb
How to Recognize and Treat Acute HIV Syndrome The diagnosis of acute human immunodeficiency virus (HIV) syndrome requires a high index of suspicion and proper laboratory testing. Patients with the syndrome may have fever, fatigue, rash, pharyngitis or other symptoms. Primary HIV infection should be considered in any patient with possible HIV exposure who presents with fever of unknown cause.  

HPV Test Used for early Detection of Cervical Cancer

An abnormal -- and ambiguous -- Pap smear can now be followed by a test for human papillomavirus (HPV)  to better detect cervical cancer, and avoid unnecessary biopsies, according to new research.

 

Ibuprofen Speeds Hepatitis C Into Cirrhosis Of The Liver

Patients with chronic hepatitis C often take the over-the-counter non-steroidal drug Ibuprofen (otherwise known as Motrin or Advil) to combat the joint pain that often accompanies the disease. But even a low dose could lead to unsuspected liver damage.

 

If we don’t do it, who will?

 

During the last few years, though, the pace of these inquiries has quickened perceptibly, as physicians, social workers and family members have become aware of suspected oral-systemic links. The request often is accompanied by a frustrated account of a dentist’s flat refusal to treat the patient. And all too often, that refusal appears to be based on nothing stronger than a general disinclination to deal with "that kind of case."  

Illegal Drug Users Need/Deserve Treatment for Hepatitis C

Researchers are recommending that illicit drug users should be eligible to receive treatment for the hepatitis C virus

 

Incidence and Risk Factors for Acute Hepatitis B in the United States, 1982-1998: Implications for Vaccination Programs

In 1982, a safe and effective vaccine became available to prevent hepatitis B virus (HBV) infection and was recommended for persons at increased risk for infection.

 

Independent Study Results Show Need for Improvement of Infection Control Products

 

In May 2006, an independent online study was performed by the Atlanta-based Arketi Group and sponsored by Inviro Medical in order to assess the opinions of those in the infection control arena regarding needlestick injuries and the available infection control products that aim to prevent them. This is an important issue facing the medical industry; according to a recent article in Infection Control Today, “healthcare workers sustain between 600,000 and one million injuries from conventional needles and sharps annually.”  

Industry is deeply involved in funding US Research

Industry supported 62% of biomedical research in the United States in 2000, almost double the proportion in 1980, while government support declined. About a quarter of academic investigators have affiliations to industry that could influence research and publication

 

Inequalities in health care use and expenditures: empirical data from eight developing countries and countries in transition The study measures inequality in the use of and spending on health services.  Richer groups are found to have a higher probability of obtaining care when sick, to be more likely to be seen by a doctor, and to have a higher probability of receiving medicines when they are ill, than the poorer groups Pdf 394 kb

Influenced by the Drug Companies?

As all encompassing the reach of the drug companies is, we as health care professionals have it within our power to prevent untoward influence by these companies. The ability to say "no" and look at evidence skeptically is one of the most important things in medicine that has been drilled in during time at Medical School.

 

Informed Consent

Informed consent is more than simply getting a patient to sign a written consent form. It is a process of communication between a patient and physician that results in the patient's authorization or agreement to undergo a specific medical intervention.

In the communications process, you, as the physician providing or performing the treatment and/or procedure (not a delegated representative), should disclose and discuss with your patient:
 

Insurance Quotes

When faced with an insidious disease like hepatitis C, paying the medical bills associated with treatment is something most patients would rather not worry about. After all, that’s what insurance is for, right?

 

International Organizations of Medical Sciences (CIOMS)

The Guidelines relate mainly to ethical justification and scientific validity of research; ethical review; informed consent; vulnerability ­ of individuals, groups, communities and populations; women as research subjects; equity regarding burdens and benefits; choice of control in clinical trials; confidentiality; compensation for injury; strengthening of national or local capacity for ethical review; and obligations of sponsors to provide health-care services.

 

Introduction to Bacteriology

(Large report-increased down-load time)

Bacteria are single-celled microorganisms that lack a nuclear membrane, are metabolically active and divide by binary fission. Medically they are a major cause of disease. Superficially, bacteria appear to be relatively simple forms of life; in fact, they are sophisticated and highly adaptable.

 

ISLAMIC MEDICAL ETHICS: The IMANA Perspective Islam considers access to health care as a fundamental right of the individual. In medicine, there are sometimes difficult decision-making options for the patient’s care. Thus, a physician at times has to decide for his /her patient in light of available knowledge, his/her experience, his/her peers and consensus of the community. In addition, a Muslim physician derives his /her conclusion from rules of Islamic laws (Shari`ah) and Islamic medical ethics. The first main principle of Islamic Medicine is theemphasis on the sanctity of human life which derives from al-Qur’an Pdf 102 kb

Issues in Documenting End-of-Life Wishes

Medical ethics in America emphasizes the right of patients to make their own decisions regarding their healthcare, and the end-of-life movement promotes honoring patient wishes on accepting or refusing life-sustaining interventions to allow death with dignity.

 

Knowledge, Attitude and Practices among Health care workers on Needle-stick injuries Health care workers who have occupational exposure to blood are at increased risk for acquiring blood-borne infections.  The level of risk depends on the number of patients with that infection in the health care facility and the precautions the health care workers observe while dealing these patients.  There are more than 20 blood-borne disease, 27 kb pdf
Knowledge of Students regarding Hepatitis and HIV/AIDS of a Private Medical University in Karachi There is a lack of awareness among the medical students entering into the profession.  It is the need of the hour to emphasize on practicing universal precautions.  In addition, some preventive measures should be taken by the management of the universities and medical students to avoid the occurrence of these problems  

Liver Biopsy - Just Think About It

Liver Biopsy: Indications, Contraindications, and Complications

 

Liver Blood Enzymes

An initial step in detecting liver damage is a simple blood test to determine the presence of certain liver enzymes in the blood.

 

Liver Cirrhosis

The liver is the largest organ (about the size of a football and averaging about 3.5 pounds) and has more functions than any other human organ. A person's entire blood supply passes through the liver several times a day, and at any given time there is about a pint of blood there.

 

Liver enzymes can be normal but Hepatitis be advanced When ALT was normal in study reported below, Normal liver was found in 17% of the patients; 34% had minimal CH, 44% mild CH, 4% moderate-severe CH, and 1 % had cirrhosis.  

Male circumcision

Male circumcision for prevention of heterosexual acquisition of HIV in men—a Cochrane review

Pdf 169 kb

Male circumcision: a role in HIV prevention? It has been suggested that following circumcision, the surface epithelium of the glans develops a protective keratin layer, a form of natural condom. Thus, circumcision could reduce the HIV incidence by directly decreasing the susceptibility of uninfected men to HIV. Circumcision could also reduce the incidence of HIV by directly decreasing the infectivity of men with HIV, as suggested by the studies of tissue samples collected from macaques infected with the simian immunodeficiency virus (SIV), which showed infected mononuclear cells in the dermis and epidermis of the penile foreskin  

Management of Cirrhotic Ascites

Treatment of Cirrhotic Ascites Treating Reversible Causes of Cirrhosis

 

Management of Resistance: Implications for Treatment Choices Power Point Presentation 1283 kb

Managing herpes infections

Presentation

 

Medicaid Program Policy Trends: Financing and Quality of HIV Care

Many state Medicaid programs have adopted managed care as well as a variety of other measures to ensure that MCOs caring for high-cost enrollees can continue to provide quality care and are protected from financial risk. This article describes several strategies that state programs have implemented to protect quality HIV/AIDS care.

 

Medical records mashup would span a lifetime Project administrators and promoters anticipate the usual challenges associated with the move to medical technology. One is a fear of private medical information being exposed to employers, advertisers and others. Another is a resistance from insurance and health care managers who want to retain control over the current system  

MEDICINE IN A STRAITJACKET

 

The art and science of medicine, through a collaborative effort by the AMA and HCFA, is to be reduced to the production of voluminous documents by the new "E&M" "guidelines." Meanwhile, the business of insurance, which now funds most of American medicine, is targeted for obliteration by so-called conservatives in Congress in the Patient Access to Responsible Care Act (PARCA), H.R. 1415. ..The two actions are not unrelated. Both medicine and insurance were compromised long ago by the practice of assigning benefits to "providers" and by broad expansions of coverage to routine, low-cost goods and services. Thus, doctors became the servants of third parties rather than patients, and insurance was transformed into third-party prepayment for consumption rather than a voluntary mechanism for sharing catastrophic risk and protecting financial assets  
Methamphetamine and Sexual Behavior: An Analysis PowerPoint Presentation 541 kb
Michigan Recommendations on HIV, Hepatitis B, and Hepatitis C Infected Health Care Workers Based upon current scientific information, the following recommendations have been adopted by MDCH to provide protection for patients and HCWs alike.  These guidelines should become part of the infection control guidelines for all health care facilities Pdf 203 kb

Microbicide research one step nearer to preventing transmission of HIV

The scientists applied a microbicide gel which contained a human antibody in the vaginas of macaque monkeys. They found that the gel protected the macaques from infection with the simian HIV virus for more than seven hours.

 

Missed Opportunities for Sexually Transmitted Diseases, Human Immunodeficiency Virus, and Pregnancy Prevention Services During Adolescent Health Supervision Visits More than half of the US high school students surveyed reported a preventive health care visit in the 12 months preceding the survey: 60.4% (95% confidence interval [CI]: 57.2%–63.6%) of female students and 57.5% (95% CI: 53.9%–61.1%) of male students. For female students, sexual experience was positively associated with a preventive health care visit (odds ratio [OR]: 1.3; 95% CI: 1.1–1.6), but for male students, sexual experience had a negative effect (OR: 0.8; 95% CI: 0.7–0.9). Of the students who reported a preventive health care visit in the 12 months preceding the survey, 42.8% (95% CI: 38.6%–47.1%) of female students and 26.4% (95% CI: 22.7%–30.2%) of male students reported having discussed STD, HIV, or pregnancy prevention at those visits. Sexual experience was associated with a higher likelihood of engaging in a dialogue about sexual health once a student entered the health care system: female students (OR: 3.8; 95% CI: 3.0–4.9) and male students (OR: 1.9; 95% CI: 1.3–2.7).  
Molecular Diagnosis of Occult HCV and HBV Infections Occult HCV and HBV infections are recently identified entities whose existence became evident when nucleic acid amplification assays of enhanced sensitivity were employed for the detection of viral genomes and their replicative intermediates. These long-term silent infections are consequences of persistent low-level viral replication progressing in hepatocytes as well as in cells of the immune system. Detection of these new forms of HCV and HBV persistence requires a thorough testing approach in which analysis of serial serum and peripheral blood lymphoid cell samples and, when feasible, liver tissue samples is performed under strict contamination-controlled conditions using nucleic acid amplifications targeting different regions of viral genomes. This review focuses on the identification and general characteristics of occult HCV and HBV infections, and also acknowledges data from experimental occult infection in the woodchuck model of hepatitis B.  

Money helps

More energy, money and international attention is now being focused on HIV/AIDS than on any other global public health issue.  A pandemic that was being quietly forgotten by the global community only three years ago has hurtled up nation and international policy agendas

Pdf 113 kb

Mounting anomalies in the epidemiology of HIV in Africa: cry the beloved paradigm The mounting toll of HIV infection in Africa is paralleled by a mounting number of anomalies in the many studies seeking to account for it.  We propose that existing data can no longer be reconciled with the exceptional role of sex in the African AIDS epidemic  

Must-Tell Rules Would Keep Sexually Active Teens Away

Almost half of the adolescent girls who seek prescribed contraception and other sexual health services would cease doing so if they knew that their parents were going to be notified -- but most would continue to have sexual intercourse

 

MYCOPLASMA -The Linking Pathogen in Neurosystemic Diseases Several strains of mycoplasma have been "engineered" to become more dangerous. They are now being blamed for AIDS, cancer, CFS, MS, CJD and other neurosystemic diseases.  
NASTAD-Focus on Spousal & Partner Notification The provision requires that states take ‘administrative or legislative action to require that a good faith effort be made to notify a spouse of a known HIV-infected patient that such spouse may have been exposed to the human immunodeficiency virus and should seek testing. Pdf 52 kb

National Surveillance of Dialysis-Associated Diseases in the United States, 1997

(LARGE REPORT-INCREASED DOWN-LOAD TIME)

The CDC has been conducting surveillance of hemoldialysis-associated hepatitis since the early 1970s.

1117 kb pdf

Needle exchange-a matter of public health.

So why is the government playing politics with this ticking time bomb?

24 kb pdf

Needs of Families With a Chronically Ill Child

Families with one chronically ill child often face stresses not only in dealing with that illness, but also in caring for unaffected children while maintaining family stability and cohesion.

 

Nevirapine distribution sites to increase

The number of sites distributing nevirapine to HIV-positive pregnant mothers in Mpumalanga would increase to 55 by early next year, premier Ndaweni Mahlangu announced on Friday.

 

New guidelines: clinicians should incorporate HIV prevention into ongoing care of patients CDC issued new guidelines that shift prevention education initiatives to those already infected.  One policy is to try to reach the infected community during routine visits to their healthcare providers.  The stigma of HIV/AIDS prevents many people from disclosing their diagnosis, and often healthcare providers are the only people with whom they can talk openly about the disease. 132 kb pdf

New guidelines on gifts from drug companies

Updated guidelines setting out boundaries for relationships between hospital doctors and healthcare firms are contained in a new paper from the Royal College of Physicians.

 

NEW ORLEANS DENTIST TO 
PAY $120,000 FOR 
REFUSING TO TREAT 
PATIENTS WITH HIV UNDER 
SETTLEMENT WITH JUSTICE
DEPARTMENT
The Justice Department sued the dentist in October 1993, alleging that Morvant and his dental corporation unfairly denied routine dental services to Russell Hodgkinson and Ismael Pena after informing them the office did not treat HIV-positive patients.   

New Recommendations: Newborns Need Hepatitis Vaccine

All US newborns should be vaccinated against hepatitis B before leaving the hospital

 

Normal Liver Enzymes in Patients With Chronic Hepatitis B or C Infection

In general, patients with hepatitis C virus infection and normal liver enzyme levels should undergo liver biopsy.

 

Obstetric Care in Patients with HIV Disease Appropriate management of pregnant patients who have human immunodeficiency virus (HIV) disease can have a major impact on maternal and infant health. The goals of therapy are to properly manage the pregnancy, treat the maternal HIV infection and minimize the risk of vertical transmission of HIV. Early detection of HIV through aggressive screening programs is necessary to initiate timely therapy.  

On the Sides

With the combo came a combination of side effects that have left many hepatitis patients suffering long after their treatment is through.

 

Operational Characteristics of Commercially Available Assays to Determine Antibodies to HIV

1998—this dual report dealing with the evaluation of the major operational characteristics of commercially available assays to detect antibodies to HIV, presents assessment of the following 20 assays carried out between 1994-1995

Pdf 17,760

Opportunistic Infections and Coinfections: Focus on Fungi and Hepatitis

In particular, among patients with good immunologic and virologic responses to HAART, it has proved possible to stop primary prophylaxis and maintenance therapy in patients with previously active infections.

 

Opportunistic Infections: They Still Exist, Even in North America and Western Europe

At the 10th Conference on Retroviruses and Opportunistic Infections (CROI), there was broad and outspoken recognition that opportunistic infections (OIs) continue to cause morbidity and mortality in patients who are unaware of their HIV infection, individuals who have inadequate access to healthcare, and patients whose CD4+ T lymphocytes remain low because they can no longer benefit from available antiretroviral agents

 

Out Of Control AIDS and the corruption of medical science Regardless of whether Duesberg is right about HIV, his case, like Fishbein's, lays bare the political machinery of American science, and reveals its reflexive hostility to ideas that challenge the dominant paradigm. Such hostility is not unusual in the history of science,15 but the contemporary situation is dramatically different from those faced by maverick scientists in the past. Today's scientists are almost wholly dependent upon the goodwill of government researchers and powerful peer-review boards, who control a financial network binding together the National Institutes of Health, academia, and the biotech and pharmaceutical industries. Many scientists live in fear of losing their funding. "Nobody is safe," one NIH-funded researcher told me. "The scientific-medical complex is a $2 trillion industry," says former drug developer Dr. David Rasnick, who now works on nutrition-based AIDS programs in Pretoria, South Africa. "You can buy a tremendous amount of consensus for that kind of money."  
Overcoming Barriers to Prevention, Care, and Treatment of Hepatitis C in Illicit Drug Users Caring for patients who use illicit drugs presents challenges to the healthcare team that require patience, experience, and an understanding of the dynamics of substance use and addiction. 124 kb pdf

Painless, Cost-Free Ways For States With Budget Shortfalls To Preserve and Even Increase Medicaid, S-CHIP, Other Health, SSI State Supplement and Food Program Funding

by Thomas P. McCormack  (Draft # 28, 3/4/07
Changes in the laws  

Physician-Industry Relations

Physicians and industry have a shared interest in advancing medical knowledge. Nonetheless, the primary ethic of the physician is to promote the patient’s best interests, while the primary ethic of industry is to promote profitability. Although partnerships between physicians and industry can result in impressive medical advances, they also create opportunities for bias and can result in unfavorable public perceptions.

 

Physicians and the Pharmaceutical Industry

Controversy exists over the fact that physicians have regular contact with the pharmaceutical industry and its sales representatives, who spend a large sum of money each year promoting to them by way of gifts, free meals, travel subsidies, sponsored teachings, and symposia

 

Policy Challenges in Modern Health Care

(Large report-Increase Download time)
Also juxtaposed in this volume are two seemingly intractable problems that afflict health. First, mechanisms for producing population health—driven by our nation’s values, culture, history, and social organization—have yielded low average health in the United States compared with other economically advanced nations. This country also faces wide disparities in health by socioeconomic status, gender, and race/ethnicity. Second, the individually oriented focus of U.S. health care has resulted in a system that is the most expensive in the world and yet is in organizational and functional disarray. Are these two problems related with respect to causes, manifestations, and the public policy solutions proposed by these authors? Pdf 1417 kb

Portal hypertensive Bleeding

Bleeding from esophageal varices occurs in approximately 30% of patients with chronic liver disease and portal hypertension. Gastrointestinal bleeding due to portal hypertension is estimated to cost approximately $1.2 billion per year in the US.

 

POST-EXPOSURE PROPHYLAXIS (PEP) The major modes of transmission of HIV include sexual route, transfusion of infected blood and blood products, intravenous drug abuse and mother to child transmission. Another mode of transmission, though largely undocumented, is transmission of infection by needle stick or other sharp injury in a hospital or a health care setting. Although avoiding occupational blood exposures is the primary means of preventing HIV transmission in health care settings, appropriate post exposure management guidelines form an important element of work place safety.  

Postexposure HIV cost effective outside occupational exposure

In persons at risk for HIV exposure through
sexual activity or injection drug use, postexposure prophylaxis (PEP) with antiretroviral medications and counseling can be a cost-effective means of preventing infection

 

Powell, on MTV show, urges condom use to prevent AIDS

Fielding particularly sober questions from a youth audience normally tuned in to watch the latest hip-hop videos, Secretary of State Colin Powell explained the war on terrorism to MTV viewers around the world Thursday and stressed the supremacy of American democratic values.

 

Preserving the Right of Informed Consent As a rule, persons living with a disability such as HIV/AIDS wish to remain as independent as possible, living in the community and enjoying friends and family. Although nursing homes and assisted living can provide necessary care, they do not offer the same level of privacy (i.e. shared rooms, open doors, no choice in caregiver) or personal autonomy (no curfew, assistance on your own schedule) as an independent living situation. A live-in-aide may be able to provide all of the daily supports necessary for someone to remain in his/her home. Pdf 455 kb
Principles of Oral Health Management for the HIV/AIDS Patient Power Point Presentation 213 kb

Properly Funded Training would Aids Physician Independence

The Royal Colleges' guidelines on receiving gifts from pharmaceutical companies is laudable in its intent, however the accompanying editorial fails to recognise the crucial issue of under-funding of training in its comments1. While pharmaceutical funding to attend international conferences might be construed as inappropriate influence by patients (naïve or not), in reality there is little alternative "independent" sources of funding to attend such valuable forums of education and learning.

 

Proposed Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health Care Settings Set forth below are comments on the Proposed Rules revising the criteria in the Listing of Impairments used by the Social Security Administration (SSA) to evaluate claims involving immune system disorders.  The undersigned organizations submitting these comments have extensive expertise in the area of HIV-related treatment and representation of HIV-positive claimants at every stage of the Social Security Administration’s disability determination process. Through our many years working in legal and medical programs and multidisciplinary agencies specializing in the needs of people living with HIV, we have learned the common difficulties faced by HIV-positive claimants and the typical responses of disability examiners and adjudicators to claims of disability based on HIV  
Psychological Issues in Pediatric HIV/AIDS Patients It has become generally recognized that acute and chronic medical conditions in the pediatric population have the potential to bring about a range of psychosocial challenges not only to patients, but also to family members and health care workers. Of these conditions, HIV/AIDS presents perhaps the most complex psychosocial issues of any medical condition. The overlapping of social, individual, family, financial, cultural, and illness factors poses a challenge to communities and healthcare teams that strive to provide comprehensive services to this population.  
Public Health Emergencies; Environmental Issues Public health emergencies can take many forms—disease epidemics, large-scale incidents of food or water contamination, or extended periods without adequate water and sewer services. 129 kb pdf
Reasons for not seeing drug representative Many doctors both hospital doctors1 and general practitioners2 feel that their workloads are increasing. There is a sense that we are being overwhelmed by a multitude of calls on our time, fitting in management and administration, continuing medical education, teaching, audit, and appraisals over and above our basic clinical work. Why then do so many doctors still find time to see drug company representatives?  
Recommendations for the Triage of HIV+ Patients These are general recommendations for clinicians who are not HIV specialist. 58 kb pdf

Reducing AIDS-related Stigma and Discrimination in Indian Hospitals

 

AIDS-related stigma and discrimination is a pervasive problem worldwide. People living with HIV/AIDS (PLHA) in India, as elsewhere, face stigma and discrimination in a variety of contexts, including the household, community, workplace, and health care setting. Research in India has shown that stigma and discrimination against HIV-positive people and those perceived to be infected are common in hospitals and act as barriers to seeking and receiving critical treatment and care services (UNAIDS 2001). Pdf 342 kb

Release of Behavioral Health, Developmental Disabilities, HIV, and Substance Abuse Information: Guidelines for Legal Compliance

Hospital, physician practices, and other health care facilities are repositories for much medical information.  Safeguarding the confidentiality of such information is a significant issue for any hospital or other health care entity that keeps patient medical records to maintain patient confidence and to avoid liability.  Because damages could ensue should inappropriate disclosure occur, patient records containing behavioral health, developmental disabilities, HIV, and substance abuse information must be handled with special attention, in accordance with state and federal laws, rules, and regulations.  Individuals involved in health information management should be well-informed about patient confidentiality requirements overall and should also track these areas carefully to develop and implement appropriate policies and procedures governing the release of patient information

50 kb pdf

Responding to HIV+ Stigma in Clinical Settings Power Point Presentation 112 kb
Risk of confidentiality breach can make HIV patients shy from treatment "A breach of confidentiality carries the potential for a greater consequence on the lives of these patients than it may in many other diagnoses, and so confidentiality has a deeper meaning for them," said Kathryn Whetten-Goldstein, assistant professor in the Terry Sanford Institute of Public Policy's Center for Health Policy, Law and Management and primary investigator for the study, which was funded by the Department of Health and Human Services. "A perceived risk of a breach of confidentiality can prompt an HIV patient to choose a clinic several hours away rather than one closer to home, to withhold information from providers or even to reject treatment altogether."  

 

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