The Autopsy Neuropathology of Aids

Kanzer, M. D.; Parisi, Joseph E.; Tuur, Sylvana M.; Lo, Su Shun

doi:10.1097/00005072-198905000-00047

Cited by 6 publications

(7 citation statements)

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“…Autopsies found that 80–100% of AIDS patients had neuropathological changes in the CNS [ 24 – 27 ]. HIV- associated encephalitis (HIVE) was also observed in some patients at this stage.…”

Section: Neuropathology Of Handmentioning

confidence: 99%

HIV-associated synaptic degeneration

Tang

2017

Mol Brain

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Human immunodeficiency virus (HIV) infection induces neuronal injuries, with almost 50% of infected individuals developing HIV-associated neurocognitive disorders (HAND). Although highly activate antiretroviral therapy (HAART) has significantly reduced the incidence of severe dementia, the overall prevalence of HAND remains high. Synaptic degeneration is emerging as one of the most relevant neuropathologies associate with HAND. Previous studies have reported critical roles of viral proteins and inflammatory responses in this pathogenesis. Infected cells, including macrophages, microglia and astrocytes, may release viral proteins and other neurotoxins to stimulate neurons and cause excessive calcium influx, overproduction of free radicals and disruption of neurotransmitter hemostasis. The dysregulation of neural circuits likely leads to synaptic damage and loss. Identification of the specific mechanism of the synaptic degeneration may facilitate the development of effective therapeutic approaches to treat HAND.

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Section: Neuropathology Of Handmentioning

confidence: 99%

HIV-associated synaptic degeneration

Tang

2017

Mol Brain

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“…32,34 HIV is a neurotropic virus and central nervous system infection takes place early in the course of the disease process. 32,34,35 Neurotropic predisposition of an HIV virus is responsible for symptoms of neurological dysfunction manifested clinically at the time of initial AIDS diagnosis in up to 40% of infected patients. 35 The HIV positive patient, irrespective of her clinical condition, meets criteria for AIDS, by definition, when CD4+ T cell count falls below 200 cells/microliter.…”

Section: Human Immunodeficiency Virusmentioning

confidence: 99%

“…32,34,35 Neurotropic predisposition of an HIV virus is responsible for symptoms of neurological dysfunction manifested clinically at the time of initial AIDS diagnosis in up to 40% of infected patients. 35 The HIV positive patient, irrespective of her clinical condition, meets criteria for AIDS, by definition, when CD4+ T cell count falls below 200 cells/microliter. 36 High maternal viral load increases the likelihood of perinatal transmission of HIV.…”

Section: Human Immunodeficiency Virusmentioning

confidence: 99%

The febrile parturient: choice of anesthesia

Kuczkowski

2002

Southern African Journal of Anaesthesia and Analgesia

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The febrile parturient: choice of anesthesia ture and temperature control mechanisms that constantly adjust body temperature, to maintain this level. Fever is defined as an increase in core body temperature above 38 ºC, which is secondary to an increase in the hypothalamic set point. 1, 3 The human body temperature rarely exceeds 41ºC. Normal circadian fluctuation in body temperature with increase in the evening and decrease in the morning continues even in febrile patients. 4 Under normal circumstances, core body temperature is tightly regulated, with a variation of approximately 0.5ºC. While it is uncertain as to the benefits of fever, there are suggestions that the increased body temperature aids in the activation of the host immune response with augmentation of bactericidal, phagocytic and chemotactic properties of polymorphonuclear leukocytes. The negative aspects of fever include increased basal metabolic rate and increased cardiac demand. FEVER: INTERACTION WITH PREGNANCYPhysiologic changes of pregnancy include an increase in the maternal basal metabolic rate. 5 Maternal body temperature in labor is also significantly affected by the degree of physical activity and intensity of uterine contractions. Pain associ- INTRODUCTION Fever is a common clinical problem in labor and delivery suites -worldwide. The febrile parturient presents a unique diagnostic dilemma and therapeutic challenge to both an obstetrician and an anesthesiologist involved in her care. Fever can result from a variety of infectious microorganisms, tissue trauma, malignancy, drug administration, endocrine and immunological disorders. However, infection is by far the most common cause of fever in the parturient. 1, 2 The infectious etiology of fever in a parturient may be pregnancy specific, such as chorioamnionitis, or not specific to pregnancy, such as urinary tract infection. The risk to the mother and the fetus is significantly increased in pregnancy complicated by infection and fever. The diverse clinical manifestations of various infectious disorders combined with the unique anesthetic implications of pregnancy may result in life-threatening complications and significantly impact upon the practice of obstetric anesthesia.The diagnosis of infection in pregnancy often raises questions about the safety of neuraxial anesthesia in febrile patients. Despite this concern, and lack of universal guidelines, it has now been well established that the presence of infection and fever in labor does not always contraindicate the administration of regional anesthesia. 2 The decision whether to administer regional anesthesia or not in a febrile parturient should be based on an individual risk-to-benefit ratio.

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“…Regional anesthesia had also been a subject of controversy due to claims of possible central nervous system involvement. [1920] It has been now clearly established that neuraxial anesthesia can be administered safely in patients with HIV infection. [2122] One of the chief concerns with this technique is the failure to treat the complications associated with post-dural puncture headache.…”

Section: Laboratory Profile and Investigationsmentioning

confidence: 99%

The potential anesthetic threats, challenges and intensive care considerations in patients with HIV infection

Bajwa

Kulshrestha

2013

J Pharm Bioall Sci

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Acquired immunodeficiency syndrome (AIDS) has become a pandemic with ever looming danger of its transmission in health professionals. The number of AIDS patients has increased tremendously over the last two decades, who present for surgical procedures as well as who get admitted in intensive care unit for their critical condition. As such anesthesiologists and intensivists are exposed to potential risk of disease transmission on a daily basis from such patients. The guidelines and protocols formulated in the western world regarding prevention of disease transmission cannot be applied uniformly in the developing nations, such as India due to various factors and limitations. As such there is a continuous need felt in this arena to prevent the catastrophic consequences of AIDS in our medical fraternity while treating such patients in operation theatres and critical care units. This study reviews the various pathophysiological aspects, anesthetic considerations, intensive care implications, and various areas where current knowledge about AIDS can be applied to prevent its potential transmission in high-risk clinical groups.

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The Autopsy Neuropathology of Aids

Cited by 6 publications

References 0 publications

HIV-associated synaptic degeneration

HIV-associated synaptic degeneration

The febrile parturient: choice of anesthesia

The potential anesthetic threats, challenges and intensive care considerations in patients with HIV infection

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