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Biomedical subjects

I Goldstone

Publications and source records attributed to I Goldstone.

18 recordsLinked to original sources
PubMed1995

Patterns of care in advanced HIV disease in a tertiary treatment centre.

A retrospective chart review of all in-patient deaths in 1992 was undertaken to examine patterns of care in advanced HIV disease at St Paul's Hospital, Vancouver, Canada. St Paul's Hospital cares for approximately 75% of the Province of British Columbia's AIDS caseload. This represents about 18% of Canada's caseload. Data were collected on demographic characteristics, the utilization of home care and community services, income and social support, symptom presentation at terminal admission and the utilization of acute hospital care and hospital based palliative care. A total of 126 deaths were reviewed. All but two subjects were homosexual/bisexual men. The median age at death was 39 years (range 24-67). Four patterns of care at death were identified: (1) aggressive therapy with resuscitation 24 (19%), (resuscitation was initiated in 58%); (2) aggressive therapy with a no resuscitation order 49 (39%), in which the palliative period was a median of three days; (3) death on the palliative care unit 33 (29%), with a median survival once palliative of 20 days; and (4) death on the palliative care unit following respite admissions 16 (13%), with a median survival once palliative of 64 days. Despite a well known and respected Palliative Care Unit and community palliative care programme, there is a marked trend towards death occurring during aggressive therapy with a 200% increase in the initiation of resuscitation compared to the previous three years. No-one has been discharged alive from hospital following the initiation of resuscitation since 1988. This study illustrates the need for providers and persons infected with HIV to reconsider expectations about treatment outcomes in advanced HIV disease.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Impact of HIV infection and AIDS on death rates in British Columbia and Canada.

OBJECTIVE: To assess the impact of HIV infection and AIDS on death rates in British Columbia and Canada. DESIGN: Descriptive, population-based study. SETTING: British Columbia and Canada. PATIENTS: All people for whom HIV infection or AIDS was listed as the underlying cause of death in Canada and all provinces from 1987 to 1991, as reported to Statistics Canada, and all people for whom HIV infection or AIDS was listed as the underlying or antecedent cause of death in British Columbia and Vancouver from 1987 to 1992, as reported to the Division of Vital Statistics, British Columbia Ministry of Health. MAIN OUTCOME MEASURES: Age- and cause-specific patterns of death, and potential years of life lost (PYLLs) for men. RESULTS: From 1987 to 1991 a total of 4189 deaths from HIV infection and AIDS (in 3941 males and 248 females) in Canada and 686 such deaths (in 671 males and 15 females) in British Columbia were reported to Statistics Canada. The rate of death from HIV infection and AIDS was 1.39 times higher (95% confidence interval [CI] 1.29 to 1.50) in British Columbia than in Canada as a whole and 1.95 times higher (95% CI 1.65 to 2.29) when HIV infection was associated with specified malignant neoplasms than with other related causes. The PYLLs from HIV infection and AIDS for men rose steadily in Canada, from 17,615 in 1987 to 38,735 in 1991; the latter is comparable to the PYLLs from stroke and colorectal cancer. In Vancouver the PYLLs from HIV infection and AIDS for men increased sharply from 1987 to 1992, surpassing the PYLLs from heart disease, malignant neoplasms and accidents. CONCLUSIONS: From 1987 to 1991 the rate of death from HIV infection and AIDS in British Columbia was higher than the national average. In Vancouver HIV infection and AIDS have become the leading causes of premature death in men, exceeding heart disease, malignant neoplasms and accidents.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Teaching about HIV/AIDS: the lessons learned.

To learn and teach about HIV/AIDS is to enter complex and sensitive territory that at times may be personally challenging. In the vast literature on HIV infection and nursing two main themes recur: nurses' lack of understanding, negative attitudes and anxieties related to HIV/AIDS and the need for education to change such attitudes and enhance nurses' knowledge and skills.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

AIDS--what is it?

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Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Nursing the AIDS patient.

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Acquired Immunodeficiency Syndrome↗