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Biomedical subjects

K Vigilante

Publications and source records attributed to K Vigilante.

7 recordsLinked to original sources

Update of HIV and AIDS in North America.

The second wave of the HIV epidemic, which increasingly affects injection drug users, women, and minorities, necessitates the development of primary care HIV services so that these individuals may benefit from new therapies. The ability to dramatically decrease vertical transmission of HIV from mother to child with antiretroviral therapy is encouraging. Better understanding of HIV pathogenesis, disease progression, antiviral therapy, and opportunistic infection prophylaxis are leading to more effective therapy and prevention. Clinical trials are ongoing to assess the efficacy of protease inhibitors in combination with nucleoside analog antiretroviral therapy to provide long term viral suppression and alter the natural history of HIV. Prophylaxis of pneumocystis, toxoplasma, MAC, TB, and invasive fungal infections is cost effective and leads to improved quality of life.

AIDS-Related Opportunistic Infections↗

Clinically significant mucosal candidiasis resistant to fluconazole treatment in patients with AIDS.

Eight cases of severe mucosal candidiasis in patients with AIDS who were taking fluconazole at a dosage of 400-800 mg/d are described. Candida albicans alone or in conjunction with Torulopsis glabrata or Candida stellatoidea was isolated from each patient. In vitro susceptibility testing demonstrated resistance to fluconazole in all eight cases. All tested isolates were susceptible to amphotericin B, and six of eight isolates tested were susceptible to itraconazole. All individuals were severely immunocompromised (CD4 lymphocyte counts: mean, 15/mm3; range, 6-39/mm3) and had been receiving prophylaxis with fluconazole for a mean of only 3 months (range, 1-7 months). The occurrence of candidal mucositis in patients receiving high doses of fluconazole is a matter of concern that requires further study in regard to the causes, prevention, and treatment of the disease.

AIDS-Related Opportunistic Infections↗

The tax code at the bedside.

Last June, Washington's Heritage Foundation sponsored a symposium called ¿Restoring the Doctor-Patient Relationship: The Challenge of Third-Party Payment and Government Regulation.¿ This article, adapted from those proceedings, argues that tax fairness and choice are critical underpinnings of ethical medicine in the managed care era.

Ethics, Medical↗