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R Danziger

Publications and source records attributed to R Danziger.

At least 19 recordsLinked to original sources
PubMed2000

Post-exposure prophylaxis after occupational and non-occupational exposures to HIV: an overview of the policies implemented in 27 European countries.

The aim of this survey, which was part of an English-French project supported by the Commission of the European Communities, was to compare access to HIV post-exposure prophylaxis (PEP) in the occupational and non-occupational contexts in 27 European countries. A protocol was designed in May 1998 in collaboration with all country consultants. Data were collected at country level by each consultant through interviews, review of local and national recommendations and results of national or local surveys. The final comparative analysis was carried out from the individual country reports and a review of the literature. The large majority of European countries have detailed procedures regarding occupational PEP: 20/27 have produced national guidelines, three have adopted the US CDC recommendations and only four have no official recommendations. Although no standard protocol exists, the more common one is a four-week implementation of a triple combination therapy. In the context of non-occupational exposure to HIV, only five countries have guidelines with specific recommendations and one country has adopted the CDC recommendations. In the majority of cases (13 countries), PEP is never recommended but is only available in a few circumstances, sometimes with major limitations. In the last eight countries, such PEP is not currently available. Although the estimations of HIV transmission risks in occupational and non-occupational contexts are really comparables, easy access to PEP after accidental sexual or blood exposures is not guaranteed for the general population in the majority of European countries.

Anti-HIV Agents↗
PubMed1999

The social impact of HIV testing: a comparative analysis of Britain and Sweden.

The role of HIV testing in the primary prevention of HIV is as yet unclear. Whereas most outcome evaluations have tended to focus on the impact of HIV testing and counselling on individuals' risk behaviours, this paper argues for a fresh perspective on HIV testing which takes into account its social impact. To illustrate the importance of the social impact of HIV testing, the paper compares HIV testing policies in the context of HIV prevention in Britain and in Sweden. It shows how contrasting representations of HIV testing and different practices around testing have had different social, economic and public health consequences in the two countries. The paper concludes with a recommendation that policy makers take fuller account of the social dimension of HIV testing in the future development of HIV testing policies.

Female↗
PubMed1998

HIV testing for HIV prevention: a comparative analysis of policies in Britain, Hungary and Sweden.

This paper compares policies on named HIV testing in the context of HIV prevention in Britain, Hungary and Sweden, and considers the extent to which these policies are based on evidence of effectiveness or on other, more contextual, factors. In Britain, testing has not featured significantly as a prevention strategy, and named testing has generally been carried out only with the voluntary, informed consent of individuals. In Hungary, testing is central to HIV prevention, and is required by law of certain groups. HIV testing is carried out mainly on a voluntary basis in Sweden, but, unlike in Britain, it has been actively promoted by public health authorities. The paper contrasts the 'right not to know' one's HIV status which is widely respected in Britain, with the 'responsibility to find out' which is more pervasive in Hungary and Sweden. Although policy makers in all three countries appear convinced that their's is the right approach, there appears to be as yet a dearth of convincing evidence to support their arguments.

Communicable Disease Control↗
PubMed1997

HIV prevention in Hungary.

Hungary is a country with relatively low HIV prevalence. Since 1989, a wide range of HIV prevention projects has been developed both by government agencies and by an increasingly active voluntary sector. While energy and resources continue to be invested in HIV information and education, some senior public health officials have argued that it is the country's compulsory HIV testing and compulsory reporting system which have enabled it to maintain its low seroprevalence levels. The testing and reporting system are soon to be reformed, however, in response to growing demands for better protection of personal privacy and confidentiality. Whether or not the forthcoming reforms will have an impact on HIV prevention, and what the nature of this impact will be, remain to be seen.

Confidentiality↗
PubMed1996

An epidemic like any other? Rights and responsibilities in HIV prevention.

Throughout the 1980s and into the 1990s, HIV prevention has been closely associated with the protection of individual human rights. Traditional public health measures such as compulsory testing and isolation have largely been rejected as ineffective in public health terms and inappropriate in the context of human rights protection. HIV prevention has been based instead chiefly on elective measures --information, education, counselling, and voluntary testing. In the past five years there have been important clinical, epidemiological, and social developments in the AIDS epidemic. These changes, combined with a growing recognition of possible weaknesses inherent in a strictly voluntarist approach to HIV prevention, may herald a new approach to AIDS control which places more weight on social responsibility in the context of HIV prevention.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Compulsory testing for HIV in Hungary.

Compulsory testing for the human immunodeficiency virus (HIV) has been a cornerstone of Hungary's AIDS prevention and care programme since 1988. This strategy is based on a two-fold public health rationale. Firstly, informing as many HIV positive people as possible of their serostatus is important for HIV prevention because infected people have a crucial role to play in preventing the further spread of the virus. Secondly, the earlier an HIV diagnosis can be provided the greater the opportunity for delaying the onset of symptoms and for maintaining as high a quality of life as possible for the affected individual. For these reasons, and because compulsory testing appears to be widely accepted within Hungary as part of a comprehensive social welfare system which places equal emphasis on citizens' rights and responsibilities, the country's public health establishment has continued to resist pressure from international agencies and other external bodies which have urged Hungary to abandon compulsory testing in favour of voluntary testing based on individual informed consent. Any changes to Hungary's HIV testing programme which occur in the coming years are more likely to be a response to the country's changing epidemiological, social and economic conditions rather than to pressure from outside.

Community Health Services↗
PubMed1996

An overview of HIV prevention in central and eastern Europe.

HIV and AIDS present a major challenge to the countries of central and eastern Europe. The manner in which this is being addressed differs from country to country, depending upon historical traditions and prevailing public health practices, social values and political priorities. This paper provides an overview of HIV prevention policies in six central and east European counties: Russia, Romania, Hungary, the Czech Republic, Poland and Lithuania. By homing in on particular aspects of these policies, the paper aims to highlight some of the more interesting contrasts that exist within this region. The paper concludes that, while significant comparisons can be made between the countries, tight parallels cannot.

Attitude to Health↗
PubMed1994

Discrimination against people with HIV and AIDS in Poland.

The recent increase in HIV seroprevalence in Poland, particularly among injecting drug users, has been accompanied by widespread discrimination against people affected by HIV and AIDS. As in other countries, this discrimination may be attributed to a large extent to fear and ignorance about HIV and AIDS together with pre-existing prejudices against the people who are most commonly associated with the epidemic. In Poland extreme hostility towards drug users combined with the powerful influence of a traditional Catholic church have so far impeded effective education about HIV and AIDS and anti-discrimination strategies.

Acquired Immunodeficiency Syndrome↗
PubMed1994

The social impact of HIV/AIDS in developing countries.

This paper highlights some of the main areas of social impact of HIV and AIDS in developing countries and suggests that these must constitute priority areas for action among international and national policy makers, as well as others concerned with HIV and AIDS. The areas of impact which are considered are: economic and demographic; labour productivity; agricultural production and development; pressures on the health sector; the role of families and households; children; women; HIV/AIDS discrimination; and the impact of HIV/AIDS on the individual. Some of the responses which have already been developed to the impact of HIV and AIDS are considered, and many of these are seen to be at least partially effective ways of addressing some of the consequences of pandemic. The paper concludes however that the escalating cost of HIV and AIDS, in personal, social and economic terms, demands a greater degree of considered, concerted and coordinated action by international, national and local agencies.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Localization and regulation of endothelial NO synthase mRNA expression in rat kidney.

Nitric oxide (NO) has effects on renal blood flow, glomerular filtration rate, renin secretion, and renal sodium excretion. Four isoforms of nitric oxide synthase (NOS) have been cloned to date. However, the molecular identity of NOS present in the renal vasculature is unknown. Endothelial NOS (NOS-III) is regulated both acutely by cell calcium and chronically by shear stress. To determine if renal blood vessels and the glomerulus express NOS-III mRNA, we used degenerate polymerase chain reaction (PCR) to clone a portion of rat NOS-III. We then assayed NOS-III mRNA in microdissected renal structures by reverse transcriptase-PCR. NOS-III mRNA was expressed at high levels in glomeruli, arcuate vessels, and interlobular artery/afferent arterioles. NOS-III mRNA was detected inconsistently in proximal tubules, thick ascending limbs, and cortical and inner medullary collecting ducts. Previous studies have shown that chronic oral treatment with the NOS inhibitor N omega-nitro-L-arginine methyl ester (L-NAME) decreases NO synthesis and causes hypertension. To determine if the systemic blockade occurs only by competitive inhibition, we determined the effect of L-NAME on glomerular NOS-III mRNA. L-NAME administration (5 days) decreased NOS-III mRNA in the glomerulus to 25 +/- 12% of control levels. We conclude that endothelial NOS-III mRNA is preferentially expressed in the glomerulus and renal vasculature, where it can modulate renal blood flow and glomerular filtration rate. Furthermore, glomerular NOS-III may be modulated at the level of mRNA abundance in vivo by systemic L-NAME.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acid Oxidoreductases↗
PubMed1994

Homologous and heterologous desensitization of a guanylyl cyclase-linked nitric oxide receptor in cultured rat medullary interstitial cells.

Selected studies of nitroglycerin tolerance have demonstrated desensitization of the nitric oxide-stimulated guanylyl cyclase. To define the mechanism by which the response to nitric oxide becomes desensitized, we studied the effects of activating both nitric oxide and atrial natriuretic peptide-stimulated guanylyl cyclases in rat medullary interstitial cells. Cells were pretreated with the nitric oxide agonists nitroprusside (SNP) and SIN-1 for 18 hr before measuring SNP- or SIN-1-stimulated cyclic GMP (cGMP) accumulation in the presence of 3-isobutyl-1-methylxanthine. Pretreatment with SNP decreased SNP- and SIN-1-stimulated cGMP accumulation without altering the EC50 for SNP. Pretreatment with SIN-1 also inhibited SNP and SIN-1-stimulated cGMP accumulation. To rule out a nonspecific metabolic effect of SNP, we showed that SNP pretreatment decreased SIN-1-stimulated soluble guanylyl cyclase activity, but had no significant effect on forskolin-stimulated cyclic AMP accumulation. Pretreatment with SNP also decreased the mRNA abundance of the alpha 1- and beta 1-subunits of guanylyl cyclase. Pretreatment with either atrial natriuretic peptide or 8-chlorophenylthio-cGMP inhibited SNP-stimulated cGMP. We conclude that the soluble guanylyl cyclase-linked nitric oxide receptor exhibits homologous and heterologous desensitization in rat medullary interstitial cells. The site of regulation is unknown, but homologous desensitization may involve decreased abundance of soluble guanylyl cyclase.

Animals↗
PubMed1989

Morphological and contractile characteristics of rat cardiac myocytes from maturation to senescence.

Morphological and contractile characteristics of individual myocytes isolated from rats of 2, 6-9, and 24-25 mo of age were measured. The average myocyte length measured under high power light microscopy in unattached cells increased from 133 microns at 2 mo to 146 microns at 6-9 mo to 162 microns at 24-25 mo of age. The average slack sarcomere length was 1.85, 1.83, and 1.82 microns at 2, 6-9, and 24-25 mo, respectively. The average cell volume measured via Coulter counter techniques approximately doubled between 2 and 24 mo. During the electrically stimulated twitch in individual unloaded myocytes contracting from slack length the absolute amplitude of cell shortening increased with age, but when expressed relative to cell length or as sarcomere shortening the age effect was obliterated. Neither the maximal velocity of myocyte shortening (cell length/s) nor the calculated maximal sarcomere shortening velocity varied with age. The time course of the twitch increased with aging, due largely to an increase in the time to peak shortening. Thus aging is associated with an increase in cell size due to the addition of sarcomeres. Except for a prolonged time course, the twitch contraction characteristics normalized for cell length and sarcomere number in unloaded ventricular myocytes contracting over a range of sarcomere lengths below the slack length do not change appreciably with age.

Aging↗
PubMedDate not supplied

Latex hypersensitivity reactions despite prophylaxis.

Latex rubber hypersensitivity represents a significant problem facing the medical, surgical, radiologic, and dental professions. As a tertiary care center, the Childrens Hospital of Philadelphia has a large population of patients with spina bifida and complex genitourinary anomalies; a number of these children have latex rubber allergy, which may first present as intraoperative anaphylaxis. Although there is no substitute for complete antigen avoidance, all medical products containing latex rubber may not have suitable alternatives. Therefore, we have formulated a protocol to prevent perioperative reactions through the use of prophylactic medications and the limitation of latex exposure. This regimen includes steroids, antihistamines, and bronchodilators when indicated. In four children, prophylaxis failed perioperatively because of parenteral infusion of latex rubber proteins.

Adolescent↗