Background: Substance abuse (SA) and mental illness (MI) commonly co-occur with HIV infection in the United States and have important implications for clinical management of HIV/AIDS. Yet SA/MI often go untreated due in part to a lack of practical, validated screening tools.
Setting: HIV clinic in academic medical center.
Methods: The 16-item SA/MI Symptoms Screener (SAMISS) targets SA/MI in HIV-positive patients. Consecutive consenting HIV-positive patients completed the SAMISS and then a reference standard diagnostic tool, SCID, the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition).
Results: Twenty percent of participants (29/148) had an SA diagnosis and 41% (59/143) had an MI diagnosis in the past year on the SCID; 48% (68/143) had 1 or both. Thirty-seven percent (55/148) screened positive for SA and 69% (99/143) screened positive for MI on the SAMISS. The SAMISS had 86% (95% CI: 68%-96%) sensitivity and 75% (66%-82%) specificity for SA and 95% (86%-99%) sensitivity and 49% (38%-60%) specificity for MI. Patients with SA were likely to show up as false positives for MI and vice versa.
Conclusion: The SAMISS functioned well as a first-line screening tool for SA/MI in this HIV clinic population. It missed few cases and was easily incorporated into a busy clinical setting. Persons screening positive require a more rigorous confirmatory psychiatric evaluation.
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http://dx.doi.org/10.1097/01.qai.0000177512.30576.9c | DOI Listing |
PLoS Med
January 2025
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
Background: Globally, over one-third of pulmonary tuberculosis (TB) disease diagnoses are made based on clinical criteria after a negative bacteriological test result. There is limited information on the factors that determine clinicians' decisions to initiate TB treatment when initial bacteriological test results are negative.
Methods And Findings: We performed a systematic review and individual patient data meta-analysis using studies conducted between January 2010 and December 2022 (PROSPERO: CRD42022287613).
Cureus
December 2024
Hematology Oncology, Miami Cancer Institute, Miami, USA.
Patients with multiple myeloma (MM) often experience infections due to aberrant immunoglobulin production by malignant plasma cells and immunosuppressive therapeutic interventions that are used to treat the condition. A rare but serious infection that may occur in these patients is Cryptococcus, an encapsulated fungus that typically infects immunocompromised individuals. Cryptococcus infections often present as pneumonia but can disseminate to the central nervous system, potentially causing meningitis.
View Article and Find Full Text PDFEuroasian J Hepatogastroenterol
December 2024
Department of Microbiology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Introduction: One of the main causes of primary hepatocellular carcinoma and chronic hepatitis is the hepatitis C virus (HCV), with significant variability in its genotypes affecting pathogenicity and treatment outcomes. In India, prevalence ranges from 0.5 to 1.
View Article and Find Full Text PDFIJTLD Open
January 2025
Nairobi Research Station, Nagasaki University Institute of Tropical Medicine (NUITM)-Kenya Medical Research Institute (KEMRI) Project, Nairobi, Kenya.
Background: The loop-mediated isothermal amplification for TB (TB-LAMP) assay is more cost-effective and accessible than the Xpert MTB/RIF assay. This study aimed to evaluate the diagnostic performance of the TB-LAMP assay in individuals with and without HIV infection.
Methods: Patients aged ≥15 years presenting with symptoms of TB were included in the study.
Res Social Adm Pharm
January 2025
Helpharma, Medellín, Colombia. Electronic address:
Background: In recent years, the life expectancy of HIV patients has increased due to the introduction and development of antiretroviral therapies. However, although it has become a chronic pathology, the patients present a higher metabolic, hepatic, and renal risk and a greater aging than the general population.
Objective: To identify the main factors associated with clinical alterations in patients with HIV.
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