Although miliary tuberculosis is uncommon during pregnancy. it is often associated with a maternal history of intravenous drug abuse, malignancy, alcoholism, or human immunodeficiency virus infection, and it is difficult to diagnose when associated with pregnancy. There is no solid evidence that pregnancy has an adverse effect on tuberculosis, thus routine therapeutic abortion is not indicated. If the early diagnosis and promptly adequate chemotherapy was done, the outcome of pregnancy in a women with miliary tuberculosis is likely to be good. Recently we have experienced a case of miliary tuberculosis at 20 weeks gestation without any risk factors of tuberculosis. So we report this case with a brief review of literature.
Abortion, Therapeutic ; Alcoholism ; Drug Therapy ; Early Diagnosis ; Female ; HIV ; Humans ; Pregnancy* ; Risk Factors ; Substance Abuse, Intravenous ; Tuberculosis ; Tuberculosis, Miliary*

Objective: To estimate the prevalence of HIV/HCV co-infection and explore the influence factors and their interaction on HIV/HCV co-infection of patient's access to methadone maintenance treatment (MMT). Methods: A face to face interviews were conducted among 750 patients at two MMT clinics in Guangxi Zhuang Autonomous Region. The questionnaires information included demographic characteristics, HIV and HCV infection status, history of drug abuse, urine test for morphine, high risk sex behaviors, needle sharing, dropped out etc. Methods of χ(2) test one-way, multivariate logistic regression and interactions were used to analyze the related factors of HIV/HCV co-infection. Results: The study subjects included 750 participants, 18.31% (127/691) of patients were co-infected with HIV and HCV. The HIV/HCV co-infection rate in patients who shared needles with others or dropped out of treatment was 35.84% (81/226) and 19.88% (64/322) respectively, which were higher than those who have never shared needles or dropped out (9.89%, 46/465 and 17.07%, 63/369). Logistic regression analysis results showed that after adjusted for confounding factors, patients who shared needles (OR=4.50, 95%CI: 2.72-7.43) and dropped out of treatment (OR=1.71, 95%CI: 1.04-2.80) were more likely to be infected with HIV/HCV. Interaction analysis showed that sharing needles and dropping out of treatment exist additive effect on co-infection of HIV and HCV (RERI=4.21, AP=0.44, SI=1.95). Conclusions: Needle sharing and dropping out of treatment are associated with HIV/HCV co-infection. Health education, psychological counseling and other measures should be taken to reduce needle sharing and dropping out of MMT.
China/epidemiology* ; Coinfection/epidemiology* ; Female ; HIV Infections/epidemiology* ; Hepatitis C/diagnosis* ; Humans ; Logistic Models ; Male ; Methadone/therapeutic use* ; Morphine ; Needle Sharing ; Opiate Substitution Treatment ; Prevalence ; Risk Factors ; Sexual Behavior ; Substance Abuse, Intravenous/drug therapy* ; Substance-Related Disorders

OBJECTIVETo identify predictors of treatment retention problems at the two initial methadone maintenance treatment (MMT) clinics in Guangdong province, and to provide reference in reducing the rate of drop-outs.

METHODSAll of the patients were investigated at baseline and followed during the treatment period. Kaplan-Meier method on Survival Analysis was used to analyze retention related factors and predictors.

RESULTS509 subjects were recruited in this study with median of retention time as 108 days (95%CI: 74 - 142 days). The retention rate at 1-, 3-, 6-, 12-months were 75.9%, 52.7%, 41.6%, 30.1%, respectively. Data from Multivariate Cox Proportional Hazard Model analysis showed predictors of retention would involve factors as HIV infection state at baseline (HR = 1.241, P = 0.047), daily methadone dose (HR = 0.633, P = 0.004) and secretly using drugs during treatment period (HR = 5.345, P = 0.000).

CONCLUSIONThe retention rates at the two initial MMT clinics in Guangdong province were low. Patients who were HIV negative at baseline but still secretly using heroine during treatment or accepted low daily average dosage of methadone, had the tendency to drop out. The results implied that retention time could be prolonged by increasing daily methadone dosage.

Acquired Immunodeficiency Syndrome ; mortality ; Adult ; China ; Female ; Heroin Dependence ; therapy ; Humans ; Male ; Methadone ; administration & dosage ; therapeutic use ; Opiate Substitution Treatment ; Patient Compliance ; statistics & numerical data ; Patient Dropouts ; statistics & numerical data ; Substance Abuse Treatment Centers ; Substance Abuse, Intravenous ; drug therapy ; Survival Rate

INTRODUCTIONBuprenorphine is an opioid partial agonist approved in several countries for the treatment of opioid dependence. It was approved in Singapore in 2002 for this indication, and is more widely available in the primary care setting and can be prescribed by all licensed physicians who have undergone designated training. There is limited literature addressing the risk of its illicit abuse via intravenous self-administration.

CLINICAL PICTUREWe report 2 such cases of the abuse of prescription buprenorphine in the psychiatric consultation-liaison service of a general teaching hospital, the treatment approaches and outcomes.

CONCLUSIONWe also briefly review the indications, uses and abuses of buprenorphine in Singapore, and as reported in other countries, and the roles of primary care physicians, in order to stimulate greater awareness and understanding among specialists and general practitioners, who would encounter these patients in various settings.

Adult ; Buprenorphine ; therapeutic use ; Drug and Narcotic Control ; Female ; Humans ; Male ; Narcotic Antagonists ; therapeutic use ; Opioid-Related Disorders ; rehabilitation ; Pregnancy ; Pregnancy Complications ; diagnosis ; therapy ; Primary Health Care ; Role ; Substance Abuse, Intravenous ; diagnosis ; prevention & control ; therapy

OBJECTIVETo investigate the survival time and its impact factors among AIDS patients who initially received antiretroviral treatment (ART) of Liangshan Yi Autonomous Prefecture, Sichuan province.

METHODSA retrospective cohort study was conducted to analyze the information of AIDS patients over 18 years old initially received ART in Liangshan Yi Autonomous Prefecture during 2005-2013, which were downloaded from Chinese AIDS Antiretroviral Therapy DATA Fax Information System. Cox proportion hazard regression model was used to identify impact factors related survival time.

RESULTSAmong 8 310 ART AIDS patients who initially received ART, their mean age was (34.59 ± 9.10) years old, 65.50% (5 443 cases) were infected with HIV through injecting drug use, the mean time from testing HIV positive to starting ART were (24.68 ± 21.69) months. 436 cases died of AIDS related diseases, 28.67% (125 cases) of them died within the first 6 months of treatment. The cumulative survival rate of receiving ART in 1, 2, 3, 4 5 years were 97.11%, 93.41%, 90.61%, 88.81%, 86.02%, respectively. Multivariate Cox regression analysis showed the male patients receiveing ART were at a higher risk death of AIDS related diseases compared to the females (HR = 1.57, 95% CI: 1.13-2.182), the patients infected with HIV through injecting drug use were at a higher risk deathcompared to the infected through heterosexual transmission (HR = 1.64, 95% CI: 1.20-2.24), before the treatment patients with tuberculosis in recent1 year had higher death hazard as compared to those without tuberculosis (HR = 1.53, 95% CI: 1.05-2.21), in the treatment of the first 3 months of AIDS related diseases or symptoms of AIDS patients had higher death hazard as compared to those not suffer these diseases (HR = 1.80, 95% CI: 1.39-2.34). The patients with baseline CD4 (+) T lymphocytes cell counts < 50/µl (HR = 9.79, 95% CI: 6.03-15.89), 50-199/µl (HR = 3.26, 95% CI: 2.32-4.59), 200-349/µl (HR = 1.69, 95% CI: 1.22-2.34), were at a higher risk death than those with CD4 (+) T lymphocytes cell counts ≥ 350/µl.

CONCLUSIONAccumulate survival rate was higher after initial antiretroviral treatment among AIDS patients in Liangshan Yi Autonomous Prefecture, Sichuan province. AIDS patients who are males, have tuberculosis in recent year, infected HIV via route of intravenous drug use, with AIDS-related illness or symptoms in 3 months before ART, lower baseline CD4 (+) T lymphocyte count have higher risk of death.

Acquired Immunodeficiency Syndrome ; drug therapy ; mortality ; Adult ; Anti-Retroviral Agents ; therapeutic use ; Asian Continental Ancestry Group ; China ; Female ; Humans ; Lymphocyte Count ; Male ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Substance Abuse, Intravenous ; Survival Rate ; Tuberculosis ; complications