Archive for March, 2011

Questions about risk behaviors are the most direct way to gauge a patient’s risk of HIV infection. However, it is also important to be aware of diseases that are acquired through similar risk behaviors – the presence of any one of these diseases significantly increases a patient’s risk of testing positive for HIV infection.

Other Sexually Transmitted Disease
The diagnosis of any sexually transmitted disease markedly raises the likelihood of HIV infection.
Not all sexually transmitted diseases (STDs) require the passage of infected body fluids from person to person for disease transmission (e.g., herpes simplex, syphilis), and therefore not all patients with STDs engage in risk behaviors that increase the likelihood of acquiring HIV infection. However, multiple studies have consistently shown marked increases in HIV seroprevalence among patients seeking treatment for other STDs. Certain STDs (e.g., gonorrhea) may be more associated with HIV than others, but in general, approximately 5% to 10% of patients with other STDs are HIV-infected. Unfortunately, studies also show that one half to two thirds of patients presenting for STD care have never been tested for HIV. Any STD diagnosis must prompt a recommendation for HIV testing.

Hepatitis
Patients with acute or chronic hepatitis В or С infections should be tested for HIV infection.
Chronic liver disease has become a major cause of morbidity and mortality in HIV-infected patients. Hepatitis В infection can be acquired either through sexual transmission or through exposure to contaminated blood. Hepatitis С infection is predominantly spread through blood exposure, most often in the setting of shared needles during intravenous drug use. Since the modes of acquisition of these infections are also risk factors for HIV infection, all patients with chronic viral hepatitis and patients with acute hepatitis В should be tested for HIV.

Psychiatric Illness
The prevalence of HIV infection in patients with severe psychiatric illnesses, including non-injection substance abuse, may be as high as 5% to 8%.
One review of seroprevalence studies demonstrated an aggregate seroprevalence of 8.5% in samples from mentally ill patients in New York City, but a 5.6% seroprevalence in smaller cities in the eastern United States. A later statewide seroprevalence survey from North Carolina found that 1.6% of patients admitted to state mental hospitals were HIV-infected. While this last number is significantly lower than those from urban centers, it still represents a fourfold increased risk over the United States population as a whole. Furthermore, it is worth noting that many patients with severe mental illness are chronically cared for in settings where HIV testing should be readily available.
Non-injection substance abuse (e.g., alcoholism or inhalational or crack cocaine use) has consistently been found to be a risk factor for HIV infection, presumably through the effect of intoxication on a patient’s ability to make sound decisions regarding risk behaviors. Although injection drug use is probably a more significant risk factor, non-action substance abuse is much more prevalent and likely drives a large number of the new HIV infections each year. Patients with active or past non-injection substance abuse are at higher risk for HIV infection.

Pregnancy
All pregnant women should be tested for HIV infection.
Babies born to HIV-infected mothers have a 25% chance of acquiring the infection in the perinatal period if the mother is not treated. However, with the advent of highly active antiretroviral therapy, it is estimated that the risk of transmission can be lowered to less than 2%. Unfortunately, a recently released report from CDC shows that only about half of pregnant women had documented HIV tests. It is precisely the process of offering HIV testing only to those women in perceived risk groups that limits the scope of testing. Because the risk-to-benefit ratio of preventing perinatal transmission so strongly favors testing, all pregnant women should be strongly encouraged to be tested. One issue that prevents an appropriately counseled woman from accepting the test may relate to domestic violence, so inquiring about its presence should be a part of counseling in such situations. A more thorough discussion of issues pertaining to HIV testing of pregnant women can be found elsewhere.
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The essential features of the negative MIMULUS state comprise:
(a) Fear of known origin.
(b) Shy, timid, nervous, very sensitive physically.
(c) Specific anxieties and phobias of abstract things like; fear of the cold, fear of some disease, fear of thunder or lightening, fear of losses, fear of accident, fear of ghosts, fear of the future etc.
(d) All types of hyper-sensitiveness; i.e. to cold, to noise, conflict, loud argument, contradiction, atmospheric change, or environmental change etc.
(e) Nervousness, apprehension of coming events, nervous laughter, blushes easily, stammers or low husky voice.
(f) Fear of loneliness, and yet timid or shy in society.
(g) Cannot face opposition evenly—becomes nervous
(h) During convalescence he is over cautious—does not move a limb lest the healing process is retarded.
The utility of Mimulus Remedy is not limited to persons afflicted with negative Mimulus state.
We see in every day life a normal person with a perfectly balanced mind, running to a doctor to procure some antidote against measles or flu for his children, when these ailments are raging in the neighbourhood. At such time he also needs the assistance of Mimulus to remove the fear complex in his mind. Sometimes, the patient is so full of ego that he will not directly admit that he has some fear, but an alert Bach Practitioner will discover from his talk, his movements and his expression, the latent fear which he is trying to conceal, and provide for it in his prescription.
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1   Lie flat on your back with one hand on top of the other, the palm resting on your lower abdomen. Exhale thoroughly through your open mouth then close your mouth and inhale through your nose. As the breath goes in, let it take your attention to your lower abdomen, while your belly rises, your hands also rise. Hold the breath for at least 10 seconds then exhale so that your belly becomes flat and your hands once again fall.
Continue relaxed deep breathing focusing on sending the breath deep into your lower abdomen and on the rise and fall of
your hands. If you become aware of any tension do exercise (2) then repeat deep breathing.
2 Stand with feet shoulder-width apart, and with the palm of one hand on top of the other rub in a clockwise motion around the abdominal area. Do this for one minute.
3 Standing with feet shoulder-width apart and hands resting on your hips, rotate your hips. Try and make the centre of the movement as low as possible. First in one direction for a minute then reverse.
4 With feet flat on the floor and hands linked behind the head adopt a crouched position. Bounce up and down and try to squat as deeply as possible.
Then continue bobbing up and down and describe a circular motion, first one way and then the other.
Crouch down with hands linked together on top of your head.
Breathe in and stand up on tiptoes, turning your hands over so that the palms face upward. Stretch as high as you can, then exhale and stretch again before returning to your original position. Repeat 10 times.
Standing with feet shoulder-width apart swing your arms around from one side to the other towards the back to twist your spine.
Then making two light fists, continue swinging but as you swing to the left and exhale, bang your lower back with your left fist at the same time as banging your lower abdomen with your right fist. As you swing to the right you exhale while banging your lower back with your right fist and lower abdomen with your left fist. Make this a smooth rhythmic motion. When digestive disorders are present we often experience tension in the shoulders and lower back. To relax the shoulders rotate the arms in each direction. Bunch your shoulders up towards your ears trying to make as much tension as possible then quickly release and feel them relax.
To loosen the lower back lie on the floor with your hands behind your head and bring your feet up to where your knees were. Drop your knees down to either side.
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