Study Shows High Satisfaction and Success With Internet-Based HIV Care

A group of HIV-positive people who received their health care via the Internet from a Barcelona HIV clinic felt that their care was comparable with—and potentially superior to—standard in-person care. These findings, published January 21 in the online journal PLoS One and reported March 21 on the website Computerworld, could offer hope to select patients in rural settings who must often travel great distances to receive specialty HIV care.

By necessity, providers in resource-poor nations have been quick to adopt electronic communications as ways to provide health care. In countries where people are sometimes more likely to have access to a cell phone than running water or transportation, and where they must sometimes travel 100 miles or more to see a doctor, “e-medicine” has significantly expanded the reach of traditional health care.

Developed countries, including the United States, have been much slower to adopt these new technologies, partially because of concerns that e-medicine would result in poorer care, along with legal concerns about patient privacy. Recent positive experiences with using the Internet and telephones to extend and improve care for people with chronic diseases, such as diabetes, are beginning to tear down the walls that have kept e-medicine from wider implementation.

To determine whether e-medicine could be used in caring for people with HIV, Agathe León, MD, from the University of Barcelona, in Spain, and her colleagues set up a virtual hospital system in 2005 to help streamline care for patients in their HIV clinic. During the first two years of operation, León’s team tested its Internet-based system involving 83 HIV-positive people who were in stable health and had CD4s over 250. The study did not require participants to have an undetectable viral load or to be on antiretroviral (ARV) therapy—though about half were. All participants had a home computer and broadband Internet access.

Over the first year of the study, half of the group received their HIV care, pharmacy consultations, psychological care and appointments with social workers over the computer, while the other half received traditional in-person service. After one year, the groups switched their mode of receiving care. Participants went into local laboratories for any necessary lab work.

León’s team conducted detailed surveys of the participants throughout the study to assess their satisfaction with the care, their psychological health and their quality of life. Each participant’s CD4 count and viral loads were also recorded.

León and her colleagues found that patient satisfaction was high and that overall health and well-being—including CD4 counts and viral loads—were no different between those receiving care through the virtual hospital and those being seen at the clinic. This held true despite the facts that 7 percent started antiretroviral (ARV) therapy during the course of the study and 28 percent switched therapy. In fact, 85 percent reported that the Internet-based system actually made it easier for them to access the care they needed from their providers.

León reported that 200 people with HIV have now been followed through the virtual hospital.

“This program allows patients to continue their treatment without altering their routine. Medication is sent to their home, or other locations specified by the patient,” representatives for León’s clinic stated. “Telemedicine is emerging as a service appropriate for this treatment, and [the virtual hospital] as a safe and effective tool.”



Article compliments of POZ.com

What causes Kidney Failure

One of the number one questions that I get asked almost all the time is how do I go into kidney failure? what caused my kidneys to fail? was there any signs or symptoms that told me it was coming on?

I'll try to answer some of these questions in my blog today.

To understand kidney failure you first have to understand what the kidneys do. The kidneys monitor body fluid along with the concentrations of sodium and potassium and the acid base balance of your body. They filter waste products of body metabolism like urea from protein and uric acid from DNA breakdown.

When blood flows into the kidney centers in the kidney decide how much water to turn into urine as well as with what concentration of electrolytes. The best example to use if the person is dehydrated from exercise or being ill the kidneys will retain as much water as possible and the urine is very very concentrated. When you're extremely hydrated your urine is more dilute, nearly clear. the kidneys also are the source of erythropoietin, a hormone that stimulates your bone marrow to make red blood cells. Most people are familiar with EPO from its extensive coverage in the media as a performance-enhancing drug.

Now that we know what the kidneys do hear are some of the reasons kidneys fail. Kidney failure can be chronic or acute. Low blood flow due to loss of blood, dehydration, and various medications can all cause a slowdown in renal function. Sepsis, the body's immune system being overwhelmed by mass infection, can shut down the kidneys.

The most common causes of renal failure are uncontrolled diabetes and uncontrolled high blood pressure.

In my case I have had high blood pressure since the day I was born.

Were there any symptoms or signs? Yes there were. But I didn't know it at the time. The first was the dark circles under my eyes which developed at around age 15. Also in my late teens it was not uncommon for me to sleep 10 to 12 hours a day. This is not abnormal for a teenager but continuing into my 20s it should have been an indicator. Slowly between my 20s in the 30s I became intolerant of certain foods. I could not eat bananas and tomatoes would make me sick. Now I understand it was an overload of potassium in my body. At age 31, I dropped from 165 pounds down 150 and seemingly overnight my strength went away. I could not even left my lightly packed suitcase. Days after my strength leaving me, I was in the hospital in full renal failure. I had an ammonia taste in my mouth but no discoloring of the skin  no discoloring of the whites of my eyes.

The cause and symptoms of renal failure are different for everyone. it is a good idea to have your doctor do a simple urinalysis for protein to determine whether or not your kidneys are functioning as they should.

Be well and remember knowledge is power!

Red