[Developing and establishing an expanded and more comprehensive HIV/AIDS nursing practice]. / Entwicklung und Etablierung einer erweiterten und vertieften HIV/Aids-Pflegepraxis.

Developing and establishing an advanced nursing practice is an essential step toward future-oriented nursing care. An action research process was initiated to establish advanced nursing practice at the HIV clinic of the outpatient department at the University Hospital Basel with the goal to offer advanced nursing care to patients. Participatory action research allows generating knowledge about a social system while at the same time tempts to promote social change. The most important goal is to constantly analyse, improve, and evaluate nursing care for patients and family caregivers. Advanced nursing practice in HIV/AIDS is based on solid knowledge regarding the illness and current therapies. Central concepts are caring, clinical experiences, evidence based practice, and patient preferences. Through a systematic step-by-step process, the nurses at the HIV clinic are being better educated and more experienced in these concepts. An essential aspect of advanced nursing practice is the specialization of each nurse in a self selected topic within HIV/AIDS care. These nurses now offer new services such as medication management and adherence support, health maintenance and prevention, and symptom management. This ongoing process of learning while establishing advanced nursing practice in HIV/AIDS, enables the nurses to face future changes in health care in a proactive way.

Importance of mental health assessment in HIV-infected outpatients.

HIV infection, even when well controlled, may be associated with important mental health problems. We sought to investigate anxiety, depression, and health-related quality of life using screening measurements in patients with HIV infection and to examine their dependency on biosocial parameters relating to HIV. Prospective clinical, virologic, and immunologic data were obtained in a cross-sectional study within the Swiss HIV Cohort Study. Four self-reported questionnaires were used in 397 HIV-infected individuals. The scores for anxiety and depression were high as measured by the Hospital Anxiety and Depression Scale (HADS) and the State Trait Anxiety Inventory (STAI). Half the population scored <75 on a visual analog scale (VAS) Patients were also affected in their quality of life as measured by the HIV Medical Outcome Study (HIV-MOS). Almost all scores were significantly worse for intravenous drug users compared with other transmission groups. People who were employed, with a higher education or with higher CD4 count tended to score better, whereas those who had been hospitalized within the last 6 months, infected for a longer time, with higher viral load, or loss of weight scored significantly worse. A multivariate analysis showed higher education, being employed, low viral load, female gender, and shorter HIV disease duration to be associated with better scores. This study highlights the importance of mental health assessment regardless of HIV-disease parameters.

[Prolactin. New clinical importance of a phylogenetically old hormone]. / Prolaktin Neue klinische Bedeutung eines phylogentisch alten Hormons

New clinical significance of a phylogenetically old hormone. Recently, human Prolactin(hPRL) has been established as an anterior pituitary hormone which can be separated from growth hormone. By radioimmunoassay of hPRL it could be shown that many pituitary tumors formerly thought to be hormonally inactive, were in fact producing prolactin. Hyperprolactinaemia, with and without pituitary tumors, causing amenorrhea and galactorrhea in females, and loss of libido and impotence in males, can be treated effectively by neurosurgical procedures in tumor cases, or by medical inhibition of hPRL-secretion with bromocryptin.