• Title/Summary/Keyword: AIDS Patient

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Safe anesthesia for office-based plastic surgery: Proceedings from the PRS Korea 2018 meeting in Seoul, Korea

  • Osman, Brian M.;Shapiro, Fred E.
    • Archives of Plastic Surgery
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    • v.46 no.3
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    • pp.189-197
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    • 2019
  • There has been an exponential increase in plastic surgery cases over the last 20 years, surging from 2.8 million to 17.5 million cases per year. Seventy-two percent of these cases are being performed in the office-based or ambulatory setting. There are certain advantages to performing aesthetic procedures in the office, but several widely publicized fatalities and malpractice claims has put the spotlight on patient safety and the lack of uniform regulation of office-based practices. While 33 states currently have legislation for office-based surgery and anesthesia, 17 states have no mandate to report patient deaths or adverse outcomes. The literature on office-base surgery and anesthesia has demonstrated significant improvements in patient safety over the last 20 years. In the following review of the proceedings from the PRS Korea 2018 meeting, we discuss several key concepts regarding safe anesthesia for office-based cosmetic surgery. These include the safe delivery of oxygen, appropriate local anesthetic usage and the avoidance of local anesthetic toxicity, the implementation of Enhanced Recovery after Surgery protocols, multimodal analgesic techniques with less reliance on narcotic pain medications, the use of surgical safety checklists, and incorporating "the patient" into the surgical decision-making process through decision aids.

A Case of Deep Neck Infection by Tuberculosis in AIDS (AIDS환자에서 발생한 결핵성 심경부감염 1례)

  • Moon Jun Hwan;Choi Ho Young;Lee Deung Ho;Jun Sung Hwan
    • Korean Journal of Bronchoesophagology
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    • v.11 no.1
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    • pp.37-41
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    • 2005
  • Deep neck infections mean infection in the potential spaces and facial planes of the neck, either abscess formation or cellulitis. Deep neck infections are caused by dental, salivary gland, pharyngeal and tonsillar infections. Sometimes, deep neck infection may be caused by tuberculosis in case of immunodefiecient patients. Acquired immunodeficiency syndrome(AIDS) is a disease associated with defective cell-mediated immunity after infected with human immunodeficiency virus(HIV). The chance of opportunistic infection in patients of AIDS increases as the level of immunodeficienty progresses. Human immunodeficiency virus infection is the most single significant risk factor for progression of pulmonary tuberculosis to extrapulmonary sites. In patients infected with HIV, the rate of extrapulomonary tuberculosis rises upto $60\%$. We report a case of a 47 year old male patient with AIDS associated with deep neck infection by tuberculosis.

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A Study of the Knowledge and Attitude Toward AIDS and Hepatitis B (Focused on Students of Department of Dental Hygiene Students) (AIDS와 B형간염에 대한 지식 및 태도에 관한연구(일부 치위생과 학생을 중심으로))

  • Choi, Sung-Suk;Lee, Kye-Hee;Ryu, Hae-Gyum
    • Journal of Korean Clinical Health Science
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    • v.2 no.3
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    • pp.195-202
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    • 2014
  • Purpose. The purpose of this study was conducted to provide the hospital infection control and personal protection, protection of the technician based on data by examining the relationship of hepatitis B knowledge of AIDS knowledge and attitudes of dental hygiene students and the purpose of the present study. Methods. The research subjects were 390 dental hygiene students in limited and data were collected through structured questionnaires. The collected data is analyzed by spss version 14.0 a statistical program for the frequency and one-way ANOVA, multiple linear regression analysis. Results. The received training students of AIDS knowledge and attitudes were higher, hepatitis B knowledge scores and attitudes about AIDS was a statistically significant difference (p <0.001), The experience clinical practice students was AIDS knowledge and attitudes were hepatitis B knowledge high score and difference was statistically significant(p <0.05), The knowledge AIDS and hepatitis B, higher score showed the attitudes significant increase was found to be a static relationship between two variables by both statistically (p <0.001). Conclusion. In order to provided with a thorough prevention program for infectious disease, strengthen school health education and clinical training to help achieve a mutually constructive relationship with the patient through proper education about infectious diseases.

An Efficient Hospital Service Model of Hierarchical Property information classified Bioinformatics information of Patient (환자의 바이오인포매스틱 정보를 속성수에 따라 계층적으로 분류한 효율적인 의료서비스 모델)

  • Seo, In-Kyu;Lee, Sang Ho
    • Journal of Convergence Society for SMB
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    • v.5 no.4
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    • pp.17-23
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    • 2015
  • Due to the development of information and communication technology as health care service is popular variety utilizing bioinformatics patient information services are being provided to the patient. In particular, the healthcare utilizing bioinformatics information, and change in a variety of healthcare trends. However, healthcare services using bioinformatics information of the patient and the complexity of the disease, new diseases (SARS, AIDS, etc .) due to the emergence of increasing health care costs and health promotion services provided to patients may not be smooth. In this paper, we propose a model for low-cost health services and medical care of patients bioinformatics fast access to information. The proposed model can be so big a bioinformatics data formation by the patient's patient information anytime / anywhere providing medical services in the home or the nearest hospital for their own disease management. In particular, the proposed model of health care services is characterized improve work efficiency, reducing the burden on hospitals by passing a medical illness to easily analyze patient information.

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A Case of Middle Ear Implantation Using the Vibrant Soundbridge in a Patient with Bilateral Mixed Hearing Loss (양측 혼합성 난청 환자에서 Vibrant Soundbridge를 이용하여 시행한 인공중이이식술 1예)

  • Shin, Yong Gook;Gu, Ja Won;Kang, Jin Wook;Song, Mee Hyun
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • v.61 no.12
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    • pp.705-709
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    • 2018
  • It is challenging to achieve sufficient hearing gain in patients with mixed hearing loss. In chronic middle ear diseases, conventional passive reconstructive surgeries often result in suboptimal hearing gain and additional hearing aids may have limitations due to insufficient sound amplification, occlusion effect, acoustic feedback, and skin irritation. Middle ear implantation (MEI) using Vibrant Soundbridge (VSB) is another option for auditory rehabilitation in mixed hearing loss as well as sensorineural hearing loss. The floating mass transducer of VSB can be placed on various middle ear structures either directly or using different types of couplers in order to deliver vibratory mechanical energy to the cochlea. We report a patient who presented with bilateral mixed hearing loss due to chronic otitis media and had limitations using conventional hearing aids in the worse hearing ear. The patient was successfully treated with MEI using the Bell coupler together with middle ear surgery in a single step.

CMV Infection in AIDS Patients Depends on the Decrease of CD4+ T Cell Count (AIDS 환자에서 CD4+ T 세포수 감소에 따른 CMV 감염)

  • Cho, Young-Keol;Kim, Yoo-Kyum;Oh, Won-Il;Cho, Goon-Jae
    • The Journal of Korean Society of Virology
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    • v.28 no.4
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    • pp.359-368
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    • 1998
  • Cytomegalovirus is the most common cause of life-threatening viral infection in HIV-infected patients. This study was done prospectively to investigate the incidence of CMV infection according to the decrease of CD4+ T cell count (CD4+) in Korean AIDS patients. Thirty-nine HIV-infected patients diagnosed before 1994 were followed for regular immunological monitoring. We have used urine shell vial method for the CMV detection from 1994 and have also checked clinical findings. Positive urine culture rate definitely depended on the CD4+ as follows; 45%, 22%, 17%, 11% and 0%, CD4+ <50, 50-100, 100-200, 200-500 and >500, respectively. Except culture positive 2 patients with CD4+ of $200{\sim}300/{\mu}l$, all eight culture positive patients with CD4+ less than $200/{\mu}l$ showed CMV related diseases on or before urine culture. But, we could not get a positive culture for a late AIDS patient with vision loss. With ganciclovir therapy, all culture results were at least negative just after or on late of first 14 days-ganciclovir infusion-course. These data suggest that the incidence of CMV disease in Korean AIDS patients is very high, and early diagnosis and treatment for CMV diseases is required for the prevention of life threatening results.

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Pregnancy Rates and Outcomes of HIV-Infected Women in Korea

  • Choi, Heun;Kim, Moo Hyun;Lee, Se Ju;Kim, Eun Jin;Lee, Woonji;Jeong, Wooyong;Jung, In Young;Ahn, Jin Young;Jeong, Su Jin;Ku, Nam Su;Baek, Ji Hyeon;Choi, Young Hwa;Kim, Hyo Youl;Kim, June Myung;Choi, Jun Yong
    • Journal of Korean Medical Science
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    • v.33 no.47
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    • pp.296.1-296.7
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    • 2018
  • Background: Antepartum, intrapartum, and postpartum preventive measures with antiretroviral drugs, appropriate delivery methods, and discouraging breastfeeding significantly decrease the risk of mother-to-child transmission of human immunodeficiency virus (HIV) infection. Herein, we investigated the pregnancy outcomes in HIV-infected Korean women. Methods: We retrospectively reviewed medical records of childbearing-age HIV-infected women between January 2005 and June 2017 at four tertiary care hospitals in Korea. Results: Among a total of 95 HIV infected women of child-bearing age with 587.61 years of follow-up duration, 15 HIV-infected women experienced 21 pregnancies and delivered 16 infants. The pregnancy rate was 3.57 per 100 patient-years. Among the 21 pregnancies, five ended with an induced abortion, and 16 with childbirth including two preterm deliveries at 24 and 35 weeks of gestation, respectively. The two preterm infants had low birth weight and one of them died 10 days after delivery due to respiratory failure. Among the 14 full-term infants, one infant was small for gestational age. There were no HIV-infected infants. Conclusion: The pregnancy rate of HIV-infected women in Korea is lower than that of the general population. Although several adverse pregnancy outcomes were observed, mother-to-child transmission of HIV infection was successfully prevented with effective preventive measures.

The Clinical Manifestation of Pulmonary Infection in AIDS Patients (국내 일개 대학병원에서 경험한 AIDS 환자의 폐 감염성 질환의 임상적 특성)

  • Jung, Jae Woo;Chung, Jin Won;Song, Ju Han;Jeon, Eun Ju;Lee, Young Woo;Choi, Jae Cheol;Shin, Jong Wook;Park, In Whon;Choi, Byoung Whui;Kim, Jae Yeol
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.6
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    • pp.554-561
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    • 2006
  • Background: In AIDS patients, the respiratory tract is one of the most frequently involved site of by an opportunistic infection, and an even common, casual pulmonary infection manifests in a peculiar ways in AIDS patients. In Korea, because of the low prevalence of AIDS, there is insufficient data compared with other Southeast Asian counties. However, considering the sexual behavior of the younger generation, it is expected that it will not be long before AIDS becomes a major public health issue in Korea. This study examined the clinical manifestation of HIV positive people and AIDS patients. The pulmonary manifestion of HIV-positive was evaluated. This study focused on the differences in the clinical manifestation between AIDS patients with pulmonary disease and simple HIV positive people. The characteristics of common pulmonary infections in AIDS patients were also analyzed. Method: The medical records of 28 HIV positive patients who visited the hospital of ChungAng University Hospital from January, 2001 to February, 2006 were analyzed retrospectively. Result: Twenty-seven patients out of 28 HIV positive patients were male and the average age was 40.6(23-65). Patients in their thirties were most commonly affected. Elven patients had pulmonary diseases. Pulmonary tuberculosis (4 cases) and pneumocystis pneumonia (4 cases) were the most common respiratory infection. One patient showed a peculiar type of systemic cryptococcus. which was accompanied by lung and pleural dissemination. The CD4+lymphocyte count of patients with a pulmonary infection was significantly lower in patients with a pulmonary manifestation than those with only a HIV infection ($79.5/mm^3$ vs $400/mm^3$, respectively)(p<.05). Patients with pulmonary disease were in a more severe immunosuppressive state. There were 4 patients with pulmonary tuberculosis, 4 with pneumocystis pneumonia, 4 with secondary syphilis, 2 with primary syphilis, and 2 with HZV infection. The average CD4 lymphocyte counts was $56/mm^3$ in those with pulmonary tuberculosis, $42/mm^3$ in those with pneumocystis pneumonia, and $455/mm^3$ in those with secondary syphilis. Conclusion: This study examined the clinical manifestation of HIV positive patients, particularly AIDS patients with pulmonary disease, A more severe immunosuppressive status was observed in HIV-related pulmonary compared with those with HIV-related extrapulmonary disease, and the frequency of pulmonary tuberculosis in pulmonary disease was higher than expected. Respiratory infection in AIDS manifest in uncommon ways e.g. disseminated cryptococcosis involving the lung and pleura. Evidently, AIDS patients with a respiratory infection have a more severe form of immunosuppression than those with a simple HIV infection. As expected, patients with a pulmonary infection were in a more severe immunosuppressed state than those with a simple HIV infection. Opportunistic infections can show peculiar clinical presentations in AIDS patients.

Oral manifestations and their correlation to baseline CD4 count of HIV/AIDS patients in Ghana

  • Frimpong, Paul;Amponsah, Emmanuel Kofi;Abebrese, Jacob;Kim, Soung Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.1
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    • pp.29-36
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    • 2017
  • Objectives: Acquired immunodeficiency syndrome (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus (HIV). People with AIDS are much more vulnerable to infections, including opportunistic infections and tumors, than people with a healthy immune system. The objective of this study was to correlate oral lesions associated with HIV/AIDS and immunosuppression levels by measuring clusters of differentiation 4 (CD4) cell counts among patients living in the middle western regions of Ghana. Materials and Methods: A total of 120 patients who visited the HIV clinic at the Komfo Anokye Teaching Hospital and the Regional Hospital Sunyani of Ghana were consecutively enrolled in this prospective and cross-sectional study. Referred patients' baseline CD4 counts were obtained from medical records and each patient received an initial physician assessment. Intraoral diagnoses were based on the classification and diagnostic criteria of the EEC Clearinghouse, 1993. After the initial assessment, extra- and intraoral tissues from each enrolled patient were examined. Data analyses were carried out using simple proportions, frequencies and chi-square tests of significance. Results: Our study included 120 patients, and was comprised of 42 (35.0%) males and 78 (65.0%) females, ranging in age from 21 to 67 years with sex-specific mean ages of 39.31 years (males) and 39.28 years (females). Patient CD4 count values ranged from 3 to 985 cells/mL with a mean baseline CD4 count of 291.29 cells/mL for males and 325.92 cells/mL for females. The mean baseline CD4 count for the entire sample was 313.80 cells/mL. Of the 120 patients we examined, 99 (82.5%) were observed to have at least one HIV-associated intraoral lesion while 21 (17.5%) had no intraoral lesions. Oral candidiasis, periodontitis, melanotic hyperpigmentation, gingivitis and xerostomia were the most common oral lesions. Conclusion: From a total of nine oral lesions, six lesions that included oral candidiasis, periodontitis, melanotic hyperpigmentation, gingivitis, xerostomia and oral hairy leukoplakia were significantly correlated with declining CD4 counts.