• Title/Summary/Keyword: Acquired Immunodeficiency syndrome

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Isolated Endobronchial Mycobacterium avium Disease Associated with Lobar Atelectasis in an Immunocompetent Young Adult: A Case Report and Literature Review

  • Kim, Hye In;Kim, Ji Won;Kim, Jun Young;Kim, Young Nam;Kim, Jin Hae;Jeong, Byeong-Ho;Chung, Myung Jin;Koh, Won-Jung
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.412-415
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    • 2015
  • The prevalence of lung diseases caused by nontuberculous mycobacteria (NTM) is increasing worldwide. Unlike pulmonary tuberculosis, endobronchial NTM diseases are very rare with the majority of cases reported in patients with human immunodeficiency virus infection and acquired immune deficiency syndrome. We reported a rare case of endobronchial Mycobacterium avium disease associated with lobar atelectasis in a young immunocompetent patient and reviewed the relevant literature.

Total elbow arthroplasty for active primary tuberculosis of the elbow: a curious case of misdiagnosis

  • Pattu, Radhakrishnan;Chellamuthu, Girinivasan;Sellappan, Kumar;Chendrayan, Kamalanathan
    • Clinics in Shoulder and Elbow
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    • v.25 no.2
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    • pp.158-162
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    • 2022
  • The incidence of musculoskeletal tuberculosis (TB) is on the rise due to the current Acquired Immunodeficiency Syndrome (AIDS) pandemic. Spine is the most common osseous site, followed by other joints. TB identified in the elbow accounts for 2%-5% of skeletal TB cases, which are secondary to pulmonary TB. Primary elbow TB is rare. We report a case of primary TB of the elbow which had a negative synovial biopsy. A 46-year-old right-hand dominant female patient with chronic pain and disability of the right elbow was diagnosed with chronic non-specific arthritis based on an arthroscopic synovial biopsy. The case was diagnosed retrospectively as active TB from bone cuts post total elbow arthroplasty. Anti-tuberculosis treatment (ATT) was given postoperatively for 12 months. The patient reported good functional outcomes at 3 years of follow-up. Such atypical presentations of osteoarticular TB are challenging to diagnose. Therefore, particularly in endemic areas, clinicians should be careful before excluding such a diagnosis even after a negative biopsy. Further research should investigate whether active TB of small joints such as the elbow can be treated with ATT, and early arthroplasty should be a focus of this research.

Determination of N-nitrosodimethylamine in zidovudine using high performance liquid chromatography-tandem mass spectrometry

  • Yujin Lim;Aelim Kim;Yong-Moon Lee;Hwangeui Cho
    • Analytical Science and Technology
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    • v.36 no.6
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    • pp.281-290
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    • 2023
  • Zidovudine is an antiretroviral agent prescribed for the prevention and treatment of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). It is typically recommended to be used in combination with other antiretroviral drugs. Zidovudine has the potential to generate N-nitrosodimethylamine (NDMA) in the presence of dimethylamine and nitrite salt under acidic reaction conditions during the drug manufacturing process. NDMA is a potent human carcinogen that may be detected in drug substances or drug products. An analytical method was developed to determine NDMA in pharmaceuticals including zidovudine using high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). The analysis involved reversed-phase chromatography on a Kinetex F5 column with a mobile phase comprising water-acetonitrile mixtures. The detection of positively charged ions was conducted using atmospheric pressure chemical ionization (APCI). The calibration curve demonstrated excellent linearity (r = 0.9997) across the range of 1-50 ng/mL with a highly sensitive limit of detection (LOD) at 0.3 ng/mL. The developed method underwent thorough validation for specificity, linearity, accuracy, precision, robustness, and system suitability. This sensitive and specific analytical method was applied for detecting NDMA in zidovudine drug substance and its formulation currently available in the market, indicating its suitability for drug quality management purposes.

Effects of Antiretroviral Therapy on the Survival of Human Immunodeficiency Virus-positive Adult Patients in Andhra Pradesh, India: A Retrospective Cohort Study, 2007-2013

  • Bajpai, Ram;Chaturvedi, Himanshu;Jayaseelan, Lakshmanan;Harvey, Pauline;Seguy, Nicole;Chavan, Laxmikant;Raj, Pinnamaneni;Pandey, Arvind
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.6
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    • pp.394-405
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    • 2016
  • Objectives: The survival outcomes of antiretroviral treatment (ART) programs have not been systematically evaluated at the state level in India. This retrospective study assessed the survival rates and factors associated with survival among adult human immunodeficiency virus (HIV)-infected patients in Andhra Pradesh, India. Methods: The present study used data from 139 679 HIV patients aged ${\geq}15$ years on ART who were registered from 2007 to 2011 and were followed up through December 2013. The primary end point was death of the patient. Mortality densities (per 1000 person-years) were calculated. Kaplan-Meier and Cox-regression models were used to estimate survival and explore the factors associated with survival. Results: The overall median follow-up time was 16.0 months (2.0 months for the deceased and 14.0 months for those lost to follow-up). Approximately 13.2% of those newly initiated on ART died during follow-up. Of those deaths, 56% occurred in the first three months. The crude mortality rate was 80.9 per 1000 person-years at risk. The CD4 count (adjusted hazard ratio [aHR],4.88; 95% confidence interval [CI], 4.36 to 5.46 for < $100cells/mm^3$ vs. > $350cells/mm^3$), functional status (aHR, 3.05; 95% CI, 2.82 to 3.30 for bedridden vs. normal), and body weight (aHR, 3.69; 95% CI, 3.42 to 3.97 for <45 kg vs. >60 kg) were strongly associated with the survival of HIV patients. Conclusions: The study findings revealed that high mortality was observed within the first three months of ART initiation. Patients with poor baseline clinical characteristics had a higher risk of mortality. Expanded testing and counseling should be encouraged, with the goal of ensuring early enrollment into the program followed by the initiation of ART in HIV-infected patients.

Hospice & Palliative Care Policy in Korea (한국의 호스피스완화의료정책)

  • Kim, Chang Gon
    • Journal of Hospice and Palliative Care
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    • v.20 no.1
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    • pp.8-17
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    • 2017
  • Globally, efforts are being made to develop and strengthen a palliative care policy to support a comprehensive healthcare system. Korea has implemented a hospice and palliative care (HPC) policy as part of a cancer policy under the 10 year plan to conquer cancer and a comprehensive measure for national cancer management. A legal ground for the HPC policy was laid by the Cancer Control Act passed in 2003. Currently in the process is legislation of a law on the decision for life-sustaining treatment for HPC and terminally-ill patients. The relevant law has expanded the policy-affected disease group from terminal cancer to cancer, human immunodeficiency virus/acquired immune deficiency syndrome, chronic obstructive pulmonary disease and chronic liver disease/liver cirrhosis. Since 2015, the National Health Insurance (NHI) scheme reimburses for HPC with a combination of the daily fixed sum and the fee for service systems. By the provision type, the HPC is classified into hospitalization, consultation, and home-based treatment. Also in place is the system that designates, evaluates and supports facilities specializing in HPC, and such facilities are funded by the NHI fund and government subsidy. Also needed along with the legal system are consensus reached by people affected by the policy and more realistic fee levels for HPC. The public and private domains should also cooperate to set HPC standards, train professional caregivers, control quality and establish an evaluation system. A stable funding system should be prepared by utilizing the long-term care insurance fund and hospice care fund.

Knowledge and Attitude toward HIV/AIDS among Professional Graduate Medical School Students (의학전문대학원 학생들의 HIV/AIDS 관련 지식 및 태도)

  • Seo, Myoung Hee;Jeong, Seok Hee;Shin, Ja Hyun;Lee, Myung In
    • Journal of Digital Convergence
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    • v.13 no.11
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    • pp.255-265
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    • 2015
  • This study was done to identify the levels of knowledge and attitude toward HIV/AIDS in professional graduate medical school students. A cross-sectional survey was used, and data were collected in 2014. Participants were 97 students in South Korea. Data were analyzed using SPSS WIN 19.0 program. The mean score for HIV/AIDS knowledge was 8.91 and attitude was 7.00 out of 15. The levels of HIV/AIDS knowledge and attitude were not statistically significantly different according to participants' general characteristics. There was a statistically significant correlation between the levels of HIV/AIDS knowledge and attitude. Medical students having a high HIV/AIDS knowledge level tended more towards a positive attitude. These findings can be used in developing effective education strategies for medical students and health care providers to increase knowledge and decrease negative attitude toward HIV/AIDS.

Correlations of AIDS Knowledge, Self-esteem, Sense of Control, Optimistic Bias toward AIDS, and Condom Use among Male College Students in China (중국 남자 대학생의 에이즈 지식, 자아존중감, 자기통제감, 에이즈에 대한 낙관적 편견, 콘돔 사용의 관계)

  • Kwon, Sue-Young;Lee, Dong-Suk
    • Journal of Digital Convergence
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    • v.16 no.4
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    • pp.277-288
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    • 2018
  • This study investigated the correlations of the AIDS knowledge, self-esteem, sense of control, optimistic bias toward AIDS, and condom use in the Chinese male college students. A cross-sectional survey was used, and 307 male students were recruited from anonymous universities in cities of two provinces in China. The data were analyzed according to descriptive statistics, ANOVA, Pearson's correlations. The Chinese male college students had an optimistic bias toward AIDS. The score of AIDS knowledge was 73%, and the self-esteem and sense of control scores were all rated higher than the median. The difference among groups according to grade and age were statistically significant in this study. The self-esteem, sense of control, and optimistic bias toward AIDS showed significant positive correlations, but AIDS knowledge, optimistic bias, and condom use have no correlations. The studies that examine psychological variables with condom use among various groups should be followed in the Chinese context.

AIDS-related Knowledge, Attitudes and AIDS-Education Needs of Male Workers in Seoul and Kyungki areas (성인 남성 직장인의 AIDS 관련 지식, 태도 및 보건교육 요구도 조사 -서울, 경기 일부 지역을 중심으로-)

  • 전미경;김초강;진기남
    • Korean Journal of Health Education and Promotion
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    • v.16 no.2
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    • pp.1-17
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    • 1999
  • AIDS (Acquired Immunodeficiency Syndrome) known as 20th century's pest is spreading rapidly internationally, and the number of patients are increasing. Since the prevention vaccine has not been developed yet, the only available effective method for preventing AIDS is the health education. Most of the AIDS-infected persons are males, and especially over twenties of age. Therefore, it is necessary to measure the knowledge and attitudes on AIDS of male workers. The purpose of this study is to examine the knowledge, attitudes and education-needs of male workers on AIDS. The data were collected by a questionnaire survey of 977 workers who work in Seoul and Kyungki areas from September 1 thru October 4, 1997. The results were as follows: 1. We examined the level of knowledge on AIDS transmission, symptoms, diagnoses, and prevention methods. Even though respondents had a moderate level of AIDS-related knowledge, still sizable numbers believed that AIDS could be transmitted through casual contact. White-collar workers, higher education groups, higher income groups or those with age thirties showed respectively higher level of knowledge than the other comparison groups. 2. 85% of the respondents recognized AIDS as a serious problem. Statistical analysis revealed that white-collar workers, higher education groups or those with age twenties had more positive attitudes towards a AIDS patient than their counterparts. 3. Over 80% of the respondents replied that AIDS education in schools, work places, social agencies or by mass-media was necessary. 62.8% of the respondents mentioned that government should play the major role in developing AIDS education program. 4. The prediction model of AIDS-education needs was examined with using the multiple logistic regression method. The education level and AIDS-related knowledge were turned to be statistically significant factors influencing positively the perceived needs of AIDS education.

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Primary Cardiac Lymphoma : 1 Case Report (원발성 심장 림프종 : 1례 보고)

  • Bae, Jun-Ho;Lee, Jong-Suk;Kim, Hyung-Jun;Kim, Min-Kyung;Park, Young-Ho;Hong, Gue-Ru;Park, Jong-Sun;Sin, Dong-Gu;Kim, Young-Jo;Sim, Bong-Sup
    • Journal of Yeungnam Medical Science
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    • v.17 no.1
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    • pp.82-86
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    • 2000
  • Primary cardiac lymphoma, defined as involving only the heart and pericardiwn, is very rare and is diagnosed predominantly late in the course of illness or autopsy. This tumor is commonly fatal and until recently were rarely diagnosed antemortem. Recently, it was reported in patients with acquired immunodeficiency syndrome. We report a case of primary cardiac lymphoma in a 56 year old female who showed progressive exertional dyspnea. On echocardiogram and CT scan, a large ill defined mass was demonstrated in right atrial and ventricular wall. It was diagnosed as B-cell type lymphoma on open cardiac biopsy.

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Anti-Toxoplasmosis Effect of Citrus Unshiu Markovich against Toxoplasma Gondii (한약제 진피의 항 톡소포자충 효과 확인)

  • Kim, Hye-Kung;Jiang, Jing-Hua;Lee, Dong-Hwan;Kim, Hye-Sook;Park, Hyun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.1
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    • pp.96-99
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    • 2008
  • Toxoplasma gondiiis a widespread apicomplexan parasite which is able to infect virtually all warm-blooded vertebrates. Twenty-two percent of the U.S. population is infected, but severe disease in adults is mainly limited to immunosuppressed patients. In patients with acquired immunodeficiency syndrome(AIDS), T. gondii causes a life-threatening opportunistic infection, with Toxoplasma encephalitis as its most severe manifestations. T. gondii is also known to cause congenital infection and is among the pathogens with the highest incidence of complications in pregnancies. Despite its clinical importance, only very few therapeutic drugs against T. gondii are available, all of which target the rapidly dividing tachyzoites, leaving the dormant encysted bradyzoite stage unaffected. We searched 15 traditional medicines that have anti-inflammatory effect from dongyibogam and Traditional Chinese medicine. In vitro studies were performed with HeLa cell cultures, with quantification of Toxoplasma growth by a cell proliferation assay. The result of experiment shows the selectivity of Citrus unshiu Markovich is 6.0. This is higher than sulfadiazine (selectivity was 1.63). For in vivo studies, mice were acutely infected intraperitoneally with $10^5$ tachyzoites of the virulent RH strain and then treated per orally for 4 days from 6 hours postinfection. Efficacy was assessed by sequential determination of parasite burdens in peritoneal cavity. In vivo, Citrus unshiu Markoviche inhibited Toxoplasma growth at a concentration of 10㎎/㎏ of body weight per day, the inhibition ratio was estimated to be 64.01%.