Combined antiviral therapy has extended the life span of people living with HIV,but it has not reduced the incidence rate of neurocognitive impairment.After entering old age,individuals with HIV experience greater cognitive impairment,leading to a decline in the quality of life and an increased social burden.At present,it is widely believed that early neurocognitive impairment is reversible,so the early detection of HIV-related neurocognitive impairment is of great significance.In recent years,resting-state functional magnetic resonance imaging has been widely used in the field of neurological and psychiatric disorders,including HIV infection-related cognitive impairment,and it has been shown to have potential significance for the early diagnosis of HIV-induced neurocognitive impairment.
Veina cava filters(VCF)are used as an alternative to anticoagulation therapy in patients with thrombo-embolic events.Some mechanical complications are commonly described.Such complications are,most of the time,asymptomatic and noninfectious.A 70-year-old woman presented with pulmonary embolism with a contraindication to anticoagulants,leading to a VCF implantation.Eight months later,she complained of mechanical back pain associated with Staphylococcus epidermidis bacteremia,leading to diagnose VCF infection associated with spondylodiscitis.Filter retrieval and long-duration antibiotic therapy allowed recovery.Patients with an endovascular prosthesis may benefit from a positron emission tomography-computed tomography in case of fever or growing blood cultures without a designed source.
We present two cases of acute aortitis identified by positron emission tomography-computed tomography imaging that are of infectious origin,notably the Streptococcus pyogenes and Fusarium species.Management of infectious aortitis,both medically and surgically,is imperative as infectious etiologies can be potentially fatal.
BACKGROUND:Sepsis is a life-threatening condition caused by the body's severe response to infection,leading to widespread inflammation and organ failure.Ulinastatin,a glycoprotein hydrolase inhibitor from human urine,has anti-inflammatory properties and has shown potential in improving the outcomes in sepsis patients. OBJECTIVE:To systematically review the efficacy and safety of ulinastatin to clarify its clinical benefits in the treatment of sepsis. METHODS:Through searches of PubMed,Embase,Cochrane Library,and four Chinese databases(SINOMED,CNKI,VIP,and WANFANG data),we searched for published randomized controlled trials from January 1,2004,to November 30,2023.Stata 16.0 software was used to perform the meta-analysis. RESULTS:A total of 39 articles were included(37 in Chinese and 2 in English),involving a total of 2,911 patients.The results of meta-analysis show that the treatment of ulinastatin could reduce mortality(risk ratio[RR]=0.52,95%confidence interval[CI][0.43,0.63],P<0.05),multiple organ dysfunction syndrome(RR=0.30,95%CI[0.18,0.49],P<0.05),length of intensive care unit stay(mean difference[MD]=-5.42,95%CI[-8.13,-2.71],P<0.05),time on mechanical ventilation(MD=-5.84,95%CI[-7.60,-4.07],P<0.05),and length of hospital stay(MD=-12.40,95%CI[-15.03,-9.77],P<0.05).Nine articles reported adverse reactions,of which 1 article reported no obvious adverse reactions. CONCLUSIONS:The results of this meta-analysis show that ulinastatin reduces sepsis case-fatality rate and improves other related outcomes,suggest that ulinastatin is effective in the treatment of sepsis.
INTRODUCTION:In the era of modern antiretroviral therapy,the incidence of AIDS-related opportunistic infections decreased dramatically.However,pulmonary infection still remains an important cause of morbidity and even mortality.In this study,we aimed to present the chest computed tomography(CT)findings of people living with HIV(PLWH)who were followed up in our institution because of opportunistic pneumonia. MATERIALS AND METHODS:The data of PLWH who received the diagnosis of acute pneumonia in our hospital between November 2016 and April 2024 were evaluated retrospectively.Patient data including chest CT images were collected from the hospital database. RESULTS:There were five eligible cases in the determined study period.Mycobacterium tuberculosis,nontuberculosis mycobacteria,Pneumocystis carinii,SARS-CoV-2,and Respiratory syncytial virus were detected as the causative agents of opportunistic pneumonia in our case series. CONCLUSION:Undiagnosed HIV/acquired immunodeficiency syndrome patients may present with serious pneumonia.Hence,patients having pneumonia with an unexpected serious course should be tested for underlying HIV infection.
