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Simon Mutembo, Jane N Mutanga, Kebby Musokotwane, Lutangu Alisheke, Christopher C Whalen
BACKGROUND: Co-infection with Mycobacterium tuberculosis remains a leading cause of morbidity and mortality among HIV infected individuals especially in developing countries. Early initiation of cART in these patients when CD4+ T cell count is less than 200cells/mm(3) has reduced disease progression and mortality. However for patients with higher CD4+ T cell counts greater than 350cells/mm(3) evidence is conflicting. In this study we seek to evaluate the effectiveness of cART in reducing mortality among TB-HIV co-infected patients with CD4 + T cells above 350cells/mm(3) at the time of TB diagnosis...
October 17, 2016: BMC Infectious Diseases
V Gómez-Dos Santos, V Díez-Nicolás, L Martínez-Arcos, J J Fabuel-Alcañiz, I Laso-García, S Álvarez-Rodríguez, F de Asís Donis-Canet, V Hevia-Palacios, M Ruiz-Hernández, F J Burgos-Revilla
: Mayor urological complications, fistulae and stenosis, mainly affect the vesicoureteral anastomosis and present in the early post-transplant period. The systematic use of ureteral catheters keeps selecbeing controversial with many groups using them only selectively depending on the existence of pretransplant or intraoperative risk factors. METHODS: We performed a bibliographic review through automatized search in the Medline bibliographic database, as the main bibliographic source, and also in Clinical Key...
October 2016: Archivos Españoles de Urología
H T Ayele, M S M van Mourik, M J M Bonten
BACKGROUND: Although isoniazid preventive therapy (IPT) is effective in the prevention of tuberculosis (TB) in people living with the human immunodeficiency virus (PLHIV), patient adherence to this strategy is suboptimal. METHODS: This prospective cohort study was conducted in the HIV/AIDS (acquired immune-deficiency syndrome) out-patient chronic care unit of Dilla University Hospital, Dilla, Ethiopia, from May 2014 to February 2015. Adherence was defined as completion of the 6-month course of treatment with 90% of pills taken, as measured by diary and pill count...
October 2016: International Journal of Tuberculosis and Lung Disease
Anuradha Basavaraju
Toxoplasma gondii is an obligate intracellular protozoan parasite presenting as a zoonotic infection distributed worldwide. In HIV-positive individuals, it causes severe opportunistic infections, which is of major public health concern as it results in physical and psychological disabilities. In healthy immunocompetent individuals, it causes asymptomatic chronic persistent infections, but in immunosuppressed patients, there is reactivation of the parasite if the CD4 counts fall below 200 cells/μl. The seroprevalence rates are variable in different geographic areas...
July 2016: Tropical Parasitology
O F Ashubu, A D Ademola, A O Asinobi
Adverse drug reactions in children are an important public health problem. Children are at a higher risk of developing adverse drug reactions as they seldom express their own drug therapy experiences. Factors that have been implicated include polypharmacy especially with anti-infective and non-steroidal anti-inflammatory drugs; also concomitant use of traditional medicines which is prevalent in some cultures. Cutaneous drug allergy is a common manifestation of adverse drug reactions.
June 2016: Annals of Ibadan Postgraduate Medicine
Mary-Ann Davies, Diana Gibb, Anna Turkova
PURPOSE OF REVIEW: It is 20 years since the start of the combination antiretroviral therapy (cART) era and more than 10 years since cART scale-up began in resource-limited settings. We examined survival of vertically HIV-infected infants and children in the cART era. RECENT FINDINGS: Good survival has been achieved on cART in all settings with up to 10-fold mortality reductions compared with before cART availability. Although mortality risk remains high in the first few months after cART initiation in young children with severe disease, it drops rapidly thereafter even for those who started with advanced disease, and longer term mortality risk is low...
September 2016: Current Opinion in HIV and AIDS
Malik Asif Humayun, Tristan Richardson, Augustin Brooks
A 17-year-old male presented with diarrhoea and malaise following his return from Kenya and Tunisia. He was managed as a case of traveller's diarrhoea. Stool cultures were negative for pathogenic bacterial growth. Two weeks later he presented with worsening lower back pain. MRI of lumbosacral spine suggested L1 osteomyelitis. CT-guided spinal aspirate grew no organisms and repeat viral serology and blood cultures (including tuberculosis screening) were negative. He was treated with a 6-week course of ceftriaxone...
September 30, 2016: BMJ Case Reports
Andrew J Prendergast, Mutsa Bwakura-Dangarembizi, Peter Mugyenyi, Joseph Lutaakome, Adeodata Kekitiinwa, Margaret J Thomason, Diana M Gibb, A Sarah Walker
OBJECTIVE: To evaluate whether cotrimoxazole prophylaxis prevents common skin conditions in HIV-infected children. DESIGN: Open-label randomized controlled trial of continuing versus stopping daily cotrimoxazole (post-hoc analysis). SETTING: Three sites in Uganda, one in Zimbabwe. PARTICIPANTS: 758 children aged >3 years receiving antiretroviral therapy (ART) for >96 weeks in the ARROW trial were randomized to stop (n = 382) or continue (n = 376) cotrimoxazole after median(IQR) 2...
September 20, 2016: AIDS
E M Le Coustumier, E Denes, C Martin, P Weinbreck
INTRODUCTION: Nocardiosis are uncommon. The diagnosis may be difficult, with significant morbidity and mortality, often occurring on frail patients. Few data are available in France. METHODS: A retrospective single center study was conducted from 2002 to 2014 and included all patients with at least one positive microbiological sample for Nocardia with a follow-up in our hospital. RESULTS: Nineteen patients, including 15 men, were included with a mean age of 58 years (25-85)...
September 19, 2016: La Revue de Médecine Interne
L Stratton, G R Caddy
Patients with Crohn's disease often require the use of immunosuppressant drugs to control disease activity. Such medication includes steroids, azathioprine, and biologic therapy. These suppress the immune response, and the patient is more susceptible to infection. We present a case of a 69-year-old gentleman with a history of Crohn's colitis who had ongoing symptoms of diarrhoea in spite of standard treatment. Biologic therapy was considered to be the next step, and screening for infection was undertaken prior to use...
2016: Case Reports in Gastrointestinal Medicine
Arun K Mishra, Pragya Yadav, Amrita Mishra
The symptoms of Staphylococcal scalded skin syndrome (SSSS) include blistering of skin on superficial layers due to the exfoliative toxins released from Staphylococcus aureus. After the acute exfoliation of skin surface, erythematous cellulitis occurs. The SSSS may be confined to few blisters localized to the infection site and spread to severe exfoliation affecting complete body. The specific antibodies to exotoxins and increased clearence of exotoxins decrease the frequency of SSSS in adults. Immediate medication with parenteral anti-staphylococcal antibiotics is mandatory...
2016: Open Microbiology Journal
Herry Mapesi, Adrià Ramírez, Marcel Tanner, Christoph Hatz, Emilio Letang
BACKGROUND: Immune reconstitution inflammatory syndrome associated with dermatophytoses (tinea-IRIS) may cause considerable morbidity. Yet, it has been scarcely reported and is rarely considered in the differential diagnosis of HIV associated cutaneous lesions in Africa. If identified, it responds well to antifungals combined with steroids. We present two cases of suspected tinea-immune reconstitution inflammatory syndrome from a large HIV clinic in rural Tanzania. CASES PRESENTATION: A first case was a 33 years-old female newly diagnosed HIV patient with CD4 count of 4 cells/μL (0 %), normal complete blood count, liver and renal function tests was started on co-formulated tenofovir/emtricitabine/efavirenz and prophylactic cotrimoxazole...
2016: BMC Infectious Diseases
Patrick Amanzi, Charles Michelo, Christopher Simoonga, Rosalia Dambe, Gershom Chongwe
INTRODUCTION: Provision of free anti-retroviral therapy in Zambia started in June 2004. There were only 15,000 people on treatment as at December that year, mainly due to lack of access. This number rose to 580,000 people as at December 2013. The general objective of this study was to determine survival of people on ART and to examine associated predictors for survival. METHODS: The study included ART patients enrolled between the year 2002 and 2013 (n=10,395) in 285 health facilities in Zambia...
2016: Pan African Medical Journal
Praveen Gundelly, Yasuhiro Suzuki, Julie A Ribes, Alice Thornton
Rhodococcus equi is an unusual zoonotic pathogen that can cause life-threatening diseases in susceptible hosts. Twelve patients with R. equi infection in Kentucky were compared to 137 cases reported in the literature. Although lungs were the primary sites of infection in immunocompromised patients, extrapulmonary involvement only was more common in immunocompetent patients (P < 0.0001). Mortality in R. equi-infected HIV patients was lower in the HAART era (8%) than in pre-HAART era (56%) (P < 0.0001), suggesting that HAART improves prognosis in these patients...
2016: BioMed Research International
Anna Longdoh Njunda, Charles Njumkeng, Shey Dickson Nsagha, Jules Clement Nguedia Assob, Tebit Emmanuel Kwenti
BACKGROUND: Coinfection with malaria and HIV is common in Sub-Saharan Africa. In the advent of a decline in the global incidence of malaria, it is important to generate updated data on the burden of malaria in people living with HIV (PLWHIV). This study was designed to determine the prevalence of malaria in PLWHIV in Yaounde, Cameroon, as well determine the association between CD4 (+) T cell count and malaria in the study population. METHODS: In a cross sectional study performed between April 2015 and June 2016, 355 PLWHIV were enrolled and blood samples were collected for analysis...
2016: BMC Public Health
Farid El Garch, Marlène Sauget, Didier Hocquet, David Lechaudee, Frédérique Woehrle, Xavier Bertrand
OBJECTIVES: In November 2015, a plasmid-mediated colistin resistance, MCR-1, was described in animals, food and humans in China and it was considered as a potential emerging threat to public health. Therefore, we screened for mcr-1 gene a European collection of colistin resistant E. coli (n=218) and Salmonella spp (n=74) isolated from diseased food-producing animals between 2004 and 2014 and characterized the mcr-1-positive clones. METHODS: Screening for mcr-1 gene was performed by PCR on isolates for which inhibition diameter was < 15 mm around a 50-μg disk of colistin...
September 8, 2016: Clinical Microbiology and Infection
Daniel Cifuentes M, Sergio Blanco L, Camila Ramírez F
High activity antiretroviral therapy may exacerbate the activity of ergot alkaloids due to an inhibition of cytochrome P450. We report a 57 years old female with AIDS treated with lamivudine, zidovudine, atazanavir, ritonavir and cotrimoxazole presenting with ischemic signs in the four limbs. There was acrocyanosis and weak radial and ulnar pulses. A family member referred that the patient used ergot alkaloids for headaches. An ergotism due to the simultaneous use of ergot alkaloids and antiretroviral therapy was suspected...
June 2016: Revista Médica de Chile
N Benamrouche, S Hasnaoui, E Badell, B Guettou, M Lazri, N Guiso, K Rahal
The objectives of this study were to undertake the microbiological and molecular characterization of Corynebacterium diphtheriae isolates collected in Algeria during epidemic and post-epidemic periods between 1992 and 2015. Microbiological characterization includes the determination of biotype and toxigenicity status using phenotypic and genotypic methods. Antimicrobial susceptibility was determined by the E-test method. Molecular characterization was performed by multi-locus sequence typing. In total, there were 157 cases of C...
August 29, 2016: Clinical Microbiology and Infection
Yeshiwork Beyene, Berhanu Geresu, Assefa Mulu
BACKGROUND: In high human immunodeficiency virus (HIV) prevalence population, tuberculosis (TB) is the leading cause of morbidity and mortality. HIV is driving the TB epidemic in many countries, especially those in sub-Saharan Africa. We assessed the survival time and predictors of mortality among tuberculosis patients under directly observed treatment, short course (DOTS) strategy in Dessie Referral Hospital tuberculosis clinic, Northeast Ethiopia. METHOD: A historical cohort design was utilized to assess survival time and determinants of mortality...
2016: BMC Public Health
Anna Calzi, Sara Grignolo, Ilaria Caviglia, Maria Grazia Calevo, Giuseppe Losurdo, Giorgio Piaggio, Roberto Bandettini, Elio Castagnola
UNLABELLED: To investigate antibiotic resistance among pathogens isolated from urines in a tertiary care children's hospital in Italy. Retrospective analysis of prospectively collected data on antibiotic susceptibility of Gram-negatives isolated from urines at the Istituto Giannina Gaslini, Genoa - Italy from 2007 to 2014. Antibiotic susceptibility was evaluated. By means of CLSI criteria from 2007 to 2010, while from 2011 EUCAST criteria were adopted. Data on susceptibility to amoxicillin-clavulanate, co-trimoxazole, cefuroxime, nitrofurantoin, fosfomycin and ciprofloxacin were evaluated for Escherichia coli, while for other Enterobacteriaceae data were collected for amoxicillin-clavulanate, co-trimoxazole and ciprofloxacin and for ciprofloxacin against Pseudomonas aeruginosa...
September 2016: European Journal of Pediatrics
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