scholarly journals Seropositive HIV diagnosis after oral histoplasmosis: the importance of multi-professional care in health

2020 ◽  
Vol 9 (9) ◽  
pp. e716997839
Author(s):  
Gabriela Fleury Seixas ◽  
Aline Fernanda Spadrizani ◽  
Danielle Gregorio ◽  
Marcelo Lupion Poleti ◽  
Thais Maria Freire Fernandes

Histoplasmosis is a systemic fungal disease, which can manifest with extrapulmonary lesions. Oral lesions are rarely the first manifestation of late histoplasmosis and can represent an important process of immune imbalance. The objective of this work is to present a clinical case of Histoplasmosis with an oral manifestation of a patient who was unaware of her condition with the Human Immunodeficiency Virus (HIV). The patient's main complaint was a painful ulcer in the central region of the tongue present for two months, whose incisional biopsy resulted in the diagnosis of Histoplasmosis. Although referred for medical treatment with an infectologist, the patient had complications resulting from the disease and died after one month. This situation demonstrates the importance of multidisciplinary care in the prevention, diagnosis and treatment of diseases. The correct diagnosis and treatment can be decisive in the prognosis of patients and demonstrates the relevance of the dentist's knowledge about the various systemic diseases that present oral manifestations.

Author(s):  
Keizo Tanitame ◽  
Nobuko Tanitame ◽  
Saiko Urayama ◽  
Kazuhiro Ohtsu

AbstractHemato/hydrocolpos due to congenital urogenital anomalies are rare conditions discovered in neonatal, infant, and adolescent girls. Diagnosis is often missed or delayed owing to its rare incidence and nonspecific symptoms. If early correct diagnosis and treatment cannot be performed, late complications such as tubal adhesion, pelvic endometriosis, and infertility may develop. Congenital urogenital anomalies causing hemato/hydrocolpos are mainly of four types: imperforate hymen, distal vaginal agenesis, transverse vaginal septum, and obstructed hemivagina and ipsilateral renal anomaly, and clinicians should have adequate knowledge about these anomalies. This article aimed to review the diagnosis and treatment of these urogenital anomalies by describing embryology, clinical presentation, imaging findings, surgical management, and postoperative outcomes.


2019 ◽  
Vol 71 (8) ◽  
pp. e308-e315
Author(s):  
McKaylee M Robertson ◽  
Sarah L Braunstein ◽  
Donald R Hoover ◽  
Sheng Li ◽  
Denis Nash

Abstract Background We estimated the time from human immunodeficiency virus (HIV) seroconversion to antiretroviral therapy (ART) initiation during an era of expanding HIV testing and treatment efforts. Methods Applying CD4 depletion parameters from seroconverter cohort data to our population-based sample, we related the square root of the first pretreatment CD4 count to time of seroconversion through a linear mixed model and estimated the time from seroconversion. Results Among 28 162 people diagnosed with HIV during 2006–2015, 89% initiated ART by June 2017. The median CD4 count at diagnosis increased from 326 (interquartile range [IQR], 132–504) cells/µL to 390 (IQR, 216–571) cells/µL from 2006 to 2015. The median time from estimated seroconversion to ART initiation decreased by 42% from 6.4 (IQR, 3.3–11.4) years in 2006 to 3.7 (IQR, 0.5–8.3) years in 2015. The time from estimated seroconversion to diagnosis decreased by 28%, from a median of 4.6 (IQR, 0.5–10.5) years to 3.3 (IQR, 0–8.1) years from 2006 to 2015, and the time from diagnosis to ART initiation reduced by 60%, from a median of 0.5 (IQR, 0.2–2.1) years to 0.2 (IQR, 0.1–0.3) years from 2006 to 2015. Conclusions The estimated time from seroconversion to ART initiation was reduced in tandem with expanded HIV testing and treatment efforts. While the time from diagnosis to ART initiation decreased to 0.2 years, the time from seroconversion to diagnosis was 3.3 years among people diagnosed in 2015, highlighting the need for more effective strategies for earlier HIV diagnosis.


1994 ◽  
Vol 2 (2) ◽  
pp. 111-113
Author(s):  
Thekkekara Alexander John ◽  
Gummiah Muniputtaha Mahesh ◽  
Rathna Nanjunda Rao ◽  
Saligram Srinivasaiah Ramesh

A 62-year-old man suffered an anterior wall infarction and subsequent rupture of the myocardium and pseudoaneurysm formation. Correct diagnosis was made followed by immediate surgery using patch closure of the defect. The patient's recovery was uneventful.


2018 ◽  
Vol 8 (4) ◽  
Author(s):  
Viet Hoa Nguyen

Abstract Introduction: Evaluating the role of laparoscopic for diagnosis and treatment of undescended testis in children. Material and Methods: Restrospective study, between 6/ 2014 and 6/2017. All the patients are aged from 1 to 16 years with undescended testis underwent laparoscopic surgery for diagnosis and treatment in Deparment of pediatric surgery – Viet Duc hospital enrolled. Results: Of 95 patiens in total had 106 undescended testis diagnosed and treated by laparoscopy. The mean age of patients was 7,5 ± 3,8 years. 44,2% undescended were on the left side, 44,2% were on the right and 11,6% were undescended bilateral. The correct diagnosis by ultrasound accounted in 79,4%. The locations of testis diagnosed by laparoscopic are : intra abdomen in 45,3%, deep inguinal orifice in 16,9%, extra inguinal orifice in 26,4%, no testicle found in 11,4%. The mean time of operation were 67,33± 28,01 pht. Scrotal positions were achieved 74,5%, remove atrophic testis accounted in 7,6%. Stephen- Flowler technique including step I were in 4,7%, step II in 1,9%. The outcome evaluated by testicular positions following 3 months after operation are : good in 79,2%, moderate 13,2%, poor in 7,6%; By classification of Aubert are : good in 81,1%, moderate in 11,3% and poor in 7,6 %. Conclusion: Laparoscopic surgery is not only a highly sensitive diagnostic method to find accurately the location and size of the testes, but also the most effective method to treat impalpable undescended testes.


PEDIATRICS ◽  
1996 ◽  
Vol 98 (3) ◽  
pp. 461-463
Author(s):  
Gary L. Darmstadt

Genital warts are common relative to other verrucous lesions of the anogenital region. Consideration of the differential diagnosis of verrucous anogenital lesions is necessary, however, to make a correct diagnosis consistently and to avoid futile, painful, and possibly traumatic attempts at treatment. In this report, I describe a child with a history suspicious for sexual abuse who was treated with inappropriate measures because of misdiagnosis of perianal lymphangioma circumscriptum as genital warts. The pathogenesis, differential diagnosis, and treatment of lymphangioma is presented. CASE REPORT A 5-year-old Hispanic boy was referred by his pediatrician to the Dermatology Service with an eruption of red papules on the left buttock and perianal region.


1993 ◽  
Vol 4 (6) ◽  
pp. 322-325 ◽  
Author(s):  
Hunter Maclean ◽  
Baljean Dhillon

Cytomegalovirus (CMV) is a non-pathogenic organism in the immunocompetent, but is a major cause of morbidity and mortality amongst patients with AIDS, and the retina is the commonest site of infection1. If left untreated, patients with CMVR will develop disease in their second eye and ultimately become blind2. However, with correct diagnosis and treatment useful vision can be maintained in the majority of cases. Fifteen to 20% of patients with AIDS will contract cytomegalovirus retinitis (CMVR)3−7 and this may be the AIDS-defining diagnosis though more commonly it occurs months after the diagnosis of AIDS. Given the increasing number of HIV positive patients and their longer survival, it is likely that CMVR will become an increasingly prevalent condition. In these patients loss of sight from CMVR has devastating consequences in terms of loss of independence and quality of life and therefore ophthalmologists and physicians should be aware of the presenting characteristics of CMVR, be familiar with therapy and its complications, and be able to recognize relapsing infection.


2021 ◽  
Vol 6 ◽  
Author(s):  
Sanghamitra Pati ◽  
Rajeshwari Sinha ◽  
Pranab Mahapatra

To meet the long term care demands of chronic diseases as well as multimorbidity, healthcare providers from different disciplines need to work collaboratively in practice. This requires healthcare providers to be appropriately trained on delivery of inter-professional care (IPC) and health communication aspects during formative professional years. In this study, we have looked at the prevailing undergraduate and postgraduate healthcare professional curricula to understand the focus on health communication and on IPC for the delivery of multidisciplinary care for multimorbidity management. We observe that while there are exclusive courses on health communication being delivered at different levels, the focus on IPC is still in stages of infancy. The IPC component is just beginning to be woven into the health professional curricula through elements like competency-based curriculum, rotational posting, inter-departmental engagements. At the same time, the need to put curricular attention on multimorbidity is also highlighted here. There remains wider scope for strengthening learning on health communication and IPC among different disciplines within the curricula in the context of multimorbidity. We expect our findings to provide key inputs to academic planners and policy makers towards the introduction of adequate curricular components for addressing multimorbidity along with necessary prescriptions for health communication and IPC in India.


HIV ◽  
2020 ◽  
pp. 107-110
Author(s):  
David E. Barker

Stroke syndromes are not markedly increased in persons living with HIV. Watershed strokes involving the distribution of one or more cerebral arteries suggest embolization from within the vascular tree (rather than a cardioembolic source). Increasingly some strokes (and arteritis) are being recognized as being related to infection rather than atherosclerosis or thrombosis. Past medical history can be an important source of clues to arrive the correct diagnosis, and treatment.


Author(s):  
Rogan Corbridge ◽  
Nicholas Steventon

This chapter provides an overview of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) and its relationship to ear, nose, and throat (ENT) problems. The pathology, effects, diagnosis, and treatment of the condition are outlined. The specific anatomically classified ENT conditions are described, along with their investigation.


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