Although it has been evident since the early days of the HIV epidemic that a dementing illness often accompanies HIV infection and that the virus invades the nervous system soon after systemic infection, the clinical syndrome has evolved with the introduction of antiretroviral therapy.
Abstract: Our understanding of the pathobiology of pulmonary arterial hypertension (PAH) has evolved considerably over the past 2 decades, with increasing recognition of the important role that aberrant vasoproliferative responses play in conjunction with disordered vasoconstriction. Classification of the many forms of PAH into categories sharing a similar pathophysiology and clinical presentations help the practicing clinician approach a complex differential diagnosis. Noninvasive tests can be used to narrow this differential but must be applied with an appreciation for their limitations. Transthoracic echocardiography is the screening tool of choice; the workup should also include chest radiography and electrocardiography. However, right heart catheterization is ultimately required to establish the diagnosis. While PAH remains a progressive and generally fatal disease, existing therapies have a significant impact on survival and new therapeutic targets offer great hope for improving the prognosis. (J Respir Dis. 2006;27(11):487-493)
A 38-year-old African American man with HIV infection presents with numerous dyspigmented macules and patches on the extremities, abdomen, and chest; the lesions are smooth, nontender, and minimally pruritic. He has been noncompliant with antiretroviral therapy since his diagnosis 3 years earlier.
A 26-year-old woman with dull left-sided chest pain, nausea, body aches, and low-grade fever is admitted to the hospital. She has been to other emergency departments (EDs) in the area recently with similar complaints and was sent home with diagnoses of anxiety and costochondritis.
Generalized papular, erythematous, nonpruritic, hyperpigmented lesions had appeared on the face, arms (A), chest, and abdomen of a 25-year-old homosexual man with AIDS during the previous month. Anupama Ravi, MD, of Atlanta also noted purple-red, nodular lesions in the right conjunctiva (B) and oral cavity, especially the lower gingiva (C). Other pertinent physical findings included facial edema and hepatosplenomegaly.
A 38-year-old African American man with HIV infection presents with numerous dyspigmented macules and patches on the extremities, abdomen, and chest; the lesions are smooth, nontender, and minimally pruritic.
A 26-year-old woman with dull left-sided chest pain, nausea, body aches, and low-grade fever is admitted to the hospital. She has been to other emergency departments (EDs) in the area recently with similar complaints and was sent home with diagnoses of anxiety and costochondritis.
Generalized papular, erythematous, nonpruritic, hyperpigmented lesions had appeared on the face, arms, chest, and abdomen of a 25-year-old homosexual man with AIDS during the previous month. Anupama Ravi, MD, of Atlanta also noted purple-red, nodular lesions in the right conjunctiva and oral cavity, especially the lower gingiva. Other pertinent physical findings included facial edema and hepatosplenomegaly.
SAN DIEGO -- For a variety of factors, HIV-infected children appear to have more psychiatric problems than uninfected children, researchers reported here.
BOSTON -- An investigational drug that inhibits programmed cell death could help to prevent fibrosis in hepatitis C-infected livers, even when standard therapies fail to clear the virus, researchers reported here.
ROCHESTER, Minn. -- A lifetime of infections with rhinoviruses, enteroviruses, or other members of the picornavirus family could lead to cumulative memory loss, according to Mayo Clinic neuroscientists.
SAN FRANCISCO -- HIV patients in their 50s do not have a higher prevalence of metabolic syndrome than others of that age, researchers reported here.
SAN FRANCISCO -- In highly treatment-experienced HIV patients, an investigational integrase inhibitor sharply reduced viral loads compared with placebo, researchers reported here.
In recent months, the widely publicized outbreak of Fusarium keratitis has called attention to the serious consequences of contamination of ocular solutions. Although contact lens solution was implicated in the recent outbreak, other ocular products can also pose the risk of infection (Box).
In recent months, the widely publicized outbreak of Fusarium keratitis has called attention to the serious consequences of contamination of ocular solutions. Although contact lens solution was implicated in the recent outbreak, other ocular products can also pose the risk of infection
TORONTO -- Experience in treating tuberculosis, even if it is outside a physician's main area of expertise, appears to play a key role in patient survival, according to researchers here.
Atlanta -- The CDC recommended last week that HIV testing should become a routine part of office exams for all patients ages 13 to 64, irrespective of risk, without any pretest requirements. MedPage Today would like your opinion on this dramatic change in public health thinking.
SHEFFIELD, England -- Smoking cigarettes seems to be an independent risk factor for HIV infection, according to researchers here. But smoking doesn't appear to be a risk factor in progression to AIDS.
ATLANTA -- An HIV test should be a routine part of health care for all Americans between the ages of 13 and 64, not just those thought to be at high risk for the disease, the CDC said today.
OKLAHOMA CITY -- A strategy for transfusion-free liver transplantation, developed for Jehovah's Witness patients, reduced overall blood use when applied to all patients, researchers here reported.
A 62-year-old previously healthy man is admitted for right upper quadrant pain; a workup reveals acute cholecystitis as the cause. During evaluation for surgery, his creatinine level is found to be 6.0 mg/dL; 1 year earlier it was 1.0 mg/dL. A trial of fluids does not lower the creatinine level. Renal ultrasonography shows no obstruction but reveals increased kidney size (left, 11.4 3 4.4 3 5.0 cm; right, 10.1 3 4.6 3 4.5 cm) with increased diffuse echogenicity.
This 18-year-old girl had been taking divalproex for seizure disorder for 2 years. Because she had gained weight while taking this medication, the patient asked for another drug. Her neurologist prescribed lamotrigine. Ten days after starting the new agent, a generalized, painful, pruritic, ery- thematous dermatitis; fever; and sore throat developed.
A 62-year-old previously healthy man is admitted for right upper quadrant pain; a workup reveals acute cholecystitis as the cause. During evaluation for surgery, his creatinine level is found to be 6.0 mg/dL; 1 year earlier it was 1.0 mg/dL.
This 18 year old girl had been taking divalporex for seizure disorder for 2 years. After requesting a new drug because of weight gain, a generalized, painful, pruritic, erythematous dermatitis; fever; and sore throat developed after ten days.
PARIS -- Testing non-small-cell lung tumors for the presence of an enzyme that aids in DNA repair can predict the success of platinum-based chemotherapy, European researchers reported.
