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1.
A 37-year-old man with AIDS presented with altered mental status four weeks after stopping his medications for Mycobacterium avium-intracellulare (MAI). He had low CD4 cell count and severe hypercalcemia. Bone marrow biopsy revealed bone marrow infiltration by granulomas positive for acid-fast bacilli and cultures grew MAI. His hypercalcemia continued to worsen with the initiation of MAI therapy but we were able to treat it successfully with pamidronate and calcitonin.  相似文献   
2.
目的 探讨G试验能否预测艾滋病合并肺孢子菌肺炎(PCP)机械通气患者的撤机.方法 回顾性分析北京佑安医院感染科监护病房2010年5月至2017年5月收治的艾滋病合并重症PCP且行机械通气治疗患者的临床资料,根据患者脱机成功与否将患者分为两组,比较两组患者G试验水平.结果 共入选49例患者,脱机成功组9例,失败组40例.两组患者基线资料比较结果显示,白蛋白、CD4计数、G试验水平差异均有统计学意义(P均<0.05).成功组G试验水平显著低于失败组,分别为331.0 ng/L(299.0~488.7 ng/L)和267.0 ng/L(236.0~294.5 ng/L).多因素分析结果显示,血清G试验水平是影响艾滋病合并重度PCP患者能够脱机与否的独立危险因素(0R=0.978,95%CI:0.959~0.998,P=0.032).结论 G试验可以作为一项脱机结局预测指标,用来预测艾滋病合并PCP患者撤机预后.  相似文献   
3.
The relationship between recruitment of mononuclear phagocytes to lymphoid and gut tissues and disease in HIV and SIV infection remains unclear. To address this question, we conducted cross‐sectional analyses of dendritic cell (DC) subsets and CD163+ macrophages in lymph nodes (LNs) and ileum of rhesus macaques with acute and chronic SIV infection and AIDS. In LNs significant differences were only evident when comparing uninfected and AIDS groups, with loss of myeloid DCs and CD103+ DCs from peripheral and mesenteric LNs, respectively, and accumulation of plasmacytoid DCs and macrophages in mesenteric LNs. In contrast, there were fourfold more macrophages in ileum lamina propria in macaques with AIDS compared with chronic infection, and this increased to 40‐fold in Peyer's patches. Gut macrophages exceeded plasmacytoid DCs and CD103+ DCs by ten‐ to 17‐fold in monkeys with AIDS but were at similar low frequencies as DCs in chronic infection. Gut macrophages in macaques with AIDS expressed IFN‐α and TNF‐α consistent with cell activation. CD163+ macrophages also accumulated in gut mucosa in acute infection but lacked expression of IFN‐α and TNF‐α. These data reveal a relationship between inflammatory macrophage accumulation in gut mucosa and disease and suggest a role for macrophages in AIDS pathogenesis.  相似文献   
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5.
Evidence from the RV144 HIV‐1 vaccine trial implicates anti‐HIV‐1 antibody‐dependent cellular cytotoxicity (ADCC) in vaccine‐conferred protection from infection. Among effector cells that mediate ADCC are natural killer (NK) cells. The ability of NK cells to be activated in an antibody‐dependent manner is reliant upon several factors. In general, NK cell‐mediated antibody‐dependent activation is most robust in terminally differentiated CD57+ NK cells, as well as NK cells educated through ontological interactions between inhibitory killer immunoglobulin‐like receptors (KIR) and their major histocompatibility complex class I [MHC‐I or human leucocyte antigen (HLA‐I)] ligands. With regard to anti‐HIV‐1 antibody‐dependent NK cell activation, previous research has demonstrated that the epidemiologically relevant KIR3DL1/HLA‐Bw4 receptor/ligand combination confers enhanced activation potential. In the present study we assessed the ability of the KIR2DL1/HLA–C2 receptor/ligand combination to confer enhanced activation upon direct stimulation with HLA‐I‐devoid target cells or antibody‐dependent stimulation with HIV‐1 gp140‐pulsed CEM.NKr‐CCR5 target cells in the presence of an anti‐HIV‐1 antibody source. Among donors carrying the HLA‐C2 ligand for KIR2DL1, higher interferon (IFN)‐γ production was observed within KIR2DL1+ NK cells than in KIR2DL1 NK cells upon both direct and antibody‐dependent stimulation. No differences in KIR2DL1+ and KIR2DL1 NK cell activation were observed in HLA‐C1 homozygous donors. Additionally, higher activation in KIR2DL1+ than KIR2DL1 NK cells from HLA–C2 carrying donors was observed within less differentiated CD57 NK cells, demonstrating that the observed differences were due to education and not an overabundance of KIR2DL1+ NK cells within differentiated CD57+ NK cells. These observations are relevant for understanding the regulation of anti‐HIV‐1 antibody‐dependent NK cell responses.  相似文献   
6.
7.
Melioidosis is a multi-system disorder which is often mistaken for tuberculosis in the Indian sub-continent. It is caused by the gram-negative bacterium Burkholderia pseudomallei. The imaging findings of melioidosis often mimic many other bacterial infections and the differentiation is sometimes difficult. The clinical manifestations of melioidosis range from asymptomatic and subclinical to acute localized forms, acute septicemia and chronic forms. We report a case of melioidosis presenting with multi-visceral abscesses (with adrenal involvement).  相似文献   
8.

Background

Systemic sclerosis (SSc), or systemic scleroderma, is a chronic multisystem autoimmune disease characterised by widespread vascular injury and progressive fibrosis of the skin and internal organs. Patients with SSc have decreased survival, with pulmonary involvement as the main cause of death. Current treatments for SSc manage a range of symptoms but not the cause of the disease. Our review describes the humanistic and cost burden of SSc.

Methods

A structured review of the literature was conducted, using predefined search strategies to search PubMed, Embase, and the Cochrane Library. Grey literature searches also were conducted.

Results

In total, 2226 articles were identified in the databases and 52 were included; an additional 10 sources were included from the grey literature. The review identified six studies reporting relevant cost estimates conducted in five different countries and four studies that assessed the humanistic burden of SSc. Total direct annual medical costs per patient for Europe varied from €3544 to €8452. For Canada, these costs were reported to be from Can$5038 to Can$10,673. In the United States, the total direct health care costs were reported to be US$17,365 to US$18,396. Different key drivers of direct costs were reported, including hospitalisations, outpatients, and medication. The total annual costs per patient were reported at Can$18,453 in Canada and varied from €11,074 to €22,459 in Europe. Indirect costs represented the largest component of the total costs. EQ-5D utility scores were lower for patients with SSc than those observed in the general population, with reported mean values of 0.49 and 0.68, respectively. The average value of the Health Assessment Questionnaire for patients with SSc was significantly higher than the control population (0.94), and the average value of the SF-36 was significantly lower than the control population: 49.99 for the physical dimension and 58.42 for the mental dimension.

Conclusions

Overall, there is a paucity of information on the burden of SSc. Nonetheless, our review indicates that the quality of life of patients with SSc is considerably lower than that of the general population. In addition, SSc places a considerable economic burden on health care systems and society as a whole.  相似文献   
9.
2017年11月3日—4日,第二届全国传染病高峰论坛——肝病和艾滋病临床免疫与细胞治疗会议在北京召开.来自感染病、免疫、创伤修复、肿瘤、生物治疗等多个领域的专家学者共聚一堂,大会围绕以下几个主题进行了学术交流和讨论:①细胞治疗政策管理法规;②艾滋病的免疫治疗;③病毒性肝炎治愈;④疑难危重肝病细胞治疗临床研究.  相似文献   
10.
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