ABSTRACT
Carbapenem-resistant Acinetobacter species are increasingly recognized as major nosocomial pathogens, especially in patients with critical illnesses or in intensive care. The ability of these organisms to accumulate diverse mechanisms of resistance limits the available therapeutic agents, makes the infection difficult to treat, and is associated with a greater risk of death. In this review, we provide an update on the epidemiology, resistance mechanisms, infection control measures, treatment, and outcomes of carbapenem-resistant Acinetobacter infections.
Subject(s)
Humans , Acinetobacter , Acinetobacter baumannii , Acinetobacter Infections , Colistin , Critical Illness , Drug Therapy , Epidemiology , Infection Control , Critical CareABSTRACT
Carbapenem-resistant Acinetobacter species are increasingly recognized as major nosocomial pathogens, especially in patients with critical illnesses or in intensive care. The ability of these organisms to accumulate diverse mechanisms of resistance limits the available therapeutic agents, makes the infection difficult to treat, and is associated with a greater risk of death. In this review, we provide an update on the epidemiology, resistance mechanisms, infection control measures, treatment, and outcomes of carbapenem-resistant Acinetobacter infections.
Subject(s)
Humans , Acinetobacter , Acinetobacter baumannii , Acinetobacter Infections , Colistin , Critical Illness , Drug Therapy , Epidemiology , Infection Control , Critical CareABSTRACT
Hemochromatosis is an inherited genetic disorder of iron metabolism which can also occur as a secondary result of iron-overload. It leads to organ damage such as cardiomyopathy, liver cirrhosis, hypogonadism, and diabetes. This paper discusses a case of secondary hemochromatosis associated with repeated transfusions, presenting as asymptomatic hypoparathyroidism and subclinical hypothyroidism with multiple organ involvement. The 29-year-old female, who had severe aplastic anemia, received multiple transfusions totaling approximately 1,400 units of red blood cells over 15 years. During her routine laboratory examination, hypocalcemia was detected with decreased intact parathyroid hormone and increased thyroid stimulating hormone. Serum ferritin, iron, and total iron binding capacity had increased to 27,583.03 ng/mL, 291 microg/dL, and 389 microg/dL, respectively. She had unusually bronze skin and computed tomography revealed iron deposition in the thyroid, liver, and heart. Multiorgan involvement as seen in this case is rare in hemochromatosis associated with secondary transfusions. To the best of the author's knowledge, this is the first case report in Korea of hypoparathyroidism and subclinical hypothyroidism due to iron deposition in the parathyroid and thyroid gland.
Subject(s)
Adult , Female , Humans , Anemia, Aplastic , Cardiomyopathies , Erythrocytes , Ferritins , Heart , Hemochromatosis , Hypocalcemia , Hypogonadism , Hypoparathyroidism , Hypothyroidism , Iron , Korea , Liver , Liver Cirrhosis , Metabolism , Parathyroid Hormone , Skin , Thyroid Gland , ThyrotropinABSTRACT
Clinical and laboratory data from Western countries suggest that pregnant women are at an increased risk for severe illness and complications associated with 2009 pandemic influenza A (H1N1). However, previous data among Korean women suggested a less severe outcome. In this study performed at a single referral center in Korea, rates of admission, pneumonia, intensive care unit admission, and death related to 2009 pandemic influenza A (H1N1) were significantly higher in 33 pregnant women than in 723 nonpregnant women of reproductive age (p<0.05 each). We report two cases of 2009 pandemic influenza A (H1N1) in pregnant Korean women who were admitted to the intensive care unit because of severe pneumonia that led to maternal and fetal death in one of the patients. This case series suggests that pregnant Korean women were also at increased risk of severe illness and complications during the 2009 pandemic influenza A (H1N1) outbreak.
Subject(s)
Female , Humans , Pregnancy , Fetal Death , Influenza, Human , Intensive Care Units , Korea , Pandemics , Pneumonia , Pregnant Women , Referral and ConsultationABSTRACT
Clinical and laboratory data from Western countries suggest that pregnant women are at an increased risk for severe illness and complications associated with 2009 pandemic influenza A (H1N1). However, previous data among Korean women suggested a less severe outcome. In this study performed at a single referral center in Korea, rates of admission, pneumonia, intensive care unit admission, and death related to 2009 pandemic influenza A (H1N1) were significantly higher in 33 pregnant women than in 723 nonpregnant women of reproductive age (p<0.05 each). We report two cases of 2009 pandemic influenza A (H1N1) in pregnant Korean women who were admitted to the intensive care unit because of severe pneumonia that led to maternal and fetal death in one of the patients. This case series suggests that pregnant Korean women were also at increased risk of severe illness and complications during the 2009 pandemic influenza A (H1N1) outbreak.
Subject(s)
Female , Humans , Pregnancy , Fetal Death , Influenza, Human , Intensive Care Units , Korea , Pandemics , Pneumonia , Pregnant Women , Referral and ConsultationABSTRACT
Despite the increasing frequency of non-albicans candidemia, reported pneumonia cases due to Candida glabrata are rare. A 50-year-old diabetic woman developed cough and pleuritic chest pain, which were refractory to empirical antibiotics and anti-tuberculosis treatment for several months. The causative organism of the pneumonia was C. glabrata, which was cultured in bronchoalveolar lavage and blood culture specimens. Amphotericin therapy resulted in successful resolution of the pneumonia and candidemia. This is the first proven case of C. glabrata pneumonia in Korea.
Subject(s)
Female , Humans , Amphotericin B , Anti-Bacterial Agents , Bronchoalveolar Lavage , Candida , Candida glabrata , Candidemia , Chest Pain , Cough , Diabetes Mellitus , Korea , PneumoniaABSTRACT
PURPOSE: We evaluated the clinical and radiological outcomes related to use of the Targon(R) proximal femoral nail for repairing femoral intertrochanteric fractures. MATERIALS AND METHODS: Between April 2004 and November 2005, the records of 56 patients with intertrochanteric fractures treated with the proximal femoral nail, were analyzed. The mean patient age was 75.2 years. The mean duration of follow-up was 32 months. There were 26 stable fractures and 30 unstable fractures. Clinical assessment included parameters of operating time, transfusion rate, pain analysis by visual analogue scale (VAS), timing of maximum tolerable weight-bearing, functional evaluation by modified Koval index, and complications. Radiological assessment was directed toward adequacy of reduction, union time, and changes observed between immediate postoperative and final follow-up roentgenograms in various parameters. RESULTS: The mean operating time was 37 minutes. Visual analogue scale at final follow-up was 2.8 on average, and 38 of 43 preoperative ambulators (88%) were able to bear weight as much as tolerable within 6 weeks postoperatively. Postoperative mobility recovered to pre-injury levels in 40 cases (71%). Radiologic evaluation showed adequate reduction in all cases. Mean union time was 8.9+/-2.5 weeks. The neck-shaft angle changed at final follow-up an average of 3.6+/-1.9(R). The femoral shaft displaced medially an average of 2.8+/-0.9 mm, and the lag screw slid an average of 4.7+/-0.6 mm. Complications such as cutting through, Z-effect, and femoral shaft fracture were not observed in any cases. CONCLUSION: The Targon(R) proximal femoral nail showed excellent results in terms of early ambulation, clinical recovery, and radiologic parameters and may be a useful implant for treating femoral intertrochanteric fractures.
Subject(s)
Humans , Early Ambulation , Femoral Fractures , Follow-Up Studies , Hip Fractures , Nails , Ursidae , Weight-BearingABSTRACT
There are many classifications for idiopathic scoliosis but none of these is perfect. In the treatment of idiopathic scoliosis, it is essential to understand the characteristics of each classification system and exploit their individual advantages.