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Background@#The coronavirus disease 2019 (COVID-19) pandemic caused disruptions to healthcare systems and endangered the control and prevention of tuberculosis (TB). We investigated the nationwide effects of COVID-19 on the national Public-Private Mix (PPM) TB control project in Korea, using monitoring indicators from the Korean PPM monitoring database. @*Methods@#The Korean PPM monitoring database includes data from patients registered at PPM hospitals throughout the country. Data of six monitoring indicators for active TB cases updated between July 2019 and June 2020 were collected. The data of each cohort throughout the country and in Daegu-Gyeongbuk, Seoul Metropolitan Area, and Jeonnam-Jeonbuk were collated to provide nationwide data. The data were compared using the χ 2 test for trend to evaluate quarterly trends of each monitoring indicator at the national level and in the prespecified regions. @*Results@#Test coverages of sputum smear (P = 0.622) and culture (P = 0.815), drug susceptibility test (P = 0.750), and adherence rate to initial standard treatment (P = 0.901) at the national level were not significantly different during the study period. The rate of loss to follow-up among TB cases at the national level was not significantly different (P = 0.088) however, the treatment success rate among the smear-positive drug-susceptible pulmonary TB cohort at the national level significantly decreased, from 90.6% to 84.1% (P < 0.001). Treatment success rate in the Seoul metropolitan area also significantly decreased during the study period, from 89.4% to 84.5% (P = 0.006). @*Conclusion@#Our study showed that initial TB management during the COVID-19 pandemic was properly administered under the PPM project in Korea. However, our study cannot confirm or conclude a decreased treatment success rate after the COVID-19 pandemic due to limited data.
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No abstract available.
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A pancreatic arteriovenous malformation (AVM) is a very rare disease entity that is usually asymptomatic; however, it may present with a massive gastrointestinal hemorrhage. Recent advances in cross-sectional imaging and the widespread availability of angiography have contributed to the diagnosis of this condition. A patient was transferred to our clinic due to unknown origin gastrointestinal bleeding and upper abdominal pain. Double balloon enteroscopy and duodenoscopy revealed a bleeding pancreatico-cholangio-duodenal fistula. We were able to diagnose an arteriovnous malformation with a pancreatico-cholangio-duodenal fistula by the use of angiography and from the post-operative pathological findings.
Subject(s)
Humans , Abdominal Pain , Angiography , Arteriovenous Malformations , Diagnosis , Double-Balloon Enteroscopy , Duodenoscopy , Fistula , Gastrointestinal Hemorrhage , Hemorrhage , Pancreas , Rare DiseasesABSTRACT
Primary extranodal non-Hodgkin's lymphomas comprise approximately 10% of all non-Hodgkin's lymphomas. However, primary tracheal non-Hodgkin's lymphoma is extremely rare, being mainly mucosa-associated lymphoid tissue lymphoma. A 65-year-old female has dry cough for one year. She was diagnosed as diffuse large B-cell lymphoma via bronchoscopic-guided biopsy. She was treated with four cycles of the R-CHOP regimen and adjuvant radiotherapy. After completion of the combined treatment, the treatment response was complete remission, and the disease free survival was 26 months.
Subject(s)
Aged , Female , Humans , B-Lymphocytes , Biopsy , Cough , Disease-Free Survival , Lymphoma , Lymphoma, B-Cell , Lymphoma, B-Cell, Marginal Zone , Lymphoma, Non-Hodgkin , Radiotherapy, AdjuvantABSTRACT
Background: Nosocomial pneumonia in an intensive care unit (ICU) is associated with a high mortality rate. Diagnosing a respiratory tract infection in critically ill patients is still difficult but detailed information for the pathogens is needed to establish an adequate antimicrobial treatment. This study examined the causative organisms and their antimicrobial resistance using bronchoalveolar lavage (BAL) from patients suspected of having pneumonia in the ICU. Methods: From January 2004 to June 2006, ICU patients with diffuse lung infiltration were prospectively enrolled. The BAL was used to diagnose the respiratory infection, with 104 > or = organisms considered a positive result. The most common organisms and their antimicrobial resistances were analyzed from the quantitative BAL cultures in the burn ICU and non-burn ICU. Results: A total 72 patients were included, 35 (M 29, F 6) in the burn ICU and 37 (M 26, F 11) in the non-burn ICU. 27 patients (77.1%) in the burn ICU and 22 patients (59.5%) in the non-burn ICU met the criteria for a positive BAL culture. The major pathogens were Staphylococcus aureus, Acinetobacter species and Pseudomonas aeruginosa. All strains (100%) of Staphylococcus aureus isolated from BAL (9 cases) were methicillin-resistant (MRSA) in the burn ICU, but 5 strains (71.4%, 7 cases) were MRSA in the non-burn ICU. Regarding Pseudomonas aeruginosa, the rate of resistance to amikacin, ciprofloxacin, cefepime, imipenem, ceftazidime, piperacillin/tazobactam in the burn and non-burn ICU ranged from 45.5% to 90% and 25% to 50%, respectively. In addition, the rate of resistance of Acinetobacter species to the above drugs in the burn and non-burn ICU ranged from 81.8% to 100% and 62.5% to 100%, respectively. Conclusions: These results are expected to provide useful guidelines for choosing the effective empirical antimicrobial therapy in patients with lung infiltrations in the burn and non-burn ICU.
Subject(s)
Humans , Acinetobacter , Amikacin , Bacteria , Bronchoalveolar Lavage , Burns , Ceftazidime , Ciprofloxacin , Critical Illness , Imipenem , Intensive Care Units , Critical Care , Lung , Methicillin Resistance , Methicillin-Resistant Staphylococcus aureus , Mortality , Pneumonia , Prospective Studies , Pseudomonas aeruginosa , Respiratory Tract Infections , Staphylococcus aureusABSTRACT
Dieulafoy's lesion is an unusual cause of gastrointestinal hemorrhage that results from the erosion of an abnormally large submucosal artery. In most cases, the lesion is encountered in the proximal stomach within 6 cm of the gastroesophageal junction. However, similar lesions have been reported in the antrum, duodenum, colon, and rectum. In particular, jejunal Dieulafoy's lesion Dieulafoy's lesion is an unusual cause of gastrointestinal hemorrhage that results from the erosion of an abnormally large submucosal artery. In most cases, the lesion is encountered in the proximal stomach within 6 cm of the gastroesophageal junction. However, similar lesions have been reported in the antrum, duodenum, colon, and rectum. In particular, jejunal Dieulafoy's lesion is extremely rare. We report a case of jejunal Dieulafoy's lesion with recurrent and massive bleeding, which was diagnosed and treated with the double-balloon enteroscopy.
Subject(s)
Arteries , Colon , Double-Balloon Enteroscopy , Duodenum , Esophagogastric Junction , Gastrointestinal Hemorrhage , Hemorrhage , Jejunum , Rectum , StomachABSTRACT
Dieulafoy's lesion is an unusual cause of gastrointestinal hemorrhage that results from the erosion of an abnormally large submucosal artery. In most cases, the lesion is encountered in the proximal stomach within 6 cm of the gastroesophageal junction. However, similar lesions have been reported in the antrum, duodenum, colon, and rectum. In particular, jejunal Dieulafoy's lesion Dieulafoy's lesion is an unusual cause of gastrointestinal hemorrhage that results from the erosion of an abnormally large submucosal artery. In most cases, the lesion is encountered in the proximal stomach within 6 cm of the gastroesophageal junction. However, similar lesions have been reported in the antrum, duodenum, colon, and rectum. In particular, jejunal Dieulafoy's lesion is extremely rare. We report a case of jejunal Dieulafoy's lesion with recurrent and massive bleeding, which was diagnosed and treated with the double-balloon enteroscopy.