Internal medicine
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Review Case Reports
Bacillus cereus necrotizing pneumonia in a patient with nephrotic syndrome.
Bacillus cereus (B. cereus) is a Gram-positive rod that is widely distributed in the environment and can be a cause of food poisoning. We herein present a case of B. cereus necrotizing pneumonia in a patient with nephrotic syndrome under corticosteroid treatment after developing transient gastroenteritis symptoms. ⋯ The patient recovered after one week of intravenous meropenem followed by a combination of oral moxifloxacin and clindamycin. B. cereus is a pathogen that causes necrotizing pneumonia in immunocompromised hosts.
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Randomized Controlled Trial Multicenter Study Comparative Study
Abacavir/lamivudine versus tenofovir/emtricitabine with atazanavir/ritonavir for treatment-naive Japanese patients with HIV-1 infection: a randomized multicenter trial.
To compare the efficacy and safety of fixed-dose abacavir/lamivudine (ABC/3TC) and tenofovir/emtricitabine (TDF/FTC) with ritonavir-boosted atazanavir (ATV/r) in treatment-naïve Japanese patients with HIV-1 infection. ⋯ Although insufficiently powered to show non-inferiority of viral efficacy of ABC/3TC relative to TDF/FTC, this pilot trial suggested that ABC/3TC with ATV/r is a safe and efficacious initial regimen for HLA-B*5701-negative patients, such as the Japanese population.
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Review Case Reports
Clostridium difficile infection associated with antituberculous agents in a patient with tuberculous pericarditis.
Clostridium difficile can cause pseudomembranous colitis (PMC). Antimicrobial agent exposure is a risk factor for Clostridium difficile-associated disease, whereas the use of antituberculous (anti-TB) agents is not. We herein report a case of PMC-associated with antituberculous therapy. ⋯ The anti-TB agents were discontinued, and the patient was treated with metronidazole and clostridium butyricum. Her symptoms were relieved and did not recur when the anti-TB agents were restarted. In this report, we review the literature and discuss the pathogenesis, clinical manifestations, diagnosis and treatment of this case.
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Review Case Reports
Persistence of secondary restless legs syndrome in a phantom limb caused by end-stage renal disease.
Our patient had secondary restless legs syndrome (RLS) in the left lower limb caused by end-stage renal disease (ESRD). Severe RLS symptoms persisted even after amputation of the affected limb. Considering that oral administration of a dopamine receptor agonist was effective in treating the RLS in the phantom limb in this case, dysfunction of the central dopaminergic system was thought to be involved in the phantom limb-RLS mechanism. The persistence of RLS symptoms even after amputation of the affected limb suggests that the area responsible for ESRD-related RLS symptoms exists at the spinal level or in the higher central nervous system.
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Autophagy is a process of lysosomal self-degradation that helps to maintain the homeostatic balance between the synthesis, degradation and recycling of cellular proteins and organelles. Autophagy does not simply function as the machinery for supplying amino acids in response to energy demands, it is an adaptive pathway of cytoprotection against cellular stressors, including starvation, reactive oxygen species (ROS), endoplasmic reticulum (ER) stress and microbial infection. ⋯ Due to the organ-specific role of gas exchange, various cell types within the lungs are serially exposed to a diverse array of cellular stressors, and growing evidence has revealed the crucial involvement of autophagy in the pathogenic processes underlying pulmonary diseases. We herein review recent findings regarding the role of autophagy in cellular processes and cell fates and summarize the role that autophagy appears to play in the pathogenesis of pulmonary diseases.