The American journal of the medical sciences
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Review Case Reports
Treatment Considerations in an HIV Elite Controller.
HIV elite controllers naturally suppress viral loads below limits of detection and evidence lack of evolution of infection for prolonged periods. The role of antiretroviral therapy (ART) in these individuals is controversial. Though recent data suggest that ART may decrease immune activation and prevent complications such as development of accelerated cardiovascular disease (CVD); treatment has not clearly demonstrated a benefit on clinical outcomes (e.g., HIV disease progression, CVD events, mortality). We describe a 49-year-old female HIV elite controller who presented with asymptomatic HIV infection for 26 years and review recent literature on the role of ART in this population.
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Antimicrobial resistance (AMR) is a worldwide public health problem that reduces therapeutic options and increases the risk of death. The causative agents of healthcare-associated infections (HAIs) are drug-resistant microorganisms of the nosocomial environment, which have developed different mechanisms of AMR. ⋯ The ESKAPE group (Enterococcus faecalis and Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter aerogenes and Escherichia coli) is a frequent causative agents of HAIs. In this review, we address the issue of acquired genetic elements that contribute to AMR in the most frequent Gram-negative of ESKAPE, with a focus on last resort antimicrobial agents and the role of transference of genetic elements for the development of AMR.
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Fabry disease is a frequent lysosomal storage disorder secondary to the deficiency of alpha-galactosidase A enzyme. This X-linked genetic disease realizes progressive and systemic manifestations that affect both male and female. Fabry disease may present as "classical", as "late-onset" or "non-classical" forms. ⋯ Diagnosis is more challenging in females who may express normal residual enzyme activity. Other plasmatic biomarkers, such as lyso-globotriaosylceramide are interesting, especially in females. In this review, we aimed to summarize main clinical manifestations of Fabry disease to know when to evoke Fabry disease and propose a practical diagnosis algorithm to know how to diagnose.
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Obesity and overweight are the most prevailing problem in most countries. Overweight people are very susceptible to diseases such as diabetes, hypertension, cardiovascular disease, metabolic syndrome, and cancers. Adequate intake of micronutrients along with a quality diet that is varied and balanced plays an important role regarding health and the immune system. Numerous studies have investigated the relationship between the quality of diet and different diseases. Genetics is a risk factor of great importance regarding obesity and overweight. Yet, the role of nutrition in relationship with the underlying mechanisms remains unclear and no specific pathways have been identified for this relation. ⋯ Intake of vitamin D from sunlight and its nutritional sources and adequate intake of Mn from a wide range of vegetables, legumes, seeds, and grains might be solutions for some overweight cases with FTO rs9939609 polymorphism.