Infecciones causadas por Candida spp. Resistente al fluconazol en pacientes con el síndrome de inmunodeficiencia adquirida (SIDA). Reporte de un caso.

Large, ulcerative lesions over the skin scalp, and oral mucosa were observed in a patient with acquired immunodeficiency syndrome (AIDS) receiving chronic suppressive therapy with fluconazole. Candida glabrata was recovered in culture from biopsy material, and was found to be resistant to reported frequency of infections with Candida spp. resistant to fluconazole has increased in recent years. We review the literature regardin fluconazole resistant infections in patients with AIDS, discuss the possible mechanisms of resistance, and management options

Cutaneous disseminated histoplasmosis in AIDS patients in south Florida

Background Histoplasma capsulatum is a dimorphic pathogenic fungus endemic to the Mississippi and Ohio river valleys. In the immunocompetent it causes a self‐limited disease, but in the immunocompromised may lead to disseminated disease (disseminated histoplasmosis (DH)). It is one of the opportunistic infections which defines the acquired immunodeficiency syndrome (AIDS) and is rarely encountered outside endemic regions. Methods Clinical, laboratory, and histologic information concerning seven patients with DH and AIDS in South Florida was recorded. Results We report seven cases of DH with mucocutaneous lesions in patients infected with the human immunodeficiency virus (HIV). All patients had markedly depressed CD4 counts of less than 40 cells/mm3, and only two had traveled to endemic areas. Two out of the seven patients were diagnosed with HIV/AIDS at the time DH was identified. All of our patients had mucocutaneous lesions at the time of diagnosis, which clinically presented as a generalized papular eruption, ulcers, and erythematous scaly plaques. Conclusions Even in non‐endemic regions, HIV‐positive patients presenting with fever, chills, weight loss, hepatosplenomegaly, anemia, cough, lymphadenopathy, and mucocutaneous lesions should have an early skin biopsy specimen taken for mycologic tissue culture and histopathologic evaluation for disseminated fungal infections

The acute effects of radiofrequency energy in articular cartilage: An in vitro study

The purpose of this investigation was to determine the acute effect of radiofrequency (RF) energy on articular cartilage. Six fresh human articular cartilage specimens were obtained from patients undergoing total knee arthroplasty for unicompartmental osteoarthritis. A jig was used as the RF-energy was delivered to 2 designated treatment areas. These areas included a normal and a diseased area of articular cartilage tested at 3 voltage settings (kilohertz per voltage root mean square), 133 to 147 (setting 2), 161 to 179 (setting 4), and 190 to 210 (setting 6) for 3 seconds. The designated testing areas were marked with tissue dye and processed using standard histological techniques. A scalloped concave excavation with a smooth surface remains at each treatment site. The chondrocytes are viable at the RF-treated sites without alterations in nuclear cytoplasmic nor lacunae structure when compared with collateral untreated areas. In conclusion, chondrocytes remain viable, no collagen abnormalities are detected, and diseased areas are smoothed without further evidence of fibrillation. RF-energy appears to be safe for use on articular cartilage

Infecciones causadas por Candida spp. Resistente al fluconazol en pacientes con el síndrome de inmunodeficiencia adquirida (SIDA).: Reporte de un caso.

Large, ulcerative lesions over the skin scalp, and oral mucosa were observed in a patient with acquired immunodeficiency syndrome (AIDS) receiving chronic suppressive therapy with fluconazole. Candida glabrata was recovered in culture from biopsy material, and was found to be resistant to reported frequency of infections with Candida spp. resistant to fluconazole has increased in recent years. We review the literature regardin fluconazole resistant infections in patients with AIDS, discuss the possible mechanisms of resistance, and management options

Spontaneous Heterotopic Pregnancy: Dual Case Report and Review of Literature

Introduction. Heterotopic pregnancy is a rare complication usually seen in populations at risk for ectopic pregnancy or those undergoing fertility treatments. It is a potentially dangerous condition occurring in only 1 in 30,000 spontaneous pregnancies. With the advent of Assisted Reproduction Techniques (ART) and ovulation induction, the overall incidence of heterotopic pregnancy has risen to approximately 1 in 3,900 pregnancies. Other risk factors include a history of pelvic inflammatory disease (PID), tubal damage, pelvic surgery, uterine Mullerian abnormalities, and prior tubal surgery. Heterotopic pregnancy is a potentially fatal condition, rarely occurring in natural conception cycles. Most commonly, heterotopic pregnancy is diagnosed at the time of rupture when surgical management is required. Case. This paper represents two cases of heterotopic pregnancies as well as a literature review. Conclusion. Heterotopic pregnancy should be suspected in patients with an adnexal mass, even in the absence of risk factors. Clinicians must be alert to the fact that confirming an intrauterine pregnancy clinically or by ultrasound does not exclude the coexistence of an ectopic pregnancy. A high index of suspicion in women is needed for early and timely diagnosis, and management with laparotomy or laparoscopy can result in a favorable and successful obstetrical outcome

Spontaneous Heterotopic Pregnancy: Dual Case Report and Review of Literature

Introduction. Heterotopic pregnancy is a rare complication usually seen in populations at risk for ectopic pregnancy or those undergoing fertility treatments. It is a potentially dangerous condition occurring in only 1 in 30,000 spontaneous pregnancies. With the advent of Assisted Reproduction Techniques (ART) and ovulation induction, the overall incidence of heterotopic pregnancy has risen to approximately 1 in 3,900 pregnancies. Other risk factors include a history of pelvic inflammatory disease (PID), tubal damage, pelvic surgery, uterine Mullerian abnormalities, and prior tubal surgery. Heterotopic pregnancy is a potentially fatal condition, rarely occurring in natural conception cycles. Most commonly, heterotopic pregnancy is diagnosed at the time of rupture when surgical management is required. Case. This paper represents two cases of heterotopic pregnancies as well as a literature review. Conclusion. Heterotopic pregnancy should be suspected in patients with an adnexal mass, even in the absence of risk factors. Clinicians must be alert to the fact that confirming an intrauterine pregnancy clinically or by ultrasound does not exclude the coexistence of an ectopic pregnancy. A high index of suspicion in women is needed for early and timely diagnosis, and management with laparotomy or laparoscopy can result in a favorable and successful obstetrical outcome