Duszność spowodowana gruźliczakami powstającymi w rdzeniu przedłużonym w czasie leczenia gruźliczego zapalenia opon mózgowo-rdzeniowych

Formation of tuberculoma is a rare response of neurotuberculosis in patients regularly and adequately treated with anti-tuberculous drugs. We report a 13-year-old girl with two tuberculomas which formed in the dorsal part of the medulla oblongata during chemotherapy for tuberculous meningitis. The tuberculomas were both removed via a suboccipital midline approach and were demonstrated by pathological findings but the girl died of cardiac arrest that was thought to be caused by postoperative medulla oblongata oedema. In combination with a literature review, we discuss the clinical features and treatment options of brainstem tuberculomas.Tworzenie się gruźliczaka jest rzadką reakcją w przebiegu właściwie leczonej gruźlicy układu nerwowego. W pracy autorzy opisują przypadek 13-letniej dziewczynki z dwoma gruźliczakami, które utworzyły się w grzbietowej części rdzenia przedłużonego w czasie farmakologicznego leczenia gruźliczego zapalenia opon mózgowo-rdzeniowych. Oba gruźliczaki usunięto z dostępu podpotylicznego w linii środkowej i potwierdzono ich rozpoznanie w badaniu histopatologicznym, ale pacjentka zmarła w wyniku zatrzymania krążenia, przypuszczalnie wskutek pooperacyjnego obrzęku rdzenia przedłużonego. Na podstawie przedstawionego przypadku i przeglądu piśmiennictwa omówiono objawy kliniczne i możliwości leczenia gruźliczaków pnia mózgu

The Double Burdens of Mental Health Among AIDS Patients With Fully Successful Immune Restoration: A Cross-Sectional Study of Anxiety and Depression in China

Background: Anxiety and depression continue to be significant comorbidities for people with HIV infection. We investigated the prevalence of and factors associated with anxiety and depression among adult HIV-infected patients across China.Methods: In this cross-sectional study, we described clinical and psychosocial variables related to depression and anxiety in 4103 HIV-infected persons. Doctors assessed anxiety and depression by asking patients whether they had experienced anxiety or depression in the prior month. Patients also self-administered the Hospital Anxiety and Depression (HAD) scale; those with score ≥8 on HAD-A/D were considered to be at high risk of anxiety or depression.Results: Associations between socio-demographic, psychosocial, and ART-related clinical factors and risk of depression or anxiety were investigated using multivariable logistic regression. Among patients assessed between 9/2014 and 11/2015, 27.4% had symptoms of anxiety, 32.9% had symptoms of depression, and 19.0% had both. Recentness of HIV diagnoses (P = 0.046) was associated with elevated odds of anxiety. Older age (P = 0.004), higher educational attainment (P < 0.001), employment (P = 0.001), support from family / friends (P < 0.001), and sleep disturbance (P < 0.001), and number of ART regimen switches (P = 0.046) were associated with risk of depression, while neither sex nor transmission route showed any associations. There were no significant associations with HIV-specific clinical factors including current CD4+ T cell count and current viral load.Conclusions: Prevalence of symptoms of anxiety and depression is high in this cohort of treatment-experienced HIV patients. Psychological and social-demographic factors, rather than HIV disease status, were associated with risk of depression and anxiety. This finding highlights the need to deliver interventions to address the mental health issues affecting HIV-infected persons with fully successful immune restoration across China

Inhibition of Protein Tyrosine Phosphatases by Low-Molecular-Weight S-Nitrosothiols and S-Nitrosylated Human Serum Albumin

The homogeneous recombinant mammalian protein tyrosine phosphatase 1B (PTP1B) and Yersinia protein tyrosine phosphatase (PTPase) are inactivated by a series of low-molecular-weight S-nitrosothiols. These compounds exhibited different inhibitory activities in a time- and concentration-dependent manner with second-order rate constants (kinact/KI) ranging from 37 to 113 M−1 min−1 against mammalian PTP1B and from 66 to 613 M−1 min−1 against Yersinia PTPase. Furthermore, the inactivation of Yersinia PTPase by S-nitrosylated protein:S-nitroso human serum albumin was investigated. Both single-S-nitrosylated and poly-S-nitrosylated human serum albumin show good inhibitory ability to Yersinia PTPase. The second-order rate constants are 472 and 1188 M−1 min−1, respectively. This result indicates a possibility that S-nitrosylated albumin in vivo may function as an inhibitor for a variety of cysteine-dependent enzymes