Multiple papular lesions in a patient with HIV and/or AIDS and coinfected with hepatitis B virus: Amyloidosis

Introduction: The most common form of systemic amyloidosis is amyloid A induced by a chronic inflammation. In HIV-infected patients, elevated serum amyloid A levels might be associated with chronic inflammation.Patient presentation: A 43-year-old male patient was admitted to hospital with a complaint of papular lesions around his eyes, existing for four months. The patient is receiving antiretroviral therapy. HIV RNA was undetectable, and the CD4 count was 770 cells/mm3. He suffered from a bladder carcinoma for four years. On examination, periocular, perioral and anogenital papules, papular lesions in the meatus of external auditory canal, and intranasal polyps were observed.Management: Microscopic examination of the biopsy material taken from the periocular lesion and then from perianal polyps revealed eosinophilic deposition, and stained positively by Congo red. Serum amyloid A level was negative. Antiretroviral therapy was continued.Conclusion: A rare form of amyloidosis in a patient with HIV and/or AIDS and coinfected with hepatitis B virus (HBV) was presented here with cutaneous and mucosal lesions

Unexpected Risks for Campers and Hikers: Tick-Borne Infections

Introduction: Camping and hiking are popular worldwide recreational activities. All age groups, elderly or young, immunocompetent or immunosupressive people may engage in these activities. During these activities, individuals may get injured or be exposed to pathogens. There is also a strong possibility of experiencing mosquito, lice, or tick bites, bee stings, or being bitten by scorpions, snakes, rodents, wild or feral animals. This study reviewed the current literature regarding tick-borne infections encountered during recreational activities.Methods: PubMed and the Web of Science databases were searched for the keywords “campers,” “hikers,” and “tick borne infections.” Major reviews, research papers, and case series on campers and hikers were reviewed, and current articles for tick-borne infections were selected and summarized.Results: People who engage in recreational activities are potentially at risk for infection from environmental sources. A group of important vector-borne diseases is tick-borne infections, the major agents of which are Babesia spp., Borrelia spp., Rickettsia spp., Ehrlichia spp., Francisella tularensis, Coxiella burnetii, Crimen-Congo Hemorrhagic Fever (CCHF), and Tick-Borne Encephalitis (TBE) viruses. These infections have a widespread geographical distribution.Conclusion: Participating in outdoor recreational activities is increasing all over the world. While partaking in these activities, humans are frequently exposed to ticks and are potentially at risk for infection. To prevent infection, public and medical awareness is necessary

The Role of Information and Communication Technology in the Acculturation of Vietnamese Refugees

One of the most significant refugee populations in the United States is the Vietnamese. This group initially fled their native country to escape political oppression at the conclusion of the Vietnam War in 1975 and continued to flee in a series of separate waves that continued for more than three decades. As a relatively new immigrant group in the U.S., the Vietnamese still face a variety of challenges as they try to reestablish their lives and adapt in a new cultural environment. Acculturation is a complex process that is influenced by a number of factors. Throughout history, U.S. immigration policy has significantly affected the admission and adaptation of refugees. As shifts in the ideological frameworks, economic demands, and attitudes towards the rest of the world occurred in the twentieth century, which eventually brought the liberalization of immigration policy, this influence slowly decreased. This allowed for factors in the domestic political, economic, and social environments to become more powerful in affecting how refugees adapt in the U.S. Information and communication technologies (ICTs) have become integral aspects in both assisting and complicating the acculturation process for refugees. These technologies are helping Vietnamese refugees culturally adjust in American communities as well as maintain ties with their native culture; thus, illustrating the multifaceted nature of acculturation. However, the impact of ICTs is not uniform across all of the different waves of refugees who fled from Vietnam. This study demonstrates that interaction and communication are key aspects in cross-cultural adaptation and the importance of media in contemporary everyday life

Drug-Induced Black Hairy Tongue: A Case Report

Black hairy tongue is a commonly observed condition of defective desquamation of the filiform papillae. The color of the elongated papillae varies from yellowish white to brown or black. A 22-years-old female presented to the department with complaints of painful, black discoloration of her tongue. Her history revealed that she had been taking doxycycline and rifampin for brucellosis. An anti-inflammatory mouthwash was administered, and the brucellosis treatment was continued. Her tongue had healed completely one month later. When doxycycline and rifampin therapy are given, the possibility of black tongue should be kept in mind. Drug discontinuation may not be necessary

Toxin-Neutralizing Antibodies Elicited by Naturally Acquired Cutaneous Anthrax are Elevated Following Severe Disease and Target Conformational Epitopes.

Understanding immune responses to native antigens in response to natural infections can lead to improved approaches to vaccination. This study sought to characterize the humoral immune response to anthrax toxin components, capsule and spore antigens in individuals (n=46) from the Kayseri and Malatya regions of Turkey who had recovered from mild or severe forms of cutaneous anthrax infection, compared to regional healthy controls (n=20). IgG antibodies to each toxin component, the poly-?-D-glutamic acid capsule, the Bacillus collagen like protein of anthracis (BclA) spore antigen, and the spore carbohydrate anthrose, were detected in the cases, with anthrax toxin neutralization and responses to Protective Antigen and Lethal Factor being higher following severe forms of the disease. Significant correlative relationships among responses to PA, LF, EF and capsule were observed among the cases. Though some regional control sera exhibited binding to a subset of the tested antigens, these samples did not neutralize anthrax toxins and lacked correlative relationships among antigen binding specificities observed in the cases. Comparison of overlapping decapeptide binding covering the entire length of PA, LF and EF proteins in 26 cases compared to 8 regional controls revealed no differences in peptide-binding specificities, strongly suggesting that anthrax toxin-neutralizing antibody responses elicited following natural cutaneous anthrax infection are directed to conformational epitopes. These studies support the concept of vaccination approaches that preserve conformational epitopes.</p

HIV’LE ENFEKTE BİR HASTADA KAPOSİ SARKOMU YÖNETİMİ

Giriş: HIV enfeksiyonunda en sık g&ouml;r&uuml;len malignite Kaposi sarkomudur. Yeni tanılı HIV enfekte hastalarda antiretroviral tedaviye (ART) hemen başlanmalıdır. Kemoterapi gereksinimi %20 civarındadır. Diğer alternatifler imm&uuml;noterapiler, kriyocerrahi, radyasyondur. &nbsp;Olgu: Kırk sekiz yaşında HIV&rsquo;le enfekte erkek hasta akciğer t&uuml;berk&uuml;lozu teşhisiyle dış merkezden sevk edildi. Yaklaşık iki yıl &ouml;ncesinden HIV&rsquo;le enfekte olduğunu &ouml;ğrenen hasta takipte değilmiş. Son bir aydır halsizlik, ateş, &ouml;ks&uuml;r&uuml;k, balgam şik&acirc;yeti olması &uuml;zerine gittiği merkezde balgam ARB pozitif olması &uuml;zerine g&ouml;r&uuml;ld&uuml;. Fizik muayenede ateş y&uuml;ksekliği (38,5 &deg;C), taşikardi (nb:94/dk),&nbsp; algılama yavaşlığı, sol akciğerde dinlemekle ral ve her iki ayak tabanında, bacağında ve skapula altında eflatun-mor renkli plak (Resim 1A, 1B ve 1C) saptandı. Laboratuvar incelemesinde anemi (Hb:12,4g/dl), l&ouml;kopeni (BK:3630/mm3), alanin aminotransferaz y&uuml;ksekliği (103U/L) vardı ve CD4 sayısı 38/mm3 (%14) idi. D&ouml;rtl&uuml; anti-t&uuml;berk&uuml;loz (INH, RIF, PZR, ETM) tedavi ve tenofovir/emtrisitabine ve efavirenz başlandı. Balgam k&uuml;lt&uuml;r&uuml;nde Mycobacterium tuberculosis komplex &uuml;redi ve INH, RIF&rsquo;e duyarlıydı. Sonrasında ayağından alınan biyopsi sonucu Kaposi sarkomu ile uyumlu olması &uuml;zerine ayaklarına 15 g&uuml;n, bacak ve sırtına 10 g&uuml;n radyoterapi aldı. Antiretroviral tedavinin &uuml;&ccedil;&uuml;nc&uuml; ayında CD4 sayısı 283 (%32) iken ayağındaki lezyonları d&uuml;zeldi. Ayağındaki lezyonların sonraki hali Resim 1D&rsquo;de g&ouml;r&uuml;lmektedir. Anti t&uuml;berk&uuml;loz tedavisi 6 aya tamamlandı.Bu olgu HIV&rsquo;le enfekte hastalarda Kaposi sarkomu ve tedavisine dikkat &ccedil;ekmek i&ccedil;in sunulmuştur.</p