The early diagnosis and treatment of ocular disease to prevent morbidity and mortality of patients with human immunodeficiency virus (HIV) is of paramount importance. Since the advent of highly active antiretroviral therapy (HAART), the incidence of ocular complications of HIV has decreased and their manifestations and natural course are also modified. This has been observed in the face of emerging immune recovery, which per se has brought new difficulties in the process of diagnosing and management of the ocular disease. Conditions such as immune recovery uveitis could affect eyes with history of opportunistic disease with a potential to cause vision loss; with this regard, differentiation of the inflammatory process from infective causes is essential. The other sexually contracted diseases are also to be included in this complex picture because of their contribution to the clinical picture and also sharing common routes of transmission with HIV. There is very little doubt that visual deterioration would further deteriorate the already compromised quality of life of this group of patients. In this review, authors wish to provide evidence available in the medical literature around the visual health issues in HIV-infected patients and raise awareness towards the changing pattern of the ocular disease in the HAART era.
There is very little knowledge about how herpes simplex virus (HSV) seropositivity of HIV-positive mothers could complicate the occurrence of neonatal herpetic disease, in the absence of genital ulcers, in this group of patients. We present a case of fatal disseminated neonatal herpes infection in a baby, born to a HIV-positive patient, and wish to discuss the potential need for changes in the management of this group of patients during pregnancy. Disseminated HSV disease is a rare, yet serious condition in newborns of HSV-infected mothers, and women with HIV infection have shown to frequently shed more HSV DNA in their genital secretions, even in the absence of active herpetic ulcers. This is the first case report of this rare association and, as a result, the evidence in support of our hypothesis has been extrapolated from other studies.
Ocular examination should be a part of the routine assessment of the patients seen at sexually transmitted diseases (STD) clinics due to the importance of these organs in the general wellbeing of patients. It is essential to keep an open eye on ocular signs and symptoms of patients with a history of exposure to common STD pathogens, to ensure prompt investigation and management of ocular complications of the STDs, which, if left unnoticed, otherwise could subject the patients to a great deal of anxiety and distress.
Internal abdominal hernias are rarely reported in the literature and have a very low rate of preoperative diagnosis. It is even rarer that they present with jaundice. A 59-year-old Caucasian female presented with a short history of jaundice, dark urine, epigastric pain, vomiting, and obstipation. Her liver biochemistry profile revealed a mixed cholestatic/hepatocellular pattern with significantly elevated bilirubin. She urgently underwent abdominal imaging which provided a preoperative diagnosis of internal herniation of the cecum within the lesser sac through the foramen of Winslow. The dilated bowel was compressing the common bile duct explaining the jaundice. This was repaired intraoperatively by anchoring the mobile cecum. In this case, we highlight the importance of maintaining a high index of suspicion for internal herniation on abdominal imaging with clinical evidence of intestinal obstruction. A foramen of Winslow hernia should be further suspected in the presence of jaundice.
The COVID-19 pandemic has had a major impact on health care systems across the globe in a short period of time. There is a growing body of evidence surrounding the findings on hybrid imaging with FDG-PET/CT, and this case highlights the importance of molecular imaging in better understanding of the biomarkers of the disease which ultimately determine the success in building a model to predict the disease severity and monitoring the response to treatment.
There is huge emphasis on noninvasive study of disease processes in the field of biomedical research. Combined PET-MRI allows simultaneous acquisition of physiologic information provided by PET images and morphologic and functional information obtained from MRI. The potential clinical and research applications of this technique in different organ systems and pathologies are promising (i.e. brain, cardiovascular, oncological, and inflammatory conditions). The purpose of this review is to illustrate the potential clinical advantages of this new technology, based on the authors' experience.
Prostate cancer is the most common malignancy in men with high incidence of recurrence following treatment. Biochemical recurrence, as indicated by rising PSA levels following successful treatment of the primary disease, is a frequent encounter in routine clinical practice. 68Gallium-PSMA positron emission tomography/computer tomography has been widely accepted as the modality of choice with the highest impact in management of this group of patients. Pitfalls of this diagnostic technique stem from the diversity of histological entities, other than prostate tumour cells, which can demonstrate increased uptake of the radiotracer. We present a case of intracranial uptake of PSMA by meningioma in a patient with BCR, as a pitfall in imaging of prostate cancer. Knowledge of normal distribution of the tracer is of utmost importance when reading positron emission tomography/computer tomography imaging especially given the relative novelty of usage of 68Gallium-PSMA.
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