Conventional magnetic-resonance (MR) imaging is not sensitive enough in depicting subtle neurodegenerative changes that occur during chronic HIV infection with good peripheral viral suppression. The aim of this study was to compare brain volumes in HIV-positive subjects with age- and education-matched healthy controls with regard to influence of aging and immunologic parameters. An overall of 65 subjects (40 HIV-positive and 25 age-, gender-, and education-matched healthy subjects) underwent conventional MR imaging with three-dimensional sequence adequate for volumetric measurements. Volumes of specific brain regions were measured and compared between HIV-positive and healthy subjects using Student t test. Correlations between obtained brain volumes and immunologic parameters were determined using Pearson's correlation test. Influence of age as a covariate was determined using ANCOVA test. Statistical value was set at p < 0.05. Volumes of nucleus accumbens (p = 0.003), putamen (p = 0.003), and thalamus (p = 0.046) were significantly decreased in HIV-positive subjects compared with healthy, while volumes of lateral ventricles were significantly increased (p = 0.043). However, influence of age on atrophy was greater than presence of HIV infection in all observed volumes. Positive correlation of nadir CD4+ count and nucleus accumbens volume was obtained, as well as of therapy with lateral ventricle volumes. Volumes of putamen correlated negatively with duration of therapy. HIV-associated atrophic changes are visible in nucleus accumbens, putamen, and thalamus in neurocognitively asymptomatic stage, while no changes can be observed in the hippocampus, affected by other types of dementias. Under therapy, the influence of physiological aging on HIV-associated atrophy is greater than the presence of HIV infection per se.
Introduction/Objective Fungal rhinosinusitis comprises of a wide range of
immune-pathological responses, including invasive, chronic, granulomatous,
and allergic diseases. Aim of this study was to determine total number of
patients, their characteristics, frequency of symptoms, the manner of
disease manifestation and the success of therapy. Methods Study included 21
patients with diagnosis FRS made according to the 2012 EPOS guidelines.
Results Based on VAS(visual analogue scale), feeling of localized pressure,
ie. facial pain was dominant in 9.57 ? 0.98, than the secretion from the
nose is 8.14 ? 1.62, problem of the breathing on the nose in 6.67 ? 3.25,
while reduction the sense of smell was in 2.14 ? 3.00. T-test showed there
is a statistically significant difference between mucosal changes on the
diseased and healthy sides of the patient's face (p <0.0001). Intraoperative
in 18 (85.71%) patients only one sinus was affected. The most commonly
affected sinus was maxillary, in 13 (54.17%) cases, followed by sphenoid
sinus in 5 (20.83%) cases. As a cause of rhinosinusitis Aspergillus was
proven in 12 (57.14%) patients. Conclusion The dominant symptom of patients
with fungal rhinosinusitis was localized pain / pressure in the area of the
affected sinus. Endoscopically, on the side of the affected sinus, the
pathological mucosa with thick, pithy, mucous secretion dominated. The
maxillary sinus is primarily unilaterally affected, in more than half of the
patients. Aspergillus has been proven to be the most common cause of
rhinosinusitis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.