Prospective Cohort Study

Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017

Infectious Diseases Society of America.

Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis.

Executive Summary Introduction Methodology Used to Prepare the Guideline Epidemiology Incidence Etiology Major Epidemiologic Points Pathogenesis Major Points for Pathogenesis Modifiable Risk Factors Intubation and Mechanical Ventilation Aspiration, Body Position, and Enteral Feeding Modulation of Colonization: Oral Antiseptics and Antibiotics Stress Bleeding Prophylaxis, Transfusion, and Glucose Control Major Points and Recommendations for Modifiable Risk Factors Diagnostic Testing Major Points and Recommendations for Diagnosis Diagnostic Strategies and Approaches Clinical Strategy Bacteriologic Strategy Recommended Diagnostic Strategy Major Points and Recommendations for Comparing Diagnostic Strategies Antibiotic Treatment of Hospital-acquired Pneumonia General Approach Initial Empiric Antibiotic Therapy Appropriate Antibiotic Selection and Adequate Dosing Local Instillation and Aerosolized Antibiotics Combination versus Monotherapy Duration of Therapy Major Points and Recommendations for Optimal Antibiotic Therapy Specific Antibiotic Regimens Antibiotic Heterogeneity and Antibiotic Cycling Response to Therapy Modification of Empiric Antibiotic Regimens Defining the Normal Pattern of Resolution Reasons for Deterioration or Nonresolution Evaluation of the Nonresponding Patient Major Points and Recommendations for Assessing Response to Therapy Suggested Performance Indicators

Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia the official statement of the American Thoracic Society and the Infectious Disease Society of America (特集 救急診療ガイドライン) -- (海外のガイドライン)

Submitted 28 November 2007, Accepted 11 Februray, 2008 Correspondence : Hee Jin Cheong, M.D. Division of Infections Disease, Department of internal Medicine, Korea University College of Medicine, 37, Guro-gu, Seoul 152-703, Korea Tel : 82-2-2626-3050, Fax : 82-2-837-1966 E-mail : heejinmd@medimail.co.kr 침습성 감염의 경우에는 심각한 면역저하 환자가 아니더라 도 발생할 수 있다(2). 아스페르길루스 감염이 부비동에서 시작된다면 두개저와 혈관들을 침범하는 두개내 침습적 아 스페르길루스 감염증을 일으킬 수 있고 혈관 침범 및 괴사 를 유발하게 되어 치명적인 결과를 가져올 수 있다. 그러나 두개저를 침범한 침습성 아스페르길루스증은 비교적 드문 질환으로 임상적 경험이 부족하여 치료 기간 및 치료 반응 평가에 대한 명확한 지침이 없는 실정이다(3). 저자들은 제 2형 당뇨병력이 있는 환자에 있어서 부비동 -안와를 포함하여 두개저까지 침범한 침습성 아스페르길 루스증을 진단하였고, 진단 및 치료적 수술을 시행한 후에 총 14주간에 걸쳐 voriconazole (Vfend ® , Pfizer, Seoul, Korea)을 투약하여 성공적으로 치료하였음을 경험하여 문 헌고찰과 함께 보고하는 바이다. 증 례

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Invasive Aspergillosis of the Paranasal Sinuses Invading Skull Base : Successful Treatment with Voriconazole

We present a case of a 64-year-old woman with acute myeloid leukemia who developed a hepatic abscess during the neutropenic period after induction chemotherapy. To treat the abscess, meropenem and ciprofloxacin were administered to target Klebsiella pneumoniae and percutaneous drainage performed. As a result, the patient’s fever and c-reactive protein (CRP) subsequently improved. After six weeks of antibiotic therapy, an abdominal computed tomography scan revealed remains of the liver abscess as well as an ileus in the small bowel. Molds from the Mucor genus were cultured from repeated liver abscess drainage and an abscess wall biopsy confirmed hepatic mucormycosis. Along with administration of amphotericin-B deoxycholate for four weeks, we performed lobectomy for hepatic mucormycosis and small bowel resection for a suspected small bowel mucormycosis. After these operations, the patient received liposomal amphotericin B for three weeks and was then maintained with oral posaconazole for more than four weeks. Our case report suggests that hepatic mucormycosis should be considered when a hepatic abscess exhibits a retarded response to antibacterial agents, especially for patients with risk factors. In addition, because an isolated hepatic mucormycosis is infrequent, a thorough search for the extent of the disease is necessary before surgical resection.

/pdf/hepatic-and-small-bowel-mucormycosis-after-chemotherapy-in-a-4h3mwmsxit.pdf

Hepatic and Small Bowel Mucormycosis after Chemotherapy in a Patient with Acute Myeloid Leukemia: A Case Report and Literature Review

A 60-year-old man undergoing maintenance hemodialysis presented with periodic fever, which resembled Pel-Ebstein fever of Hodgkin’s lymphoma. Despite scores of diagnostic evaluations, origin of the fever remained obscure. On positron emission tomography/computed tomography scan, focal hot uptakes were seen in the mediastinum and mediastinoscopic biopsy showed many acid-fast bacilli with chronic granulomatous inflammation and necrosis. After a week of anti-tuberculosis medication, the patient remained afebrile without recourse to antipyretics.

/pdf/mediastinal-tuberculous-lymphadenitis-with-periodic-fever-24rvy7lpgz.pdf

Mediastinal Tuberculous Lymphadenitis with Periodic Fever

Frailty is a geriatric syndrome with increased risk for poor health outcomes, including falls, cognitive impairment, hospitalization, and mortality. In previous studies, associations between frailty and sleep-related factors or sleep disorders have been investigated. We examined the relationship between frailty and insomnia, which are both common condition in older adults. Hormonal changes with aging and/or lifestyle changes all affect sleep physiology, which are vulnerable to the risk of insomnia. As the severity of frailty decreases the quality of sleep, and the long/short sleep duration is related to the risk of frailty, it can be assumed that frailty and sleep are reciprocally related. The association between frailty and insomnia has been variously proven in epidemiological studies conducted around the world. A close evaluation of insomnia and frailty in older adults provides a basis for improving the health of people in the aged society. There are few related studies in Korea, and in the future, not only basic epidemiological studies but also studies explaining the psychoneuroendocrinological mechanism of the relationship between insomnia and frailty should be performed together.

/pdf/frailty-and-insomnia-in-older-adults-4gr36z56.pdf

Frailty and Insomnia in Older Adults

Objective: This study aims to examine clinical characteristics and to identify possible risk factors of sleep disturbances in people living with HIV (PLWH).Methods: All research data of patients who were first diagnosed with HIV/AIDS from January 1, 2012 to December 31, 2021 and complained of sleep disturbance at least once were retrospectively reviewed by the Severance Clinical Research Analysis Portal (SCRAP) service of Severance hospital. The presence of sleep disturbance was evaluated based on whether insomnia disorder diagnosis code was included or whether insomnia medication was prescribed. The patients were divided into either the group with sleep disturbance within 3 months (SDW3) and the group with after 3 months (SDA3). All data were reported using descriptive statistics.Results: Of the 674 patients diagnosed with HIV during the period, 56 patients experienced sleep disturbances at least once and approximately 50% of patients have experienced sleep disturbance in the first 3 months after HIV diagnosis. CD4+ cell count at the time of first onset of sleep disturbance was significantly lower (p=0.03) and HIV viral load at the time of first onset of sleep disturbance was significantly higher (p<0.001) in SDW3 group. SDW3 patients showed higher rates of opportunistic infections compared to SDA3 patients.Conclusion: The current study suggests that further investigation of the underlying pathophysiology of sleep disturbance and association with immunological changes for early diagnosis and treatment of sleep disturbance in PLWH.

Woo Joo Kim

Papers

Invasive Aspergillosis of the Paranasal Sinuses Invading Skull Base : Successful Treatment with Voriconazole

Hepatic and Small Bowel Mucormycosis after Chemotherapy in a Patient with Acute Myeloid Leukemia: A Case Report and Literature Review

Mediastinal Tuberculous Lymphadenitis with Periodic Fever

Frailty and Insomnia in Older Adults

Clinical Characteristics of HIV-Infected Patients With Sleep Disturbance