The study of human immunodeficiency virus (HIV) infection during pregnancy is of great significance because most women are first diagnosed with HIV during pregnancy. Similarly, it is equally important in cases where one or both partners are HIV-positive and wish to conceive. Since the first case of HIV was reported in the 1980s, antiviral drugs have been developed to prevent progression to acquired immunodeficiency syndrome (AIDS), which allows many AIDS patients to be asymptomatic or have only mild symptoms. This case shows that consecutive pregnancies and births are possible through proper antiretroviral therapy along with regular prenatal examinations in HIV-positive women.Rather than recommending contraception or expressing negative opinions about pregnancy in HIV-infected couples, active HIV treatment and prenatal care should be conducted to support a safe pregnancy and lower the chance of vertical HIV transmission. Recently, there has been a case report on successive childbirths of HIV-positive pregnant women who continued to receive antiretroviral therapy after their first childbirth at our hospital. Through this case, we report that safe delivery of HIV-infected mothers is possible, and further subsequent childbirths can be achieved with the use of appropriate antiretroviral therapy.

The study of human immunodeficiency virus (HIV) infection during pregnancy is of great significance because most women are first diagnosed with HIV during pregnancy. Similarly, it is equally important in cases where one or both partners are HIV-positive and wish to conceive. Since the first case of HIV was reported in the 1980s, antiviral drugs have been developed to prevent progression to acquired immunodeficiency syndrome (AIDS), which allows many AIDS patients to be asymptomatic or have only mild symptoms. This case shows that consecutive pregnancies and births are possible through proper antiretroviral therapy along with regular prenatal examinations in HIV-positive women.Rather than recommending contraception or expressing negative opinions about pregnancy in HIV-infected couples, active HIV treatment and prenatal care should be conducted to support a safe pregnancy and lower the chance of vertical HIV transmission. Recently, there has been a case report on successive childbirths of HIV-positive pregnant women who continued to receive antiretroviral therapy after their first childbirth at our hospital. Through this case, we report that safe delivery of HIV-infected mothers is possible, and further subsequent childbirths can be achieved with the use of appropriate antiretroviral therapy.

The study of human immunodeficiency virus (HIV) infection during pregnancy is of great significance because most women are first diagnosed with HIV during pregnancy. Similarly, it is equally important in cases where one or both partners are HIV-positive and wish to conceive. Since the first case of HIV was reported in the 1980s, antiviral drugs have been developed to prevent progression to acquired immunodeficiency syndrome (AIDS), which allows many AIDS patients to be asymptomatic or have only mild symptoms. This case shows that consecutive pregnancies and births are possible through proper antiretroviral therapy along with regular prenatal examinations in HIV-positive women.Rather than recommending contraception or expressing negative opinions about pregnancy in HIV-infected couples, active HIV treatment and prenatal care should be conducted to support a safe pregnancy and lower the chance of vertical HIV transmission. Recently, there has been a case report on successive childbirths of HIV-positive pregnant women who continued to receive antiretroviral therapy after their first childbirth at our hospital. Through this case, we report that safe delivery of HIV-infected mothers is possible, and further subsequent childbirths can be achieved with the use of appropriate antiretroviral therapy.

The study of human immunodeficiency virus (HIV) infection during pregnancy is of great significance because most women are first diagnosed with HIV during pregnancy. Similarly, it is equally important in cases where one or both partners are HIV-positive and wish to conceive. Since the first case of HIV was reported in the 1980s, antiviral drugs have been developed to prevent progression to acquired immunodeficiency syndrome (AIDS), which allows many AIDS patients to be asymptomatic or have only mild symptoms. This case shows that consecutive pregnancies and births are possible through proper antiretroviral therapy along with regular prenatal examinations in HIV-positive women.Rather than recommending contraception or expressing negative opinions about pregnancy in HIV-infected couples, active HIV treatment and prenatal care should be conducted to support a safe pregnancy and lower the chance of vertical HIV transmission. Recently, there has been a case report on successive childbirths of HIV-positive pregnant women who continued to receive antiretroviral therapy after their first childbirth at our hospital. Through this case, we report that safe delivery of HIV-infected mothers is possible, and further subsequent childbirths can be achieved with the use of appropriate antiretroviral therapy.

The study of human immunodeficiency virus (HIV) infection during pregnancy is of great significance because most women are first diagnosed with HIV during pregnancy. Similarly, it is equally important in cases where one or both partners are HIV-positive and wish to conceive. Since the first case of HIV was reported in the 1980s, antiviral drugs have been developed to prevent progression to acquired immunodeficiency syndrome (AIDS), which allows many AIDS patients to be asymptomatic or have only mild symptoms. This case shows that consecutive pregnancies and births are possible through proper antiretroviral therapy along with regular prenatal examinations in HIV-positive women.Rather than recommending contraception or expressing negative opinions about pregnancy in HIV-infected couples, active HIV treatment and prenatal care should be conducted to support a safe pregnancy and lower the chance of vertical HIV transmission. Recently, there has been a case report on successive childbirths of HIV-positive pregnant women who continued to receive antiretroviral therapy after their first childbirth at our hospital. Through this case, we report that safe delivery of HIV-infected mothers is possible, and further subsequent childbirths can be achieved with the use of appropriate antiretroviral therapy.

PURPOSE: Nutritional therapy (NT), such as enteral nutrition (EN) or parenteral nutrition (PN), is essential for the malnourished patients. Although the complications related to NT has been well described, multicenter data on symptoms in the patients with receiving NT during hospitalization are still lacking. METHODS: Nutrition support team (NST) consultations, on which NT-related complications were described, were collected retrospectively for one year. The inclusion criteria were patients who were (1) older than 18 years, (2) hospitalized, and (3) receiving EN or PN at the time of NST consultation. The patients' demographics (age, sex, body mass index [BMI]), type of NT and type of complication were collected. To compare the severity of each complication, the intensive care unit (ICU) admission, hospital stay, and type of discharge were also collected. RESULTS: A total of 14,600 NT-related complications were collected from 13,418 cases from 27 hospitals in Korea. The mean age and BMI were 65.4 years and 21.8 kg/m2. The complications according to the type of NT, calorie deficiency (32.4%, n=1,229) and diarrhea (21.6%, n=820) were most common in EN. Similarly, calorie deficiency (56.8%, n=4,030) and GI problem except for diarrhea (8.6%, n=611) were most common in PN. Regarding the clinical outcomes, 18.7% (n=2,158) finally expired, 58.1% (n=7,027) were admitted to ICU, and the mean hospital days after NT-related complication were 31.3 days. Volume overload (odds ratio [OR]=3.48) and renal abnormality (OR=2.50) were closely associated with hospital death; hyperammonemia (OR=3.09) and renal abnormality (OR=2.77) were associated with ICU admission; “micronutrient and vitamin deficiency” (geometric mean [GM]=2.23) and volume overload (GM=1.61) were associated with a longer hospital stay. CONCLUSION: NT may induce or be associated with several complications, and some of them may seriously affect the patient's outcome. NST personnel in each hospital should be aware of each problem during nutritional support.
Adult ; Body Mass Index ; Demography ; Diarrhea ; Enteral Nutrition ; Hospitalization ; Humans ; Hyperammonemia ; Intensive Care Units ; Korea ; Length of Stay ; Multicenter Studies as Topic ; Nutrition Therapy ; Nutritional Support ; Parenteral Nutrition ; Referral and Consultation ; Retrospective Studies ; Vitamins

BACKGROUND: Malnutrition is associated with many adverse clinical outcomes. The present study aimed to identify the prevalence of malnutrition in hospitalized patients in Korea, evaluate the association between malnutrition and clinical outcomes, and ascertain the risk factors of malnutrition. METHODS: A multicenter cross-sectional study was performed with 300 patients recruited from among the patients admitted in 25 hospitals on January 6, 2014. Nutritional status was assessed by using the Subjective Global Assessment (SGA). Demographic characteristics and underlying diseases were compared according to nutritional status. Logistic regression analysis was performed to identify the risk factors of malnutrition. Clinical outcomes such as rate of admission in intensive care units, length of hospital stay, and survival rate were evaluated. RESULTS: The prevalence of malnutrition in the hospitalized patients was 22.0%. Old age (≥ 70 years), admission for medical treatment or diagnostic work-up, and underlying pulmonary or oncological disease were associated with malnutrition. Old age and admission for medical treatment or diagnostic work-up were identified to be risk factors of malnutrition in the multivariate analysis. Patients with malnutrition had longer hospital stay (SGA A = 7.63 ± 6.03 days, B = 9.02 ± 9.96 days, and C = 12.18 ± 7.24 days, P = 0.018) and lower 90-day survival rate (SGA A = 97.9%, B = 90.7%, and C = 58.3%, P < 0.001). CONCLUSION: Malnutrition was common in hospitalized patients, and resulted in longer hospitalization and associated lower survival rate. The rate of malnutrition tended to be higher when the patient was older than 70 years old or hospitalized for medical treatment or diagnostic work-up compared to elective surgery.
Cross-Sectional Studies ; Hospitalization ; Humans ; Intensive Care Units ; Korea ; Length of Stay ; Logistic Models ; Malnutrition ; Multivariate Analysis ; Nutrition Assessment ; Nutritional Status ; Prevalence ; Risk Factors ; Survival Rate

Acute pancreatitis in pregnancy is rare and occurs in approximately 3 in 10,000 pregnancies. It rarely complicates pregnancy, and can occur during any trimester, however over half (52%) of cases occur during the third trimester and during the post-partum period. Gallstones are the most common cause of acute pancreatitis. On the other hand, acute pancreatitis caused by hypertriglyceridemia due to increase of estrogen during the gestational period is very unusual, but complication carries a higher risk of morbidity and mortality for both the mother and the fetus. We experienced a case of pregnant woman who died of acute exacerbation of hypertriglyceridemia-induced acute pancreatitis at 23 weeks of gestation. We report on progress and management of this case along with literature reviews.
Estrogens ; Female ; Fetus ; Gallstones ; Hand ; Humans ; Hypertriglyceridemia ; Maternal Death* ; Mortality ; Mothers ; Pancreatitis* ; Pregnancy Trimester, Third ; Pregnancy* ; Pregnant Women

BACKGROUND/AIMS: Waist circumference (WC) is a risk factor for metabolic syndrome and is related to insulin resistance (IR) and nonalcoholic fatty liver disease (NAFLD). The purpose of this study was to determine the association between WC and IR and NAFLD in apparently healthy Korean adults. METHODS: The volunteers included in this cross-sectional study comprised 9,159 adults (5,052 men, 4,107 women) who participated in a comprehensive health checkup program. IR was evaluated by the homeostasis model assessment of IR (HOMA-IR) and was considered to be present when the HOMA-IR score was >2. NAFLD was evaluated by ultrasound examination. Elevated alanine aminotransferase (ALT) was defined as >40 IU/L in men and >35 IU/L in women. Logistic regression was performed to determine the odds ratios (ORs) and 95% confidence intervals (95% CIs) for NAFLD, IR, and ALT according to categorized levels of WC. RESULTS: NAFLD was found in 2,553 (27.9%) of the participants (82.6% men, 17.4% women), while IR and elevated ALT were found in 17.2% (68.1% men, 31.9% women) and 10% (83% men, 17% women), respectively. After adjusting for confounding factors, the prevalence of NAFLD, IR, and elevated ALT was significantly associated with increases in WC quartile: highest quartile for NAFLD in men, OR=15.539, 95% CI=12.687-19.033; highest quartile for NAFLD in women, OR=48.732, 95% CI=23.918-99.288 (P<0.001); and highest quartile for IR in men, OR=17.576, 95% CI=13.283-23.255; highest quartile for IR in women, OR=11.078, 95% CI=7.813-15.708 (P<0.001); highest quartile for elevated ALT in men, OR=7.952, 95% CI=6.046-10.459; and highest quartile for elevated ALT in women, OR=8.487, 95% CI=4.679-15.395 (P<0.001). CONCLUSIONS: WC contributes to IR and NAFLD in apparently healthy Korean adults, and thus may be an important factor in the development of IR and NAFLD.
Adult ; Alanine Transaminase/blood ; Area Under Curve ; Asian Continental Ancestry Group ; Body Mass Index ; Cross-Sectional Studies ; Fatty Liver/*diagnosis ; Female ; Humans ; *Insulin Resistance ; Male ; Middle Aged ; Odds Ratio ; Republic of Korea ; Risk Factors ; *Waist Circumference

Microscopic polyangiitis (MPA) is a systemic small vessel vasculitis, which is frequently complicated with rapidly progressive necrotizing glomerulonephritis. Patients with MPA often have demonstrable perinuclear antineutrophil cytoplasm antibodies (p-ANCA) in serum. The most common age of onset is 40 to 60 years and is more common in men. Gastrointestinal (GI) tract involvement is present in about 30-40%. Small bowel involvement is more common and ischemic colitis in the rectum is rare. We have experienced a case of microscopic polyangiitis with ischemic colitis in the rectum, p-ANCA positive and cresent formation on renal biopsy. A 72-year-old woman was admitted with two weeks history of abdominal pain. Total colonoscopy revealed colon obstruction with severe mucosal edema. Urine study showed hematuria and proteinuria. Serum creatinine was elevated progressively. Serume p-ANCA was positive. The titer of p-ANCA was decreased and colon obstruction was recovered after steroid and cyclophosphamide therapy.
Abdominal Pain ; Age of Onset ; Aged ; Antibodies ; Antibodies, Antineutrophil Cytoplasmic ; Biopsy ; Colitis, Ischemic* ; Colon ; Colonoscopy ; Creatinine ; Cyclophosphamide ; Cytoplasm ; Edema ; Female ; Glomerulonephritis ; Hematuria ; Humans ; Male ; Microscopic Polyangiitis* ; Proteinuria ; Rectum ; Vasculitis