1.Aging with HIV: The Burden of Comorbidities, Polypharmacy, and Drug Interactions in Korean People Living withHIV Aged ≥50 Years
Jin KIM ; Hyun-Ju NAM ; Ji-Yeon KIM ; Mi-Kyung HEO ; Sung Un SHIN ; Uh Jin KIM ; Seong Eun KIM ; Seung-Ji KANG ; Jihwan BANG ; Jin-Soo LEE ; Mi-Ok JANG ; Kyung-Hwa PARK
Infection and Chemotherapy 2024;56(4):534-543
Background:
The life expectancy of people living with human immunodeficiency virus (PLWH) has significantly improved with advancements in antiretroviral therapy (ART). However, aging PLWH face a growing burden of noncommunicable diseases (NCDs), polypharmacy, and drug-drug interactions (DDIs), which pose challenges in their management. This study investigates the prevalence of NCDs, polypharmacy, and DDIs among PLWH aged ≥50 years in Korea and their impact on quality of life (QOL).
Materials and Methods:
A cross-sectional study was conducted among 243 PLWH aged ≥50 years receiving ART for at least three months at three university hospitals in Korea between January and July 2022. Data were collected through electronic medical records and personal interviews, assessing demographics, comorbidities, polypharmacy, ART adherence, and QOL using the Korean version of WHOQOL-HIV BREF scale. Potential DDIs were analyzed using the University of Liverpool HIV Drug Interaction Database, and potentially inappropriate medications (PIMs) were identified using the 2023 American Geriatrics Society Beers Criteria. We classified participants into three age groups:50–<65 years, 65–<75 years, and ≥75 years.
Results:
The prevalence of comorbidities was 71.6%, with older participants (≥75 years) showing a significantly higher burden, including bone diseases, osteoarthritis, and dementia (P<0.001). Polypharmacy was observed in 28.4% of participants and increased with age, with 53.3% of those aged ≥75 years taking ≥10 pills daily.Polypharmacy was associated with poorer QOL (71.6 vs. 76.6, P=0.010). Amber-flag DDIs were found in 81 participants (33.3%), most commonly involving metformin and divalent cations. No red-flag DDIs were identified.PIMs were observed in 6.6% of participants aged ≥65 years.
Conclusion
Aging PLWH in Korea face significant challenges from comorbidities, polypharmacy, and DDIs, which negatively impact QOL. Integrated, age-specific, and multidisciplinary care strategies are urgently needed to improve outcomes and ensure the well-being of older PLWH.
2.Recurrent Bilateral Facial Palsy Associated with Herpes Simplex Virus Infection
Nam Jin HEO ; Suyeon SEO ; Seung Ho CHOO ; Byoung Joon KIM
Journal of the Korean Neurological Association 2024;42(4):366-369
Bell's palsy is the most common cause of facial paralysis with a lifetime risk of one in 60 in general population. The exact pathophysiology is unknown, but it is suspected to be associated with viral infections such as herpes simplex virus (HSV). Recurrent facial palsy is a rare condition that can be caused by various factors but the cause remains unknown. We report a case of recurrent facial palsy who had antibodies of Lyme immunoglobulin G (IgG), HSV IgG, and IgM.
3.Lately Obtained Baseline Waves in Motor Evoked Potential Monitoring during the Surgery of Frontal Lobe Tumor
Suyeon SEO ; Nam Jin HEO ; In Seok LEE ; Dae-Won SEO ; Jung Seok LEE
Journal of the Korean Neurological Association 2024;42(4):411-415
Intraoperative neurophysiologic monitoring during brain tumor surgery should acquire a baseline data as soon as possible. However, motor unit potentials (MEP) in our case showed baseline data could not be acquired in the early stage of surgery, but consecutive trials had abrupt appearance of MEP just after dura opening. This case shows the acquisition of baseline MEP during brain tumor surgery should not be given up until the dura is open especially in a state of raised intracranial pressure.
4.Central Anticholinergic Syndrome Induced by Atropine Eye Drops: A Case Report
Jung Sun HEO ; Je Jin LEE ; Sang Uk CHOI ; Nam Ju MOON ; Joon Hyung YEO
Journal of the Korean Ophthalmological Society 2024;65(11):745-748
Purpose:
We present a case of central anticholinergic syndrome following the administration of atropine eye drops.Case summary: A 60-year-old male presented with decreased visual acuity in his left eye and was diagnosed with intraocular lens dislocation. Preoperatively, Isopto atropine® eye drops (1 drop at 15-minutes intervals) were used for pupil dilation. Within an hour of the first instillation, the patient exhibited drowsiness, disorientation, agitation, and urinary retention. Laboratory tests and computed tomography of the brain were unremarkable. Considering the recent administration of atropine eye drops, a diagnosis of central anticholinergic syndrome was made. The surgery was postponed and the patient recovered fully after 3 hours of observation. He remained asymptomatic during an additional day of hospitalization.
Conclusions
A small dose of atropine eye drops even at a therapeutic dose can induce central anticholinergic syndrome. Therefore, ophthalmologists should be aware of this rare and severe complication.
5.Aging with HIV: The Burden of Comorbidities, Polypharmacy, and Drug Interactions in Korean People Living withHIV Aged ≥50 Years
Jin KIM ; Hyun-Ju NAM ; Ji-Yeon KIM ; Mi-Kyung HEO ; Sung Un SHIN ; Uh Jin KIM ; Seong Eun KIM ; Seung-Ji KANG ; Jihwan BANG ; Jin-Soo LEE ; Mi-Ok JANG ; Kyung-Hwa PARK
Infection and Chemotherapy 2024;56(4):534-543
Background:
The life expectancy of people living with human immunodeficiency virus (PLWH) has significantly improved with advancements in antiretroviral therapy (ART). However, aging PLWH face a growing burden of noncommunicable diseases (NCDs), polypharmacy, and drug-drug interactions (DDIs), which pose challenges in their management. This study investigates the prevalence of NCDs, polypharmacy, and DDIs among PLWH aged ≥50 years in Korea and their impact on quality of life (QOL).
Materials and Methods:
A cross-sectional study was conducted among 243 PLWH aged ≥50 years receiving ART for at least three months at three university hospitals in Korea between January and July 2022. Data were collected through electronic medical records and personal interviews, assessing demographics, comorbidities, polypharmacy, ART adherence, and QOL using the Korean version of WHOQOL-HIV BREF scale. Potential DDIs were analyzed using the University of Liverpool HIV Drug Interaction Database, and potentially inappropriate medications (PIMs) were identified using the 2023 American Geriatrics Society Beers Criteria. We classified participants into three age groups:50–<65 years, 65–<75 years, and ≥75 years.
Results:
The prevalence of comorbidities was 71.6%, with older participants (≥75 years) showing a significantly higher burden, including bone diseases, osteoarthritis, and dementia (P<0.001). Polypharmacy was observed in 28.4% of participants and increased with age, with 53.3% of those aged ≥75 years taking ≥10 pills daily.Polypharmacy was associated with poorer QOL (71.6 vs. 76.6, P=0.010). Amber-flag DDIs were found in 81 participants (33.3%), most commonly involving metformin and divalent cations. No red-flag DDIs were identified.PIMs were observed in 6.6% of participants aged ≥65 years.
Conclusion
Aging PLWH in Korea face significant challenges from comorbidities, polypharmacy, and DDIs, which negatively impact QOL. Integrated, age-specific, and multidisciplinary care strategies are urgently needed to improve outcomes and ensure the well-being of older PLWH.
6.Recurrent Bilateral Facial Palsy Associated with Herpes Simplex Virus Infection
Nam Jin HEO ; Suyeon SEO ; Seung Ho CHOO ; Byoung Joon KIM
Journal of the Korean Neurological Association 2024;42(4):366-369
Bell's palsy is the most common cause of facial paralysis with a lifetime risk of one in 60 in general population. The exact pathophysiology is unknown, but it is suspected to be associated with viral infections such as herpes simplex virus (HSV). Recurrent facial palsy is a rare condition that can be caused by various factors but the cause remains unknown. We report a case of recurrent facial palsy who had antibodies of Lyme immunoglobulin G (IgG), HSV IgG, and IgM.
7.Lately Obtained Baseline Waves in Motor Evoked Potential Monitoring during the Surgery of Frontal Lobe Tumor
Suyeon SEO ; Nam Jin HEO ; In Seok LEE ; Dae-Won SEO ; Jung Seok LEE
Journal of the Korean Neurological Association 2024;42(4):411-415
Intraoperative neurophysiologic monitoring during brain tumor surgery should acquire a baseline data as soon as possible. However, motor unit potentials (MEP) in our case showed baseline data could not be acquired in the early stage of surgery, but consecutive trials had abrupt appearance of MEP just after dura opening. This case shows the acquisition of baseline MEP during brain tumor surgery should not be given up until the dura is open especially in a state of raised intracranial pressure.
8.Central Anticholinergic Syndrome Induced by Atropine Eye Drops: A Case Report
Jung Sun HEO ; Je Jin LEE ; Sang Uk CHOI ; Nam Ju MOON ; Joon Hyung YEO
Journal of the Korean Ophthalmological Society 2024;65(11):745-748
Purpose:
We present a case of central anticholinergic syndrome following the administration of atropine eye drops.Case summary: A 60-year-old male presented with decreased visual acuity in his left eye and was diagnosed with intraocular lens dislocation. Preoperatively, Isopto atropine® eye drops (1 drop at 15-minutes intervals) were used for pupil dilation. Within an hour of the first instillation, the patient exhibited drowsiness, disorientation, agitation, and urinary retention. Laboratory tests and computed tomography of the brain were unremarkable. Considering the recent administration of atropine eye drops, a diagnosis of central anticholinergic syndrome was made. The surgery was postponed and the patient recovered fully after 3 hours of observation. He remained asymptomatic during an additional day of hospitalization.
Conclusions
A small dose of atropine eye drops even at a therapeutic dose can induce central anticholinergic syndrome. Therefore, ophthalmologists should be aware of this rare and severe complication.
9.Recurrent Bilateral Facial Palsy Associated with Herpes Simplex Virus Infection
Nam Jin HEO ; Suyeon SEO ; Seung Ho CHOO ; Byoung Joon KIM
Journal of the Korean Neurological Association 2024;42(4):366-369
Bell's palsy is the most common cause of facial paralysis with a lifetime risk of one in 60 in general population. The exact pathophysiology is unknown, but it is suspected to be associated with viral infections such as herpes simplex virus (HSV). Recurrent facial palsy is a rare condition that can be caused by various factors but the cause remains unknown. We report a case of recurrent facial palsy who had antibodies of Lyme immunoglobulin G (IgG), HSV IgG, and IgM.
10.Lately Obtained Baseline Waves in Motor Evoked Potential Monitoring during the Surgery of Frontal Lobe Tumor
Suyeon SEO ; Nam Jin HEO ; In Seok LEE ; Dae-Won SEO ; Jung Seok LEE
Journal of the Korean Neurological Association 2024;42(4):411-415
Intraoperative neurophysiologic monitoring during brain tumor surgery should acquire a baseline data as soon as possible. However, motor unit potentials (MEP) in our case showed baseline data could not be acquired in the early stage of surgery, but consecutive trials had abrupt appearance of MEP just after dura opening. This case shows the acquisition of baseline MEP during brain tumor surgery should not be given up until the dura is open especially in a state of raised intracranial pressure.

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