Aids related lymphomas
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HIV can increase the risk of developing lymphomas through sustained B-cell activation and high cytokine levels. AIDS-related lymphomas are categorized based on location into systemic, primary central nervous system, and body cavity-based types. The two major histological groups are immunoblastic lymphoma and small non-cleaved cell lymphoma (Burkitt lymphoma). Human herpes viruses have been linked to some forms of AIDS-related lymphomas.
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Chapter 9 - HIV/HCV Co-infection: Through the eyes of a co-infected hemophiliac
Occular manifestations of HIV
An unnamed adult film star tested positive for HIV during a routine examination, prompting the Hollywood adult film industry to shut down production indefinitely. Ocular manifestations of HIV infection are common, affecting around 70-80% of those with HIV. Manifestations can include lesions around the eye, inflammation and infections of the front and back of the eye, and neurological issues. Complications depend on whether the virus causes inflammation, nerve damage, or scarring of tissues. Monitoring CD4 counts helps predict risk of specific infections, though some can occur at higher counts due to antiretroviral therapy. A variety of opportunistic infections and cancers can impact the eyes.
OROFACIAL MANIFESTATIONS AS INDICATORS OF HIV/AIDS AMONG DENTAL PATIENTS /...
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Kaposi's Sarcoma
El sarcoma de Kaposi es una enfermedad por la que se forman tumores malignos (cancerosos) en la piel, las membranas mucosas, los ganglios linfáticos y otros órganos.
Para detectar (encontrar) y diagnosticar el sarcoma de Kaposi se utilizan pruebas que examinan la piel, los pulmones y el tubo digestivo.
Después de que se diagnostica un sarcoma de Kaposi, se realizan prueban para determinar si las células cancerosas se diseminaron a otras partes del cuerpo.
Ciertos factores afectan el pronóstico (probabilidad de recuperación) y las opciones de tratamiento.
Ocular manifestations of AIDS
This document discusses ocular manifestations of HIV/AIDS. It begins by describing HIV/AIDS etiology, noting that HIV-1 is the most common type worldwide. It then discusses various ocular manifestations associated with different CD4 counts, including Kaposi's sarcoma, CMV retinitis, and HIV retinopathy. Specific conditions of the anterior segment like molluscum contagiosum and of the posterior segment like CMV retinitis are then described in more detail, including characteristics, treatment options, and images. The document emphasizes that CMV retinitis is the most common opportunistic infection and discusses antiviral treatments for it like ganciclovir and foscarnet. It concludes by noting
HIV/AIDS & TB
The document discusses the deadly combination of the HIV/AIDS and tuberculosis (TB) pandemics. It states that around 12 million people worldwide are co-infected with HIV and TB, and that each disease makes the other worse. New tools are needed to combat the co-epidemic, including vaccines, diagnostics, and treatments. The Aeras Global TB Vaccine Foundation is working to develop new TB vaccines to help eliminate TB globally by 2050.
Tb hiv-coinfection
- There is an estimated 1 million people worldwide who have TB and HIV co-infection, with a high burden in sub-Saharan Africa and Asia.
- People living with HIV are 26-31 times more likely to develop TB than those without HIV. TB is the most common illness in those with HIV and a major cause of HIV-related death.
- Clinical manifestations of TB in those with HIV depend on immune deficiency level, ranging from typical localized TB to atypical disseminated forms with more advanced HIV disease. Diagnosis involves screening algorithms, radiography, sputum smear microscopy, mycobacterial culture, and molecular and serological tests.
Presenting problems in HIV infection
This document discusses the presenting problems in HIV infection. It describes the stages of infection from acute to asymptomatic to symptomatic disease. Common respiratory infections associated with HIV include pneumonia, Pneumocystis jiroveci pneumonia, tuberculosis, and atypical mycobacterial infections. Other organ systems affected by opportunistic infections in HIV patients with low CD4 counts include the cardiovascular and gastrointestinal systems. Mucocutaneous manifestations are also common.
Ocular manifestations of hiv
Ocular Manifestations of HIV outlines common eye diseases seen in patients with HIV/AIDS. A study in Ethiopia found 60% of HIV patients had at least one ocular manifestation, most commonly retinal microvasculopathy (24%). Posterior segment manifestations include opportunistic infections like cytomegalovirus retinitis (30-40% of patients) and varicella zoster virus retinitis. Neuro-ophthalmic manifestations occur in 10-15% of patients and include optic neuritis, optic atrophy, and cranial nerve palsies. Children with HIV have fewer ocular manifestations than adults.
HIV and Lungs
This is based on the Chapter of Fishman's Pulmonary Medicine reviewing the relation of HIV and Lungs.
Hiv Hcv Coinfected Patient
- The document discusses dental management considerations for patients infected with HIV and/or HCV, including common oral manifestations such as candidiasis, periodontal diseases, and viral diseases.
- Treatment planning requires assessing a patient's medical history, disease progression, ability to withstand treatment, and risk of bleeding or infection based on lab results.
- Invasive dental procedures for patients with HIV/HCV may require modifications like antibiotic pre-medication, and extra precautions are needed for those with advanced liver disease or bleeding problems.
Cutaneous manifestations of hiv infection
This document summarizes and classifies the various cutaneous (skin) manifestations that can occur due to HIV infection. It divides these manifestations into infectious, neoplastic and other categories. It provides detailed descriptions of common conditions in each category such as Kaposi's sarcoma, molluscum contagiosum, herpes simplex, and pruritic papular eruption. For each condition, it describes the clinical features and may include microscopic pathology images to illustrate findings. The document serves as a comprehensive reference for the cutaneous signs of HIV infection.
Hiv related lung disorders
This document discusses various lung disorders related to HIV infection. It notes that HIV-1 is more prevalent globally while HIV-2 is found principally in West Africa. Common transmission routes for HIV include sexual contact, intravenous drug use, and mother-to-child. Those at high risk include homosexuals/bisexuals, intravenous drug users, infants born to infected mothers, and recipients of blood/blood products. The document then discusses various classes of antiretroviral drugs and associated lung diseases like bacterial pneumonias, tuberculosis, and Pneumocystis jiroveci pneumonia, their symptoms, diagnoses and treatments.
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OROFACIAL MANIFESTATIONS AS INDICATORS OF HIV/AIDS AMONG DENTAL PATIENTS /...
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This document discusses lymphoma, including:
1. Lymphoma is a cancer of lymphocytes that develops in lymphatic tissue. There are two main types: Hodgkin's lymphoma and non-Hodgkin's lymphoma.
2. Hodgkin's lymphoma is characterized by Reed-Sternberg cells and has several subtypes. Non-Hodgkin's lymphoma is more common and includes over 60 subtypes.
3. The document covers epidemiology, risk factors, clinical presentation, diagnostic process, staging, treatment and prognosis for both Hodgkin's and non-Hodgkin's lymphomas. Treatment involves chemotherapy, radiation therapy, immunotherapy or stem cell transplantation depending on the lymphoma subtype and stage.
Lymphoma
Lymphoma refers to tumors of the lymphatic system, specifically lymphocytes and their precursor cells. The two main types are Hodgkin's lymphoma and non-Hodgkin's lymphoma. Hodgkin's lymphoma is characterized by the presence of Reed-Sternberg cells. It commonly affects lymph nodes in a stepwise fashion and has a bimodal age distribution. Non-Hodgkin's lymphoma can involve both B and T cells and often spreads more diffusely beyond lymph nodes. Diagnosis involves an excisional lymph node biopsy. Treatment depends on disease stage and may involve chemotherapy, with or without radiation therapy. Prognosis can be determined using factors in the International Prognostic Index.
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Viruses can cause cancer through both direct and indirect mechanisms. Directly, some viruses encode oncogenic proteins that inactivate tumor suppressor genes like p53, leading to uncontrolled cell growth. Indirectly, chronic viral infections cause inflammation and oxidative stress that damage DNA over many years and increase cancer risk. Several viruses are known human carcinogens, including hepatitis B and C viruses, human papillomavirus, Epstein-Barr virus, human T-cell lymphotropic virus type-1, Kaposi's sarcoma-associated herpesvirus, and Merkel cell polyomavirus, which are associated with liver cancer, cervical cancer, lymphomas, sarcomas, and other cancers.
Aids2007
The document summarizes the history and biology of HIV/AIDS. It describes how HIV/AIDS was initially recognized in the 1980s due to cases of rare opportunistic infections and cancers in homosexual men. Scientific research eventually identified HIV as the causative infectious retrovirus, which targets and destroys CD4+ T cells, leading to immunosuppression and AIDS if untreated. The global epidemic of HIV/AIDS was also discussed.
Aids
The document summarizes the history and biology of HIV/AIDS. It describes how HIV was identified in the 1980s based on clusters of opportunistic infections in homosexual men. HIV targets and destroys CD4+ T cells, gradually weakening the immune system until opportunistic infections can cause AIDS. No cure exists yet, but combination antiretroviral therapy can suppress HIV and prolong life. Over 40 million people worldwide are infected with HIV.
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1) Hodgkin lymphoma is a cancer of the lymphatic system that is characterized by the presence of Reed-Sternberg cells on histology and spreading in an orderly fashion to contiguous lymph nodes.
2) Risk factors include certain viruses like Epstein-Barr virus, a weakened immune system, age (most common in teens/young adults and those over 55), and family history.
3) Clinical presentation includes enlarged, painless lymph nodes as well as potential involvement of extralymphatic sites and "B" symptoms like night sweats and fever.
4) Staging involves determining the number and location of affected lymph nodes and sites of spread, with each stage divided into A or B
Non hodgkin's lymphoma
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Hodgkin's lymphoma is a cancer characterized by the presence of Reed-Sternberg cells in lymph nodes. It is most common in teenagers, young adults, and older adults over age 55. Risk factors include certain viruses, a weakened immune system, and family history. Symptoms include enlarged, painless lymph nodes and systemic B symptoms like fever, weight loss, and night sweats. Diagnosis involves an excisional lymph node biopsy followed by testing. Staging uses the Ann Arbor system and treatment depends on stage, with chemotherapy such as ABVD commonly used along with radiation therapy. Long term complications can include secondary cancers, organ damage, and fertility issues.
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Aids and malignancies
The document discusses several AIDS-defining and non-AIDS defining cancers that are more common in HIV-positive individuals. Kaposi sarcoma, caused by HHV-8, and two types of non-Hodgkin lymphoma were originally considered AIDS-defining cancers. While antiretroviral therapy has decreased AIDS deaths and increased the population of HIV-infected individuals, it has also led to an increase in both AIDS-defining and non-AIDS defining cancers due to people living longer with HIV. The document provides details on the pathogenesis, diagnosis and treatment of several AIDS-defining cancers including Kaposi sarcoma, multicentric Castleman's disease, and plasmablastic lymphoma.
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Chapter 7 oncogenic viruses
This document discusses various oncogenic viruses and their role in cancer development. It describes two main mechanisms by which viruses can cause cancer - direct and indirect. Direct mechanisms involve viral oncogenes promoting cancer in infected cells, while indirect mechanisms involve chronic inflammation from viral infection promoting cancer in nearby uninfected cells. Specific viruses discussed that are known to cause cancer include human papillomavirus (HPV), Epstein-Barr virus (EBV), Merkel cell polyomavirus, Kaposi's sarcoma-associated herpesvirus (KSHV), and others. The document provides details on the life cycles of these viruses and the molecular mechanisms by which their gene products subvert cellular controls and promote oncogenesis.
Week 6 presentation
Mr. Salim, a 62-year-old man, presented with right neck and left groin swelling for 3 months along with 7-8 kg of weight loss. Biopsy revealed diffuse large B-cell non-Hodgkin lymphoma (NHL). He was diagnosed with stage IV NHL and treated with rituximab and CHOP chemotherapy. The presentation discusses lymphadenopathy causes, lymphoma types and differences between Hodgkin and non-Hodgkin lymphomas, risk factors, investigations and treatments. Key points include distinguishing reactive from tumoral lymph nodes, indolent versus aggressive NHL subtypes, common genetic abnormalities in lymphomas, and involvement of Epstein-Barr virus in certain malignancies.
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The umbilical cord
The umbilical cord connects the fetus to the placenta and measures approximately 50 cm in length and 2 cm in diameter at term. It contains one vein that carries oxygenated blood to the fetus and two arteries that carry deoxygenated blood away. The cord inserts into the placenta near its center in most cases. Abnormalities can include abnormal insertion points, short or long length, knots, torsion, hematoma, or having a single umbilical artery instead of two.
The placenta
The placenta develops from fetal and maternal tissues to function as the respiratory, nutritive, excretory, barrier and endocrine organ of pregnancy. It transfers oxygen, nutrients and waste between the mother and fetus. The placenta can develop abnormalities in its shape, size, position or adhesion to the uterine wall which may cause complications like preterm birth or hemorrhage. Placental lesions like infarcts may also occur due to conditions like hypertension.
The foetal membranes
The document discusses the fetal membranes, which include the chorion and amnion. The chorion is the outer membrane that is attached to the placenta and uterine wall. The amnion lines the chorion and encloses the fetus and amniotic fluid. The amniotic fluid provides protection and nutrition for the fetus, and aids in temperature regulation and movement. It is composed primarily of water, carbohydrates, proteins and minerals. The amniotic fluid circulates continuously, with production from the fetal membranes, fetal urine and transudation from maternal and fetal blood.
Physiology of reproduction
The document summarizes the key stages in human reproduction from fertilization through early pregnancy development. It describes how sperm mature and are capacitated in the female reproductive tract. Upon ovulation, sperm meet and fertilize the ovum in the fallopian tubes. The zygote then undergoes cell division and develops into a blastocyst that implants in the uterus. The trophoblast cells of the blastocyst invade the uterine lining and develop into a placenta to exchange nutrients and waste with the mother's blood. Major developmental milestones in early pregnancy include chorion, amnion and decidua formation.
Minor complaints during pregnancy
The document discusses several minor complaints that may occur during pregnancy, including gingivitis, ptyalism, heartburn, constipation, hemorrhoids, varicosities, dyspnea, urinary symptoms, leucorrhea, leg cramps, paraethesia, and backache. For each complaint, the causes and recommended treatments are provided.
Diagnosis of pregnancy
This document discusses the diagnosis of pregnancy over three trimesters. In the first trimester, common symptoms include missed periods, morning sickness, frequent urination, and breast changes. Signs include enlarged, soft breasts and uterus, and a softer, purplish cervix. Pregnancy tests detect human chorionic gonadotropin in urine or blood. Ultrasounds can visualize the gestational sac after 4-5 weeks. In the second trimester, symptoms decrease while the abdomen enlarges and fetal movement is felt. Signs include skin changes and palpable fetal parts. The third trimester confirms pregnancy through palpation of fetal parts and auscultation of the fetal heart.
Antenatal care
Antenatal care involves regular checkups during pregnancy to monitor the health of the mother and baby. Checkups include exams, tests, and education on nutrition, exercise, hygiene, warning signs and avoiding risks. The goals are to prevent or treat complications, detect issues, and ensure healthy development. Women receive more frequent exams as their due date approaches, and are instructed on a nutritious diet, moderate exercise, adequate rest, hygienic practices, and when to seek medical help if problems arise.
Postpartum mood disorders
The document discusses postpartum mood disorders, including prevalence, risk factors, screening tools, diagnosis, and treatment options. It notes that postpartum mood disorders range from mild and temporary postpartum blues to more severe postpartum depression and postpartum psychosis. Screening tools like the Edinburgh Postnatal Depression Scale can help identify at-risk women. Treatment involves psychosocial therapies and may include antidepressant medication depending on severity. A multidisciplinary approach is important to address biological, psychological and social factors.
Normal and abnormal puerperium
Uterine fibroids are benign smooth muscle tumors that develop in the uterus. They are the most common solid pelvic tumors, affecting 20-25% of women during their reproductive years. Fibroids can vary in size and location, and may cause heavy menstrual bleeding, pelvic pressure or pain. Treatment options include observation, medical therapy to reduce estrogen levels, or surgical removal of fibroids.
Version
Version refers to changing the fetal lie or position in the uterus. There are three main types: external cephalic version, internal podalic version, and bipolar podalic version. External cephalic version involves manipulating the fetus externally to convert a breech presentation to head-first. Internal podalic version is performed under anesthesia when the cervix is fully dilated to grasp the fetus's feet and convert a transverse lie to breech. Bipolar podalic version uses both internal and external manipulation through a partially dilated cervix for special circumstances. Complications can include fetal distress, premature separation of the placenta, and maternal hemorrhage.
Vacuum extraction (ventouse)
Vacuum extraction is a method to assist in childbirth using suction from a cup placed on the baby's head to help with traction during contractions. There are different types of cups including metal, soft, and bird's cups. Vacuum extraction is indicated when forceps cannot be used and has advantages over forceps like less need for anesthesia and less compression force applied. Complications can include maternal lacerations and cervical injuries or fetal issues like cephalhematomas and scalp lacerations.
Symphysiotomy
Symphysiotomy is a surgical procedure that divides the symphysis pubis bone to widen the pelvis during childbirth. It is indicated when cephalopelvic disproportion makes vaginal delivery difficult or dangerous but cesarean section is not available or advised. The procedure involves making a small incision above the pubic bone and gradually separating the joint using a scalpel. Complications can include bleeding, injury to nearby organs, infection, and long-term issues like incontinence or an unstable pelvis.
Forceps delivery
This document discusses obstetric forceps, which are metal instruments used to extract a baby's head during delivery. It describes different types of forceps and their proper application techniques. Forceps are indicated for prolonged second stage of labor, maternal distress, or fetal distress. Correct application involves inserting one blade along each side of the baby's head. Potential complications include laceration, hemorrhage, nerve injury, or problems for the baby such as skull fractures. Failure to deliver with forceps may require removal and assessment to determine if cesarean section is needed.
Episiotomy
This document discusses episiotomy, which is an incision made in the perineum during childbirth to widen the vaginal opening. It can help prevent tearing and complications. The two main types are median and mediolateral episiotomies. Median episiotomies involve a midline incision while mediolateral incisions extend laterally towards the ischial tuberosity. Episiotomies are usually performed when the vaginal opening is distended during crowning to prevent stretching injuries. They are sutured closed after delivery.
Caesarean section
The document discusses Caesarean section, including indications, types, procedure, complications, and mode of delivery in subsequent pregnancies. A Caesarean section is a surgical procedure to deliver one or more babies through incisions in the abdomen and uterus. The rate of Caesarean sections has increased from 5% in 1970 to 25% in 1990 due to factors such as abandoning difficult procedures in favor of C-sections and increased use for breech births. Complications can include hemorrhage, infections, and injuries to the mother or baby.
Normal labour
Normal labour involves the spontaneous expulsion of a single, mature fetus through the birth canal within 3-18 hours without complications. It occurs when hormonal and mechanical factors cause the cervix to efface and dilate in stages from 3cm to full 10cm dilation. Labour proceeds through four stages: 1) cervical dilation, 2) expulsion of the fetus, 3) expulsion of the placenta, and 4) recovery. The fetus descends through the birth canal with increased flexion to facilitate delivery of the head.
Anatomy of the foetal skull
The fetal skull consists of three parts: the vault, face, and base. The vault is made up of the frontal, parietal, and occipital bones which are separated by sutures. The face extends from the chin to the nose. Fontanelles are soft spots located where sutures meet which are important for assessing fetal position and flexion. The skull has various longitudinal and transverse diameters used to determine which will engage and pass through the birth canal during delivery.
Anatomy of the female pelvis
The female pelvis is divided into the false pelvis and true pelvis. The true pelvis is further divided into the pelvic inlet, cavity, and outlet. The document describes the boundaries and diameters of each region including the anatomical transverse diameter of 13cm at the inlet. It also discusses the pelvic planes and axes, and the Caldwell-Moloy classification of pelvic types including the gynaecoid, anthropoid, android, and platypelloid pelvis.
Active management of normal labour
This document outlines the active management of normal labour in 4 stages: antenatal preparation, first stage (history, exam, procedures), second stage (delivery of baby), third stage (delivery of placenta), and fourth stage (postpartum care of mother and baby). The goal is a healthy delivery with minimal effects. Key procedures include monitoring contractions/fetal heart with a partogram, positioning, nutrition, analgesia, perineal support, and immediate newborn care.
Thyrotoxicosis in pregnancy
Thyrotoxicosis in pregnancy can cause complications like abortion and preterm labour. Clinical features include weight loss, heat intolerance, tremors, and fast heart rate. It is treated with antithyroid drugs like propylthiouracil or carbimazole. Epilepsy in pregnancy commonly presents as grand mal seizures, which are treated with phenobarbitone or phenytoin along with folic acid. Rhesus isoimmunization occurs when an Rh-negative mother develops antibodies against Rh-positive blood from her baby. It can be prevented by giving the mother anti-D immunoglobulin after delivery or pregnancy events involving blood transfer from baby to mother. Affected babies may require monitoring, phot