Three-valve endocarditis in a patient with bioprosthetic aortic valve replacement and intravenous drug use: a case report.

Background: Here, we outline the case of a US Veteran's Health Administration (VA) patient with a history of recent bioprosthetic aortic valve replacement (AVR) and recent intravenous drug use (IVDU) who was found to have three-valve infective endocarditis (IE) resulting in septic shock. We highlight this case because it represents an uncommon case of three-valve IE in the setting of recent bioprosthetic valve replacement and IVDU, and it raises the need for continued awareness of mental health and drug rehabilitation in the US military veteran population.

Case Summary: A 62-year-old gentleman with recent bioprosthetic AVR presented with dyspnoea and lower extremity oedema and was found to have a heart failure exacerbation.

Effect of the duration of protease inhibitor therapy in HIV-infected individuals on the severity of obstructive sleep apnea.

Background: Protease inhibitors (PIs) are a vital part of the antiretroviral therapy. Long-term use of PIs may cause lipodystrophy, a clinical syndrome characterized by peripheral lipoatrophy and central fat accumulation, which may increase the risk of developing obstructive sleep apnea (OSA) in HIV-infected patients. We hypothesize that a longer duration of PIs' use might be associated with increasing severity of OSA in HIV-infected patients.

The Largest American Study Comparing Transient Elastography and the Aminotransferase-to-platelet Ratio Index Score, Two Noninvasive Tests for Liver Fibrosis Staging in HIV/HCV Coinfected Patients.

Objective: Elastography has become the standard of care of diagnostic approaches for liver disease, particularly when dealing with hepatitis C. There areno studies in the inner-city populations of Newark, New Jersey, that describe the comparison of noninvasive markers, such as FibroScan andaminotransferase-to-platelet ratio index (APRI) scoring.

Methods: Using a chart review method, we used a case-control study method of gathering and analyzing the data, using < or = 0.

Decompensated HCV patients with co morbidities including HIV who are medically treated are shown to minimize decompensation related admissions and healthcare cost: A case series.

Hepatitis C virus infection is a hot topic for both effective treatment and elevated cost. This case series describes the cost saving for the healthcare system of any nation of treating HCV in many situations, including that of overt cirrhosis. Case#1 is of a HCV/HIV infected cirrhotic patient with MELD score of 17, Child Pugh score B, recurrent esophageal bleeds ceased after successful treatment with sofosbuvir and simepravir.