Characteristics of Native Americans with HIV and implications for care.

Limited data have been published about HIV infections and response to antiretroviral therapy in the Native American population. We reviewed baseline characteristics of 112 Native American patients to determine if there were any shared characteristics that would dictate the best treatment for this population. Metabolic diseases and psychiatric disorders were common findings among our patients.

Conjugal amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a disease characterized by progressive degeneration of motor neurons in the motor cortex, brainstem, and spinal cord. The incidence of sporadic ALS is 1.5 to 2.

Primary hyperparathyroidism and pregnancy.

Primary hyperparathyroidism is the third most common endocrine disorder after diabetes and thyroid disease, and women are affected twice as often as men. Hyperparathyroidism in pregnancy was first reported in 1931. Maternal complications in patients with hyperparathyroidism can be as high as 67%.

Clostridium difficile-associated diarrhea in a tertiary care medical center.

This retrospective, case-control study aimed to identify variables associated with the incidence of Clostridium difficile-associated diarrhea (CDAD) in acute care facilities and to specifically identify the relationship of fluoroquinolones and acid suppressive agents in the development of CDAD. Seventy-one symptomatic patients positive for C. difficile toxin A or B hospitalized for at least 72 hours were compared with 142 control patients hospitalized for at least 72 hours who were not positive for C.

Insulin glargine and cancer risk: an opinion statement of the Endocrine and Metabolism Practice and Research Network of the American College of Clinical Pharmacy.

Diabetes mellitus has reached epidemic proportions worldwide, eliciting extensive research on both the disease process and its treatment. Regardless of diabetes type, the progressive nature of the disease makes insulin the long-term mainstay of diabetes management. Recently, the insulin analog glargine was reported in several epidemiologic studies to be associated with an increased risk of cancer.

Is statin therapy safe in patients with HIV/hepatitis C coinfection?

Statins are effective therapy for hypercholesterolemia and are commonly indicated in patients with HIV and hepatitis C virus infections. Unfortunately, in patients coinfected with these viruses, the safety of statins has not been conclusively evaluated. We retrospectively evaluated five coinfected patients in our outpatient clinic who received statin therapy.

Use of daptomycin in a pregnant patient with Staphylococcus aureus endocarditis.

Objective: To report on 6 weeks of daptomycin treatment for tricuspid valve endocarditis caused by Staphylococcus aureus in a pregnant female in her second trimester.

Case Summary: A 24-year-old, 14-week pregnant patient with no significant medical history, but with a history of intravenous drug abuse presented with tricuspid valve endocarditis caused by methicillin-sensitive S. aureus.

Novel treatment approach to combat an infection with Acinetobacter.

The antimicrobial resistance of gram-negative pathogens has become problematic. In some cases related to Pseudomonas spp. and Acinetobacter spp.

Using team-based learning in an endocrine module taught across two campuses.

Objectives: To implement a team-based learning (TBL) format in an endocrine module to promote students' active learning in a course delivered to 2 campuses.

Methods: Course lectures were transformed into 13 TBL sessions consisting of content pre-assignments (self-directed learning), in-class readiness assurance tests (accountability), and team problem solving of patient cases and faculty-led class discussion (knowledge application). Student performance was evaluated through multiple assessments during the TBL sessions and on unit examinations.

Tophaceous gout in a patient with rheumatoid arthritis.

Chronic gout and rheumatoid arthritis are common medical manifestations with debilitating effects on patients. However, these conditions are not typically identified concomitantly and can be hard to distinguish from one another. We report a rare case of a 50-year-old white woman with a history of chronic gout and rheumatoid arthritis who presented with intradermal tophaceous gout.

Gelatinous bone marrow in an HIV-positive patient.

Gelatinous bone marrow transformation has been identified in patients with anorexia, malignancy, malabsorption, and HIV/AIDS. This represents a deposition of gelatinous material within the bone marrow, along with atrophy. We report the case of an HIV-seropositive man who presented with low back pain related to his gelatinous bone marrow changes.

Two-year changes in bone mineral density and T scores in patients treated at a pharmacist-run teriparatide clinic.

Study Objectives: To determine changes in bone mineral density (BMD) and T scores of patients after 2 years of teriparatide therapy, and to determine the number of fractures that occurred during therapy.

Design: Prospective, observational study.

Setting: Pharmacist-run teriparatide clinic in a private-practice endocrinology group.

Achieving American Diabetes Association goals in HIV-seropositive patients with diabetes mellitus.

This retrospective study examined whether the goals set forth by the American Diabetes Association were being attained in an HIV specialty clinic run by internal medicine physicians. The charts of 40 HIV patients with diabetes were reviewed. Patients were divided into two groups: those who had seen a clinical pharmacist for medication adherence counseling (n = 20) and those who had not (n = 20).

Cytomegalovirus encephalitis in an HIV-seropositive person.

Cytomegalovirus (CMV) infection is common in persons with HIV/AIDS. It can affect the eye, lung, liver, GI tract, and nervous system. It is also a common cause of blindness in persons infected with HIV.

Iopamidol-induced meningoencephalopathy in an HIV-seropositive patient.

Central nervous system infectious and metabolic abnormalities are common in HIV-positive patients. Drug therapy, opportunistic infections, the clinical course of HIV disease itself, and very rarely iodinated radiographic contrast agents can all be linked to these abnormalities. The following case describes an HIV-seropositive patient who developed encephalopathy after undergoing a cervical myelogram that utilized iopamidol dye (Isovue-M 300 mg/mL).

Comparison of the Achilles Express ultrasonometer with central dual-energy X-ray absorptiometry.

Background: Quantitative ultrasound (QUS) devices provide portable, easy-to-operate, low-cost options for point-of-care screening of bone mineral density (BMD). Community pharmacists should be aware of the precision, sensitivity, and specificity of these devices prior to their purchase.

Objective: To determine the precision, sensitivity, and specificity of the Achilles Express ultrasonometer compared with central dual-energy X-ray absorptiometry (cDXA) as well as its utility as a bone density screening device in the community pharmacy setting.

Adverse reactions associated with dapsone therapy in HIV-positive patients: a case presentation and review.

Dapsone is commonly used for the prophylaxis of Pneumocystis jiroveci pneumonia in patients with a diagnosis of HIV infection who have allergies to sulfa-based drugs. Dapsone has several adverse effects in its profile that make it a potentially dangerous second-line agent. We report an adverse effect encountered in an HIV-positive patient receiving dapsone and review the common adverse effects encountered with this alternative treatment option.

Legionella pneumonia and HIV infection: a case report.

Legionella pneumonia is commonly diagnosed in patients who are chronically immunosuppressed, but it is rarely diagnosed in patients who have HIV/AIDS. We report the successful diagnosis and treatment of Legionella pneumonia in a patient with HIV infection that was diagnosed at the same admission.