The Human Immunodeficiency Virus (HIV) and the Acquired Immunodeficiency Syndrome (AIDS) remain significant public health concerns worldwide. This review seeks to present an updated perspective on the spread, consequences, and control measures of HIV/AIDS, focusing on military personnel as a particular at-risk group. It starts by outlining general information about the transmission of the virus and summarizing recent global epidemiological trends. This review further explores the difficulties that HIV/AIDS presents in military settings, including policies regarding the management of service members living with the virus. Additionally, it examines several prevention strategies implemented by militaries around the world, such as educational programs, provision of condoms, and efforts to reduce the stigma associated with the infection.
The SARS-CoV-2 pandemic challenged the authorities into taking measures that limit the spread of the virus in the community. TAMEC project (Advanced Community Approaches to Epidemic Management) developed a system that detects the contacts of patients infected with the SARS-CoV-2 virus and alerts them using mobile applications. It allows real-time analysis of confirmed patients and identified contacts, early detection of new outbreaks, and provides decision- making information to prevent viral transmission. The system uses its patent for homomorphic encryption, a method that allows to process and manipulate data in an encrypted format, without having access to the original data. Thus, the solution proposed in the TAMEC project fully respects the privacy rules of citizens imposed by the EU, using the concept of privacy preservation. Our solution offers the possibility to identify and validate a risk score that could become an extremely helpful tool in the stratification of COVID-19 patients. The TAMEC system is innovative in its simplicity and ability to facilitate the prevention of the spread of the SARS-CoV-2 virus in the community
The idea of using mobile hospitals - a fully functional hospital is a system with a high degree of complexity - in case of a pandemic crisis, is not new, but shows how much they are needed. Solutions belonging to the category of mobile architecture are increasingly common, technical and logistic difficulties are solved in more perfect way. This applies mostly to objects with simple layouts and functional relationships, with relatively little technical equipment. In the case of healthcare facilities there are several factors increasing the difficulty: multitude of functional connections, sanitary requirements, technical equipment, and internal infrastructure. The Romanian military and civilian specialists from Bucharest Central Military Emergency University Hospital (SUUMC) showed that is possible to build a hospital as a modular and mobile structure in order to fight COVID 19, but the strategic actions and the effort needed to organize and run mobile hospital far exceeds the expenditure, protocols and specialized M.D.s necessary to run the stationary hospital.
Background: This topic is aimed to review the treatment approach in adult patients diagnosed with urosespsis, in order to decrease mortality and to maximize the outcome of the antibiotic stewardship efforts. Methods: We present an approach of antibiotic therapy in urosepsis from an infectious diseases physician perspective, based on the recently published data integrating the epidemiology of the urinary tract infections in a multidisciplinary hospital from Romania. Results: The principles of therapy in urosepsis should have five goals, but not limited to rapid diagnosis, specific intensive care unit treatment, obtaining urine and blood cultures, anti-infective treatment and identifying and correction of underlying risk factors. Due to the higher prognostic value, the antimicrobial therapy in urosepsis should consist in “two steps” regimen: initial antimicrobial therapy, based on “empirical” approach for the first 48 - 72 hours and directed or “definitive” antimicrobial therapy adapted to the susceptibility profile of the isolated pathogens, the penetration into the urinary tract and the patient clinical response. Clinicians should be aware of the different antibiotic susceptibility profile of the bacteria from the hospital compared to the community. Thus, the initial choice of antimicrobial agents depends on several criteria like the severity of illness and the risk factors for multidrug resistant pathogens: the immune status of the patient (age, debilitating chronic illnesses, immunosuppressive treatment or uncontrolled malignancies), broad-spectrum antimicrobial use and health care environment exposures in the previous 3 to 6 months, susceptibility of prior urinary isolates, and local community resistance prevalence of bacteria. Conclusions: Our important messages highlighted the need of a holistic approach of urosepsis, in a multidisciplinary team, with integration of risk factors for AMR, focusing on the first phase of antibiotic treatment as the main driven of the survival rate.
Introduction: Tuberculosis (TB) is still one of the most frequent infectious diseases, causing 2 million deaths a year worldwide. The prevalence of TB has increased in both immunocompetent and immunocompromised and virtually, it can affect any organ. Up to 25% of tuberculosis cases present extra-pulmonary involvement. The diagnosis of extra-pulmonary TB (EPTB) is difficult, often requiring biopsy. Material and methods: We present two cases of EPTB in immunocompetent young women. The first case is about a 15-years old female who presented with persistent high fever, ascites and an increased CA-125 serum level. Biochemical analysis of ascites fluid revealed a high value of adenosine deaminase (ADA), negative Ziehl-Neelsen stain and undetectable Mycobacterium tuberculosis at PCR assay. The peritoneal biopsy confirmed the diagnosis of peritoneal TB. The second case, a 29-years old female with a seven-month history of cervical lymph nodes swelling, with drainage and excision biopsy performed, misdiagnosed as cats-scratch disease based on the histological description as granulomatous lymphadenitis, which turned out to be tuberculous lymphadenitis at the second histopathological opinion. In conclusion, these cases highlight the need for tuberculosis consideration in the differential diagnosis of extra-pulmonary involvement, even in immunocompetent individuals, in order to decrease the misdiagnoses and complications rates.
