Browsing by Author "Shinha, Takashi"

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    Clostridium paraputrificum Bacteremia Associated with Colonic Necrosis in a Patient with AIDS
    (Hindawi, 2015-01-27) Shinha, Takashi; Hadi, Christiane; Medicine, School of Medicine
    Clostridium species are anaerobic Gram-positive rods that can cause a broad range of invasive infections in humans, including myonecrosis and bacteremia. Importantly, clostridial bacteremia is frequently associated with underlying medical conditions, such as colonic malignancy. Characterizing Clostridium spp. and understanding their associated clinical disease spectrum are paramount to provide optimal treatment, thereby decreasing morbidity and mortality especially in those with underlying debilitating comorbidities. Clostridium paraputrificum is an infrequently isolated Clostridium species and its clinical significance has not been well described. We herein report a case of bacteremia due to C. paraputrificum in a 65-year-old man with AIDS who developed acute colonic necrosis complicated by septic shock. We then review other cases of bacteremia associated with C. paraputrificum in the literature in addition to discussing the clinical significance of anaerobic bacteremia in general. To our knowledge, our report is the second case of C. paraputrificum bacteremia in a patient with AIDS.
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    Relationships between renal parameters and serum and urine markers of inflammation in those with and without HIV infection
    (Mary Ann Liebert, 2015-04) Shinha, Takashi; Mi, Deming; Liu, Ziyue; Orschell, Christie M.; Lederman, Michael M.; Gupta, Samir K.; Department of Medicine, IU School of Medicine
    We sought to determine the relationships among intrarenal and systemic inflammation and renal disease in HIV. We compared paired serum and urinary levels (normalized to urine creatinine) of monocyte chemotactic protein-1 (MCP-1), regulated on activation normal T cell expressed and secreted (RANTES), interferon-γ-induced protein-10 (IP-10), interleukin-8 (IL-8), and β2-microglobulin (B2M) between two groups of HIV-infected subjects not receiving antiretroviral therapy (ART) [A: not expecting to initiate ART immediately due to having CD4 cell counts ≥350/μl, N=26; B: about to initiate ART, N=19], a group of HIV-infected subjects receiving virologically suppressive antiretroviral therapy [C, N=30], and a group of HIV-uninfected, healthy volunteers [D, N=45]. We then correlated these inflammatory biomarker levels with urine protein/creatinine ratios (uPCR), urine albumin/creatinine ratios (uACR), and estimated glomerular filtration rates (eGFR). Urine inflammatory biomarker levels were highest in Group B. When combining all four study groups, statistically significant positive correlations included uPCR with urine IL-8, urine MCP-1, urine IP-10, and serum IP-10 and uACR with urine IL-8, urine B2M, serum IP-10, and serum B2M. eGFR was statistically significantly negatively correlated with serum MCP-1 and serum B2M. Paired serum and urine levels of IP-10 and B2M (but not IL-8, RANTES, or MCP-1) were significantly correlated with each other in the overall group. The levels of urine inflammatory markers tested differed by HIV status and use of virologically suppressive ART. These urine and serum inflammatory markers were differentially correlated with uPCR, uACR, and eGFR, suggesting that different intrarenal and systemic inflammatory pathways may contribute to different measures of nephropathy.