Soo Youn Lee has completed his M.D at the age of 26 years from Chosun University, colloege of Medicine. She is the director of ICU at Sejong General Hospital, Buchoen, Republic of Korea. She has published 6 papers in reputed.
Enterococci have become common nosocomial pathogens and are currently the third-leading causes of nosocomial bloodstream infection. Vancomycin-resistant enterocolli(VRE), mostly Enterococcus faecium, are increasingly involve, especially in critical patients with co-morbid condition.The options for treatment of VRE have improved over the years with the advent of oxazolidinone linezolid, the glycylcycline tigecycline, and the lipopiptide daptomycin. Nonetheless, toxicities my limit their use. We here report a case of VRE prosthetic valve endocarditis with daptomycin due to severe lactic acidosis complicated by linezolid. A 45 yars old female, who had undegone prosthetic aortic valve replacement 15 years back, presented with cardiogenic shock. Chest xray showed pulmonary edema. Pannus formation on a Hancock II 21mm aortic valve prosthetis in the aortic position as depicted by transthoracic ehocardiogram. Oliguria was developed and eGFR was rise. She underwent continous renal replacement therapy. Until waiting redo aortic valve replacement, abruptly fever was developed. Transthoracic echocardiography showed a vegetation at tricuspid valve. Urgent aortic valve replacement was done without complication. Blood cultures grew Enterocuccus faecium, which was resistant to vancomycin but susceptible to linezolid and daptomycin. However, tissue cultures showed no growth results. Treatment with intravenous linezolid was initiated. Her bacteremia initially cleared. After 16 days on treatment of linezolid, lactic acid was elevated up to 15mmol/L. We switched linezolid to daptomycin. Lactic acid was decreased to normal range after 8 days stopping linezolid. Severe lactic acidosis with linezolid present barriers to effective treatmetnt. Serial follow up of lactic acid during treatment with linezolid is crucial to managment patients with VRE.
My name is Chantal Mukandoli, I migrated to Canada from Rwanda in 2006. I was the representative of ICW Central Africa from 2003 to 2006. Before I migrated to Canada, my work with ICW, We- Act, Care International, and Presbyterian Church included: outreach, advocacy, activism, peer mentor and educator. I also participated in International advocacy platforms including demanding the formation of ICW in the early years. I represented Central Africa in fundraising efforts for various HIV-related projects. I also used my voice and personal stories to share my life living with HIV. In 2006, during the International AIDS Conference I submitted an abstract which was accepted, and presented on the health of women raped during genocide in Rwanda in 1994. The abstract highlighted women, who got infected by HIV, got stigmatized and discriminated, and those who were poor and disabled. I felt rejuvenated, more powerful and knowledgeable by engaging with other powerful women from diverse backgrounds. As a long-time survivor living with HIV, I had so much to share with other women, including newly diagnosed women. It was an opportunity to bring out a voice for women living with HIV in Canada. My dream is to end the stigma and discrimination I face as a woman living with HIV, and be the mentor for other women. It is my hope that women will be able to disclose their HIV status without fear of being discriminated, beaten, killed, and refused services or employment. In XXX I decide to get involved with the Toronto People With AIDS Foundation to give back and show appreciation for all that they did for me as a client. ** Chantal can you fill in all the programs that you are involved in?? ( circle of care, speakers bureau, etc.) PWA is a place where people can find a safe and welcoming place to talk about their issues, advocate for their rights, and participate meaningfully in programs and services.
This project engaged 40 HIV+ women 50+ in group exercises and skills-building activities at workshops The workshops were hosted in Toronto (n=10) and Hamilton, Ontario (n=10), and Montreal, Quebec (n=20). All workshops took place between July and November 2017, each lasting 4.5 hours. The workshop participants identified themselves as follows: 87% as female, 13% identified as transwomen, and their age range was 45 – 50 (28%) and 50+ (72%) Co-facilitated by two older adult women living with HIV, the workshops topics included: Complexities of HIV stigma and discrimination and reduction strategies; Self-care strategies; Adherence to HIV medications; HIV disclosure to children and other family members, Healthy sexual relationships; Social skills like cooking, knitting and sewing; Basic skills in home-based care English as a second language among others.