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  • Author: Mihai Olteanu x
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Pulmonary tuberculosis with atypical presentation because of unknown previous HIV infection – case report



People coinfected with tuberculosis (TB) and human immunodeficiency virus (HIV) are 20–37 times more likely to develop active TB disease than non-HIV-infected people. Syndemic interaction between HIV and TB epidemics has made testing for TB a must for HIV-infected people and vice versa. We present the case of a young male diagnosed with HIV infection, due to mandatory HIV testing for all TB cases in Romania.

Case presentation

A 30-year-old man was hospitalized for fever, chills and productive cough not influenced by previous antibiotic home treatment. He was admitted with tachycardia and bilateral presence of coarse crackles in lower pulmonary areas. Chest X-ray suggested bilateral bronchopneumonia; the results from blood tests showed inflammation, leukocytosis and anaemia. Hemocultures were negative. Under wide-spectrum antibiotic treatment, his general condition partially improved, but on the seventh day, chest X-ray revealed abscess in the left inferior lobe and the progression of previous lesions. Chest computed tomography revealed multiple large consolidation areas in both lung areas, a 13 cm diameter abscess and multiple mediastinal adenopathy of 2–4 cm in diameter. Acid fast bacilli smear from sputum was positive. After the diagnosis of pulmonary TB, anti-TB treatment was started; the patient was subsequently diagnosed with HIV infection. He received specific anti-TB treatment, and 3 weeks later, retroviral treatment was initiated. Clinical evolution was favourable and radiological appearance improved. In addition, he did not present any adverse effects of therapy.


HIV testing for all TB cases is a must because HIV-TB coinfection raises important diagnostic and treatment problems.

Open access
Case Study on Vulnerability Increase for a Reinforced Concrete Frame Structure


Seismic vulnerability for a structure represents the susceptibility to be affected by an event with a given intensity. The vulnerability of a structure can be influenced by the design methods or by different problems that may appear during the execution process.

This paper shows a case study for the vulnerability increase of a reinforced concrete frame structure in 2 different situations:

a) modification produced due to code changes, meaning P100-2006 respectively P100-2013;

b) modifications produced the structure taking into account the errors which have occurred during the execution process;

For both cases, capacity curves were plotted considering the nonlinear analysis, also called pushover. The numerical simulation was performed in SAP2000 software. These curves were compared with the response spectrum corresponding to the site conditions in order to obtain the performance point. For accurate results, fragility curves were plotted for both considered situations, according to previous research of the authors.

The paper emphasizes the importance of each stage during the execution of a structure. More over the differences in the vulnerability index show the importance on the overall behavior of the structure. Solution to increase strength and safety for the structure are also given at the end of the paper

Open access
Polymorphisms in autophagy genes and active pulmonary tuberculosis susceptibility in Romania


Autophagy, a homeostatic process involved in nutrient regeneration and immune responses, may be involved in intracellular killing of M. tuberculosis. Several studies linked variation in autophagy genes with susceptibility to pulmonary tuberculosis, but others did not confirm these findings.

We genotyped single nucleotide polymorphisms (SNPs) in the ATG5 (rs2245214, c.574-12777G>C) and NOD2 (rs2066844, c.2104C>T) genes for 256 pulmonary tuberculosis patients and 330 unrelated healthy controls in Romania. Both SNPs have been reported as relevant for the autophagy process and potentially for susceptibility to active pulmonary tuberculosis.

In our study, the polymorphisms in ATG5 and NOD2 were not associated with tuberculosis. This suggests that the two genetic variants we focused on are not related to the risk for developing active TB in a Romanian population.

Open access