scholarly journals Combination antiretroviral therapy is associated with reduction in liver fibrosis scores in patients with HIV and HBV co-infection

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Rongrong Yang ◽  
Xien Gui ◽  
Hengning Ke ◽  
Yong Xiong ◽  
Shicheng Gao
Keyword(s):  
Logistic Regression ◽  
Antiretroviral Therapy ◽  
Liver Fibrosis ◽  
Observational Study ◽  
Binary Logistic Regression ◽  
Retrospective Observational Study ◽  
Combination Antiretroviral Therapy ◽  
Naive Group ◽  
Before And After ◽  
Group 1

Abstract Background Liver fibrosis is common in individuals with HIV/HBV co-infection, but whether cART could reverses liver fibrosis is unclear. Methods This was a retrospective observational study. Binary logistic regression was used to assess predictors of liver fibrosis in individuals with HIV/HBV co-infection. Comparison of FIB-4 scores before and after cART were compared using X2 test and t test. Results Four hundred and fifty-eight individuals with HIV/HBV co-infection were included in this study. It was found that cART (HR 0.016, 95% CI: 0.009–0.136; P < 0.001) was one of protection factors to against liver fibrosis. Forty individuals who had normal levels of ALT, AST and PLT during the whole course of diseases were stratified into FIB-4 < 1.45 (n = 14), 1.45 ≤ FIB-4 ≤ 3.25 (n = 19) and FIB-4 > 3.25 (n = 7) groups by their FIB-4 scores before cART. In 1.45 ≤ FIB-4 ≤ 3.25 group, 57.9%(11/19) of the individuals dropped to FIB-4 < 1.45 group by cART; in FIB-4 > 3.25 group, 85.7%(6/79) dropped to 1.45 ≤ FIB-4 ≤ 3.25 group, while 14.3%(1/7) dropped to FIB-4 < 1.45 group. In cART-naive group, 1 year, 2–5 years and 5–10 years post-cART groups, FIB-4 scores were 4.29 ± 0.43, 3.63 ± 0.38, 2.90 ± 0.36 and 2.52 ± 0.38, respectively (P = 0.034); and the incidence of liver fibrosis were 7.38%(104/141), 63.6%(98/154), 60.8%(62/102) and 47.5%(29/61), respectively (P = 0.004). Conclusion cART was associated with decreased FIB-4 scores and the benefit of cART in reversing liver fibrosis can sustain for a decade in patients with HIV/HBV co-infection.

scholarly journals Combination Antiretroviral Therapy is Associated with Reduction in Liver Fibrosis Scores in Patients with HIV and HBV Co-Infection

2021 ◽  
Author(s):  
Rongrong Yang ◽  
Xien Gui ◽  
Hengning Ke ◽  
Yong Xiong ◽  
Shicheng Gao
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Antiretroviral Therapy ◽  
Liver Fibrosis ◽  
Cox Regression ◽  
Wilcoxon Test ◽  
Combination Antiretroviral Therapy ◽  
Paired Samples ◽  
Before And After ◽  
Group 1

Abstract Objective To evaluate the risk factors for liver fibrosis in HIV/HBV co-infection population, and further to clarify whether ART reverses fibrogenic effect of HIV infection. Methods This was an observational retrospective study. Multivariate Cox regression was used to assess predictors of liver fibrosis in HIV/HBV co-infection patients. FIB-4 scores before and after cART were compared using Wilcoxon test for paired samples. Results In this study enrolled 458 cases of HIV/HBV co-infection patients, we found ART (HR 0.016, 95% CI: 0.009-0.136; P<0.001) were one of protection factors to against liver fibrosis. Forty cases of those who had normal levels of ALT, AST and PLT during the whole course of diseases were stratified into FIB-4<1.45 (n=14), 1.45≤FIB-4 ≤3.25 (n=19) and FIB-4>3.25 (n=7) groups by their FIB-4 scores before ART. After ART, in 1.45≤FIB-4≤3.25 group, FIB-4 grade in 57.9%(11/19) of the patients dropped to a lower FIB-4 grade (FIB-4<1.45); in FIB-4>3.25 group, 85.7%(6/79) of the patients dropped to 1.45≤FIB-4≤3.25 grade, while 14.3%(1/7) dropped to FIB-4<1.45 grade. In ART-naive group, 1 year, 2-5 years and 5-10 years after ART groups, FIB-4 scores were 4.29±0.43, 3.63±0.38, 2.90±0.36 and 2.52±0.38, respectively (P=0.034); and the incidence of liver fibrosis were 7.38%(104/141), 63.6%(98/154), 60.8%(62/102) and 47.5%(29/61), respectively (P=0.004). Conclusion ART was associated with improvement of FIB-4 scores and the benefit of ART in reversing liver fibrosis can sustain for a decade in patients with HIV/HBV co-infection.

scholarly journals Assessment of pain and postoperative nausea and vomiting and their association in the early postoperative period: an observational study from Palestine

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Reem M. Elsaid ◽  
Ashraqat S. Namrouti ◽  
Ahmad M. Samara ◽  
Wael Sadaqa ◽  
Sa’ed H. Zyoud
Keyword(s):  
Logistic Regression ◽  
Observational Study ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Binary Logistic Regression ◽  
Nausea And Vomiting ◽  
Prior History ◽  
Factors Associated ◽  
Duration Of Surgery ◽  
History Of

Abstract Background Postoperative nausea and vomiting (PONV) and postoperative pain (POP) are most commonly experienced in the early hours after surgery. Many studies have reported high rates of PONV and POP, and have identified factors that could predict the development of these complications. This study aimed to evaluate the relationship between PONV and POP, and to identify some factors associated with these symptoms. Methods This was a prospective, multicentre, observational study performed at An-Najah National University Hospital and Rafidia Governmental Hospital, the major surgical hospitals in northern Palestine, from October 2019 to February 2020. A data collection form, adapted from multiple previous studies, was used to evaluate factors associated with PONV and POP in patients undergoing elective surgery. Patients were interviewed during the first 24 h following surgery. Multiple binary logistic regression was applied to determine factors that were significantly associated with the occurrence of PONV. Results Of the 211 patients included, nausea occurred in 43.1%, vomiting in 17.5%, and PONV in 45.5%. Multiple binary logistic regression analysis, using PONV as a dependent variable, showed that only patients with a history of PONV [odds ratio (OR) = 2.28; 95% confidence interval (CI) = 1.03–5.01; p = 0.041] and POP (OR = 2.41; 95% CI = 1.17–4.97; p = 0.018) were significantly associated with the occurrence of PONV. Most participants (74.4%) reported experiencing pain at some point during the first 24 h following surgery. Additionally, the type and duration of surgery were significantly associated with POP (p-values were 0.002 and 0.006, respectively). Conclusions PONV and POP are common complications in our surgical patients. Factors associated with PONV include a prior history of PONV and POP. Patients at risk should be identified, the proper formulation of PONV protocols should be considered, and appropriate management plans should be implemented to improve patients’ outcomes.

scholarly journals Metabolic Syndrome Prevalence and Cardiovascular Risk Assessment in HIV-Positive Men with and without Antiretroviral Therapy

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 578
Author(s):  
Win-Long Lu ◽  
Yuan-Ti Lee ◽  
Gwo-Tarng Sheu
Keyword(s):  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Antiretroviral Drugs ◽  
Hiv Positive ◽  
Naive Group ◽  
Treatment Naïve ◽  
Group 2 ◽  
Group 1

Treatment of HIV infection is a lifelong process and associated with chronic diseases. We evaluated the prevalence and predictors of metabolic syndrome (MetS) and cardiovascular diseases (CVDs) with individual antiretroviral drugs exposure among HIV-infected men in Taiwan. A total of 200 patients’ data were collected with a mean age of 32.9. Among them, those who had CD4 positive cell number less than 350/mL were eligible to have highly active antiretroviral therapy (HAART). Patients were divided into group-1 that contains 45 treatment-naïve participants, and group-2 that includes 155 HAART treatment-experienced participants. MetS prevalence between group-1 and group-2 was 18% and 31%, respectively. The Framingham Risk Score (FRS) for the naïve and experienced groups were 4.7 ± 4.2 and 3.87 ± 5.92, respectively. High triglyceride (TG > 150 mg/dL) in group-1 and group-2 were 15.6% and 36.6% (p < 0.05), whereas, lower high-density lipoprotein (HDL < 39 mg/dL) in group-1 and group-2 presented as 76.7% versus 51% (p < 0.05), respectively. In group-2, treatment with protease inhibitors (PIs) resulted in higher TG levels when compared with non-nucleotide reverse transcriptase inhibitors (NNRTIs) and integrase inhibitors (InSTIs). The prevalence of MetS in the treatment-naïve group was lower than that of the treatment-experienced group; high TG level resulted in higher MetS prevalence in the treatment-experienced group. In contrast, the cardiovascular risk of FRS in the treatment-naïve group was higher than that of the treatment-experienced group, which may result from the low HDL level. Although group-1 participants have a higher risk of developing CVDs, in group-2, an increasing TG level in PIs user indicated higher CVDs risk. TG and HDL are two significant biofactors that required regular evaluation in HIV-positive individuals.

Modeling Pedestrian and Motorist Interaction at Semi-Controlled Crosswalks: The Effects of a Change from One-Way to Two-Way Street Operation

2019 ◽  
Vol 2673 (11) ◽  
pp. 433-446 ◽  
Author(s):  
Jon D. Fricker ◽  
Yunchang Zhang
Keyword(s):  
Logistic Regression ◽  
Control Strategies ◽  
Binary Logistic Regression ◽  
Pavement Markings ◽  
Video Recordings ◽  
Ordered Logistic Regression ◽  
Before And After ◽  
The One ◽  
Pedestrian Crossing ◽  
And Control

A large number of crosswalks are indicated by pavement markings and signs, but are not signal-controlled. In this paper, such a location is called “semi-controlled.” At locations where such a crosswalk has moderate amounts of pedestrian and vehicle traffic, pedestrians and motorists often engage in a non-verbal “negotiation” to determine who should proceed first. This paper describes the detailed analysis of video recordings of more than 3,400 pedestrian–motorist interactions at semi-controlled crosswalks. The study also took advantage of a conversion from one-way operation in spring 2017 to two-way operation in spring 2018 on the street chosen for data collection and analysis. This permitted before and after studies at the same location. The pedestrian models used mixed effects logistic regression and binary logistic regression to identify factors that influence the likelihood of a pedestrian crossing under specified conditions. The complementary motorist models used generalized ordered logistic regression to identify factors that impact a driver’s likelihood of decelerating, which was found to be a more useful factor than likelihood of yielding to pedestrian. The data showed that 56.5% of drivers slowed down or stopped for pedestrians on the one-way street. This value rose to 63.9% on the same street after it had been converted to two-way operation. Moreover, two-way operation eliminated the effects of the presence of other vehicles on driver behavior. Relationships were found that can lead to policies and control strategies designed to improve the operation of such a crosswalk.

scholarly journals Differences in reimbursement listing of anticancer therapies in China: an observational study

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e031203 ◽  
Author(s):  
Xiaodong Guan ◽  
Yichen Zhang ◽  
Haishaerjiang Wushouer ◽  
Luwen Shi ◽  
Dennis Ross-Degnan ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Observational Study ◽  
Study Design ◽  
Primary Outcome ◽  
Insurance Coverage ◽  
Essential Medicines ◽  
Appropriate Use ◽  
Economic Level ◽  
Drug List ◽  
Before And After

ObjectiveAccess to highly priced anticancer medications usually requires insurance coverage. A first step towards coverage of such medications is their inclusion in reimbursement lists. We assessed listing for reimbursement in China between 2009 and 2018 of anticancer medications on the WHO’s Essential Medicines List.Setting and study designUsing publicly available data, we assessed which anticancer medications listed in the 20th WHO Model List of Essential Medicines (EML) were included in China’s National Reimbursement Drug List (NRDL). For five targeted anticancer medications on the WHO EML, we also assessed inclusion in the 31 Chinese Provincial Reimbursement Drug Lists (PRDLs). Logistic regression was used to test whether inclusion of targeted anticancer medications was associated with provincial economic levels.Primary outcome measuresInclusion of five targeted anticancer medications in the NRDL and PRDLs before and after 2017.ResultsThe 2017 NRDL included all anticancer medications on the WHO EML (except for one not approved in China at the time), and by 2018, all 31 PRDLs listed the targeted anticancer medications except for nilotinib; four provinces had covered all five targeted medications before the 2017 NRDL coverage mandate. Provincial economic level and regional incidence of specific cancers seemed unrelated to the inclusion of five targeted anticancer medications in PRDLs.ConclusionOur findings suggest that by including medications in the national and provincial reimbursement lists, China has taken an important first step in promoting access to targeted anticancer medications. Further research is needed to determine whether inclusion in PRDLs improved the availability, appropriate use and affordability of highly priced targeted anticancer medications in China.

Incidence, immunological and clinical characteristics of reactivation of latentToxoplasma gondiiinfection in HIV-infected patients

2014 ◽  
Vol 143 (3) ◽  
pp. 600-607 ◽  
Author(s):  
P. KODYM ◽  
M. MALÝ ◽  
O. BERAN ◽  
D. JILICH ◽  
H. ROZSYPAL ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
T Lymphocytes ◽  
Clinical Characteristics ◽  
Geometric Mean ◽  
Mean Value ◽  
Significant Decline ◽  
Toxoplasmic Encephalitis ◽  
Combination Antiretroviral Therapy ◽  
Immunological Mechanisms ◽  
Before And After

SUMMARYTo determine changes in incidence of reactivation ofToxoplasma gondiiinfection, manifesting as toxoplasmic encephalitis, and to assess the immunological mechanisms controlling reactivation in HIV-infected patients, a Czech cohort of 502 HIV/T. gondiico-infected patients was followed for 2909·3 person-years. The incidence of toxoplasmic encephalitis between the periods before and after the introduction of combination antiretroviral therapy (cART) was compared. Toxoplasmic encephalitis was diagnosed in 21 patients. In those patients the geometric mean value of CD4+T lymphocytes was 12·6 times lower than in patients with non-reactivatedT. gondiiinfection but an additionally significant decline in CD8+T lymphocytes (3·3-fold) and natural killer cells (4·3-fold) was observed. This confirms the significance of these parameters. A twelvefold decrease inToxoplasmareactivation incidence (40·2vs. 3·4/1000 person-years) between monitored periods was seen. In the cART era,Toxoplasmareactivation was observed only in patients with unrecognized HIV infection or refusing therapy.

scholarly journals The Occurrence of Seizure Clusters in Patients With Epilepsy Is Partly Determined by Epilepsy Severity: A Single-Center Retrospective Observational Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Rui Zhong ◽  
Qingling Chen ◽  
Xinyue Zhang ◽  
Weihong Lin
Keyword(s):  
Logistic Regression ◽  
Observational Study ◽  
Regression Models ◽  
Final Analysis ◽  
Retrospective Observational Study ◽  
Logistic Regression Models ◽  
History Of ◽  
Drug Resistant Epilepsy ◽  
The Individual ◽  
Patients With Epilepsy

Purpose: This retrospective observational study aimed to investigate the self-reported prevalence of seizure clusters (SCs) in patients with epilepsy (PWE) and its relationship with clinical characteristics.Methods: We retrospectively analyzed data from consecutive PWE from our hospital in northeastern China. Data were collected from the databank of a tertiary epilepsy center. Logistic regression models were employed to investigate the relationships between the individual patient demographic/clinical variables and the occurrence of SC.Results: In total, 606 consecutive PWE were included in the final analysis, and 268 (44.2%) patients experienced at least one seizure cluster. In multivariate logistic regression models, age (OR: 1.014; 95% CI: 1.002–1.027; p = 0.02), seizure frequency (OR: 2.08; 95% CI: 1.555–2.783; p &lt; 0.001), multiple seizure types (OR: 5.111; 95% CI: 1.737–15.043; p = 0.003), number of current anti-seizure medications (ASM) (OR: 1.533; 95% CI: 1.15–2.042; p = 0.004), drug-resistant epilepsy (OR: 1.987; 95% CI: 1.159–3.407; p = 0.013), and a history of status epilepticus (OR: 1.903; 95% CI: 1.24–2.922; p = 0.003) were independent variables associated with a history of SC in PWE.Conclusion: Seizure clusters (SCs) are common occurrences at our study center. The occurrence of SC in individuals with epilepsy, to some extent, is determined by the epilepsy severity.

scholarly journals Liver fibrosis indices associated with substantial hematoma expansion in Chinese patients with primary intracerebral hemorrhage

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Huan Wang ◽  
Jiongxing Wu ◽  
Xue Yang ◽  
Junfeng Liu ◽  
Wendan Tao ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Liver Fibrosis ◽  
Intracerebral Hemorrhage ◽  
Chinese Population ◽  
Binary Logistic Regression ◽  
Chinese Patients ◽  
Hematoma Expansion ◽  
West China Hospital ◽  
West China ◽  
Increased Risk

Abstract Background Whether liver fibrosis is associated with increased risk for substantial hematoma expansion (HE) after intracerebral hemorrhage (ICH) is still uncertain. We evaluated the association between various liver fibrosis indices and substantial HE in a Chinese population with primary ICH. Methods Primary ICH patients admitted to West China Hospital within 24 h of onset between January 2015 and June 2018 were consecutively enrolled. Six liver fibrosis indices were calculated, including aspartate aminotransferase (AST)-platelet ratio index (APRI), AST/alanine aminotransferase ratio-platelet ratio index (AARPRI), fibrosis-4 (FIB-4), modified fibrosis-4 (mFIB-4), fibrosis quotient (FibroQ) and Forns index. Substantial HE was defined as an increase of more than 33% or 6 mL from baseline ICH volume. The association of each fibrosis index with substantial HE was analyzed using binary logistic regression. Results Of 436 patients enrolled, about 85% showed largely normal results on standard hepatic assays and coagulation parameters. Substantial HE occurred in 115 (26.4%) patients. After adjustment, AARPRI (OR 1.26, 95% CI 1.00-1.57) and FIB-4 (OR 1.15, 95% CI 1.02-1.30) were independently associated with substantial HE in ICH patients within 24 h of onset, respectively. In ICH patients within 6 h of onset, each of the following indices was independently associated with substantial HE: APRI (OR 2.64, 95% CI 1.30-5,36), AARPRI (OR 1.55, 95% CI 1.09-2.21), FIB-4 (OR 1.35, 95% CI 1.08-1.68), mFIB-4 (OR 1.09, 95% CI 1.01-1.18), FibroQ (OR 1.08, 95% CI 1.00-1.16) and Forns index (OR 1.37, 95% CI 1.10-1.69). Conclusions Liver fibrosis indices are independently associated with higher risk of substantial HE in Chinese patients with primary ICH, which suggesting that subclinical liver fibrosis could be routinely assessed in such patients to identify those at high risk of substantial HE.

scholarly journals Ketamine Infusion in Post-Surgical Pain Management after Head and Neck Surgery: A Retrospective Observational Study

2019 ◽  
Vol 13 (1) ◽  
pp. 132-138
Author(s):  
Vincenzo Pota ◽  
Maria B. Passavanti ◽  
Caterina Aurilio ◽  
Manlio Barbarisi ◽  
Luca G. Giaccari ◽  
...  
Keyword(s):  
Observational Study ◽  
Head And Neck ◽  
Pain Control ◽  
Neck Surgery ◽  
Retrospective Observational Study ◽  
Ketamine Infusion ◽  
Surgical Pain ◽  
Significant Difference ◽  
Before And After ◽  
Remifentanil Group

Background: Head and neck cancer affects approximately 382,000 new patients per year worldwide with a significant portion undergoing surgical treatment. During postoperative period key elements in the Intensive Care Unit (ICU) are airway management and pain control. Objective: We evaluated the average change of inpatient pain control using a Numerical Rating Score (NRS). We also evaluated the time of extubation after ICU admission recording the incidence of desaturation and the necessity of re-intubation. Secondary outcomes were the incidence of postoperative complications, included those narcotics-related, and the use of rescue analgesics. Methods: In this retrospective observational study, we analyzed data of registry before and after we have changed our postoperative analgesic protocol from remifentanil infusion to ketamine infusion. Results: Medical records of 20 patients were examined. 10 patients received 0.5 mg/kg ketamine bolus at the end of surgery, followed by a continuous infusion of 0.25 mg/kg/h. All patients presented a significant decrease in pain intensity from the 4th to 48th postoperative hour (p < 0.05), but statically not a significant difference in NRS score was recorded between the two groups. Time to extubation was shorter in ketamine group compared to the remifentanil group (112.30 min ± 16.78 vs. 78 min ± 14.17; p < 0.05). Desaturation rate was 10% in the remifentanil group, while no case was recorded in the ketamine group. Conclusion: The level of analgesia provided by ketamine and remifentanil was comparable. Ketamine was superior in ventilatory management of the patient with more rapid extubation and with no case of desaturation.

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