scholarly journals Mathematical temporal prediction of CD4+ lymphocytes in HIV/AIDS patients in antiretroviral treatment

2020 ◽  
Author(s):  
Javier Rodríguez ◽  
Signed E. Prieto ◽  
Carlos E. Pérez

Abstract Background: The measurement of CD4 + lymphocyte count through flow cytometry, is necessary for the following up of HIV-infected patients in antiretroviral therapy, however, populations in low-income countries are limited to this test. For this, values of leukocytes and CD4 + lymphocytes counts greater than 500, between 200 and 500 and lesser than 200 cells were taken from 250 HIV-infected individuals in sequential dates up to three years. Then, temporal series of 12 prototypical patients were analyzed in search of predictive patterns between CD4 + lymphocytes and leukocytes, and then, these patterns were applied with the remaining data in a blind study in order to calculate the probability of success of the methodology for each range and its combinations, as well as sensitivity and specificity values.Results: Five patterns with predictive percentages greater than 99% were found for the distinct conditions of the methodology, with sensitivity and specificity values of 99%.Conclusions: A predictive theoretical simplification was achieved between leukocytes counts and CD4 + lymphocytes. This method could be useful to improve the surveillance and survival of HIV-infected individuals in low-income countries where flow cytometry cannot be afforded.

2019 ◽  
Author(s):  
Javier Rodríguez Velásquez ◽  
Signed Prieto Bohórquez ◽  
Carlos Pérez Díaz

Abstract Background: CD4+ lymphocyte count, measured through flow cytometry, is necessary for the following up of HIV-infected patients in antiretroviral therapy, however, the access to this test is limited in low-income countries. The objective of this investigation is to develop a mathematical methodology that allows to temporarily predict CD4+ values greater than 500, between 200 and 500, lesser than 200 for each patient. Methods: values of the populations of CD4+ lymphocytes greater than 500, between 200 and 500 and lesser than 200 cells and leukocytes in 250 patients were taken in sequential dates and combinations of the ranges. Temporal series of 12 prototypical patients were analyzed in search of predictive patterns, and then, these patterns were applied in the remaining patients in a blind study, finding the probability of success of the methodology for each range and its combinations, as well as sensitivity and specificity values. Results: five patterns with predictive percentages greater than 99% were found for the distinct conditions of the methodology, with values of sensitivity and specificity of 99%. Conclusions: through a predictive theoretical simplification a temporal self-organization was established for the measurements of leukocytes and CD4+ lymphocytes, which could be useful to improve the surveillance and survival of patients.


2012 ◽  
Vol 6 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Joseph O Mugisha ◽  
Katherine Donegan ◽  
Sarah Fidler ◽  
Gita Ramjee ◽  
Andrew Hodson ◽  
...  

Objectives: To assess whether mean corpuscular volume (MCV) is useful in detecting non-adherence to AZTcontaining therapy. Design: Observational study within randomised controlled trial. Methods: We combined data from two treatment arms in SPARTAC, an RCT of short-course cART in primary HIV infection, classifying participants as responders (HIV-RNA decrease ≥1 log10 or reaching <400copies/ml) or nonresponders following cART initiation. We assessed the sensitivity and specificity of using different percentage increases in MCV for accurately differentiating between responders and non-responders. We further examined changes in MCV levels up to 24 weeks after protocol-indicated cART cessation. Results: Of 119 participants included in this analysis, 73 (61%) were women, 71 of whom were randomised in Africa. Ninety-eight (88%) and 84 (85%) were classified as responders at 4 and 12 weeks respectively following cART initiation. MCV increased by a mean 3% and 1% at week 4, and 14% and <1% at 12 weeks for responders and non-responders. A 2% MCV increase at 4 weeks had 62% sensitivity and specificity for identifying virological response. At 12 weeks, an 8% increase had 89% sensitivity and specificity. In responders, MCV remained lower for individuals in African compared to non-African sites throughout and rose from 85 vs 90 fL at cART start to 96 vs 103 fL at 12 weeks post-initiation then fell to 88 vs 93 fL and 86 vs 89 fL at 12 and 48 weeks post-cessation. Conclusion: In low-income countries, where HIV RNA may be unavailable, 12-weekly MCV measurements may be useful in monitoring adherence to AZT-containing regimens.


2009 ◽  
Vol 37 (3) ◽  
pp. 828-834 ◽  
Author(s):  
C Yilmaz ◽  
SA Yuca ◽  
N Yilmaz ◽  
AF Öner ◽  
H Çaksen

The aetiology of subacute sclerosing panencephalitis (SSPE) remains to be fully elucidated, although it follows infection with a hypermutant defective M-protein measles virus. This study analysed peripheral blood lymphocyte subgroups to determine their role in the pathophysiology of SSPE. It included 22 children with SSPE aged 2-15 years (patient group) and 22 age- and gender-matched healthy children (control group). In children < 6 years old, there were no statistically significant differences between the two groups in the proportions of lymphocytes expressing the surface markers CD3, CD8, CD19 or CD16/56, or in CD4/CD8 ratio. The proportion of CD4+ lymphocytes in SSPE patients < 6 years of age was significantly lower compared with the control group. In children ≥ 6 years old, there were no significant differences in the lymphocyte subgroups. In conclusion, these findings suggest that a low CD4+ lymphocyte count might be responsible for SSPE in younger children.


2016 ◽  
Vol 70 (4) ◽  
pp. 327-330
Author(s):  
F Bottari ◽  
S Igidbashian ◽  
S Boveri ◽  
A Tricca ◽  
C Gulmini ◽  
...  

AimsMortality for cervical cancer varies between the different regions of the world, with high rates in low-income countries where screening programmes are not present and organised. However, increasing screening coverage is still a priority in all countries: one way to do that is to base screening on self-sampled screening. The success of a self-sampling screening strategy depends on capacity to recruit unscreened women, on the performance and acceptability of the device and on the clinical performance of the high-risk human papillomavirus (HPV) test.MethodsThis study based on 786 enrolled women investigates the best cut-off value of Hybrid Capture 2 HPV test (HC2) for self-sampled specimens in terms of sensitivity and specificity.ResultsIn this population, we found that the sensitivity and the specificity for cervical intraepithelial neoplasia grade 2 or more detection of HC2 performed on self-sampled specimens were 82.5% and 82.8%, respectively considering the relative light units (RLU) cut-off value of 1. Increasing the cut-off value the sensitivity decreases and the specificity raises and the best area under the curve for the RLU cut-off value is 1.ConclusionsOur results confirm that the cut-off value of 1 suggested by Qiagen for PreservCyt specimen is the best cut-off value also for self-sampled specimens.


Author(s):  
Davor Petrović ◽  
Vida Čulić ◽  
Zofia Swinderek-Alsayed

AbstractJoubert syndrome (JS) is a rare congenital, autosomal recessive disorder characterized by a distinctive brain malformation, developmental delay, ocular motor apraxia, breathing abnormalities, and high clinical and genetic heterogeneity. We are reporting three siblings with JS from consanguineous parents in Syria. Two of them had the same homozygous c.2172delA (p.Trp725Glyfs*) AHI1 mutation and the third was diagnosed prenatally with magnetic resonance imaging. This pathogenic variant is very rare and described in only a few cases in the literature. Multinational collaboration could be of benefit for the patients from undeveloped, low-income countries that have a low-quality health care system, especially for the diagnosis of rare diseases.


2013 ◽  
pp. 121-136
Author(s):  
Duong Pham Bao

The objective of this article is to review the development of the rural financial system in Vietnam in recent years, especially, after Doi moi. There are two opposite schools of thought in the literature on rural credit policies in developing countries. One is the conventional supply-side (government-led) approach while the other is called “a new paradigm” that emphasizes the importance of the viability of financial providers and the well functioning of rural credit markets. Conventional theories of rural finance contend that rural finance in low-income countries is generally accompanied by many failures. Contrary to these theories, rural finance in Vietnam does not encounter the above-mentioned failures so far. Up to the present time, it is progressing well. Using a supply-side approach, methodologically, this study reviews the development of the rural financial system in Vietnam. The significance of this study is to challenge the extreme view of dichotomizing between the old and the new credit paradigms. Analysis in this study contends that a rural financial market that, (1) is initiated and spurred by government; (2) operates principally under market mechanisms; and (3) is strongly supported by rural organizations (semi-formal/informal institutions) can progress stably and well. Therefore, the extremely dichotomizing approach must be avoided.


EMJ Radiology ◽  
2020 ◽  

Retained foreign bodies have become very rare in countries where the safety rules in the operating theatre are very rigorous and follow precise guidelines. There are low-income countries where hospital structures are precarious, in which the implementation of surgical safety rules has only been effective recently. Surgical teams in these countries are not yet well trained in the observance of the guidelines concerning swab count, meaning that textilomas are not uncommon. Abdominal textiloma may be asymptomatic, or present serious gastrointestinal complications such as bowel obstruction, perforation, or fistula formation because of misdiagnosis. It may mimic abscess formation in the early stage or soft tissue masses in the chronic stage. This case report presents a 27-year-old female who underwent an emergency laparotomy in a rural surgical centre for an ectopic pregnancy. Two months later, a swelling had appeared on the left side of her abdomen, gradually increasing in size, which was not very painful but caused digestive discomfort and asthenia. Intermittent fever was described and treated with antibiotics. The patient was referred to a better equipped centre to benefit from a CT scan. A textiloma was strongly suspected on the CT but a left colic mass was not excluded. Laparotomy confirmed the diagnosis of textiloma and the postoperative course was uneventful. Prevention rules must be strengthened in these countries where patients can hardly bear the costs of iterative surgeries for complications that are avoidable.


2020 ◽  
Vol 1 ◽  
pp. 5
Author(s):  
Audu Onyemocho ◽  
Agwa Moses ◽  
Aboh Kisani ◽  
Omole Namben Victoria ◽  
Anejo-Okopi Joseph

Objective: Rabies, one of the oldest and fatal infectious diseases known to human race, is transmitted by infected dogs. The global target of zero dog-mediated rabies human deaths has been set for 2030; however, the realization of this goal poses challenges in most low-income countries where rabies is endemic due to weak surveillance. Dogs have been increasingly deployed for domestic uses over the years, especially for security purposes. This study assessed the assessment of knowledge and practice of vaccination of dogs against rabies by dog owners. Materials and Methods: A cross-sectional community-based study was employed to study 400 dog owners in Makurdi metropolis through multistage sampling techniques. Sighting of valid dog vaccination card was used as criteria for current vaccination. Bivariate analysis was carried out to establish the relationship between the respondent knowledge of rabies and dog vaccination with significant value set at P < 0.05. Results: The mean age of the respondents was 31 (Â ± 0.8) years, majority of them had tertiary and secondary education (40.0% and 39.0%, respectively), 26.0% were traders, and 50.0% were married. Overall, 73.0% of the respondents had good knowledge score, 61.0% had seen at least a rabid dog in their life time, and 74.0% have a history of dog vaccination, but evidence of up to date vaccination of dogs by owners was seen in only 18.0% of all the vaccination cards sighted. The relationship between the educational status of the respondents, their knowledge score, and their dog vaccination was statistically significant (P < 0.05). Conclusion: Knowledge of rabies among dog owners in Makurdi was good, but the practice of dog vaccination was poor. Educational status was a good predictor of practice. Awareness campaign on dog vaccination should be strengthened and adequate measures should be put in place at the veterinary hospitals in Makurdi for vaccination of dogs.


Sign in / Sign up

Export Citation Format

Share Document