scholarly journals Factors associated with subclinical atherosclerosis in HIV infected patients from northeast of Brazil

2021 ◽  
Vol 10 (12) ◽  
pp. e442101220484
Author(s):  
Ursula Maria Moreira Costa Burgos ◽  
Enaldo Vieira de Melo ◽  
Angela Maria da Silva ◽  
Antônio Carlos Sobral Sousa ◽  
Willams de Matos ◽  
...  
Keyword(s):  
Lipid Profile ◽  
Subclinical Atherosclerosis ◽  
Coronary Calcification ◽  
Antiretroviral Drugs ◽  
Male Gender ◽  
Hazard Ratio ◽  
Related Factors ◽  
Factors Associated ◽  
Undetectable Viremia ◽  
Traditional Risk Factors

Introduction: AIDS has changed its morbidity curve, rising cardiovascular diseases. HIV-infected patients have increased cardiovascular event rates but data on the prevalence of subclinical atherosclerosis are not uniform. Methods: HIV-infected patients underwent to coronary tomography for CACs assessement. We performed a comparison between 97 HIV-infected patients and 129 seronegative healthy controls. The univariable analysis matched the association of HIV infection, cardiovascular risk profile, and HIV-related factors with subclinical atherosclerosis. Results: HIV-infected patients with CACs above zero were older (54.8±7.0 vs. 43.3.5±11.0 years; p<0.001) and more likely to have hypertension (36.7% vs. 12.5%; p=0.07) than HIV(-) CACs zero ones. Factors associated with altered CACs in unadjusted hazard ratio were age (HR=1.13; 95%CI=1.07-1.20; p<0.0001) and hypertension (HR=4.05; 95%CI=1.42-11.60; p=0.0009). When adjusted hazard ratio was constructed age, male gender and protease inhibitors (PI) use appeared as factors associated with coronary calcification. HIV-infected patients were less likely to have hypertension (20.2% vs 50.4%; p<0.001) and diabetes (5.3% vs 23.3%; p<0.001) than HIV uninfected ones. Conversely, both groups have same CACs level. Among HIV-infected patients altered CACs was 30.9%, vs 42.3% among control. Most of HIV-infected patients showed undetectable viremia and high CD4+ count, in parallel with lipid profile disturbances. Conclusion: Increased CAC incidence was associated with age, male gender and PI use among HIV-infected patients. Despite younger, fewer traditional risk factors and with controlled disease, the PLHIV had similar CAC scores compared with controls. Besides viruses itself, antiretroviral drugs play a role, mainly because control viruses at expense of worsening in lipid profile.

scholarly journals Factors Associated with the Occurrence of Skin Diseases among Children Attending the Children’s Outpatient Clinic in a Tertiary Care Hospital in Southern Nigeria

2021 ◽  
pp. 23-29
Author(s):  
Uju S. Azubogu ◽  
Inumanye Ojule
Keyword(s):  
Study Design ◽  
Outpatient Clinic ◽  
Skin Diseases ◽  
Multiple Logistic Regression Analysis ◽  
Tertiary Care ◽  
Male Gender ◽  
Care Hospital ◽  
Related Factors ◽  
Cross Sectional ◽  
Factors Associated

Aims: To determine the factors associated with the occurrence of skin diseases among children attending the Children’s Outpatient Clinic of the University of Port Harcourt Teaching Hospital (UPTH). Study Design: A Cross sectional study design was used. It was both descriptive and analytical. Place and Duration of Study: The study was carried out in the Children’s Outpatient Clinic of the Department of Paediatrics, UPTH from June to August 2020 (3 months). Methodology: We studied 370 children aged less than 18 years. A semi structured interviewer-administered questionnaire was used to obtain all relevant data. This was followed by dermatological examination of the children to make diagnosis of skin diseases. Relevant samples for laboratory confirmation were also obtained where necessary. Results: Among the 88 children (23.7%) who had skin diseases, our study showed that the socio-demographic factors associated with the occurrence of skin diseases includes: male gender (p=0.001) and low socio-economic class (p<0.001). Hygiene-related factors associated with occurrence of skin diseases includes: lack of water within the home (p=0.001), bath frequency < twice per day (p=0.001) and sharing of personal items (p<0.001). On multiple logistic regression analysis of these factors, the factors predictive of skin diseases were: male gender (p=0.000), low and middle socioeconomic class (p=0.004) and lack of water within the home (p=0.013). Conclusion: Several socio-demographic and hygiene-related factors were identified to be associated with the occurrence of skin diseases among children in our study. These factors provide an important window for interventions to prevent and control the burden of skin diseases among children in our setting.

scholarly journals Drug Resistance and Its Related Factors in ART-failure Patients From 2018 to 2019 in Liaoning Province, China

2021 ◽  
Author(s):  
Qianqian Wei ◽  
Yan Zhao ◽  
Yani Lv ◽  
Xu Kang ◽  
Shan Pan ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Resistance Rate ◽  
Antiretroviral Drugs ◽  
Liaoning Province ◽  
Resistance Mutations ◽  
Cross Sectional Survey ◽  
Related Factors ◽  
Cross Sectional ◽  
Factors Associated ◽  
Hiv 1

Abstract Background: To understand the prevalence of HIV-1 drug resistance and the mutation patterns in ART-failure individuals in Liaoning Province, China, we conducted a cross-sectional survey.Patients and methods: Plasma samples were collected from HIV-1-positive individuals who experienced ART failure in Liaoning Province between April 2018 and September 2019.Genotype resistance test was performed using an in-house assay on these collected samples. Factors associated with drug resistance were identified by logistic regression analysis.Results: A total of 256 HIV-1-positive individuals experiencing ART failure were tested for drug resistance from April 2018 to September 2019. Of these, the most predominant genotype was CRF01_AE, accounting for 77.73%. The resistance rate to any of the three classes of antiretroviral drugs (NNRTIs, NRTIs, and PIs) was 64.84%. Among 256 ART-failure patients, 62.89% showed drug resistance to NNRTIs, 50.39% to NRTIs, and 3.13% to PIs. G190S (31.25%) and Y181C (25.78%) mutations were the most common NNRTIs resistance mutations, and K65R (29.69%), M184V (28.52%) were the most common NRTIs resistance mutations. Factors associated with drug resistance included current ART regimen, viral load.Conclusion: The high drug resistance rate among ART-failure individuals in Liaoning Province needs more attention. Corresponding strategies for the risk factors associated with HIV drug resistance can better control and prevent the prevalence of resistance.

scholarly journals Trends and factors associated with modification or discontinuation of the initial antiretroviral regimen during the first year of treatment in the Turkish HIV-TR Cohort, 2011–2017

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Volkan Korten ◽  
◽  
Deniz Gökengin ◽  
Gülhan Eren ◽  
Taner Yıldırmak ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Virologic Failure ◽  
Risk Function ◽  
Transcriptase Inhibitor ◽  
Cox Proportional Hazards ◽  
Antiretroviral Drugs ◽  
Competing Risk ◽  
First Year ◽  
Strand Transfer ◽  
Factors Associated

Abstract Background There is limited evidence on the modification or stopping of antiretroviral therapy (ART) regimens, including novel antiretroviral drugs. The aim of this study was to evaluate the discontinuation of first ART before and after the availability of better tolerated and less complex regimens by comparing the frequency, reasons and associations with patient characteristics. Methods A total of 3019 ART-naive patients registered in the HIV-TR cohort who started ART between Jan 2011 and Feb 2017 were studied. Only the first modification within the first year of treatment for each patient was included in the analyses. Reasons were classified as listed in the coded form in the web-based database. Cumulative incidences were analysed using competing risk function and factors associated with discontinuation of the ART regimen were examined using Cox proportional hazards models and Fine-Gray competing risk regression models. Results The initial ART regimen was discontinued in 351 out of 3019 eligible patients (11.6%) within the first year. The main reason for discontinuation was intolerance/toxicity (45.0%), followed by treatment simplification (9.7%), patient willingness (7.4%), poor compliance (7.1%), prevention of future toxicities (6.0%), virologic failure (5.4%), and provider preference (5.4%). Non-nucleoside reverse transcriptase inhibitor (NNRTI)-based (aHR = 4.4, [95% CI 3.0–6.4]; p < 0.0001) or protease inhibitor (PI)-based regimens (aHR = 4.3, [95% CI 3.1–6.0]; p < 0.0001) relative to integrase strand transfer inhibitor (InSTI)-based regimens were significantly associated with ART discontinuation. ART initiated at a later period (2015-Feb 2017) (aHR = 0.6, [95% CI 0.4–0.9]; p < 0.0001) was less likely to be discontinued. A lower rate of treatment discontinuation for intolerance/toxicity was observed with InSTI-based regimens (2.0%) than with NNRTI- (6.6%) and PI-based regimens (7.5%) (p < 0.001). The percentage of patients who achieved HIV RNA < 200 copies/mL within 12 months of ART initiation was 91% in the ART discontinued group vs. 94% in the continued group (p > 0.05). Conclusion ART discontinuation due to intolerance/toxicity and virologic failure decreased over time. InSTI-based regimens were less likely to be discontinued than PI- and NNRTI-based ART.

Management of Recurrent or Progressing Skull Base Chondrosarcomas: Predictors of Long-Term Outcomes

2020 ◽  
Author(s):  
Jonathan D. Breshears ◽  
Franco DeMonte ◽  
Ahmed Habib ◽  
Paul W. Gidley ◽  
Shaan M. Raza
Keyword(s):  
Natural History ◽  
Skull Base ◽  
Radiation Treatment ◽  
Systemic Disease ◽  
Primary Treatment ◽  
Salvage Treatment ◽  
Low Grade ◽  
Related Factors ◽  
Factors Associated ◽  
Initial Recurrence

Abstract Background Skull base chondrosarcomas (CSA) are difficult tumors to cure and there is little data regarding salvage therapy. Objective This study aims to identify presentation and treatment-related factors which impact the progression free survival (PFS) and disease specific survival (DSS) for recurrent CSA, and to identify salvage treatment factors associated with successful restoration to the natural history following primary treatment. Methods This single-institution retrospective review included patients with recurrent/progressive CSA over a 25-year period. Survival analysis for factors impacting PFS and DSS was performed. Salvage treatment factors associated with achieving PFS ≥newly diagnosed median PFS were identified using univariate statistics. Analysis was performed on first recurrences and all recurrences combined. Results A total of 47 recurrence/progression events were analyzed from 17 patients (median two events/patient, range = 1–8). The overall PFS and DSS for the initial recurrence was 32 (range = 3–267) and 79 (range = 3–285) months, respectively. Conventional grade III or mesenchymal histology significantly predicted shorter PFS and DSS (p < 0.0001). After stratification by histology, previous radiation predicted shorter PFS for low-grade tumors (p = 0.009). Gross total resection (GTR) after a first time recurrence was significantly associated with successful salvage treatment (p < 0.05); however, this was rare. Conclusion In this series, high grade histology and prior radiation treatment negatively impacted salvage treatment outcomes, while GTR was associated with restoration to natural history following primary treatment. Careful consideration of histology, systemic disease status, previous treatments, and the anatomic extent of the skull base disease can optimize the outcomes of salvage intervention.

scholarly journals Factors Associated With Peripartum Virologic Suppression in Eastern Cape Province, South Africa: A Retrospective Cross-Sectional Analysis

2021 ◽  
Author(s):  
Oladele Vincent Adeniyi ◽  
Chikwelu Larry Obi ◽  
Daniel Ter Goon ◽  
Benson Iweriebor ◽  
Nonkosi Selanto-Chairman ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Virologic Suppression ◽  
Eastern Cape Province ◽  
Eastern Cape ◽  
Child Transmission ◽  
Cross Sectional ◽  
Factors Associated ◽  
Undetectable Viremia ◽  
Sectional Analysis ◽  
Mother To Child

Abstract Background This study describes the characteristics of pregnant women on antiretroviral therapy (ART) and the rate of peripartum virologic suppression in a large prevention of mother-to-child transmission cohort who delivered in some selected maternity centers in Eastern Cape Province, South Africa. In addition, the study examines the factors associated with virologic suppression in the cohort. Methods This multicenter, retrospective cross-sectional analysis included medical data of 1709 women with human immunodeficiency virus between September 2015 and May 2016 in Eastern Cape Province. The main outcome measure was the rate of peripartum virologic suppression, defined as viral load (VL) &lt;1000 copies/mL and undetectable viremia (VL &lt;20 copies/mL). Correlates of peripartum virologic suppression and undetectable viremia were examined by fitting logistic regression model analysis. Results Of 1463 women with available VL results, the overall rate of peripartum suppression was 82%, and undetectable viremia was 56.9%. Being aged 24 years or younger (adjusted odds ratio [AOR], 0.68 [95% confidence interval {CI}, .48–.94]), smoking during pregnancy (AOR, 0.50 [95% CI, .28–.90]), and starting ART in the first trimester were associated with lower odds of viral suppression (&lt;1000 copies/mL). Women who had never defaulted ART had an increased odds of having an undetectable VL (AOR, 3.09 [95% CI, 2.12–4.49]) and virologic suppression (AOR, 3.88 [95% CI, 2.62–5.74]) compared to those who defaulted. Conclusions More than half of the women achieved undetectable VL, and 4 in 5 women achieved viral suppression at delivery in the region. Early antenatal booking, combined with enhanced adherence support for pregnant women on ART, would be crucial toward achieving the goal of elimination of mother-to-child transmission in the region.

Comprehensive genomics depict accessory genes encoding pathogenicity and biofilm determinants in Enterococcus faecalis

2021 ◽  
Vol 16 (3) ◽  
pp. 175-184
Author(s):  
Karthika Suryaletha ◽  
Sivakumar K Chandrika ◽  
Sabu Thomas
Keyword(s):  
Enterococcus Faecalis ◽  
Signaling System ◽  
Phosphotransferase System ◽  
Related Factors ◽  
Polysaccharide Lyase ◽  
Factors Associated ◽  
Analysis Methodology ◽  
Accessory Genes ◽  
Genes Encoding ◽  
Phage Proteins

Aim: Enterococcus faecalis is a leading nosocomial pathogen in biofilm-associated polymicrobial infections. The study aims to understand pathogenicity and biofilm determinants of the pathogen by genome analysis. Methodology: Genome sequencing of a strong biofilm forming clinical isolate Enterococcus faecalis SK460 devoid of Fsr quorum-signaling system, was performed and comparative genomics was carried out among a set of pathogenic biofilm formers and nonpathogenic weak biofilm formers. Results: Analysis revealed a pool of virulence and adhesion related factors associated with pathogenicity. Absence of CRISPR-Cas system facilitated acquisition of pheromone responsive plasmid, pathogenicity island and phages. Comprehensive analysis identified a subset of accessory genes encoding polysaccharide lyase, sugar phosphotransferase system, phage proteins and transcriptional regulators exclusively in pathogenic biofilm formers. Conclusion: The study identified a set of genes specific to pathogenic biofilm formers and these can act as targets which in turn help to develop future treatment endeavors against enterococcal infections.

Sign in / Sign up

Export Citation Format

Share Document