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https://www.readbyqxmd.com/read/28329668/stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-in-us-adults
#1
Derek Y Hsu
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening disorders. The incidences, mortality and cost of SJS and TEN in US adults are not well-characterized. We analyzed data from the 2009-2012 Nationwide Inpatient Sample, containing a representative 20% sample of all hospitalizations in the US. SJS, SJS/TEN and TEN were identified by a validated algorithm using ICD-9- CM codes. The mean incidences of SJS, SJS/TEN and TEN were 9.3, 1.6, and 1.9 per million people per year, respectively...
September 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28329652/the-inpatient-burden-of-psoriasis-a-nationwide-analysis
#2
Derek Y Hsu
Psoriasis is a chronic inflammatory skin disorder associated with substantial morbidity and mortality. Little is known about psoriasis in the inpatient setting. We sought to determine the inpatient burden of psoriasis in the US. We analyzed the 2002-2012 Nationwide Inpatient Sample, containing a representative 20% stratified sample of all hospitalizations in the US. Psoriasis was determined by a validated algorithm using ICD-9-CM codes. Demographics, inflation-adjusted cost, length of stay, comorbidities, and sex- adjusted mortality were analyzed using descriptive statistics and regression analysis...
September 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28329372/practical-review-of-recognition-and-management-of-obesity-and-lipohypertrophy-in-hiv-infection
#3
Jordan E Lake, Takara Stanley, Caroline Apovian, Shalendar Bhasin, Todd T Brown, Jaqueline Capeau, Judith S Currier, Michael P Dube, Julian Falutz, Steven K Grinspoon, Giovanni Guaraldi, Esteban Martinez, Grace A McComsey, Fred R Sattler, Kristine M Erlandson
Background: Obesity and lipohypertrophy are common in treated HIV infection and contribute to morbidity and mortality among HIV-infected adults on antiretroviral therapy (ART). Methods: We present a consensus opinion on the diagnosis, clinical consequences and treatment of excess adiposity in adults with treated HIV infection. Results: Obesity and lipohypertrophy commonly occur among HIV-infected adults on ART, and may have overlapping pathophysiologies and/or synergistic metabolic consequences...
February 24, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28329310/immunologic-pathways-that-predict-mortality-in-hiv-infected-ugandans-initiating-art
#4
Sulggi Lee, Helen Byakwaga, Yap Boum, Tricia H Burdo, Kenneth C Williams, Michael M Lederman, Yong Huang, Russell P Tracy, Huyen Cao, Jessica E Haberer, Annet Kembabazi, David R Bangsberg, Jeffrey N Martin, Peter W Hunt
Plasma kynurenine/tryptophan (KT) ratio, a marker of adaptive immune defects, strongly predicts mortality during treated HIV disease in Ugandans compared to U.S.-based populations, Here, KT ratio, and T cell and plasma biomarkers of immune activation were measured among 535 HIV-infected Ugandans prior to ART initiation and at month 6 of viral suppression. Month 6 KT ratio (aHR=2.74), sCD14 (aHR=2.32), IL-6 (aHR=2.34), and D dimer (aHR=1.95) were associated with mortality occurring ≥6 months after ART initiation, KT ratio remained significantly predictive of mortality even after adjustment for the additional biomarkers, suggesting an independent contribution to clinical outcomes in resource-limited settings...
March 1, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28329236/impact-of-hiv-drug-resistance-on-hiv-aids-associated-mortality-new-infections-and-antiretroviral-therapy-program-costs-in-sub-saharan-africa
#5
Andrew N Phillips, John Stover, Valentina Cambiano, Fumiyo Nakagawa, Michael R Jordan, Deenan Pillay, Meg Doherty, Paul Revill, Silvia Bertagnolio
To inform the level of attention to be given by antiretroviral therapy (ART) programs to HIV drug resistance (HIVDR), we used an individual-level model to estimate its impact on future AIDS deaths, HIV-incidence and ART program costs in sub-Saharan Africa (SSA) for a range of program situations. We applied this to SSA through the Spectrum-Goals model. In a situation in which current levels of pre-treatment HIVDR are over 10% (mean 15%), 16% of AIDS deaths (890,000 deaths) , 9% of new infections (450,000) and 8% ($6...
February 17, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28329108/increased-mortality-among-persons-with-chronic-hepatitis-c-with-moderate-or-severe-liver-disease-a-cohort-study
#6
Javier A Cepeda, David L Thomas, Jacquie Astemborski, Mark S Sulkowski, Gregory D Kirk, Shruti H Mehta
Background: Despite the availability of curative treatment for hepatitis C virus (HCV) infection, because of cost, treatment is often denied until liver fibrosis has progressed to at least moderate fibrosis and in some cases cirrhosis. That practice is justified on assumptions that there are no medical consequences to having moderate disease and that disease stage transitions can be anticipated. Methods: We performed transient elastography on 964 people chronically infected with HCV with a history of injection drug use living in Baltimore, Maryland...
March 10, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28328551/higher-body-mass-index-is-associated-with-greater-proportions-of-effector-cd8-t-cells-expressing-cd57-in-women-living-with-hiv
#7
Michael J A Reid, Sanjiv M Baxi, Lila A Sheira, Alan L Landay, Edward A Frongillo, Adebola Adedimeji, Mardge H Cohen, Eryka Wentz, Deborah R Gustafson, Daniel Merenstein, Peter W Hunt, Phyllis C Tien, Sheri D Weiser
BACKGROUND: A low proportion of CD28-CD8+ T cells that express CD57 is associated with increased mortality in HIV infection. The effect of increasing BMI changes in the proportion of CD57+CD28-CD8+ T cells among HIV-infected individuals on ART is unknown. SETTING: In a U.S. cohort of HIV-infected women, we evaluated associations of BMI and waist circumference with 3 distinct CD8+ T cell phenotypes: % CD28-CD57+CD8+ T cells, % CD57+ of CD28-CD8+ T cells and % CD28- of all CD8 T cells...
March 20, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28326084/hiv-infection-and-compromised-mucosal-immunity-oral-manifestations-and-systemic-inflammation
#8
REVIEW
Samantha E Heron, Shokrollah Elahi
Mucosal surfaces account for the vast majority of HIV transmission. In adults, HIV transmission occurs mainly by vaginal and rectal routes but rarely via oral route. By contrast, pediatric HIV infections could be as the result of oral route by breastfeeding. As such mucosal surfaces play a crucial role in HIV acquisition, and spread of the virus depends on its ability to cross a mucosal barrier. HIV selectively infects, depletes, and/or dysregulates multiple arms of the human immune system particularly at the mucosal sites and causes substantial irreversible damage to the mucosal barriers...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28325538/lifetime-risk-of-a-diagnosis-of-hiv-infection-in-the-united-states
#9
Kristen L Hess, Xiaohong Hu, Amy Lansky, Jonathan Mermin, Hildegard Irene Hall
PURPOSE: To estimate lifetime risk of receiving an HIV diagnosis in the United States if existing infection rates continue. METHODS: We used mortality, census, and HIV surveillance data for 2010 to 2014 to calculate age-specific probabilities of an HIV diagnosis. The probabilities were applied to a hypothetical cohort of 10 million live births to estimate lifetime risk. RESULTS: Lifetime risk was 1 in 68 for males and 1 in 253 for females...
February 21, 2017: Annals of Epidemiology
https://www.readbyqxmd.com/read/28325073/management-of-a-tracheoesophageal-fistula-in-a-patient-with-aids
#10
Alberto Cabañero, Fernando Dronda, David Saldaña, José Manuel Hermida, Gemma Muñoz, Santiago Moreno
Despite the high frequency of gastrointestinal complications and opportunistic infections in HIV-1 infected patients, tracheoesophageal (TEF) and bronchoesophageal (BEF) fístulas are rare. Our objective is to comunicate an additional and unusual case of TEF in an HIV-1-infected patient whose immunologic status was good with complete suppression of viral replication, so although uncommon, TEF/BEF of an infectious origen should be considered in AIDS. Endoscopic treatment with tracheal/esophageal stents is not without morbidity and mortality...
March 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28321877/pharmacological-interventions-for-acute-hepatitis-b-infection-an-attempted-network-meta-analysis
#11
REVIEW
Konstantinos Mantzoukis, Manuel Rodríguez-Perálvarez, Elena Buzzetti, Douglas Thorburn, Brian R Davidson, Emmanuel Tsochatzis, Kurinchi Selvan Gurusamy
BACKGROUND: Infection with hepatitis B virus (HBV) can be symptomatic or asymptomatic. Apart from chronic HBV infection, the complications related to acute HBV infection are severe acute viral hepatitis and fulminant hepatitis characterised by liver failure. The optimal pharmacological treatment of acute HBV infection remains controversial. OBJECTIVES: To assess the benefits and harms of pharmacological interventions in the treatment of acute HBV infection through a network meta-analysis and to generate rankings of the available treatments according to their safety and efficacy...
March 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28321466/the-risk-and-clinical-outcome-of-candidemia-depending-on-underlying-malignancy
#12
Olivier Lortholary, Charlotte Renaudat, Karine Sitbon, Marie Desnos-Ollivier, Stéphane Bretagne, Françoise Dromer
PURPOSE: To assess the risk factors and outcomes associated with fungemia caused by the six most commonly occurring Candida species in patients with and without malignancies. METHODS: Analysis of the episodes of fungemia due to common Candida species in adults, based on an active hospital-based surveillance program (Paris area, France, 2002 to 2014). RESULTS: Of the 3417 patients (3666 isolates), 1164 (34.1%) had a solid tumor (45.7% digestive tract) and 586 (17...
March 20, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28320938/effectiveness-of-unaids-targets-and-hiv-vaccination-across-127-countries
#13
Jan Medlock, Abhishek Pandey, Alyssa S Parpia, Amber Tang, Laura A Skrip, Alison P Galvani
The HIV pandemic continues to impose enormous morbidity, mortality, and economic burdens across the globe. Simultaneously, innovations in antiretroviral therapy, diagnostic approaches, and vaccine development are providing novel tools for treatment-as-prevention and prophylaxis. We developed a mathematical model to evaluate the added benefit of an HIV vaccine in the context of goals to increase rates of diagnosis, treatment, and viral suppression in 127 countries. Under status quo interventions, we predict a median of 49 million [first and third quartiles 44M, 58M] incident cases globally from 2015 to 2035...
March 20, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28320384/diagnostic-accuracy-incremental-yield-and-prognostic-value-of-determine-tb-lam-for-routine-diagnostic-testing-for-tuberculosis-in-hiv-infected-patients-requiring-acute-hospital-admission-in-south-africa-a-prospective-cohort
#14
Stephen D Lawn, Andrew D Kerkhoff, Rosie Burton, Charlotte Schutz, Andrew Boulle, Monica Vogt, Ankur Gupta-Wright, Mark P Nicol, Graeme Meintjes
BACKGROUND: We previously reported that one-third of HIV-positive adults requiring medical admission to a South African district hospital had laboratory-confirmed tuberculosis (TB) and that almost two-thirds of cases could be rapidly diagnosed using Xpert MTB/RIF-testing of concentrated urine samples obtained on the first day of admission. Implementation of urine-based, routine, point-of-care TB screening is an attractive intervention that might be facilitated by use of a simple, low-cost diagnostic tool, such as the Determine TB-LAM lateral-flow rapid test for HIV-associated TB...
March 21, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28320186/neurological-complications-after-tuberculous-meningitis-in-a-multi-state-cohort-in-the-united-states
#15
Alexander E Merkler, Alexandra S Reynolds, Gino Gialdini, Nicholas A Morris, Santosh B Murthy, Kiran Thakur, Hooman Kamel
BACKGROUND AND PURPOSE: To assess the rate of neurological complications and mortality after tuberculous meningitis in the United States. METHODS: The authors performed a retrospective cohort study of all patients 18years or older hospitalized for tuberculous meningitis in California between 2005 and 2010, New York between 2006 and 2012, and Florida between 2005 and 2012. Outcomes of interest were mortality and the following neurological complications: stroke, seizure, hydrocephalus requiring a ventriculoperitoneal shunt, vision impairment, and hearing impairment...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28317812/evaluation-of-pulmonary-tuberculosis-case-detection-improvement-with-the-deployment-of-xpertmtb-rif-in-the-tuberculosis-control-program-of-cross-river-state-nigeria
#16
Ernest Afu Ochang, Ubleni E Emanghe, Atana Ewa, Akaninyene Otu, Jonah B Offor, Micheal Odo, Aniekan Etokidem, Barinadaa Afirima, Oju Eni Owuna, Sunday M Obeten, Martin M Meremikwu
OBJECTIVE/BACKGROUND: Global indices show that Nigeria has the highest tuberculosis (TB)-related mortality rate. Overdependence on Ziehl-Neelsen (ZN) smear microscopy for diagnosis and human immunodeficiency virus (HIV)/AIDS has limited control efforts. The new polymerase chain reaction-based XpertMTB/Rif (Cepheid Inc., CA, USA), which detects Mycobacterium tuberculosis and rifampicin resistance, was introduced in Cross River State in 2014. We evaluated the increment in pulmonary TB case detection following introduction of XpertMTB/Rif into the Cross River State TB control program...
January 2017: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28317290/the-effect-of-engagement-in-an-hiv-aids-integrated-health-programme-on-plasma-hiv-1-rna-suppression-among-hiv-positive-people-who-use-illicit-drugs-a-marginal-structural-modelling-analysis
#17
L Ti, H Dong, T Kerr, R B Turje, S Parashar, J E Min, J Montaner, E Wood, M-J Milloy
OBJECTIVES: HIV treatment-as-prevention campaigns emphasize early diagnosis and immediate access to care and antiretroviral therapy for HIV-positive individuals in order to increase levels of plasma HIV RNA viral load (VL) suppression. However, the possible role of harm reduction-based programmes in this objective has not yet been well evaluated. The objective of the study was to examine the relationship between being a client of the Dr. Peter Centre (DPC; an HIV/AIDS-focused adult integrated health programme) and VL suppression among highly active antiretroviral therapy (HAART)-exposed HIV-positive people who use illicit drugs (PWUD) in Vancouver, Canada...
March 19, 2017: HIV Medicine
https://www.readbyqxmd.com/read/28317139/mortality-after-inpatient-treatment-for-severe-pneumonia-in-children-a-cohort-study
#18
Moses M Ngari, Greg Fegan, Martha K Mwangome, Mwanajuma J Ngama, Neema Mturi, John Anthony Gerard Scott, Evasius Bauni, David James Nokes, James A Berkley
BACKGROUND: Although pneumonia is a leading cause of inpatient mortality, deaths may also occur after discharge from hospital. However, prior studies have been small, in selected groups or did not fully evaluate risk factors, particularly malnutrition and HIV. We determined 1-year post-discharge mortality and risk factors among children diagnosed with severe pneumonia. METHODS: A cohort study of children aged 1-59 months admitted to Kilifi County Hospital with severe pneumonia (2007-12)...
March 20, 2017: Paediatric and Perinatal Epidemiology
https://www.readbyqxmd.com/read/28314381/dysregulation-of-alveolar-macrophage-ppar%C3%AE-nadph-oxidases-and-tgf%C3%AE-sub-1-sub-in-otherwise-healthy-hiv-infected-individuals
#19
Samantha M Yeligar, Janine M Ward, Frank L Harris, Lou Ann Brown, David Guidot, Sushma K Cribbs
<u>Rationale:</u> Despite antiretroviral therapy (ART), respiratory infections increase mortality in individuals living with chronic human immunodeficiency virus (HIV) infection. In experimental and clinical studies of chronic HIV infection, alveolar macrophages (AMs) exhibit impaired phagocytosis and bacterial clearance. Peroxisome proliferator-activated receptor (PPAR)γ, NADPH oxidase (Nox) isoforms Nox1, Nox2, Nox4, and transforming growth factor-beta 1 (TGFβ<sub>1</sub>) are critical mediators of AM oxidative stress and phagocytic dysfunction...
March 17, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28306597/diagnosis-of-viral-hepatitis
#20
Philippa J Easterbrook, Teri Roberts, Anita Sands, Rosanna Peeling
PURPOSE OF REVIEW: Chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections and HIV-HBV and HCV coinfection are major causes of chronic liver disease worldwide. Testing and diagnosis is the gateway for access to both treatment and prevention services, but there remains a large burden of undiagnosed infection globally. We review the global epidemiology, key challenges in the current hepatitis testing response, new tools to support the hepatitis global response (2016-2020 Global Hepatitis Health Sector strategy, and 2017 WHO guidelines on hepatitis testing and their key recommendations) and future directions and innovations in hepatitis diagnostics...
March 16, 2017: Current Opinion in HIV and AIDS
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