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https://www.readbyqxmd.com/read/29150377/urgent-versus-post-stabilisation-antiretroviral-treatment-in-hospitalised-hiv-infected-children-in-kenya-push-a-randomised-controlled-trial
#1
Irene N Njuguna, Lisa M Cranmer, Vincent O Otieno, Cyrus Mugo, Hellen M Okinyi, Sarah Benki-Nugent, Barbra Richardson, Joshua Stern, Elizabeth Maleche-Obimbo, Dalton C Wamalwa, Grace C John-Stewart
BACKGROUND: Urgent antiretroviral therapy (ART) among hospitalised HIV-infected children might accelerate recovery or worsen outcomes associated with immune reconstitution. We aimed to compare urgent versus post-stabilisation ART among hospitalised HIV-infected children in Kenya. METHODS: In this unmasked randomised controlled trial, we randomly assigned (1:1) HIV-infected, ART-naive children aged 0-12 years who were eligible for treatment to receive ART within 48 h (urgent group) or in 7-14 days (post-stabilisation group) at four hospitals in Kenya (two in Nairobi and two in western Kenya)...
November 14, 2017: Lancet HIV
https://www.readbyqxmd.com/read/29149263/vitamin-d-and-assisted-reproductive-treatment-outcome-a-systematic-review-and-meta-analysis
#2
Justin Chu, Ioannis Gallos, Aurelio Tobias, Bee Tan, Abey Eapen, Arri Coomarasamy
STUDY QUESTION: Is serum vitamin D associated with live birth rates in women undergoing ART? SUMMARY ANSWER: Women undergoing ART who are replete in vitamin D have a higher live birth rate than women who are vitamin D deficient or insufficient. WHAT IS KNOWN ALREADY: Vitamin D deficiency has been associated with an increased risk of abnormal pregnancy implantation as well as obstetric complications such as pre-eclampsia and fetal growth restriction...
November 15, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29143099/-left-atrial-appendage-clusure-in-nonvalvular-atrial-fibrillation-clinical-evidence-2017
#3
REVIEW
Steffen Gloekler, Bajram Hajredini, Simon Rycerz, Sebastian Jäckle, Werner Jung
Nonvalvular atrial fibrillation (AF) is the most common arrhythmia with a prevalence of 1-2% and affects approximately 15-20% of all octogenarians. Patients are at increased risk of thromboembolic stroke, with an overall risk of 5% per year. Thrombi form almost exclusively in the left atrial appendage (LAA), a blind sac-like heterogeneous structure trabeculated by pectinate muscles. In the past five decades, life-long oral anticoagulation (OAC) with vitamin K antagonists (VKA) has been the state-of-the art treatment to prevent stroke and systemic embolism from thrombi in AF...
November 15, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29142136/size-composition-and-evolution-of-hiv-dna-populations-during-early-antiretroviral-therapy-and-intensification-with-maraviroc
#4
Antoine Chaillon, Sara Gianella, Steven M Lada, Josué Perez-Santiago, Parris Jordan, Caroline Ignacio, Maile Karris, Douglas Richman, Sanjay R Mehta, Susan J Little, Joel O Wertheim, Davey M Smith
Residual viremia is common during antiretroviral therapy (ART), and could be caused by ongoing low-level virus replication or by release of viral particles from infected cells. ART Intensification should impact ongoing viral propagation but not virion release. Eighteen acutely infected men were enrolled in a randomized controlled trial, and followed for a median of 107 weeks. Participants started ART with (n=9) or without (n=9) intensification with maraviroc (MVC) within 90 days of infection. Levels of HIV DNA and cell-free RNA were quantified by droplet digital PCR...
November 15, 2017: Journal of Virology
https://www.readbyqxmd.com/read/29141712/clinical-outcomes-during-treatment-interruptions-in-human-immunodeficiency-virus-hepatitis-b-virus-co-infected-patients-from-sub-saharan-africa
#5
Anders Boyd, Laura Houghtaling, Raoul Moh, Mariama Abdou Chekaraou, Delphine Gabillard, Serge Paul Eholié, Xavier Anglaret, Fabien Zoulim, Christine Danel, Karine Lacombe, For The Anrs Trivacan And Anrs VarBVA Studies
Antiretroviral treatment (ART) interruptions increase the risk of severe morbidity/mortality in human immunodeficiency virus (HIV)-infected individuals from subSaharan Africa. We aimed to determine whether the risk is further increased among HIV-hepatitis B virus (HBV) co-infected patients in this setting. In this sub-analysis of a randomized-control trial, 632 participants from Côte d'Ivoire randomized to receive continuous-ART (C-ART), structured ART interruptions of 2-months off, 4-months on (2/4-ART), and CD4-guided ART interruptions (CD4GT, interruption at 350/mm(3) and reintroduction at 250/mm(3)) were analyzed...
October 30, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29138199/electrosclerotherapy-for-capillary-malformations-study-protocol-for-a-randomised-within-patient-controlled-pilot-trial
#6
Sophie E R Horbach, Albert Wolkerstorfer, Daniel Martijn de Bruin, Chantal M A M van der Horst
INTRODUCTION: The current state-of-the-art treatment modality for hypertrophic capillary malformations (CMs), laser therapy, has a considerable rate of non-responders and recurrence. Intralesional bleomycin injections (or 'sclerotherapy') are commonly used to treat venous and lymphatic malformations with an excellent effect, but these intravascular injections are not possible in CMs due to the small diameter of the vessels. Electroporation-an electric field applied to the tissue-could increase the permeability of endothelial cells, which could theoretically facilitate targeted localised bleomycin delivery...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29137174/hdomo-smart-sensor-integration-for-an-active-and-independent-longevity-of-the-elderly
#7
Emanuele Frontoni, Rama Pollini, Paola Russo, Primo Zingaretti, Graziano Cerri
The aim of this paper is to present the main results of HDOMO, an Ambient Assisted Living (AAL) project that involved 16 Small and Medium Enterprises (SMEs) and 2 research institutes. The objective of the project was to create an autonomous and automated domestic environment, primarily for elderly people and people with physical and motor disabilities. A known and familiar environment should help users in their daily activities and it should act as a virtual caregiver by calling, if necessary, relief efforts...
November 13, 2017: Sensors
https://www.readbyqxmd.com/read/29136117/cost-effectiveness-of-community-based-hiv-self-testing-in-blantyre-malawi
#8
Hendramoorthy Maheswaran, Aileen Clarke, Peter MacPherson, Felistas Kumwenda, David G Lalloo, Elizabeth L Corbett, Stavros Petrou
Background: HIV self-testing (HIVST) is effective, with scale-up underway in sub-Saharan Africa. We assessed cost-effectiveness of adding HIVST to existing facility-based HIV testing and counselling (HTC) services. Both 2010 (initiate at CD4<350 cells/μl) and 2015 (initiate all) WHO guidelines for antiretroviral treatment (ART) were considered. Methods: A microsimulation model was developed that evaluated cost-effectiveness, from both health provider and societal perspectives, of an HIVST service implemented in a cluster-randomised trial (CRT) (ISRCTN02004005) in Malawi...
November 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29136032/virological-response-and-resistance-among-hiv-infected-children-receiving-long-term-antiretroviral-therapy-without-virological-monitoring-in-uganda-and-zimbabwe-observational-analyses-within-the-randomised-arrow-trial
#9
Alexander J Szubert, Andrew J Prendergast, Moira J Spyer, Victor Musiime, Philippa Musoke, Mutsa Bwakura-Dangarembizi, Patricia Nahirya-Ntege, Margaret J Thomason, Emmanuel Ndashimye, Immaculate Nkanya, Oscar Senfuma, Boniface Mudenge, Nigel Klein, Diana M Gibb, A Sarah Walker
BACKGROUND: Although WHO recommends viral load (VL) monitoring for those on antiretroviral therapy (ART), availability in low-income countries remains limited. We investigated long-term VL and resistance in HIV-infected children managed without real-time VL monitoring. METHODS AND FINDINGS: In the ARROW factorial trial, 1,206 children initiating ART in Uganda and Zimbabwe between 15 March 2007 and 18 November 2008, aged a median 6 years old, with median CD4% of 12%, were randomised to monitoring with or without 12-weekly CD4 counts and to receive 2 nucleoside reverse transcriptase inhibitors (2NRTI, mainly abacavir+lamivudine) with a non-nucleoside reverse transcriptase inhibitor (NNRTI) or 3 NRTIs as long-term ART...
November 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29136001/a-combination-intervention-strategy-to-improve-linkage-to-and-retention-in-hiv-care-following-diagnosis-in-mozambique-a-cluster-randomized-study
#10
Batya Elul, Matthew R Lamb, Maria Lahuerta, Fatima Abacassamo, Laurence Ahoua, Stephanie A Kujawski, Maria Tomo, Ilesh Jani
BACKGROUND: Concerning gaps in the HIV care continuum compromise individual and population health. We evaluated a combination intervention strategy (CIS) targeting prevalent barriers to timely linkage and sustained retention in HIV care in Mozambique. METHODS AND FINDINGS: In this cluster-randomized trial, 10 primary health facilities in the city of Maputo and Inhambane Province were randomly assigned to provide the CIS or the standard of care (SOC). The CIS included point-of-care CD4 testing at the time of diagnosis, accelerated ART initiation, and short message service (SMS) health messages and appointment reminders...
November 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29135584/concomitant-medication-polypharmacy-interactions-and-imperfect-adherence-are-common-in-australian-adults-on-suppressive-art
#11
Krista J Siefried, Limin Mao, Lucette A Cysique, John Rule, Michelle L Giles, Don E Smith, James Mcmahon, Tim R Read, Catriona Ooi, Ban K Tee, Mark Bloch, John de Wit, Andrew Carr
OBJECTIVES: We quantified concomitant medication (CM) polypharmacy, pharmacokinetic (PK) and pharmacodynamic (PD) interactions, adverse effects and adherence in Australian adults on effective ART. DESIGN: Cross-sectional. METHODS: Patients recruited into a nation-wide cohort and assessed for prevalence and type of CM (including polypharmacy, defined as ≥5 CMs), PK or PD interactions, potential CM adverse effects and CM adherence. Factors associated with CM polypharmacy and with imperfect adherence were identified using multivariable logistic regression...
November 10, 2017: AIDS
https://www.readbyqxmd.com/read/29135576/assisted-partner-notification-services-are-cost-effective-for-decreasing-hiv-burden-in-western-kenya-a-mathematical-modeling-analysis
#12
Monisha Sharma, Jennifer A Smith, Carey Farquhar, Roger Ying, Peter Cherutich, Matthew Golden, Beatrice Wamuti, David Bukusi, Hans Spiegel, Ruanne V Barnabas
BACKGROUND: Assisted partner services (aPS) or provider notification for sexual partners of persons diagnosed HIV-positive can increase HIV testing and linkage in sub-Saharan Africa (SSA) and is a high yield strategy to identify HIV-positive persons. However, its cost-effectiveness is not well-evaluated. METHODS: Using effectiveness and cost data from an aPS trial in Kenya, we parameterized an individual-based, dynamic HIV transmission model. We estimated costs for both a program scenario and a task-shifting scenario using community health workers to conduct the intervention...
November 10, 2017: AIDS
https://www.readbyqxmd.com/read/29133325/minimally-invasive-surgery-versus-open-surgery-in-the-treatment-of-lumbar-spondylolisthesis-study-protocol-of-a-multicentre-randomised-controlled-trial-misos-trial
#13
Mark P Arts, Jasper Fc Wolfs, Jos Ma Kuijlen, Godard Cw de Ruiter
INTRODUCTION: Patients with symptomatic spondylolisthesis are frequently treated with nerve root decompression, in addition to pedicle screw fixation and interbody fusion. Minimally invasive approaches are gaining attention in recent years, although there is no clear evidence supporting the proclamation of minimally invasive spine surgery (MISS) being better than open surgery. We present the design of the MISOS (Minimal Invasive Surgery versus Open Surgery) trial on the effectiveness of MISS versus open surgery in patients with degenerative or spondylolytic spondylolisthesis...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29132916/insulin-degrading-enzyme-in-the-fight-against-alzheimer-s-disease
#14
REVIEW
Igor V Kurochkin, Enrico Guarnera, Igor N Berezovsky
After decades of research and clinical trials there is still no cure for Alzheimer's disease (AD). While impaired clearance of amyloid beta (Aβ) peptides is considered as one of the major causes of AD, it was recently complemented by a potential role of other toxic amyloidogenic species. Insulin-degrading enzyme (IDE) is the proteolytic culprit of various β-forming peptides, both extracellular and intracellular. On the basis of demonstrated allosteric activation of IDE against Aβ, it is possible to propose a new strategy for the targeted IDE-based cleansing of different toxic aggregation-prone peptides...
November 10, 2017: Trends in Pharmacological Sciences
https://www.readbyqxmd.com/read/29132380/addressing-challenges-in-scaling-up-tb-and-hiv-treatment-integration-in-rural-primary-healthcare-clinics-in-south-africa-suthi-a-cluster-randomized-controlled-trial-protocol
#15
Kogieleum Naidoo, Santhanalakshmi Gengiah, Nonhlanhla Yende-Zuma, Nesri Padayatchi, Pierre Barker, Andrew Nunn, Priashni Subrayen, Salim S Abdool Karim
BACKGROUND: A large and compelling clinical evidence base has shown that integrated TB and HIV services leads to reduction in human immunodeficiency virus (HIV)- and tuberculosis (TB)-associated mortality and morbidity. Despite official policies and guidelines recommending TB and HIV care integration, its poor implementation has resulted in TB and HIV remaining the commonest causes of death in several countries in sub-Saharan Africa, including South Africa. This study aims to reduce mortality due to TB-HIV co-infection through a quality improvement strategy for scaling up of TB and HIV treatment integration in rural primary healthcare clinics in South Africa...
November 13, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29132279/-i-will-take-arvs-once-my-body-deteriorates-an-analysis-of-swazi-men-s-perceptions-and-acceptability-of-test-and-start
#16
Alfred K Adams, Agostino M Zamberia
Swaziland has the highest HIV prevalence in the world. To mitigate the spread and devastation caused by HIV and to improve the wellbeing of people living with HIV, the country has adopted the latest available HIV prevention campaigns, including "Test and Start". Because evidence from randomised controlled trials has demonstrated a significant risk reduction in HIV transmission when HIV-positive people start antiretroviral therapy (ART) early, Swaziland aims to find these people and link them to treatment. This study presents findings regarding the perceptions of this promising HIV-prevention intervention among men aged 17-69 years...
December 2017: African Journal of AIDS Research: AJAR
https://www.readbyqxmd.com/read/29130452/augmenting-intracortical-brain-machine-interface-with-neurally-driven-error-detectors
#17
Nir Even-Chen, Sergey D Stavisky, Jonathan C Kao, Stephen I Ryu, Krishna V Shenoy
OBJECTIVE: Making mistakes is inevitable, but identifying them allows us to correct or adapt our behavior to improve future performance. Current brain-machine interfaces (BMIs) make errors that need to be explicitly corrected by the user, thereby consuming time and thus hindering performance. We hypothesized that neural correlates of the user perceiving the mistake could be used by the BMI to automatically correct errors. However, it was unknown whether intracortical outcome error signals were present in the premotor and primary motor cortices, brain regions successfully used for intracortical BMIs...
November 13, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/29124676/cost-effectiveness-analysis-of-the-gonadotropin-treatments-hp-hmg-and-rfsh-for-assisted-reproductive-technology-in-france-a-markov-model-analysis
#18
Paul Barriere, Géraldine Porcu-Buisson, Samir Hamamah
OBJECTIVES: The objectives of this study were to assess (1) the expected cost of a live birth (LB) after in vitro fertilization with two different gonadotropin treatments [high purified human menopausal gonadotropin (HP-hMG) and recombinant follicle-stimulating hormone (rFSH)] as the single cost variable, and (2) the cost effectiveness of HP-hMG relative to rFSH in the context of the routine practice of assisted reproductive technology (ART) in France. METHODS: A Markov model was developed to simulate the therapeutic management, the in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) courses, and the effects of complications in hypothetical cohorts of 30,000 patients undergoing IVF/ICSI with fresh embryo transfer (up to four attempts) using data from the MERIT and MEGASET clinical trials or from French routine ART practice...
November 9, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/29122843/multiorgan-multimodality-imaging-in-cardiometabolic-disease
#19
Vidhya Kumar, Willa A Hsueh, Subha V Raman
Cardiometabolic disease, spanning conditions such as obesity to type 2 diabetes mellitus with excess cardiovascular risk, represents a major public health burden. Advances in preclinical translational science point to potential targets across multiple organ systems for early intervention to improve cardiometabolic health. Validation in clinical trials and translation to care would benefit from in vivo diagnostic techniques that facilitate therapeutic advancements. This review provides a state-of-the-art, multimodality perspective spanning the multiple organ systems that contribute to cardiometabolic disease...
November 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29119934/direct-acting-antivirals-for-hiv-hcv-co-infected-individuals-as-good-as-it-gets
#20
Giuseppe Bruno, Annalisa Saracino
Although HIV/HCV co-infected individuals were historically considered a "difficult to treat" population in the era of Interferon (IFN)-based anti-HCV treatment, the introduction of direct-acting antivirals, characterized by excellent efficacy and good safety profile, has widely revolutionized the HCV treatment scenario. Recent real life studies reported excellent sustained virological response rates in HIV/HCV co-infected subjects, thus confirming data obtained in randomized clinical trials. However, certain issues have recently emerged in this population...
November 8, 2017: Current HIV Research
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