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Advanced practice HIV clinic

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https://www.readbyqxmd.com/read/28212116/developing-a-community-of-practice-for-hiv-care-supporting-knowledge-translation-in-a-regional-training-initiative
#1
Donna M Gallagher, Lisa R Hirschhorn, Laura S Lorenz, Priyatam Piya
INTRODUCTION: Ensuring knowledgeable, skilled HIV providers is challenged by rapid advances in the field, diversity of patients and providers, and the need to retain experienced providers while training new providers. These challenges highlight the need for education strategies, including training and clinical consultation to support translation of new knowledge to practice. New England AIDS Education and Training Center (NEAETC) provides a range of educational modalities including academic peer detailing and distance support to HIV providers in six states...
February 15, 2017: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/28133803/use-of-broadly-neutralizing-antibodies-for-hiv-1-prevention
#2
REVIEW
Amarendra Pegu, Ann J Hessell, John R Mascola, Nancy L Haigwood
Antibodies have a long history in antiviral therapy, but until recently, they have not been actively pursued for HIV-1 due to modest potency and breadth of early human monoclonal antibodies (MAbs) and perceived insurmountable technical, financial, and logistical hurdles. Recent advances in the identification and characterization of MAbs with the ability to potently neutralize diverse HIV-1 isolates have reinvigorated discussion and testing of these products in humans, since new broadly neutralizing MAbs (bnMAbs) are more likely to be effective against worldwide strains of HIV-1...
January 2017: Immunological Reviews
https://www.readbyqxmd.com/read/28126366/testing-for-zika-virus-infection-in-pregnancy-key-concepts-to-deal-with-an-emerging-epidemic
#3
REVIEW
Catherine Eppes, Martha Rac, James Dunn, James Versalovic, Kristy O Murray, Melissa A Suter, Magda Sanz Cortes, Jimmy Espinoza, Maxim D Seferovic, Wesley Lee, Peter Hotez, Joan Mastrobattista, Steven L Clark, Michael A Belfort, Kjersti M Aagaard
Zika virus is an emerging mosquito-borne (Aedes genus) arbovirus of the Flaviviridae family. Following epidemics in Micronesia and French Polynesia during the past decade, more recent Zika virus infection outbreaks were first reported in South America as early as May 2013 and spread to now 50 countries throughout the Americas. Although no other flavivirus has previously been known to cause major fetal malformations following perinatal infection, reports of a causal link between Zika virus and microcephaly, brain and ocular malformations, and fetal loss emerged from hard-hit regions of Brazil by October 2015...
January 23, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28125026/time-to-consider-moving-beyond-exclusive-breastfeeding-in-southern-africa
#4
Janet M Wojcicki
While there have been considerable advances in the reduction of mother to child transmission of HIV (MTCT) in sub-Saharan Africa with the advance of anti-retroviral therapies (ART), there remain challenges in the late postpartum period.  Structural issues including food insecurity and stigma make better maternal ART adherence and exclusive breastfeeding unreachable for some women. There are no other scientifically researched feeding options as there have been few studies on different types of mixed feeding practices and risk of HIV infection...
January 24, 2017: Children
https://www.readbyqxmd.com/read/27906733/routine-inpatient-human-immunodeficiency-virus-screening-missed-prevention-opportunities
#5
Daniel C Baker
PURPOSE/OBJECTIVES: This article reviews the current guidelines for human immunodeficiency virus (HIV) screening among inpatients and explores adherence to the guidelines and barriers to their implementation. BACKGROUND: In 2006, the Centers for Disease Control and Prevention released updated recommendations suggesting HIV screening for all patients in all healthcare settings. DESCRIPTION: A nonsystematic review of current HIV screening guidelines, as well as research and nonresearch literature, addressing rates of inpatient screening was performed...
January 2017: Clinical Nurse Specialist CNS
https://www.readbyqxmd.com/read/27712863/patients-perceptions-and-experiences-of-shared-decision-making-in-primary-hiv-care-clinics
#6
Shannon M Fuller, Kimberly A Koester, Ryan R Guinness, Wayne T Steward
Shared decision-making (SDM) is considered best practice in health care. Prior studies have explored attitudes and barriers/facilitators to SDM, with few specific to HIV care. We interviewed 53 patients in HIV primary care clinics in California to understand the factors and situations that may promote or hinder engagement in SDM. Studies in other populations have found that patients' knowledge about their diseases and their trust in providers facilitated SDM. We found these features to be more nuanced for HIV...
January 2017: Journal of the Association of Nurses in AIDS Care: JANAC
https://www.readbyqxmd.com/read/27649715/statistical-methods-for-down-selection-of-treatment-regimens-based-on-multiple-endpoints-with-application-to-hiv-vaccine-trials
#7
Ying Huang, Peter B Gilbert, Rong Fu, Holly Janes
SummaryBiomarker endpoints measuring vaccine-induced immune responses are essential to HIV vaccine development because of their potential to predict the effect of a vaccine in preventing HIV infection. A vaccine's immune response profile observed in phase I immunogenicity studies is a key factor in determining whether it is advanced for further study in phase II and III efficacy trials. The multiplicity of immune variables and scientific uncertainty in their relative importance, however, pose great challenges to the development of formal algorithms for selecting vaccines to study further...
September 20, 2016: Biostatistics
https://www.readbyqxmd.com/read/27271083/time-to-haart-initiation-after-diagnosis-and-treatment-of-opportunistic-infections-in-patients-with-aids-in-latin-america
#8
Brenda Crabtree-Ramírez, Yanink Caro-Vega, Bryan E Shepherd, Beatriz Grinsztejn, Marcelo Wolff, Claudia P Cortes, Denis Padgett, Gabriela Carriquiry, Valeria Fink, Karu Jayathilake, Anna K Person, Catherine McGowan, Juan Sierra-Madero
BACKGROUND: Since 2009, earlier initiation of highly active antiretroviral therapy (HAART) after an opportunistic infection (OI) has been recommended based on lower risks of death and AIDS-related progression found in clinical trials. Delay in HAART initiation after OIs may be an important barrier for successful outcomes in patients with advanced disease. Timing of HAART initiation after an OI in "real life" settings in Latin America has not been evaluated. METHODS: Patients in the Caribbean, Central and South America network for HIV Epidemiology (CCASAnet) ≥18 years of age at enrolment, from 2001-2012 who had an OI before HAART initiation were included...
2016: PloS One
https://www.readbyqxmd.com/read/27265053/a-comprehensive-identification-evidence-based-alternative-for-hiv-aids-treatment-with-haart-in-the-healthcare-industries
#9
You-Shyang Chen
BACKGROUND AND OBJECTIVE: The HIV/AIDS-related issue has given rise to a priority concern in which potential new therapies are increasingly highlighted to lessen the negative impact of highly active anti-retroviral therapy (HAART) in the healthcare industry. With the motivation of "medical applications," this study focuses on the main advanced feature selection techniques and classification approaches that reflect a new architecture, and a trial to build a hybrid model for interested parties...
July 2016: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/27240277/enfuvirtide-peg-conjugate-a-potent-hiv-fusion-inhibitor-with-improved-pharmacokinetic-properties
#10
Shuihong Cheng, Yan Wang, Zhenxing Zhang, Xun Lv, George F Gao, Yiming Shao, Liying Ma, Xuebing Li
Enfuvirtide (ENF) is a clinically used peptide drug for the treatment of HIV infections, but its poor pharmacokinetic profile (T1/2 = 1.5 h in rats) and low aqueous solubility make the therapy expensive and inconvenience. In this study, we present a simple and practical strategy to address these problems by conjugating ENF with polyethylene glycol (PEG). Site-specific attachment of a 2 kDa PEG at the N-terminus of ENF resulted in an ENF-PEG (EP) conjugate with high solubility (≥3 mg/mL) and long half-life in rats (T1/2 = 16...
October 4, 2016: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/27177151/clinical-outcomes-of-hiv-care-delivery-models-in-the-us-a-systematic-review
#11
April D Kimmel, Erika G Martin, Hadiza Galadima, Rose S Bono, Ali Bonakdar Tehrani, John W Cyrus, Margaret Henderson, Kenneth A Freedberg, Alexander H Krist
With over 1 million people living with HIV, the US faces national challenges in HIV care delivery due to an inadequate HIV specialist workforce and the increasing role of non-communicable chronic diseases in driving morbidity and mortality in HIV-infected patients. Alternative HIV care delivery models, which include substantial roles for advanced practitioners and/or coordination between specialty and primary care settings in managing HIV-infected patients, may address these needs. We aimed to systematically review the evidence on patient-level HIV-specific and primary care health outcomes for HIV-infected adults receiving outpatient care across HIV care delivery models...
October 2016: AIDS Care
https://www.readbyqxmd.com/read/27159224/implementation-and-operational-research-use-of-symptom-screening-and-sputum-microscopy-testing-for-active-tuberculosis-case-detection-among-hiv-infected-patients-in-real-world-clinical-practice-in-uganda
#12
Monika Roy, Winnie Muyindike, Tara Vijayan, Michael Kanyesigye, Mwebesa Bwana, Megan Wenger, Jeffrey Martin, Elvin Geng
BACKGROUND: The uptake of intensified active TB case-finding among HIV-infected patients using symptom screening is not well understood. We evaluated the rate and completeness of each interim step in the TB pulmonary "diagnostic cascade" to understand real-world barriers to active TB case detection. METHODS: We conducted a cohort analysis of new, antiretroviral therapy-naive, HIV-infected patients who attended a large HIV clinic in Mbarara, Uganda (March 1, 2012-September 30, 2013)...
August 15, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27150958/survival-functions-for-defining-a-clinical-management-lost-to-follow-up-ltfu-cut-off-in-antiretroviral-therapy-art-program-in-zomba-malawi
#13
Beth Rachlis, Donald C Cole, Monique van Lettow, Michael Escobar
BACKGROUND: While, lost to follow-up (LTFU) from antiretroviral therapy (ART) can be considered a catch-all category for patients who miss scheduled visits or medication pick-ups, operational definitions and methods for defining LTFU vary making comparisons across programs challenging. Using weekly cut-offs, we sought to determine the probability that an individual would return to clinic given that they had not yet returned in order to identify the LTFU cut-off that could be used to inform clinical management and tracing procedures...
2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27147691/hiv-and-orthopaedics-musculoskeletal-manifestations-and-outcomes
#14
REVIEW
Juan Pretell-Mazzini, Ty Subhawong, Victor H Hernandez, Rafael Campo
➤Advances in combined antiretroviral therapy (cART) in recent years have transformed HIV infection into a chronic disease when treatment is available, increasing a patient's life expectancy and the chances that orthopaedic surgeons will encounter such patients in their clinical practice.➤Musculoskeletal manifestations in patients with HIV infection are common and sometimes are the initial presentation of the disease. Knowledge about neoplasms and associated conditions affecting muscle, bones, and joints is essential for successful management...
May 4, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27114879/harm-reduction-interventions-in-hiv-care-a-qualitative-exploration-of-patient-and-provider-perspectives
#15
Suzanne Carlberg-Racich
Background. A culture of stringent drug policy, one-size-fits-all treatment approaches, and drug-related stigma has clouded clinical HIV practice in the United States. The result is a series of missed opportunities in the HIV care environment. An approach which may address the broken relationship between patient and provider is harm reduction-which removes judgment and operates at the patient's stage of readiness. Harm reduction is not a routine part of care; rather, it exists outside clinic walls, exacerbating the divide between compassionate, stigma-free services and the medical system...
2016: PeerJ
https://www.readbyqxmd.com/read/27086186/the-hiv-primary-care-workforce-of-tomorrow-the-ucsf-integrated-hiv-aids-primary-care-capacity-nurse-practitioner-program
#16
Carmen J Portillo, Suzan Stringari-Murray, Christopher B Fox, Erica Monasterio, Carol Dawson Rose
The increasing demand for primary care services and the current health care workforce shortage is predicted to cause drastic reductions in the number of clinicians who are competent to provide HIV care. For the past decade, the University of California, San Francisco (UCSF) School of Nursing has provided HIV specialty education for Advanced Practice Nursing students in the Master's curriculum. In 2013, UCSF was funded by the Health Resources Services Administration to establish a nurse practitioner (NP) HIV primary care education program to expand the number of NPs prepared to provide culturally appropriate comprehensive HIV primary care...
May 2016: Journal of the Association of Nurses in AIDS Care: JANAC
https://www.readbyqxmd.com/read/26966547/lower-response-to-simeprevir-and-sofosbuvir-in-hcv-genotype-1-in-routine-practice-compared-with-clinical-trials
#17
Brittany E Yee, Nghia H Nguyen, Minjuan Jin, Glen Lutchman, Joseph K Lim, Mindie H Nguyen
BACKGROUND: High sustained virological response at 12 weeks after end of treatment (SVR12) with 12 weeks of simeprevir and sofosbuvir±ribavirin (SMV+SOF±RBV) has been demonstrated in hepatitis C virus genotype 1 (HCV-1) but is based on limited data. Therefore, we performed a meta-analysis of available data evaluating the effectiveness of SMV+SOF±RBV in HCV-1. METHODS: We performed a comprehensive literature search in June 2015 to identify randomised controlled trials (RCTs) and observational studies of HCV-1 patients treated with 12 weeks of SMV+SOF±RBV...
2016: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/26944096/getting-into-the-brain-potential-of-nanotechnology-in-the-management-of-neuroaids
#18
REVIEW
Madhavan Nair, Rahul Dev Jayant, Ajeet Kaushik, Vidya Sagar
In spite of significant advances in antiretroviral (ARV) therapy, the elimination of human immunodeficiency virus (HIV) reservoirs from the periphery and the central nervous system (CNS) remains a formidable task. The incapability of ARV to go across the blood-brain barrier (BBB) after systemic administration makes the brain one of the dominant HIV reservoirs. Thus, screening, monitoring, and elimination of HIV reservoirs from the brain remain a clinically daunting and key task. The practice and investigation of nanomedicine possesses potentials for therapeutics against neuroAIDS...
August 1, 2016: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/26918160/harnessing-the-protective-potential-of-hiv-1-neutralizing-antibodies
#19
REVIEW
S Abigail Smith, Cynthia A Derdeyn
Recent biological, structural, and technical advances are converging within the HIV-1 vaccine field to harness the power of antibodies for prevention and therapy. Numerous monoclonal antibodies with broad neutralizing activity against diverse HIV-1 isolates have now been identified, revealing at least five sites of vulnerability on the envelope (Env) glycoproteins. While there are practical and technological barriers blocking a clear path from broadly neutralizing antibodies (bNAb) to a protective vaccine, this is not a dead end...
2016: F1000Research
https://www.readbyqxmd.com/read/26836803/the-road-to-success-long-term-prognosis-for-persons-living-with-hiv-in-denmark-time-trends-and-risk-factors
#20
REVIEW
Nicolai Lohse
The work on this thesis began in 2003 when the global HIV epidemic was out of control. A minority of persons with HIV were benefitting fully from the recently introduced highly efficacious antiretroviral therapy (ART) combinations. Among the global challenges were lack of access to good healthcare, drug toxicity, and emergence of drug-resistant virus. It was unknown how long the drugs could maintain their efficacy in the individual even if administered as intended, and there was a fear that the increased drug pressure would increase the prevalence of drug resistance, subsequently leading to transmission of resistant virus from one individual to another, and thereby waning the treatment options available...
February 2016: Danish Medical Journal
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