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Aid in dying

Enrique Bernal, Jose Miguel Gómez, Inma Jarrín, Alfredo Cano, Angeles Muñoz, Antonia Alcaraz, Arkaitz Imaz, Jose Antonio Iribarren, María Rivero, Piedad Arazo, Félix Gutiérrez, CoRIS Study Group
BACKGROUND: The objetive was investigate the long-term impact of low level viremia (LLV) on all-cause mortality, AIDS and non-AIDS events (NAEs), and virological failure in patients receiving ART. METHODS: We analyzed ART-naïve adults from the cohort of the Spanish AIDS Research Network (CoRIS) who initiated ART from 2004 to 2015 and achieved plasma viral load (VL) below 50 copies/ml. LLV50-199 was defined as two consecutive VL between 50 and 199 copies/ml, and LLV200-499 as two consecutive VL between 50 and 499 copies/ml with at least one between 200 and 499 copies/ml...
March 13, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Liqin Gao, Bin Yang, Hairong Zhang, Qishui Ou, Yulan Lin, Mei Zhang, Zhenhuan Zhang, Sunghee Kim, Bing Wu, Zeng Wang, Lengxi Fu, Jingan Lin, Ruiqing Chen, Ruilong Lan, Junying Chen, Wei Chen, Long Chen, Hengshan Zhang, Deping Han, Jingrong Chen, Paul Okunieff, Jianhua Lin, Lurong Zhang
Early diagnosis of sepsis is critical for successful treatment. The clinical value of DcR3 in early diagnosis of sepsis was determined in a dynamic follow-up study. Alterations in plasma levels of DcR3, PCT, CRP, and IL-6 were measured by ELISA and compared among patients with sepsis ( n = 134), SIRS ( n = 60) and normal adults ( n = 50). Correlations and dynamic patterns among the biomarkers, APACHE II scores, clinical outcomes, and pathogens were also examined. Plasma DcR3 was significantly increased in sepsis compared to SIRS and normal adults (median 3...
February 16, 2018: Oncotarget
Lester W M Chan, Antony W Gardner, Merng Koon Wong, Kenon Chua, Ernest B K Kwek
INTRODUCTION: Non-prosthetic peri-implant fractures (NPPIFs) are an under-reported entity. Management is challenging because of alterations in anatomy, the presence of orthopaedic implants and phenomena such as stress shielding, disuse osteopenia and fracture remodeling. The aims of this paper were to review patterns of injury, management and outcomes and to propose a classification system to aid further research. MATERIALS AND METHODS: This study is a multi-centered retrospective case series...
March 12, 2018: Archives of Orthopaedic and Trauma Surgery
Michael J Taunton, Robert T Trousdale, Rafael J Sierra, Ken Kaufman, Mark W Pagnano
BACKGROUND: The choice of surgical approach for THA remains controversial. Some studies suggest that the direct anterior approach (DAA) leads to less muscle damage than the miniposterior approach (MPA), but there is little high-quality evidence indicating whether this accelerates recovery, or whether this approach-which may be technically more demanding-is associated with component malposition or more complications. QUESTIONS/PURPOSES: (1) Does the DAA result in faster return to activities of daily living than the MPA? (2) Does the DAA have superior patient-reported outcome measures than the MPA? (3) Does the DAA result in improved radiographic outcomes than the MPA? (4) Does the DAA have a higher risk of complications than the MPA? METHODS: Between March 1, 2013, and May 31, 2016, 116 patients undergoing primary unilateral THA were randomized to either the DAA or MPA; 15 patients withdrew after randomization, and one died 6 months after surgery from a stroke unrelated to the procedure...
February 2018: Clinical Orthopaedics and related Research
Christopher Lund, Peter Guevara
Currently, there is no consensus on whether crowns fabricated via computer-aided design/computer-aided manufacturing (CAD/CAM) need to be replaced following an endodontic procedure. The aim of this in vitro study was to evaluate the effect of endodontic access preparation and repair on the failure load of lithium disilicate and resin nanoceramic crowns. The hypothesis was that there would be no difference in the failure load between the intact and repaired crowns. Eighty identical mandibular CAD/CAM crowns (40 lithium disilicate glass ceramic [IPS e...
March 2018: General Dentistry
Elizabeth Nalintya, David B Meya, Sarah Lofgren, Kathy Huppler Hullsiek, David R Boulware, Radha Rajasingham
BACKGROUND: Cryptococcus is a leading cause of AIDS-related mortality. Cryptococcal antigen (CrAg) is detectable in blood before meningitis onset, and predicts death. CrAg screening amongst those with advanced HIV, and treatment of those CrAg+ with fluconazole has demonstrated survival benefit. However, implementation and widespread uptake have been slow outside of clinical trials. METHODS: We designed a CrAg screening program for routine care that incorporated intensive education and training of clinic staff...
March 2, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Christie Hancock, Phillip Knouse, Imad Almanaseer, Jacob Bitran
BACKGROUND: Double-hit lymphomas (DHLs) are high-grade diffuse large B-cell lymphomas with concurrent translocations involving myc and bcl-2 and/or bcl-6. A patient with DHL often has advanced disease at presentation and typically responds poorly to standard therapy with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone). More intensive treatment regimens have been studied; however, few data are available on the outcomes in elderly patients (aged > 70 years) treated with these therapies...
February 15, 2018: Clinical Lymphoma, Myeloma & Leukemia
Bernadette N Ng'eno, Timothy A Kellogg, Andrea A Kim, Anne Mwangi, Mary Mwangi, Joyce Wamicwe, George W Rutherford
Understanding how HIV is acquired can inform interventions to prevent infection. We constructed a risk profile of 10-24 year olds participating in the 2012 Kenya AIDS Indicator Survey and classified them as perinatally infected if their biological mother was infected with HIV or had died, or if their father was infected with HIV or had died (for those lacking mother's data). The remaining were classified as sexually infected if they had sex, and the remaining as parenterally infected if they had a blood transfusion...
January 1, 2018: International Journal of STD & AIDS
Angelika Feichtner, Dietmar Weixler, Alois Birklbauer
In some cases terminally ill patients fear of prolonged dying and suffering can manifest itself in the voluntary refusal of food and fluids, aiming to accelerate the dying process. This represents a considerable area of conflict, because of the ethical responsibility to not aid a person's death but also to respect a patients autonomy.There is a clear separation between an assisted suicide and following a patient's wishes. Not to accept the voluntary refusal of FVNF would have to be considered as forced treatment of patients while they are capable of self-determination...
February 27, 2018: Wiener Medizinische Wochenschrift
Andreas D Haas, Elizabeth Zaniewski, Nanina Anderegg, Nathan Ford, Matthew P Fox, Michael Vinikoor, François Dabis, Denis Nash, Jean d'Amour Sinayobye, Thêodore Niyongabo, Aristophane Tanon, Armel Poda, Adebola A Adedimeji, Andrew Edmonds, Mary-Ann Davies, Matthias Egger
INTRODUCTION: By 2020, 90% of all people diagnosed with HIV should receive long-term combination antiretroviral therapy (ART). In sub-Saharan Africa, this target is threatened by loss to follow-up in ART programmes. The proportion of people retained on ART long-term cannot be easily determined, because individuals classified as lost to follow-up, may have self-transferred to another HIV treatment programme, or may have died. We describe retention on ART in sub-Saharan Africa, first based on observed data as recorded in the clinic databases, and second adjusted for undocumented deaths and self-transfers...
February 2018: Journal of the International AIDS Society
Marie-Christine Guilbert, Elisabeth P Frost, Jane E Brock, Susan C Lester
Papillary endothelial hyperplasia (PEH) is a rare non-neoplastic exuberant organizing hematoma that can closely mimic angiosarcoma due to a resemblance to malignant anastomosing blood vessels. It could be particularly difficult to distinguish PEH from angiosarcoma in breast core needle biopsies. We identified all cases of these lesions diagnosed on core needle biopsy in order to identify clinical, radiologic, and pathologic features that could prove helpful to arrive at the correct diagnosis. Four cases of PEH and 4 cases of angiosarcoma were identified...
February 24, 2018: Breast Journal
Charlotte Probst, Charles D H Parry, Jürgen Rehm
OBJECTIVES: To quantify HIV/AIDS mortality attributable to alcohol use in the adult general population of South Africa in 2012 by socioeconomic status (SES). DESIGN: Comparative risk assessment based on secondary individual data, aggregate data and risk relations reported in the literature. SETTING: South African adult general population. PARTICIPANTS: For metrics of alcohol use by SES, sex and age: 27 070 adults that participated in a nationally representative survey in 2012...
February 21, 2018: BMJ Open
Laura M Funk, Sheryl Peters, Kerstin Stieber Roger
The importance of emotional support for dying persons and their families has been well established, yet we know less about how care workers understand emotional processes related to death and dying, or how these understandings are connected to care practices and emotional labour at the end of life. The aim of this study was to explore how healthcare workers interpret and respond to emotional needs of dying persons and their families. Qualitative data were collected between 2013 and 2014 through in-depth, in-person interviews with 14 nurses and 12 healthcare aides in one Western Canadian city...
February 20, 2018: Health & Social Care in the Community
L Ottria, D Lauritano, L Oberti, V Candotto, F Cura, A Tagliabue, L Tettamanti
HIV infection is one of the major health problem of the last decades. This disease causes a chronic infection that can lead to acquired immunodeficiency syndrome (AIDS). According to the Global AIDS update, released in 2016 by HIV department of World Health Organization (WHO) and by the Joint United Nations Program on HIV/AIDS (UNAIDS), at the end of 2015, 36.7 million people were infected by HIV: 34.9 million of these were adults and 1.8 million were children under 15 years of age. The same report shows that during 2015, 2...
January 2018: Journal of Biological Regulators and Homeostatic Agents
Qi-Cai Sun, Xuan-Liang Ru, Yan-Fei Xia, Xiao-Li Liu, Bai-Shan Song, Song Qiao, Shi-Gui Yan, Xiang-Hua Wang
OBJECTIVE: To explore clinical efficacy of hip replacement for hip-joint diseases with Parkinson disease. METHODS: From December 2011 to December 2016, 18 patients with hip-joint diseases with Parkinson disease treated by hip replacement, including 8 males and 10 females aged from 59 to 87 years old with an average of 71 years old. Among them, 3 cases were developmental dysplasia of hip, 3 cases were femoral head necrosis and 12 cases were femoral neck fracture...
December 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Jerome T Galea, Milagros Wong, Maribel Muñoz, Emiliano Valle, Segundo R Leon, Dayana Díaz Perez, Lenka Kolevic, Molly Franke
AIDS deaths among adolescents are increasing globally. This qualitative study investigated the barriers and facilitators to cART adherence among Peruvian adolescents living with HIV. Guided by a social ecological model, we analyzed transcripts from 24 psychosocial support groups for HIV-positive adolescents aged 13-17 years and 15 individual, in-depth interviews with cART providers and caregivers to identify the barriers and facilitators to cART adherence at the individual, family/caregiver and hospital levels...
2018: PloS One
Jennifer M Boggs, Arne Beck, Sam Hubley, Edward L Peterson, Yong Hu, L Keoki Williams, Deepak Prabhakar, Rebecca C Rossom, Frances L Lynch, Christine Y Lu, Beth E Waitzfelder, Ashli A Owen-Smith, Gregory E Simon, Brian K Ahmedani
OBJECTIVE: Mitigation of suicide risk by reducing access to lethal means, such as firearms and potentially lethal medications, is a highly recommended practice. To better understand groups of patients at risk of suicide in medical settings, the authors compared demographic and clinical risk factors between patients who died by suicide by using firearms or other means with matched patients who did not die by suicide (control group). METHODS: In a case-control study in 2016 from eight health care systems within the Mental Health Research Network, 2,674 suicide cases from 2010-2013 were matched to a control group (N=267,400)...
February 15, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
Tae Hyun Jung, Tassos Kyriakides, Mark Holodniy, Denise Esserman, Peter Peduzzi
OBJECTIVES: To investigate the association between recurrent AIDS-defining events and a semi-competing risk of death in patients with advanced, multi-drug resistant HIV infection and to identify individuals at increased risk for these events using a joint frailty model. STUDY DESIGN AND SETTING: 368 patients with antiretroviral treatment failure in the OPTIMA Trial randomized to two antiretroviral treatment strategies using a 2x2 factorial design, intensive vs. standard and interruption vs...
February 9, 2018: Journal of Clinical Epidemiology
Ugra Mohan Jha, Neeraj Dhingra, Yujwal Raj Jones, Bharat Bhusan Rewari, L Jeyaseelan, Pauline Harvey, Laxmikant Chavan, Niranjan Saggurti, D C S Reddy
OBJECTIVE: To assess the survival probability and associated factors among children living with human immunodeficiency virus (CLHIV) receiving antiretroviral therapy (ART) in India. METHODS: The data on 5874 children (55% boys) from one of the high HIV burden states of India from the cohort were analyzed. Data were extracted from the computerized management information system of the National AIDS Control Organization (NACO). Children were eligible for inclusion if they had started ART during 2007-2013, and had at least one potential follow-up...
February 9, 2018: Indian Pediatrics
Bora Lee, Kyung Chul Oh, Daewon Haam, Joon-Hee Lee, Hong-Seok Moon
STATEMENT OF PROBLEM: Intraoral scanners are effective for direct digital impression when dental restorations are fabricated using computer-aided design and computer-aided manufacturing (CAD-CAM); however, if the abutment tooth cannot be dried completely or the prepared margin is placed subgingivally, accurate digital images cannot always be guaranteed. PURPOSE: The purpose of this in vitro study was to compare the internal and marginal discrepancies of zirconia copings fabricated directly using an intraoral scanner with those fabricated indirectly with impression scanning...
February 7, 2018: Journal of Prosthetic Dentistry
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