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Geoffrey Fatti, Ashraf Grimwood, Jean B Nachega, Jenna A Nelson, Kelsea LaSorda, Gert van Zyl, Nelis Grobbelaar, Helen Ayles, Richard Hayes, Nulda Beyers, Sarah Fidler, Peter Bock
BACKGROUND: There have been concerns about reduced adherence and HIV virological suppression (VS) amongst clinically well people living with HIV initiating antiretroviral treatment (ART) with high pre-ART CD4 cell counts. We compared virological outcomes by pre-ART CD4 count, where universal ART initiation was provided in the HPTN 071 (PopART) trial in South Africa prior to routine national and international implementation. METHODS: This prospective cohort study included adults initiating ART at facilities providing ART irrespective of CD4 count since January 2014...
March 16, 2019: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Rudy S Suidan, Weiguo He, Charlotte C Sun, Hui Zhao, Grace L Smith, Ann H Klopp, Nicole D Fleming, Karen H Lu, Sharon H Giordano, Larissa A Meyer
OBJECTIVE: To assess treatment patterns, outcomes, and costs for women with low-(LIR) and high-intermediate risk endometrial cancer (HIR) who are treated with and without adjuvant radiotherapy. METHODS: All patients with stage I endometrioid endometrial cancer who underwent surgery from 2000 to 2011 were identified from the SEER-Medicare database. LIR was defined as G1-2 tumors with <50% myometrial invasion or G3 with no invasion. HIR was defined as G1-2 tumors with ≥50% or G3 with <50% invasion...
March 2019: Gynecologic Oncology
Heather Wasik, Cozumel Pruette, Rebecca Ruebner, Mara McAdams-DeMarco, Sheng Zhou, Alicia Neu, Dorry Segev, Allan Massie
Pediatric kidney transplant (KT) candidates often have multiple potential living donors (LD); no evidence-based tool exists to compare potential LD, or to decide between marginal LD vs deceased donor (DD) kidney transplantation (KT). We developed a pediatric living kidney donor profile index (P-LKDPI) on the same scale as the DD KDPI by using Cox regression to model the risk of all-cause graft loss as a function of living donor characteristics and DD KDPI. HLA-B mismatch (aHR per mismatch=1.04 1.271.55 ), HLA-DR mismatch (aHR per mismatch=1...
March 15, 2019: American Journal of Transplantation
Angela Russolillo, Akm Moniruzzaman, Julian M Somers
Importance: People with criminal histories experience high rates of opioid dependence and are frequent users of acute health care services. It is unclear whether methadone adherence prevents hospitalizations. Objective: To compare hospital admissions during medicated and nonmedicated methadone periods. Design, Setting, and Participants: A retrospective cohort study involving linked population-level administrative data among individuals in British Columbia, Canada, with provincial justice contacts (n= 250 884) and who filled a methadone prescription between April 1, 2001, and March 31, 2015...
March 1, 2019: JAMA Network Open
Seulggie Choi, Kyuwoong Kim, Jooyoung Chang, Sung Min Kim, Seon Jip Kim, Hyun-Jae Cho, Sang Min Park
OBJECTIVES: Although chronic periodontitis has been associated with Alzheimer's disease, the effect of chronic periodontitis on vascular dementia as well as the role of lifestyle behaviors such as smoking, alcohol consumption, and physical activity in this association are still unclear. DESIGN: Retrospective cohort study. SETTING: Population based. PARTICIPANTS: The study population was derived from the Korean National Health Insurance Service-Health Screening Cohort...
March 15, 2019: Journal of the American Geriatrics Society
Francisco Leyva, Abbasin Zegard, Robin Taylor, Paul W X Foley, Fraz Umar, Kiran Patel, Jonathan Panting, Charles J Ferro, Shajil Chalil, Howard Marshall, Tian Qiu
BACKGROUND AND AIMS: Patients with moderate-to-severe chronic kidney disease (CKD) are underepresented in clinical trials of cardiac resynchronization therapy (CRT)-defibrillation or CRT-pacing (CRT-P). We sought to determine whether outcomes after CRT-D are better than after CRT-P over a wide spectrum of CKD. METHODS AND RESULTS: Clinical events were quantified in relation to pre-implant estimated glomerular filtration rate (eGFR) after CRT-D (n = 410 [39.2%]) or CRT-P (n = 636 [60...
March 15, 2019: Pacing and Clinical Electrophysiology: PACE
Chih-Cheng Chang, Kuo-How Huang, Sung-Po Hsu, Yuan-Chii G Lee, Yuh-Mou Sue, Shu-Hui Juan
The therapeutic effects of simvastatin for renal cell carcinoma (RCC) are controversial. In this study, the effects of simvastatin on the carcinogenic properties of 3-methylcholanthrene (3MC; an aryl-hydrocarbon receptor [AhR] agonist) in human renal epithelial cells (hRECs) were investigated. We exposed in vitro and in vivo models to 3MC to induce RCC onset. 3MC upregulated the epithelial-mesenchymal transition (EMT) and tumor biomarkers; the models exhibited the reciprocal expression of histone deacetylase 1 (HDAC1) and RhoA, namely increased HDAC1 and decreased RhoA expression, through hypoxia-inducible-factor (HIF)- and AhR-dependent mechanisms...
March 14, 2019: Scientific Reports
Charlotte Slagelse, Henrik Gammelager, Lene Hjerrild Iversen, Henrik Toft Sørensen, Christian F Christiansen
OBJECTIVES: Acute kidney injury (AKI) is a frequent postoperative complication, but the mortality impact within different postoperative time frames and severities of AKI are poorly understood. We examined the occurrence of postoperative AKI among colorectal cancer (CRC) surgery patients and the impact of AKI on mortality during 1 year after surgery. DESIGN: Observational cohort study. We defined the exposure, AKI, as a 50% increase in plasma creatinine or initiation of renal replacement therapy within 7 days after surgery or an absolute increase in creatinine of 26 µmol/L within 48 hours...
March 13, 2019: BMJ Open
N T T Kyaw, A M V Kumar, K W Y Kyaw, S Satyanarayana, M J Magee, A C Min, J Moe, Z Z Aung, T K Aung, M M Oo, K T Soe, H N Oo, S T Aung, A D Harries
SETTING: Myanmar, a country with a high human immunodeficiency virus-tuberculosis (HIV-TB) burden, where the tuberculin skin test or interferon-gamma release assays are not routinely available for the diagnosis of latent tuberculous infection. OBJECTIVE: To assess the effect of isoniazid (INH) preventive therapy (IPT) on the risk of TB disease and mortality among people living with HIV (PLHIV). DESIGN: A retrospective cohort study of routinely collected data on PLHIV enrolled into care between 2009 and 2014...
March 1, 2019: International Journal of Tuberculosis and Lung Disease
Min-Yu Lai, Wei-Chih Kan, Ya-Ting Huang, John Chen, Chih-Chung Shiao
Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) is an excellent prognostic⁻predictive tool in heart failure (HF) patients, but its plasma level changes following therapy. The comparison of prognosis⁻predictivity of a single measurement of plasma NT-pro BNP in different follow-up periods in acute HF patients has been less studied. This study aimed to evaluate whether the association between initial plasma NT-proBNP levels and all-cause mortality would decrease along with an increased follow-up period in patients with acute HF...
March 13, 2019: Journal of Clinical Medicine
Righetti Barbara Pacheco Harrison, Daura-Jorge Fábio Gonçalves, Mattos Jacó Joaquim, Siebert Marília Nardelli, Bezamat Carolina, Fruet Pedro, Genoves Rodrigo, Taniguchi Satie, Da Silva Josilene, Montone Rosalinda Carmela, Simões-Lopes Paulo César, Bainy Afonso Celso Dias, Lüchmann Karim Hahn
Adverse effects of exposure to persistent organic pollutants (POPs) threaten the maintenance of odontocete populations. In southern Brazil, coastal bottlenose dolphins from the Laguna Estuarine System (LES) and Patos Lagoon Estuary (PLE) were sampled using remote biopsies during the winter and summer months. Levels of bioaccumulated POPs were measured in the blubber. The activities of glutathione S-transferase (GST), glutathione reductase (GR), glutathione peroxidase (GPx), and superoxide dismutase (SOD) were also quantified, as were the mRNA transcript levels of aryl hydrocarbon receptor (AhR), AhR nuclear translocator (ARNT), cytochrome P450 1A1-like (CYP1A1), metallothionein 2A (MT2A), GST-π, GPx-4, GR, interleukin 1 alpha (IL-1α), and major histocompatibility complex II (MHCII) in the skin...
March 2, 2019: Chemosphere
Kyrylo Klimenko, Sine A Rosenberg, Marianne Dybdahl, Eva B Wedebye, Nikolai G Nikolov
The Aryl hydrocarbon receptor (AhR) plays important roles in many normal and pathological physiological processes, including endocrine homeostasis, foetal development, cell cycle regulation, cellular oxidation/antioxidation, immune regulation, metabolism of endogenous and exogenous substances, and carcinogenesis. An experimental data set for human in vitro AhR activation comprising 324,858 substances, of which 1,982 were confirmed actives, was used to test an in-house-developed approach to rationally select Quantitative Structure-Activity Relationship (QSAR) training set substances from an unbalanced data set...
2019: PloS One
Thibaut Davy-Mendez, Sonia Napravnik, Oksana Zakharova, David A Wohl, Claire E Farel, Joseph J Eron
OBJECTIVE: Characterize virologic and immunologic outcomes of INSTI-based antiretroviral therapy (ART) in experienced patients with and without virologic failure. DESIGN: Prospective clinical cohort. METHODS: ART-experienced, INSTI-naïve participants in the University of North Carolina Center for AIDS Research HIV Clinical Cohort (UCHCC) initiating an INSTI-containing regimen 2007-2016 were followed from INSTI initiation (baseline) to the earliest of: outcome of interest, loss to follow-up (LTFU, one year without clinical visit), or death...
March 11, 2019: AIDS
Bao Sun, Fazhong He, Yongchao Gao, Jiecan Zhou, Lei Sun, Rong Liu, Heng Xu, Xiaoping Chen, Honghao Zhou, Zhaoqian Liu, Wei Zhang
PURPOSE: The prognostic impact of visit-to-visit glycemic variability on clinical outcomes in patients with different glycemic control and type 2 diabetes remains obscure. We investigated glucose variability and clinical outcomes for patients in the groups of Good glycemic control (GC), Insufficient glycemic control (IC), and Poor glycemic control (PC) in a prospective cohort study. METHODS: By using data from Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation (ADVANCE), 930 patients were enrolled from 61 centers in China and grouped into GC, IC, and PC according to their glycated hemoglobin A1c (HbA1c ) and fasting plasma glucose (FPG)...
March 13, 2019: Endocrine
Hsin-Chung Lin, Kuo-Yang Huang, Chi-Hsiang Chung, Hsin-An Lin, Rei-Min Chen, Chang-Huei Tsao, Wu-Chien Chien, Tzong-Shi Chiueh
BACKGROUND: Trichomonas vaginalis is a protozoan parasite that causes trichomoniasis and annually infects approximately 276 million people worldwide. We observed an ambiguously higher probability of trichomoniasis in patients from the psychiatric department of Tri-Service General Hospital. Herein, we aimed to investigate the association between trichomoniasis and the risk of developing psychiatric disorders. METHODS: The nationwide population-based study utilized the database of the National Health Insurance (NHI) programme in Taiwan...
March 12, 2019: Parasites & Vectors
Jiehui Li, James E Cone, Robert M Brackbill, Ingrid Giesinger, Janette Yung, Mark R Farfel
Dust created by the collapse of the World Trade Center (WTC) towers on 9/11 included metals and toxicants that have been linked to an increased risk of pulmonary fibrosis (PF) in the literature. Little has been reported on PF among WTC responders. This report used self-reported physician diagnosis of PF with an unknown sub-type to explore the association between levels of WTC dust exposure and PF. We included 19,300 WTC responders, enrolled in the WTC Health Registry in 2003⁻2004, who were followed for 11 years from 2004 to 2015...
March 7, 2019: International Journal of Environmental Research and Public Health
Shao-Wei Chen, Yueh-An Lu, Cheng-Chia Lee, An-Hsun Chou, Victor Chien-Chia Wu, Su-Wei Chang, Pei-Chun Fan, Ya-Chung Tian, Feng-Chun Tsai, Chih-Hsiang Chang
BACKGROUND: Acute kidney injury (AKI) is a common complication of extracorporeal membrane oxygenation (ECMO) treatment. The aim of this study was to elucidate the long-term outcomes of adult patients with AKI who receive ECMO. MATERIALS AND METHODS: The study analyzed encrypted datasets from Taiwan's National Health Insurance Research Database. The data of 3251 patients who received first-time ECMO treatment between January 1, 2003, and December 31, 2013, were analyzed...
2019: PloS One
Herman Meurs, Johan Zaagsma, Harm Maarsingh, Marcel van Duin
Asthma is a chronic inflammatory disease characterized by recurrent airways obstruction, airway hyperresponsiveness (AHR), airway inflammation and airway remodeling, which is often associated with allergy and allergic rhinitis. Many patients with asthma are poorly controlled by current drug treatment, particularly a subgroup of patients with difficult-to-treat severe asthma, characterized by chronic symptoms, severe exacerbations, progressive loss of lung function and resistance to corticosteroids. New therapeutic options are therefore highly warranted...
March 13, 2019: Allergy
Matthew A Spinelli, David V Glidden, Peter L Anderson, Monica Gandhi, Stephanie Cohen, Eric Vittinghoff, Megan E Coleman, Hyman Scott, Oliver Bacon, Richard Elion, Michael A Kolber, Susan P Buchbinder, Albert Y Liu
BACKGROUND: Objective adherence metrics for tenofovir (TFV) disoproxil fumarate/emtricitabine(FTC)-based PrEP were critical for interpretation of efficacy in PrEP clinical trials, and there is increasing interest in using drug levels to tailor interventions for reengagement and adherence. Point-of-care immunoassays (POC) for TFV, which examine short-term adherence, are in development. However the ability of poor short-term and long-term adherence to predict future PrEP non-retention is unknown...
February 21, 2019: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Gayathree Murugappan, Shufeng Li, Ruth B Lathi, Valerie L Baker, Michael L Eisenberg
STUDY QUESTION: Is female infertility associated with higher risk of cancer? SUMMARY ANSWER: Although absolute risks are low, infertility is associated with higher risk of cancer compared to a group of non-infertile women. WHAT IS KNOWN ALREADY: Infertile women are at higher risk of hormone-sensitive cancers. Information on risk of non-gynecologic cancers is rare and conflicting, and the effect of pregnancy on these risk associations is known for only a minority of cancer types...
March 13, 2019: Human Reproduction
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