2,308 research outputs found
James Pryor, 51, of Arizona, on Monday awoke to find that his bicycle was one of
No full textJames Pryor, 51, of Arizona, on Monday awoke to find that his bicycle was one of the 162 bikes stolen in Portland since April 1. Pryor was on the last leg of a cycling trip from southwestern California to northeastern Maine. Details
Choice of initial antiretroviral drugs and treatment outcomes among HIV-infected patients in sub-Saharan Africa: systematic review and meta-analysis of observational studies
No full textBackground: The effectiveness of antiretroviral therapy (ART) depends on the choice of regimens during initiation. Most evidences from developed countries indicated that there is difference between efavirenz (EFV) and nevirapine (NVP). However, the evidences are limited in resource poor countries particularly in Africa. Thus, this systematic review and meta-analysis was carried out to summarize reported long-term treatment outcomes among people on first line therapy in sub-Saharan Africa.Methods: Observational studies that reported odds ratio, relative risk, hazard ratio, or standardized incidence ratio to compare risk of treatment failure among HIV/AIDS patients who initiated ART with EFV versus NVP were systematically searched. Searches were conducted using the MEDLINE database within PubMed, Google Scholar, HINARI, and Research Gates between 2007 and 2016. Information was extracted using standardized form. Pooled risk ratios (RR) and 95% confidence intervals (CI) were calculated using random-effect, generic inverse variance method.Result: A total of 6394 articles were identified, of which, 29 were eligible for review and abstraction in sub-Saharan Africa. Seventeen articles were used for the meta-analysis. Of a total of 121,092 independent study participants, 76,719 (63.36%) were females. Of these, 40,480 (33.43%) initiated with NVP containing regimen. Two studies did not report the median CD4 cell counts at initiation. Patients who have low CD4 cell counts initiated with EFV containing regimen. The pooled effect size indicated that treatment failure was reduced by 15%, 0.85 (95% CI: 0.75-0.98), and non-nucleoside reverse transcriptase inhibitor (NNRTI) switch was reduced by 43%, 0.57 (95% CI: 0.37-0.89).Conclusion: The risk of treatment failure and NNRTI switch were lower in patients who initiated with EFV than NVP-containing regimen. The review suggests that initiation of patients with EFV-containing regimen will reduce treatment failure and NNRTI switch.Funding
No funding was obtained for this study.
Acknowledgements
The authors would like to acknowledge University of Gondar, College of Medicine and Health Sciences for the opportunity given to conduct this review
FIGURE 4 in A further new species of Palaemonella Dana, 1852 from the coasts of the Arabian Peninsula (Malacostraca: Decapoda: Palaemonidae)
No full textFIGURE 4. Habitat of Palaemonella yalla sp. nov.: A, type locality, shallow near-shore sandflat with some rocks, coral rubble and patchy seagrass near Thuwal, Red Sea coast of Saudi Arabia, with one of the authors filling a collection vial with water; B, collection locality of the non-type specimen, shallow tidal sandflat with living massive corals and coral rubble on the eastern coast of Masirah Island, Oman. Photographs by A. Anker.Published as part of <i>Anker, Arthur & Assayie, Aymere Awoke, 2023, A further new species of Palaemonella Dana, 1852 from the coasts of the Arabian Peninsula (Malacostraca: Decapoda: Palaemonidae), pp. 427-436 in Zootaxa 5369 (3)</i> on page 433, DOI: 10.11646/zootaxa.5369.3.6, <a href="http://zenodo.org/record/10151690">http://zenodo.org/record/10151690</a>
Multi-state models for the analysis of time-to-treatment modification among HIV patients under highly active antiretroviral therapy in Southwest Ethiopia
No full textBACKGROUND: Highly active antiretroviral therapy (HAART) has shown a dramatic change in controlling the burden of HIV/AIDS. However, the new challenge of HAART is to allow long-term sustainability. Toxicities, comorbidity, pregnancy, and treatment failure, among others, would result in frequent initial HAART regimen change. The aim of this study was to evaluate the durability of first line antiretroviral therapy and to assess the causes of initial highly active antiretroviral therapeutic regimen changes among patients on HAART.METHODS: A Hospital based retrospective study was conducted from January 2007 to August 2013 at Jimma University Hospital, Southwest Ethiopia. Data on the prescribed ARV along with start date, switching date, and reason for change was collected. The primary outcome was defined as the time-to-treatment change. We adopted a multi-state survival modeling approach assuming each treatment regimen as state. We estimate the transition probability of patients to move from one regimen to another.RESULT: A total of 1284 ART naive patients were included in the study. Almost half of the patients (41.2%) changed their treatment during follow up for various reasons; 442 (34.4%) changed once and 86 (6.69%) changed more than once. Toxicity was the most common reason for treatment changes accounting for 48.94% of the changes, followed by comorbidity (New TB) 14.31%. The HAART combinations that were robust to treatment changes were tenofovir (TDF) + lamivudine (3TC)+ efavirenz (EFV), tenofovir + lamivudine (3TC) + nevirapine (NVP) and zidovudine (AZT) + lamivudine (3TC) + nevirapine (NVP) with 3.6%, 4.5% and 11% treatment changes, respectively.CONCLUSION: Moving away from drugs with poor safety profiles, such as stavudine(d4T), could reduce modification rates and this would improve regimen tolerability, while preserving future treatment options.</p
I awoke one night when the winds blew high,
No full textvoiceCollected by Mary C . Parler
Transcribed by James Lee
Sung by Booth Campbell
October, 1954
Reel 234, Item 6
Mary of the Wild Moor
I awoke one night when the winds blew high,
And blew coldly across the wild moor,
Twas then Mary came with her child,
All alone to her own father's door.
Crying Father, pray do let me in,
Take pity on me I am poor,
Or the child at my bosom will die,
From the winds that blow cross the wild moor.
But her father was deaf to her cries,
Not a voice not a sound reached the door,
But the watchdog barked and
The winds blew coldly across the wild moor.
Now what must a father have felt,
When he went to the door in the morn;
There he found Mary dead and the child,
Fondly clasped in its dead mother's arms.
The father in grief passed away,
And the child to the grave soon was born,
And there's no one lives there till this day,
The cottage to ruin has gone.
The villagers point to the spot,
Where the willow weeps over the door,
Saying there Mary perished and died,
From the winds that blow crost the wild moor.Funding for digitization provided by the Arkansas Humanities Council and the Happy Hollow Foundation
Profiles of hematological parameters in Plasmodium falciparum and Plasmodium vivax malaria patients attending Tercha General Hospital, Dawuro Zone, South Ethiopia
No full textNefsu Awoke,1 Amsalu Arota2 1Department of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia; 2School of Medicine, Department of Medical Laboratory Science, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia Background: Malaria is a major health problem in the tropics, with 300–500 million cases and 1.1–2.7 million deaths occurring annually. The hematological alterations associated with malaria infection may vary depending on: level of malaria endemicity, background hemoglobinopathy, malaria immunity, host genetic factors, and parasite strain variations.Objective: The aim of the study was to determine the profiles of hematologic parameters in Plasmodium falciparum and Plasmodium vivax malaria infections at Tercha General Hospital, Dawuro Zone, South Ethiopia.Methodology: A total of 340 study participants were included in the study, out of which 170 were malaria cases, and the remaining 170 were malaria negatives. An institution-based cross-sectional study was conducted. Malaria diagnosis was based on thick and thin blood films microscopy. Hematological parameters were determined by using an automated, CELL-DYN 1800 hematology analyzer. Malaria parasite density was determined by counting the asexual parasites against 200 WBCs, and then calculated by using the standard formula. The diagnostic accuracy of hematological parameters was measured by computing sensitivity, specificity, and likelihood ratios.Results: The mean values of Hgb, Hct, platelet, WBC, RBC, and lymphocyte were significantly lower in malaria patients than malaria negatives. The prevalence of thrombocytopenia and anemia in malaria patients was 84% and 67%, respectively. There was an inverse correlation between P. falciparum and P. vivax parasite density and lymphocyte count, as well as platelet count.Conclusion and recommendation: Thrombocytopenia and anemia were the two common hematological abnormalities observed in malaria cases. The platelet count during malaria infection was inversely correlated with the asexual stage parasite density. Patients with acute febrile illness having thrombocytopenia should alert the treating physician about the possibility of malaria infection. Malaria patients should be checked for the presence of hematological abnormalities such as anemia and have to be managed for those abnormalities. Keywords: malaria, P. falciparum, P. vivax, hematological parameters, Dawro, anemia, thrombocytopenia, Terch
FIGURE 2 in A further new species of Palaemonella Dana, 1852 from the coasts of the Arabian Peninsula (Malacostraca: Decapoda: Palaemonidae)
No full textFIGURE 2. Palaemonella yalla sp. nov., holotype, ovigerous female (pocl 3.9 mm, cl 5.2 mm), Thuwal, Saudi Arabia, FLMNH UF 71446: A, right first pereiopod, lateral; B, same, distal portion of carpus and chela, mesial; C, right second pereiopod, lateral; D, same, distal portion of merus, latteral; E, same, distal portion of carpus, lateral; F, same, distal portion of carpus, mesial; G, same, chela, lateral; H, same, chela fingers slightly open, lateral; I, right third pereiopod, lateral; J, same, distal portion of propodus and dactylus, lateral; K, right fourth pereiopod, lateral; L, right fifth pereiopod, lateral; M, same, distal portion of propodus and dactylus, mesial. Scales are in mm.Published as part of <i>Anker, Arthur & Assayie, Aymere Awoke, 2023, A further new species of Palaemonella Dana, 1852 from the coasts of the Arabian Peninsula (Malacostraca: Decapoda: Palaemonidae), pp. 427-436 in Zootaxa 5369 (3)</i> on page 431, DOI: 10.11646/zootaxa.5369.3.6, <a href="http://zenodo.org/record/10151690">http://zenodo.org/record/10151690</a>
FIGURE 1 in A further new species of Palaemonella Dana, 1852 from the coasts of the Arabian Peninsula (Malacostraca: Decapoda: Palaemonidae)
No full textFIGURE 1. Palaemonella yalla sp. nov., holotype, ovigerous female (pocl 3.9 mm, cl 5.2 mm), Thuwal, Saudi Arabia, FLMNH UF 71446 [A–O]: A, anterior region of carapace and cephalic appendages, dorsal; B, same, lateral; C, carapace, lateral; D, pleon, posterior pleonites, lateral; E, telson, dorsal; F, same, posterior margin, dorsal; G, right mandible, mesial (molar process broken); H, right maxillule, lateral; I, right maxilla, lateral; J, right first maxilliped, lateral; K, right second maxilliped, lateral; L, same, detail of epipod and podobranch, mesial; M, right third maxilliped, ventrolateral; N, same, detail of antepenultimate article, lateral; O, right uropod, dorsal; non-type, ovigerous female (pocl 3.4 mm, cl 5.6 mm), Masirah Island, Oman, FLMNH UF 71445 [P]: rostrum, lateral. Scales are in mm.Published as part of <i>Anker, Arthur & Assayie, Aymere Awoke, 2023, A further new species of Palaemonella Dana, 1852 from the coasts of the Arabian Peninsula (Malacostraca: Decapoda: Palaemonidae), pp. 427-436 in Zootaxa 5369 (3)</i> on page 430, DOI: 10.11646/zootaxa.5369.3.6, <a href="http://zenodo.org/record/10151690">http://zenodo.org/record/10151690</a>
Modeling Outcomes of First-Line Antiretroviral Therapy and Rate of CD4 Counts Change among a Cohort of HIV/AIDS Patients in Ethiopia: A Retrospective Cohort Study.
No full textBackgroundAntiretroviral therapy has shown to be effective in reducing morbidity and mortality in patients infected with HIV for the past couples of decades. However, there remains a need to better understand the characteristics of long-term treatment outcomes in resource poor settings. The main aim of this study was to determine and compare the long-term response of patients on nevirapine and efavirenz based first line antiretroviral therapy regimen in Ethiopia.MethodsHospital based retrospective cohort study was conducted from January 2009 to December 2013 at University hospital located in Northwest Ethiopia. Human subject research approval for this study was received from University of Gondar Research Ethics Committee and the medical director of the hospital. Cox-proportional hazards model was used to assess the effect of baseline covariates on composite outcome and a semi-parametric mixed effect model was used to investigate CD4 counts response to treatments.ResultsA total of 2386 HIV/AIDS naive patients were included in this study. Nearly one-in-four patients experienced the events, of which death, lost to follow up, treatment substitution and discontinuation of Non-Nucleoside Reverse Transcriptase Inhibitors(NNRTI) accounted: 99 (26.8%), 122 (33.0%), 137 (37.0%) and 12 (3.2%), respectively. The hazard of composite outcome on nevirapine compared with efavirenz was 1.02(95%CI: 0.52-1.99) with p-value = 0.96. Similarly, the hazard of composite outcome on tenofovir and stavudine compared with zidovudine were 1.87 (95%CI: 1.52-2.32), p-value ConclusionsThis study revealed that treatment responses were comparable whether nevirapine or efavirenz was chosen to initiate antiretroviral therapy for HIV/AIDS patients in Ethiopia. There was significant difference on risk of composite outcome between patients who were initiated with Tenofovir containing ART regimen compared with zidovudine after controlling for NNRTI drug combinations
Modelling trends of CD4 counts for patients on antiretroviral therapy (ART): a comprehensive health care clinic in Nairobi, Kenya
No full textBackground: In resource-limited settings, changes in CD4 counts constitute an important component in patient monitoring and evaluation of treatment response as these patients do not have access to routine viral load testing. In this study, we quantified trends on CD4 counts in patients on highly active antiretroviral therapy (HAART) in a comprehensive health care clinic in Kenya between 2011 and 2017. We evaluated the rate of change in CD4 cell count in response to antiretroviral treatment. We further assessed factors that influenced time to treatment change focusing on baseline characteristics of the patients and different initial drug regimens used. This was a retrospective study involving 432 naive HIV patients that had at least two CD4 count measurements for the period. The relationship between CD4 cell count and time was modeled using a semi parametric mixed effects model while the Cox proportional hazards model was used to assess factors associated with the first regimen change. Results: Majority of the patients were females and the average CD4 count at start of treatment was 362.1 cell /mm(3). The CD4 count measurements increased nonlinearly over time and these trends were similar regardless of the treatment regimen administered to the patients. The change of logarithm CD4 cell count rises fast for in the first 450 days of antiretroviral initiation. The average time to first regimen change was 2142 days. Tenoforvir (TDF) based regimens had a lower drug substitution(aHR 0.2682, 95% CI:0.08263- 0.8706) compared to Zidovudine(AZT). Conclusion: The backbone used was found to be associated with regimen changes among the patients with fewer switches being observed, with the use of TDF when compared to AZT. There was however no significant difference between TDF and AZT in terms of the rate of change in logarithm CD4 count over time.The authors acknowledge Director, Kenya Medical Research Institute (KEMRI), for authorizing this study and permitting the publication of this manuscript. We also acknowledge VLIR-UOS for student fnancial support to carry out the research under TEAM projects ”Capacity building network in biostatistics for public health innovation in Kenya”. We also wish to acknowledge the editor and two anonymous reviewers that took their time and whose input led to tremendous improvement of the manuscript.
This study has not received funding. However, student research support was provided by VLIR-UOS under TEAM project ”Capacity building network in biostatistics for public health innovation in Kenya”
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