193,375 research outputs found
The UN-SUSTAINABLE Match in HCV Recipients. Evidences from the Italian D-MELD Study on Balancing Donor-Recipient Risk Factors
No full textThe UN-SUSTAINABLE Match in HCV Recipients. Evidences from the Italian D-MELD Study on Balancing Donor-Recipient Risk Factor
Regional and temporal changes in AIDS in Europe before HAART
No full textIn a prospective observational study 4485 patients from 46 clinical centres in 17 European countries were followed between April 1994 and November 1996. Information on AIDS-defining events (ADEs) were collected together with basic demographic data, treatment history and laboratory results. The centres were divided into four geographical regions (north, central, south-west and south-east) so that it was possible to identify any existing regional differences in ADEs. The regional differences that we observed included a higher risk of all forms of Mycobacterium tuberculosis infections (Tb) and wasting disease in the south-west and an increased risk of infections with the Mycobacterium avium complex (MAC) in the north. In Cox multivariable analyses, where north was used as the reference group, we observed hazard ratios of 6.87, 7.77, 2.29 and 0.16 (P < 0.05 in all cases) for pulmonary Tb, extrapulmonary Tb, wasting disease and MAC respectively in the south-west. Pneumocystis carinii pneumonia (PCP) was less commonly diagnosed in the central region (RH = 0.51, 95% CI 0.32-0.79, P = 0.003) and most common in the south-east (RH = 1.04, 95% CI 0.71-1.51, P = 0.85). Comparisons with a similar 'AIDS in Europe' study that concentrated on the early phase of the epidemic reveal that most of the regional differences that were observed in the 1980s still persist in the mid-1990s
Evaluating survival after allogeneic bone marrow transplant for chronic myeloid leukemia in chronic phase”.
No full textInflammatory Articular Disease in Patients with Inflammatory Bowel Disease: Result of the Swiss IBD Cohort Study
No full textBACKGROUND
Inflammatory bowel diseases (IBD) are systemic conditions that commonly display extraintestinal manifestations. Inflammatory articular disease (IAD: axial or peripheral) is the most common extraintestinal manifestation. The aim of this study was to evaluate the prevalence and the clinical characteristics associated with IAD in patients with IBD.
METHODS
We analyzed patients enrolled in the Swiss IBD cohort study. IAD was defined as persistent or recurrent joint pain with an inflammatory pattern (night pain, progressive relief during the day, morning stiffness lasting at least 30 minutes) or the presence of arthritis as diagnosed by the physicians. A multivariate logistic regression was performed to analyze which disease characteristics were independently associated with the presence of IAD.
RESULTS
A total of 2353 patients with IBD, 1359 with Crohn's disease, and 994 with ulcerative colitis (UC) were included. Forty-four percent of patients fulfilled the criteria for IAD, whereas 14.5% presented with other extraintestinal manifestations. IAD was associated with Crohn's disease, with female sex, with older age, and generally in patients with more active intestinal disease. Only in UC, IAD was further associated with tobacco smoking and with increasing body mass index.
CONCLUSIONS
This population of patients with IBD displays a high prevalence of IAD. IAD was more strongly associated with Crohn's disease than UC. Other risk factors for IAD were female sex, advanced age, active digestive disease, and tobacco consumption in patients with UC, which is interesting given the established association between smoking and other inflammatory arthritides
“Long Term Follow-up of the Italian Trial of Interferon-a Versus Conventional Chemotherapy in Chronic Myeloid Leukemia”.
No full textThe prognosis and main prognostic indicators of Guillain-Barré syndrome. A multicentre prospective study of 297 patients
No full textTo assess the prognosis of the Guillain-Barré syndrome and identify the main prognostic indicators, 297 patients with Guillain-Barré syndrome recruited through a network of Italian centres were followed up for 24 months or until clinical recovery, whichever was earliest. For each patient the time to plateau, improvement, clinical recovery, or death was calculated, and prognostic indicators (age, sex, antecedent events, disability at admission and nadir, electrophysiological patterns) and treatments were noted. The mean duration of follow-up was 309 days. During this period, 212 patients (71%) recovered, 48 (16%) had residua and 33 (11%) died. The mean times to nadir, improvement and clinical recovery were 12, 28 and 200 days. Using life-tables and survival curves, the cumulative probability of achieving the plateau of symptoms was 73% by 1 week and 98% by 4 weeks. Improvement started during the first week in 36% of cases and within 4 weeks in 85%. The rates of clinical recovery at 1 and 4 weeks, 6, 12 and 24 months were 4, 24, 57, 70 and 82%, respectively. The chance of recovery was significantly affected by age, antecedent gastroenteritis, disability, electrophysiological signs of axonopathy, latency to nadir and duration of active disease. The main treatments did not seem to affect the chance of recovery
Guselkumab in Patients With Moderately to Severely Active Ulcerative Colitis: QUASAR Phase 2b Induction Study
No full textBackground & Aims: The QUASAR Phase 2b Induction Study evaluated the efficacy and safety of guselkumab, an interleukin-23p19 subunit antagonist, in patients with moderately to severely active ulcerative colitis (UC) with prior inadequate response and/or intolerance to corticosteroids, immunosuppressants, and/or advanced therapy. Methods: In this double-blind, placebo-controlled, dose-ranging, induction study, patients were randomized (1:1:1) to receive intravenous guselkumab 200 or 400 mg or placebo at weeks 0/4/8. The primary endpoint was clinical response (compared with baseline, modified Mayo score decrease ≥30% and ≥2 points, rectal bleeding subscore ≥1-point decrease or subscore of 0/1) at week 12. Guselkumab and placebo week-12 clinical nonresponders received subcutaneous or intravenous guselkumab 200 mg, respectively, at weeks 12/16/20 (uncontrolled study period). Results: The primary analysis population included patients with baseline modified Mayo scores ≥5 and ≤9 (intravenous guselkumab 200 mg, n = 101; 400 mg, n = 107; placebo, n = 105). Week-12 clinical response percentage was greater with guselkumab 200 mg (61.4%) and 400 mg (60.7%) vs placebo (27.6%; both P <. 001). Greater proportions of guselkumab-treated vs placebo-treated patients achieved all major secondary endpoints (clinical remission, symptomatic remission, endoscopic improvement, histo-endoscopic mucosal improvement, and endoscopic normalization) at week 12. Among guselkumab week-12 clinical nonresponders, 54.3% and 50.0% of patients in the 200- and 400-mg groups, respectively, achieved clinical response at week 24. Safety was similar among guselkumab and placebo groups. Conclusions: Guselkumab intravenous induction was effective vs placebo in patients with moderately to severely active UC. Guselkumab was safe, and efficacy and safety were similar between guselkumab dose groups. ClinicalTrials.gov number: NCT04033445
Online Individualized Active Communication Education- -a Swedish pilot study
No full textIntroductionThe group rehabilitation program Active Communication Education program (ACE), has been translated and evaluated in two Swedish studies. Statistically significant effects were found for activity and participation and communication strategies. The qualitative analyze showed that the participants found the structure and the content of the program to be beneficial and “learning from the group” was found to be the most pronounced advantage of the program. All individuals do not want to or do not have the possibility to participate in group activities and therefore are individual education programs requested. Could an individual educational program, administered via the internet, be beneficial even without the possibility to learn from the peers in a group? The aim with this study was to translate and, in a pilot study, evaluate the Individual Active Communication Education program (I-ACE) for a Swedish population.Method The originally I-ACE program, developed in Australian, was translated and mixed with contents from the Swedish ACE program to a five week, online education program. Participants were recruited by advertisements in hearing health care centers and at social medium forums. Twenty-four individuals participated and received I-ACE material by mail every week. The effects were evaluated with standardized questionnaires and open ended items.ResultStatistically significant effects were found for activity and participation and for communication strategies. The qualitative analyze showed that the participants were satisfied with the content of the program. Learning about communication strategies and own reflections about the hearing problems were the most pronounced advantages.ConclusionThe Swedish version of the I-ACE with material administered by mail worked well and was found to increase participants’ activity and participation and communication strategies. Further research, including a control group, is needed to draw conclusions about the effectiveness of the I-ACE program.</p
A comparison between abacavir and efavirenz as the third drug used in combination with a background therapy regimen of 2 nucleoside reverse-transcriptase inhibitors in patients with initially suppressed viral loads
No full textBackground. Our objective was to compare the rate of viral rebound and therapy failure in patients receiving abacavir or efavirenz as the third drug ( in addition to 2 non-abacavir nucleosides) in combination antiretroviral therapy ( cART) and to compare the rate of metabolic alteration associated with these regimens.Methods. We conducted a multicohort prospective observational study of human immunodeficiency virus infected patients who had attained viral loads <= 80 copies/mL while receiving cART, without having previously received antiretrovirals. The rates of virological rebound, therapy failure, and lipid-level alteration during follow-up were calculated as the number of events divided by person-years of follow-up ( PYFU). A multivariable analysis was performed using a Poisson regression model.Results. We studied a total of 744 patients; the median age was 37 years, 27% of the patients were female, and 41% were heterosexual. There was a total of 854 PYFU spent receiving efavirenz and 285 spent receiving abacavir. The nucleoside reverse-transcriptase inhibitor pairs most frequently used were zidovudine/lamivudine ( 66% of PYFU), stavudine/lamivudine ( 17.6%), and stavudine/didanosine ( 5.4%). The adjusted relative rates of virological failure and therapy failure for abacavir, compared with those for efavirenz, were 2.17 ( 95% confidence interval [ CI], 1.12 - 4.18;) and 1.41 ( 95% CI, 1.01 - 2.01;), respectively. P = .02 P = .05Conclusions. Patients with virological suppression while receiving regimens containing abacavir appear more likely to experience virological and therapy failure than those receiving efavirenz as their third drug. Although this is a selected group of adherent patients, bias cannot be ruled out, because this is a nonrandomized comparison
Contrast enhanced gray-scale sonography in assessment of joint vascularity in rheumatoid arthritis: results from the IACUS study group
No full textThe purpose of this study way to assess the value of contrast enhanced gray-scale
ultrasound (CEUS) in detection of vascularity in joints of patients with
rheumatoid arthritis (RA) in a multicenter study of the International Arthritis
Contrast Ultrasound (IACUS) study group. We assessed 113 joints in 113 patients
(44 men, 69 women; mean age 51+/-14 years) with clinical diagnosis of RA.
Gray-scale ultrasound (US), power Doppler US (PDUS) and CEUS, using a low
mechanical index US technique, was performed. CEUS was done by bolus
administration of the contrast agent SonoVue (Bracco, Milan, Italy) with a dosage
of 4.8-ml SonoVue flushed with 10 ml saline. Detection of joint vascularity was
performed for differentiation of active synovitis from inactive intra-articular
thickening (synovitis/effusion). With the use of US and PDUS, active synovitis
could be differentiated from inactive intra-articular thickening in 68/113 joints
(60.1%), whereas CEUS enabled differentiation in 110/113 (97.3%) joints
(p<0.0001). Thickness measurement of active synovitis was significantly improved
after contrast administration (p=0.008). In conclusion, CEUS improves the
differentiation of active synovitis from inactive intra-articular thickening.
Since CEUS has shown an ability to improve assessment of vascularized synovial
proliferation in RA affected joints, this technique may have further potential in
monitoring therapy
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