853 research outputs found
HIV and the body: a review of multidisciplinary management.
No full textThe increase in the life expectancy achieved following the introduction of more effective antiretroviral therapy (ART) in recent years now means that the HIV-infected population are for the first time being exposed to the age-related diseases that affect the general population. Nevertheless, the prevalence of these diseases (which include cardiovascular disease, dyslipidaemia, glucose intolerance and diabetes) is higher, and their onset earlier in the HIV population, probably due to the complex interplay between HIV infection, coinfection with hepatitis B and C, and ART. As a result, HIV physicians are now required to adopt a new approach to the management of HIV, which involves screening and regular monitoring of all HIV-infected individuals for the presence of comorbidities and prompt referral to other clinical specialties when required. If this challenge to patient management is to be overcome, it is clear that educating physicians in the diagnosis and treatment of age-associated comorbidities is essential, either through ongoing programmes such as the HIV and the Body initiative, an overarching independent medical education programme established in 2007 and overseen by an independent Steering Committee, organized and funded by Gilead, and/or through internal training. To assist in this process, this article provides an overview of common comorbidities affecting HIV-infected persons and provides practical guidance on their management
Hyaluronic acid levels predict risk of hepatic encephalopathy and liver-related death in HIV/viral hepatitis coinfected patients
No full textBackground: Whereas it is well established that various soluble biomarkers can predict level of liver fibrosis, their ability to predict liver-related clinical outcomes is less clearly established, in particular among HIV/viral hepatitis co-infected persons. We investigated plasma hyaluronic acid’s (HA) ability to predict risk of liver-related events (LRE; hepatic coma or liver-related death) in the EuroSIDA study.
Methods: Patients included were positive for anti-HCV and/or HBsAg with at least one available plasma sample. The earliest collected plasma sample was tested for HA (normal range 0–75 ng/mL) and levels were associated with risk of LRE. Change in HA per year of follow-up was estimated after measuring HA levels in latest sample before the LRE for those experiencing this outcome (cases) and in a random selection of one sixth of the remaining patients (controls).
Results: During a median of 8.2 years of follow-up, 84/1252 (6.7%) patients developed a LRE. Baseline median (IQR) HA in those without and with a LRE was 31.8 (17.2–62.6) and 221.6 ng/mL (74.9–611.3), respectively (p<0.0001). After adjustment, HA levels predicted risk of contracting a LRE; incidence rate ratios for HA levels 75–250 or ≥250 vs. <75 ng/mL were 5.22 (95% CI 2.86–9.26, p<0.0007) and 28.22 (95% CI 14.95–46.00, p<0.0001), respectively. Median HA levels increased substantially prior to developing a LRE (107.6 ng/mL, IQR 0.8 to 251.1), but remained stable for controls (1.0 ng/mL, IQR –5.1 to 8.2), (p<0.0001 comparing cases and controls), and greater increases predicted risk of a LRE in adjusted models (p<0.001).
Conclusions: An elevated level of plasma HA, particularly if the level further increases over time, substantially increases the risk of contracting LRE over the next five years. HA is an inexpensive, standardized and non-invasive supplement to other methods aimed at identifying HIV/viral hepatitis co-infected patients at risk of hepatic complications
Electromagnetic brain activity evoked by affective stimuli in schizophrenia
No full textSchizophrenia is typically associated with cognitive deficits, but symptoms also point to alterations in the processing of affective material, with potential impact on behavioral performance. This impact may unfold on multiple time scales, but initial processing of rapidly unfolding social cues may be particularly important. MEG-assessed regional brain activity associated with the capacity to process the emotional content of rapid visual stimuli (3/s) was examined in 12 individuals with schizophrenia and 12 matched controls. Patients showed less differentiation of emotional versus neutral stimuli 90–300 ms following picture onset. Together with group differences in the lateral topography of valence effects, these results are discussed as evidence of deficient automatic processing of emotionally potent stimuli in schizophrenia
The use of intrahepatic portosystemic shunt in HIV positive patients: A retrospective multicentric study
No full textStat-1 decoy oligonucleotide treatment reduces acute rejection in mice heart transplantation
No full textCare of HIV patients with chronic hepatitis B: updated recommendations from the HIV-Hepatitis B Virus International Panel.
No full textStat-1 decoy oligonucleotide treatment reduces acute rejection in mice heart transplantation
No full textCare of patients with chronic hepatitis B and HIV co-infection: recommendations from an HIV-HBV International Panel.
No full textOptimal use of maraviroc in clinical practice
No full textMaraviroc belongs to a new class of anti-HIV drugs named CCR5 antagonists, which block HIV entry into cells. It has proven potent efficacy in treatment-experienced patients with multiple drug failure. Its favourable toxicity profile makes the drug attractive for consideration in other clinical scenarios, including patients with earlier stages of disease, cardiovascular risk and viral hepatitis coinfection. Because of its unique mechanism of action-blocking viral entry, studies in patients with primary HIV infection and in the context of preexposure and postexposure prophylaxis are particularly warranted. However, given its exclusive activity against CCR5 tropic strains, viral tropism testing is mandatory before using CCR5 antagonists in the clinic. Efforts to improve the reliability of viral tropism assessment using genotypic tests are underway, and it is likely that these tools will soon replace phenotypic assays, which are more expensive, difficult to perform and take a long time. © 2008 Wolters Kluwer Health Lippincott Williams & Wilkins
An embedding technique for the solution of reaction–diffusion equations on algebraic surfaces with isolated singularities
No full textIn this paper we construct a parametrization-free embedding technique for numerically evolving reaction-diffusion PDEs defined on algebraic curves that possess an isolated singularity. In our approach, we first desingularize the curve by appealing to techniques from algebraic geometry. We create a family of smooth curves in higher dimensional space that correspond to the original curve by projection. Following this, we pose the analogous reaction-diffusion PDE on each member of this family and show that the solutions (their projection onto the original domain) approximate the solution of the original problem. Finally, we compute these approximants numerically by applying the Closest Point Method which is an embedding technique for solving PDEs on smooth surfaces of arbitrary dimension or codimension, and is thus suitable for our situation. In addition, we discuss the potential to generalize the techniques presented for higher-dimensional surfaces with multiple singularities.The authors thank Colin Macdonald for many helpful discussions. The authors also thank the people who contributed to the cp_matrices code (see github.com/cbm755/cp_matrices), in particular Colin Macdonald, Ingrid von Glehn, and Yujia Chen. Thomas März was supported by award KUK-C1-013-04 made by King Abdullah University of Science and Technology (KAUST). Parousia Rockstroh and Steven Ruuth were supported by a grant from NSERC Canada (RGPIN 227823) and by award KUK-C1-013-04 made by King Abdullah University of Science and Technology (KAUST)
- …
