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treatment failure and associated factors among first line patients on highly active antiretroviral therapy in Ethiopia:a systematic review and meta-analysis

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Global Health Research and Policy 2019年第1期4卷 68-77页

作者： Moges Agazhe Assemie Muluneh Alene Daniel Bekele Ketema Selishi Mulatu Department of Public Health College of Health Science Debre Markos UniversityP.O.Box 269Debre MarkosEthiopia Department of Nursing School of Health Science Bahir Dar UniversityBahir DarEthiopia

Background:Antiretroviral therapy(ART)restores immune function and reduces human immunodeficiency virus(HIV)related adverse *** results of previous studies in Ethiopia were replete with inconsistent findings;nonexistence of national representative figures and determinant factors are found as significant *** aim of this systematic review and meta-analysis was to assess the existing evidence on ART treatment failure and associated factors in ***:Relevant studies on ART treatment failure were retrieved from international databases:PubMed,Google Scholar,Scopus,and Science Direct systematically prior to March 14,*** identified studies reporting the proportion of first line treatment failure among HIV patients in Ethiopia were *** authors independently extracted all necessary data using a standardized data extraction format.A random-effects model was used to calculate pooled estimates and associated factors in Stata/se *** Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the ***:From 18 articles reviewed;the pooled proportion of first line treatment failure among ART users in Ethiopia was 15.3%(95%CI:12,18.6)with(I2=97.9%,ptreatment failure assessment criteria were carried out,accordingly the highest prevalence(11.5%)was noted on immunological and the lowest(5.8%)was observed virological treatment *** had found poor adherence(OR=8.6,95%CI:5.6,13.4),not disclosed(OR=2.1,95%CI:1.5,3.0),advanced WHO clinical stage III/IV(OR=2.4,95%CI:1.5,3.8),change in regimen(OR=2.5,95%CI:1.6,3.9)and being co-infected(OR=2.56,95%CI:2.2,3.0)were statistically significant factors for treatment ***:In this study,treatment failure among ART users in Ethiopia was ***,co-infection,advanced WHO clinical stage,regimen change,and disclosure are determinant factors for treatment ***,improve d

关键词： Antiretroviral therapy First-line treatment treatment failure Switching to second-line HIV/AIDS Ethiopia

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Effect of treatment failure on the Cag A EPIYA motif in Helicobacter pylori strains from Colombian subjects

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World Journal of Gastroenterology 2017年第11期23卷 1980-1989页

作者： Javier Andres Bustamante-Rengifo Andres Jenuer Matta Alvaro Jairo Pazos Luis Eduardo Bravo Department of Microbiology School of Basic ScienceUniversidad del Valle Registro Poblacional de Cáncer de Cali Department of PathologySchool of MedicineUniversidad del Valle Department of Biology Universidad de Narino

AIM To evaluate effect of treatment failure on cag A and vac A genotypes in Helicobacter pylori(H. pylori) isolates from *** One hundred and seventy-six participants infected with H. pylori from Colombia were treated during 14 d with the triple-standard therapy. Six weeks later, eradication was evaluated by 13C-Urea breath test. Patients with treatment failure were subjected to endoscopy control; biopsies obtained were used for histopathology and culture. DNA from H. pylori isolates was amplified using primers specific for cag A and vac A genes. The phylogenetic relationships among isolates obtained before and after treatment were established by conglomerate analysis based on random amplified polymorphic DNA(RAPD) *** treatment effectiveness was at 74.6%. Of the par-ticipants with treatment failure, 25 accepted subjected to a second endoscopy. Prevalence of posttreatment infection was 64%(16/25) and 40%(10/25) by histology and culture, respectively. Upon comparing the cag A and vac A genotypes found before and after therapy, multiple cag A genotypes(cag A-positive and cag A-negative) were found before treatment; in contrast, cag A-negative genotypes decreased after treatment. vac A s1m1 genotype was highly prevalent in patients before and after therapy. The 3'cag A region was successfully amplified in 95.5%(21/22) of the isolates obtained before and in 81.8%(18/22) of the isolates obtained after treatment. In the isolates obtained from patients with treatment failure, it was found that 72.7%(16/22) presented alterations in the number of EPIYA motifs, compared to isolates found before *** Unsuccessful treatment limits colonization by lowvirulence strains resulting in partial and selective eradication in mixed infections, and acts on the cag A-positive strains inducing genetic rearrangements in cag A variable region that produces a loss or gain of EPIYA repetitions.

关键词： Helicobacter pylori RAPD-PCR treatment failure EPIYA motifs 3’ cag A variable region

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Hepatitis C virus treatment failure:Clinical utility for testing resistance-associated substitutions

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World Journal of Hepatology 2021年第9期13卷 1069-1078页

作者： Ezequiel Ridruejo Matias Javier Pereson Diego M Flichman Federico Alejandro Di Lello Hepatology Section Department of MedicineCentro de Educacion Medica e Investigaciones Clinicas Norberto Quirno“CEMIC”Ciudad Autonoma de Buenos Aires C1425ASUnspecifiedArgentina Facultad de Farmacia y Bioquimica Instituto de Investigaciones en Bacteriologea y Virologea Molecular(IBaViM)Universidad de Buenos AiresCiudad Autonoma de Buenos Aires 1113Argentina Instituto de Investigaciones Biomedicas en Retrovirus y Sindrome de Inmunodeficiencia Adquirida(INBIRS) Universidad de Buenos AiresCiudad Autonoma de Buenos Aires 1113Argentina

The hepatitis C virus has a high mutation capacity that leads to the emergence of resistance-associated substitutions(RAS).However,the consequence of resistance selection during new direct-acting antiviral drug(DAA)treatment is not necessarily the therapeutic *** fact,DAA treatment has shown a high rate(>95%)of sustained virological response even when high baseline RAS prevalence has been *** the context of RAS emergence and high rates of sustained viral response,the clinical relevance of variants harboring RAS is still ***,in order to summarize the data available in international guidelines,we have reviewed the clinical utility of testing RAS in the era of new pangenotypic DAA drugs.

关键词： Hepatitis C virus treatment failure Resistance Direct-acting antiviral

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Analysis of the treatment failure of the collateral ligament terminal of the finger proximal interphalangeal joint with Mircro Arc Bone Anchor

Analysis of the treatment failure of the collateral ligament...

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2014年浙江省医学会手外科暨显微外科学学术年会

作者： WANG Ke-jie DONG Chun-gang WANG Xin Partment of Hand Surgery Ningbo 6th Hospital

Objective To analyze the causes for failures in repairing ruptures of the collateral ligament terminals of the finger proximal interphalangeal joint with Mircro Arc Bone *** A retrospective analysis was done to study the causes for the 6 failed repairments of ruptures of the collateral ligament terminals of the finger proximal interphalangeal joint with Mircro Arc Bone Anchor which had been performed in our hospital from July2008 to Junuary *** Causes of the failures cases were infection,pull out of suture anchors,foreign body reaction,ligament *** A thorough knowledge of bone quality,anchor placement and surgical techniques has a significant impact on the proper use of the device.

关键词： Mircro Arc Bone Anchor collateral ligament terminals treatment failure

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Tenofovir rescue therapy for chronic hepatitis B patients after multiple treatment failures

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World Journal of Gastroenterology 2012年第47期18卷 6996-7002页

作者： Yu Jin Kim Dong Hyun Sinn Geum-Youn Gwak Moon Seok Choi Kwang Cheol Koh Seung Woon Paik Byung Chul Yoo Joon Hyeok Lee Department of Medicine Samsung Medical CenterSungkyunkwan University School of MedicineSeoul 135-710South Korea

AIM:To evaluate the efficacy and safety of tenofovir disoproxil fumarate(TDF) for chronic hepatitis B(CHB) patients after multiple ***:A total of 29 CHB patients who had a suboptimal response or developed resistance to two or more previous nucleoside/nucleotide analogue(NA) treatments were *** subjects were treated with TDF alone(n = 13) or in combination with lamivudine(LAM,n = 12) or entecavir(ETV,n = 4) for ≥ 6 *** virologic response(CVR) was defined as an achievement of serum hepatitis B virus(HBV) DNA level ≤ 60 IU/mL by real-time polymerase chain reaction method during *** assessment was based on serum creatinine and phosphorus *** patients had histories of LAM and adefovir dipivoxil(ADV) treatment and 18 patients were exposed to LAM,ADV,and ***-seven patients(93.1%) were hepatitis B e antigen(HBeAg) positive and the mean value of the baseline serum HBV DNA level was 5.5 log IU/mL ± 1.7 log IU/*** median treatment duration was 16 mo(range 7 to 29 mo).RESULTS:All the patients had been treated with LAM and developed genotypic and phenotypic resistance to *** to ADV was present in 7 patients and 10 subjects had a resistance to *** patient had a resistance to both ADV and *** cumulative probabilities of CVR at 12 and 24 mo of TDF containing treatment regimen calculated by the Kaplan Meier method were 86.2% and 96.6%,*** one patient failed to achieve CVR,serum HBV DNA level decreased by 3.9 log IU/mL from the baseline and the last serum HBV DNA level during treatment was 85 IU/mL,achieving near *** patients in this study showed viral breakthrough or primary non-response during the follow-up *** cumulative probability of HBeAg clearance in the 27 HBeAg positive patients was 7.4%,12%,and 27% at 6,12,and 18 mo of treatment,*** efficacy of TDF containing regimen was not statistically different according to the presence of specific HBV mutatio

关键词： Tenofovir Chronic hepatitis B treatment failure

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Infliximab to treat severe ulcerative colitis

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World Journal of Gastroenterology 2009年第14期15卷 1771-1773页

作者： Dídia Bisamra Cury Marcelo de Souza Cury Geraldo Vinicius Hemerly Elias Sender Jankiel Mizsputen Department of Gastroenterology Federal University of So Paulo rua Botucatu 740 So Paulo SP 04023-900 Brazil

A 48-year-old female with severe ulcerative colitis refractory to conventional therapy was referred to our facility for management. The patient showed extensive ulcerative colitis since the age of 20 years and had failed therapy with 5-aminosalicylic acid agents and azathioprine. The disease remained active despite treatment with steroids and cyclosporine. The clinical and endoscopic parameters were consistent with severe disease. Infectious precipitants were ruled out. Given the severity of the disease and in order to avoid a colectomy, we started the patient on infliximab therapy. A dramatic clinical and endoscopic response was observed and she remained in remission at the end of a 1-year follow-up period. We discuss findings in the literature regarding the use ofinfliximab therapy in patients with ulcerative colitis who have failed steroids and cyclosporine.

关键词： Cyclosporine Infliximab treatment failure Ulcerative colitis Inflammatory bowel diseases

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Second and third line treatment options for Helicobacter pylori eradication

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World Journal of Gastroenterology 2014年第6期20卷 1517-1528页

作者： Mingjun Song Tiing Leong Ang Department of Gastroenterology Changi General Hospital

Helicobacter pylori is a highly successful bacterium with a high global prevalence and the infection carries significant disease burden. It is also becoming increasingly difficult to eradicate and the main reason for this is growing primary antibiotic resistance rates in a world where antibiotics are frequently prescribed and readily available. Despite knowing much more about the bacterium since its discovery, such as its genomic makeup and pathogenesis, we have seen declining treatment success. Therefore, clinicians today must be prepared to face one, two or even multiple treatment failures, and should be equipped with sufficient knowledge to decide on the appropriate salvage therapy when this happens. This article discusses the factors contributing to treatment failure and reviews the second and thirdline treatment strategies that have been investigated. Established empiric second line treatment options include both bismuth based quadruple therapy and levofloxacin based triple therapy. Antibiotic testing is recommended prior to initiating third line treatment. In the event that antibiotic susceptibility testing is unavailable, third line treatment options include rifabutin, rifaximin and sitafloxacin based therapies.

关键词： Helicobacter pylori treatment failure Salvage therapy Drug resistance Microbial Bismuth Ofloxacin Moxifloxacin Metronidazole Rifabutin Rifaximin Sitafloxacin

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Second-line bismuth-containing quadruple therapy for Helicobacter pylori eradication and impact of diabetes

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World Journal of Gastroenterology 2017年第6期23卷 1059-1066页

作者： Sung Eun Kim Moo In Park Seun Ja Park Won Moon Jae Hyun Kim Kyoungwon Jung Hae Koo Kim Young Dal Lee Department of Internal Medicine Kosin University College of MedicineBusan 49267South Korea

To investigate Helicobacter pylori (H. pylori) eradication rates using second-line bismuth-containing quadruple therapy and to identify predictors of eradication *** study included 636 patients who failed first-line triple therapy and received 7 d of bismuth-containing quadruple therapy between January 2005 and December 2015. We retrospectively demonstrated H. pylori eradication rates with respect to the year of therapy as well as demographic and clinical factors. H. pylori eradication was confirmed by a 13C-urea breath test or a rapid urease test at least 4 wk after the completion of bismuth-based quadruple therapy: proton pump inhibitor, metronidazole, bismuth, and *** overall eradication rates by intention-to-treat analysis and per-protocol analysis were 73.9% (95%CI: 70.1%-77.4%) and 94.5% (95%CI: 92.4%-96.5%), respectively. Annual eradication rates from 2005 to 2015 were 100.0%, 92.9%, 100.0%, 100.0%, 100.0%, 97.4%, 100.0%, 93.8%, 84.4%, 98.9%, and 92.5%, respectively, by per-protocol analysis. A multivariate analysis showed that diabetes mellitus (OR = 3.99, 95%CI: 1.56-10.20, P = 0.004) was associated with H. pylori eradication therapy *** second-line bismuth-containing quadruple therapy for H. pylori infection is still effective in Korea, and diabetes mellitus is suggested to be a risk factor for eradication failure.

关键词： Helicobacter pylori Disease eradication treatment failure Bismuth Diabetes mellitus

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Diabetes and tuberculosis:An emerging dual threat to healthcare

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World Journal of Diabetes 2024年第7期15卷 1409-1416页

作者： Sahana Shetty Joseph M Pappachan Cornelius James Fernandez Department of Endocrinology Kasturba Medical CollegeManipalManipal Academy of Higher EducationManipal 576104KarnatakaIndia Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom Faculty of Biology Medicine and HealthThe University of ManchesterManchester M139PLUnited Kingdom Department of Endocrinology&Metabolism Pilgrim HospitalUnited Lincolnshire Hospitals NHS TrustBoston PE219QSUnited Kingdom

Tuberculosis(TB)remains a huge global healthcare challenge even in the 21^(st) century though the prevalence has dropped in developed countries in recent *** mellitus(DM)is an important risk factor for the development and perpetuation of TB owing to the immune dysfunction in patients with *** coexistence of both diseases in the same individual also aggravates disease severity,complications,and chance of treatment failure because of gross immune alterations posed by DM as well as *** complex cellular and humoral immunological factors are involved in the dangerous interaction between TB and DM,some of which remain unknown even *** is highly important to identify the risk factors for TB in patients with DM,and vice versa,to ensure early diagnosis and management to prevent complications from this ominous *** their research study published in the recent issue of the World Journal of Diabetes,Shi et al elaborate on the factors associated with the development of TB in a large cohort of DM patients from *** such research output from different regions of the world is expected to improve our knowledge to fight the health devastation posed by TB in patients with diabetes.

关键词： Tuberculosis Diabetes mellitus Immune dysfunction treatment failure Multi-drug resistant tuberculosis

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treatment and disease management patterns for bacillus Calmette-Guérin unresponsive nonmuscle invasive bladder cancer in North America,Europe and Asia:A real-world data analysis

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Current Urology 2022年第3期16卷 147-153页

作者： Edward I.Broughton Danielle S.Chun Kyna M.Gooden Katie L.Mycock Ivana Rajkovic Gavin Taylor-Stokes WW Health Economics and Outcomes Research Bristol Myers SquibbPrincetonNJUSA The University of North Carolina Chapel HillNCUSA Observational Research Department Adelphi Real WorldBollingtonUK

Background:This study examined real-world treatment and management of bacillus Calmette-Guérin(BCG)-unresponsive patients across 3 continents,including patients unable or unwilling to undergo *** and methods:Physicians actively involved in managing patients with nonmuscle invasive bladder cancer completed online case report forms for their 5 consecutive patients from the broad BCG-unresponsive population and a further 5 consecutive BCG-unresponsive patients who did not undergo cystectomy(in Japan,physicians provided a total of 5 patients across both cohorts).Results:Most patients had received 1(37%)or 2(24%)maintenance courses of *** or more maintenance BCG courses were received by patients in Japan(59%)and China(31%),while in Germany 76%of patients received only 1 *** patients became BCG-unresponsive during their first(44%)or second(22%)treatment course;in Germany,77%became BCG-unresponsive during their first treatment *** countries did not provide another course of BCG after a patient first became unresponsive,whereas unresponsive patients in Japan and China were most likely to be retreated with BCG."Untreated-on watch and wait"was the main treatment/management approach received post-BCG treatment for 42%or more of patients in most countries except China(39%)and the United States(36%)."Following treatment guidelines"was consistently the top reason for post-BCG treatment selection across all treatment ***:This study confirmed the global unmet need for patients with nonmuscle invasive bladder cancer,and found that many patients experienced periods of no treatment after not responding to BCG therapy.

关键词： Bacillus Calmette-Guérin Bladder cancer Cystectomy treatment failure Urinary tract

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