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Advances in technology for the laboratory diagnosis of individuals with hiv/AIDS coinfected with Mycobacterium tuberculosis

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Biosafety and Health 2024年第3期6卷 133-142页

作者： Jin Sun Xiaoxu Han Hongxia Yan Xin Zhang Taiyi Jiang Tong Zhang Hao Wu Grigory Kaminskiy Yingmin Ma Eduard Karamov Bin Su Beijing Key Laboratory for hiv/AIDS Research Clinical and Research Center for Infectious DiseasesBeijing Youan HospitalCapital Medical UniversityBeijing 100069China State Health Organization Tula Regional Center for Control and Prevention of AIDS and Infectious Diseases Tula 300002Russia Department of Respiratory and Critical Care Medicine Beijing Youan HospitalCapital Medical UniversityBeijing 100069China Gamaleya National Research centre for Epidemiology and Microbiology of the Ministry of Health of the Russian Federation Moscow 123098Russia

The high morbidity and mortality rate of individuals with human immunodeficiency virus(hiv)/acquired immunodeficiency syndrome(AIDS)coinfected with Mycobacterium tuberculosis(MTB)is a tough challenge for current global tuberculosis prevention and control ***/MTB coinfection is more complex than a single infection,and the interaction between the two diseases aggravates the deterioration caused by the disease,resulting in increased hospitalizations and *** screening and early diagnosis facilitate the timely initiation of anti-tuberculosis treatment in hiv/MTB coinfected individuals,thereby reducing transmission and the incidence of adverse *** date,pathogenic detection has remained the gold standard for diagnosing tuberculosis,but its sensitivity and specificity are greatly affected by the body's immune status,which limits its application in the diagnosis of hiv/MTB ***,immunology and molecular detection technology has developed *** detection technologies,such as interferon-γ release assays,interferon-gamma inducible protein 10,and GeneXpert MTB/RIF assay have overcome the limitations of traditional detection methods,significantly improved the sensitivity and specificity of tuberculosis diagnosis,and brought new hope to the detection of hiv/MTB *** this article,the principle,scope of application,and latest research progress of relevant detection methods are reviewed to provide a reference for the early diagnosis of hiv/MTB coinfection.

关键词： Human immunodeficiency virus(hiv) Mycobacterium tuberculosis(MTB)coinfection Mycobacterium tuberculosis(MTB) Early diagnosis

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Anorexia nervosa:outpatient treatment and medical management

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World Journal of Psychiatry 2022年第4期12卷 558-579页

作者： Stein Frostad Mette Bentz Department of Mental Health Research Division of PsychiatryHaukeland University HospitalBergen 5021Norway Child and Adolescent Mental Health centre Capital Region of DenmarkUniversity of CopenhagenCopenhagen 2400Denmark

Anorexia nervosa(AN)is a disabling,costly and potentially deadly *** failure and relapse are common after completing treatment,and a substantial proportion of patients develop severe and enduring *** time from AN debut to the treatment initiation is normally unreasonably *** the past 20 years there has been empirical support for the efficacy of several treatments for ***,outpatient treatment with family-based therapy or individual psychotherapy is associated with good outcomes for a substantial proportion of *** intervention improves outcomes and should be a priority for all *** treatment is usually the best format for early intervention,and it has been demonstrated that even patients with severe or extreme AN can be treated as outpatients if they are medically *** care is more disruptive,more costly,and usually has a longer waiting list than does outpatient *** decision as to whether to proceed with outpatient treatment or to transfer the patient for inpatient therapy may be *** core aim of this opinion review is to provide the knowledge base needed for performing safe outpatient treatment of *** scientific essentials for outpatient treatment are described,including how to assess and manage the medical risks of AN and how to decide when transition to inpatient care is *** following aspects are discussed:early intervention,outpatient treatment of AN,including outpatient psychotherapy for severe and extreme AN,how to determine when outpatient treatment is safe,and when transfer to inpatient healthcare is *** treatments,ethical issues and outstanding research questions are also addressed.

关键词： Anorexia nervosa outpatient treatment Medical management outpatient psychotherapy Inpatient healthcare

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Neurocognitive Disorders in Patients with hiv Infection with Virologic Suppression for More than 10 Years

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World Journal of AIDS 2017年第1期7卷 59-66页

作者： André Filipe dos Santos-Silva Joana Margarida Almeida Alves Isabel Ramos Maria del Cármen Piñ eiro-Calvo Cláudia Sousa Maria do Rosário Serrã o António Carlos Eugénio Megre Sarmento Infectious Diseases Department S&atilde o Joã o Hospital centre Oporto Portugal Faculty of Medicine of the University of Oporto Oporto Portugal Psychiatry and Mental Health Department S&atilde o Joã o Hospital centre Oporto Portugal Neurology Department S&atilde o Joã o Hospital centre Oporto Portugal

Background: hiv-associated neurocognitive disorder (HAND) may appear in patients with viral and immunological response to treatment and remain unnoticed during the initial stage of the infection. The goal of this study is to evaluate the development and/or progression of HAND in patients with undetectable viral load for more than ten years. Methods: We included adult hiv-infected patients who were under antiretroviral treatment and had undetectable plasma viral load for more than ten years (blips were included). These patients had already been subjected to neurocognitive evaluation five years previously. Demographic, clinical and analytical data were analysed. For the neurocognitive evaluation, the WAIS-III subtests (digit symbol coding and symbol search), trail making test (TMT) A and B, Stroop test and categorical verbal fluency (animals) tests were used. SPSS??version 22.0 for Windows was used for statistical analysis. Results: In this re-evaluation, performed 4.76 (±1.82) years after the first one, 9 (36%) patients showed deficits in processing speed (WAIS-III and TMT A), 8 (32%) executive function (TMT B and Stroop) and 12 (48%) verbal fluency. There were significant statistical differences between the past and current executive function tests (p = 0.029 and p = 0.01), highlighting worsening of deficits. No differences were found for the other tests. No association was found between deficit progression and the studied variables. Conclusions: Although not generally noticed on regular appointments, in this small population, worsening of executive function deficits (mental flexibility and divided attention) was found. Classical risk factors for HAND did not appear to interfere in its progression. Speed of information processing and categorical verbal fluency remained stable.

关键词： hiv HAND Dementia Impairment

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A Systematic Review to Explore the Factors Related to Parent to Child Transmission of hiv, Survival and treatment Provision of Children with hiv in India

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World Journal of AIDS 2015年第3期5卷 245-255页

作者： Arvind Kumar Singh Partha Haldar Sanjay Kumar Rai Shashi Kant centre for Community Medicine All India Institute of Medical Sciences New Delhi India

Introduction: There are a multitude of factors that impact the transmission of hiv from parent to child and the subsequent survival of infected children. Changing dynamics in hiv transmission have led to an increase in the number of children living with hiv in India. This review synthesizes the evidence related to transmission of hiv to children, survival and treatment provision among children living with hiv. Methods: A systematic search was conducted in MEDLINE, IndMed, Web of Science, Google Scholar and major journals related to hiv/AIDS to identify relevant studies published between 1992 and 2015. Inclusion criteria included studies related to parent to child transmission of hiv, treatment of children living with hiv and survival of children living with hiv. One of the authors reviewed the studies and extracted the data in a pre-coded extraction sheet. Results: Thirty-three studies were included in the review. hiv transmission rate from parent to Child who received nevirapine prophylaxis ranged from 2.1% to 27.3%. Extended dose regimen of nevirapine prophylaxis was found to be more effective than the single dose regimen. Adherence to ART ranged from 65% to 95%. Adherence varied depending upon the level of health care facility. Both social and medical factors were associated with non-adherence. CD 4 count at the time of diagnosis and delayed age at hiv diagnosis were important predictors of survival. Conclusion: Shift in policy to provide option B regimen is yielding better results. If the age at diagnosis could be reduced further, it would increase the survival of children living with hiv. The program needs to increase access to the health care facilities.

关键词： PPTCT1 ART Children India Adherence Prophylaxis

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Risk factors of treatment default and death among tuberculosis patients in a resource-limited setting

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Asian Pacific Journal of Tropical Medicine 2014年第12期7卷 977-984页

作者： Isaac Alobu Sarah N.Oshi Daniel C.Oshi Kingsley N.Ukwaja National Tuberculosis and Leprosy Control Programme Ministry of HealthAbakalikiEbonyi StateNigeria centre for Development and Reproductive Health Enugu.Enugu StateNigeria Department of Internal Medicine Federal Teaching HospitalAbakalikiEbonyi StateNigeria

Objective:To evaluate the rates,timing and determinants of default and death among adult tuberculosis patients in ***:Routine surveillance data were used.A retrospective cohort study of adult tuberculosis patients treated during 2011 and 2012 in two large health facilities in Ebonyi *** was *** logistic regression analyses were used to tdentify independent predictors for treatment default and ***:Of 1668 treated patients,the default rate was 157(9.4%),whilst 165(9.9%) ***,35.7%(56) of the treatment defaults and 151(91.5%) of deaths occurred during the intensive phase of *** of default increased with increasing age(adjusted odds ratio(aOR) 1.2;95%confidence interval(CI)1.1-1.9).smear-negative TB case(aOR 2.3:CI 1.5-3.6).extrapulmonary TB case(aOR 2.7:CI 1.3-5.2).and patients who received the longer treatment regimen(aOR 1,6;1.1-2.2).Risk of death was highest in extrapulmonary TB(aOR 3.0:CI 1.4-6.1) and smear-negative TB cases(aOR 2.4:*** residents(aOR 1.7:CI 1.2-2.6),hiv co-infected(aOR 2.5:CI 1.7-3.6),not receiving antiretroviral therapy(aOR 1.6:CI 1.1-2.9),and not receiving cotrimoxazole prophylaxis(aOR 1.7:CI 1.2—2.6).Conclusions:Targeted interventions to improve treatment adherence for patients with the highest risk of default or death are urgently *** needs to he urgently addressed by the National Tuberculosis Programme.

关键词： Tuberculosis Epidemiology treatment default Mortality treatment outcome Health services Nigeria

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Olecranon Fractures in Children: About 21 Cases Treated at the Owendo University Hospital Center at Libreville (Gabon)

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Open Journal of Orthopedics 2022年第3期12卷 113-121页

作者： Cyprien Mba Mba Natacha Boumas Christelle Mezene Mendome Scarlette Mengue Mba Meyo Magdalie Nancy Mamfoumbi Arthur Matsanga Francois Ondo N’dong centre Hospitalier Universitaire d’Owendo Orthopedic and Trauma Surgery Department Libreville Gabon Pediatric Surgery Department of centre Hospitalier Universitaire Mère Enfant Fondation Jeanne Ebori Libreville Gabon centre Hospitalier Universitaire d’Owendo Anesthesia and Resuscitation Department Libreville Gabon Department of Surgery University of Health Sciences Libreville Gabon

Background: The olecranon fractures in children are relatively rare articular fractures. The aim of this work is to study the epidemiological, clinical and therapeutic particularities of this fracture in children at Owendo University Teaching Hospital. Patients and Methods: This was a retrospective analytical, monocentric study over 2 years from January 1, 2018 to January 1, 2020 at the Owendo University Hospital in Libreville and relating to the medical files of patients treated for a fracture of the olecranon in children in the service and regularly followed in outpatient consultation. Results: We collected 21 patients with an average age of 8.7 years. Falls dominated the etiologies. The Bracq classification was the one used in our series with the predominance of type D. The treatment was orthopedic in 33.3% of cases and surgical in 66.7% of cases. With an average follow-up of 12 months, the results were good in 71.5%, average in 19.0% and poor in 9.5%. Conclusion: The analysis of our results compared to those of the authors of the literature according to the precise parameters seems satisfactory.

关键词： Fracture Olecranon Child Prognosis Libreville

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Assessment of a six-week computer-based remediation program for social cognition in chronic schizophrenia

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上海精神医学 2015年第5期27卷 296-306页

作者： Linda K BYRNE Lingyi PAN Marita McCABE David MELLOR Yifeng XU School of Psychology Deakin University Melbourne Australia Shanghai Mental Health centre Shanghai China

Background: Programs to remediate cognitive deficits have shown promising results in schizophrenia, but remediation of social cognition deficits is less well understood. Social cognitive deficits may cause more disability than the widely recognized neurocognitive deficits, suggesting that this is an area worthy of further investigation. Aim: Implement and evaluate a brief computerized memory, attention, and facial affect recognition (FAR) cognitive remediation program designed to improve n outpatients with chronic schizophrenia. Methods: Baseline assessments of FAR and of clinical, cognitive, and psychosocial functioning were completed on 20 males with schizophrenia enrolled in an outpatient rehabilitation program at the Shanghai Mental Health Center (the intervention group) and on 20 males with schizophrenia recruited from among regular outpatients at the Center (the control group). Both groups received treatment as usual, but the intervention group also completed an average of 12.7 sessions of a computer-based remediation program for neurocognitive, social, and FAR functioning over a 6-week period. The baseline measures were repeated in both groups at the end of the 6-week trial. Results: There were no statistically significant differences in the changes in clinical symptoms (assessed by the Positive and Negative Syndrome Scale, PANSS) or cognitive measures (assessed using the Hong Kong List Learning Test and the Letter-Number Sequencing Task) between the intervention and control groups over the 6-week trial, but there were modest improvements on the PANSS for the intervention group between baseline and after the intervention. There was a significantly greater improvement in the social functioning measure (the Personal and Social Performance scale, PSP) in the intervention group than in the control group. The pre-post change in the total facial recognition score in the intervention group was statistically significant (paired t-test=-2.60, p=0.018), and there was a

关键词：精神分裂症社会功能计算机辅助治疗方案患者慢性认知功能障碍面部识别

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Hepatitis B Surface Antigen Serum Level Is Correlated with Fibrosis Severity in treatment-Naïve, Chronic Hepatitis B Patients in Côte d’Ivoire (West Africa)?

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Open Journal of Gastroenterology 2015年第11期5卷 164-172页

作者： Mamert Fulgence Yao Bathaix Dramane Soro Aboubacar Demba Bangoura Adjéka Stanislas Doffou Siaka Koné Ya Henriette Kissy Dimitri Hartrydt Kouamé Aoudi Ousmane Dé Mahassadi Kouamé Alassane Attia Koffi Alain Aya Thérèse N’dri Yoman Department of Hepatology and Gastroenterology of the centre Hospitalier Universitaire de Yopougon (CHU-Y) Abidjan Cote d’Ivoire Department of Hepatology and Gastroenterology of the centre Hospitalier Universitaire de Cocody (CHU-C) Abidjan Cote d’Ivoire

HBsAg serum level (quantification) may be useful for managing hepatitis B virus (HBV) infection patients. However few studies especially in Africa have evaluated the association between HBsAg serum level and liver fibrosis severity. The objective of this study was to estimate the correlation between HBsAg serum level and liver fibrosis severity with treatment naive chronic hepatitis B patients in Cote d’Ivoire. Methodology: It is a prospective study covering from February 1st, 2014 to April 30st, 2015 at centre Hospitalier et Universitaire de Yopougon and a private medical office in Abidjan, Cote d’Ivoire. Inclusion criteria for patients were: HBsAg positive, known HBeAg status, serum HBsAg levels, serum HBV DNA levels, complex serum markers and absence of HCV, HDV, or hiv co-infection, drinking more than 30 g/day for men and 20 g/day in women over 10 years, metabolic disease and/or hepatic overload. Pearson’s Chi-square test (r2), Anova, Spearman, T-Student, Pearson’s (r) correlations and Mann Withney’s Test were carried out as appropriate. A p value < 0.05 was taken as significant. Results: We recruited, 105 patients (77 men) of whom the medium age was 39.01 ± 9.72 years. Predominant hepatitis B viral genotype was E (93%). Less than 10% patients had an inactive HBV in HBeAg-negative. Patients had an average high HBsAg serum level (mean 12111.2 ± 10617.4 IU/ml) as well as the one viral load (mean 4.4 e7 ± 7.5 e7). Serum ALAT levels averaged at the upper limit of normal value. The average liver fibrosis score was 0.34 ± 0.22 and the degree of viral activity was 0.19 ± 0.20. Half of our patients had no fibrosis (35.24%) or had mild fibrosis (20.95%). No significant association was observed between HBsAg serum level and patient age (p = 0.3994), genre (p = 0.8075) or serum ALT levels (p = 0, 0787). In multivariate analysis, there’s a significant correlation (r = 0.239, p = 0.014) between HBV DNA levels and HBsAg serum level. There’s a significant correlation (r = 0.92

关键词： Hepatitis B Surface Antigen Serum Level Liver Fibrosis Chronic Hepatitis B Viral Africa

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Diversity of Human Immunodeficiency Virus Type-1 Subtypes in Western Kenya

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World Journal of AIDS 2014年第4期4卷 365-372页

作者： F. O. Adungo M. M. Gicheru N. I. Adungo M. M. Matilu R. W. Lihana S. A. Khamadi centre for Infectious and Parasitic Diseases Control Research Kenya Medical Research Institute Busia Kenya Department of Zoological Sciences Kenyatta University Nairobi Kenya centre for Virus Research Kenya Medical Research Institute Nairobi Kenya

Background: hiv/AIDS is the principal pandemic in the world today.?Two viral types (hiv-1 and hiv-2), with numerous groups (M, N and O for hiv-1 and A through H for hiv-2) have emerged. These have further proliferated into numerous subtypes, sub-subtypes and circulating recombinant forms (CRF) over the last 30 years.?hiv-1 variants circulate together within a geographical region providing an opportunity for recombination of viral strains within infected individuals.?In Kenya, at least nine different genetic hiv-1 subtypes and several recombinant forms have been defined within group M, which accounts for the majority of cases in the AIDS pandemic. Objective:?To determine the genetic diversity of hiv-1 in the western region of Kenya bordering Uganda. Methodology: A cross sectional study was carried out at Busia District Hospital between 2007 and 2009. A total of 75 patients were sampled randomly from a cohort of 1000 clients on antiretroviral therapy. Blood samples were analysed at the hiv Laboratory, Kenya Medical Research Institute, Nairobi, Kenya. PCR was carried out on the?Pol?region of hiv, sequenced and analysed by BLAST for subtypes. Results: BLAST analysis revealed the following circulating subtypes: 40/75 (53.30%) were hiv-1 group M subtype A1;21/75 (28.0%) were subtype D;5/75 (6.7%) were subtype G;4/75 (5.30%) were subtype C;and 2/75 (2.70%) were subtype A2. Only one isolate was identified for the other subtypes?viz: 1/75 (1.30%) resembled subtype B;1/75 (1.30%) was A1/C, and 1/75 (1.30%) was A1/D. Conclusion: The study showed increasing hiv-1 diversity along the Kenya-Uganda border with the emergence of A1/C and A1/D recombinants. Such hiv-1?diversityvis a vis?the recent expanded access to antiretroviral therapy in resource limited settings calls for continuous evaluation of anti-hiv regimens. There?is need therefore, for regular surveillance and monitoring for mutations that are likely to lead to drug resistance if we have to achieve successful treatment o

关键词： hiv-1 Subtypes Genetic Diversity

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Antimicrobial stewardship and targeted therapies in the changing landscape of maternal sepsis

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Journal of Intensive Medicine 2024年第1期4卷 46-61页

作者： Nishel M Shah Esmita Charani Damien Ming Fook-Choe Cheah Mark R Johnson Department of Metabolism Digestion and ReproductionImperial College LondonChelsea and Westminster HospitalLondonUK Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance Imperial College LondonLondonUK Division of Infectious Diseases and hiv Medicine Department of MedicineGroote Schuur HospitalUniversity of Cape TownCape TownSouth Africa Department of Infectious Diseases Imperial College LondonChelsea and Westminster HospitalLondonUK Department of Paediatrics Faculty of MedicineUniversiti Kebangsaan Malaysia Medical CentreKuala LumpurMalaysia

Pregnant and postnatal women are a high-risk population particularly prone to rapid progression to sepsis with significant morbidity and mortality ***,severe maternal infections can have a serious detrimental impact on neonates with almost 1 million neonatal deaths annually attributed to maternal infection or *** this review we discuss the susceptibility of pregnant women and their specific physiological and immunological adaptations that contribute to their vulnerability to sepsis,the implications for the neonate,as well as the issues with antimicrobial stewardship and the challenges this poses when attempting to reach a balance between clinical care and urgent ***,we review advancements in the development of pregnancy-specific diagnostic and therapeutic approaches and how these can be used to optimize the care of pregnant women and neonates.

关键词： Sepsis Pregnancy Immunology Cardiovascular Personalised medicine Antibiotic stewardship

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