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Ebsen Henderson posted an update 3 days, 3 hours ago
be required before wide-scale implementation.
Our findings support prediction modelling as a useful tool that can be leveraged to improve outcomes across the HIV care continuum. Utilizing information from multiple sources, the risk prediction score tool applied here can be refined further with the ultimate goal of being used in a screening tool by practitioners working with ALWHIV. Specifically, the tool could help identify and provide early interventions to adolescents at the highest risk of poor adherence and/or viral non-suppression. However, further fine-tuning and external validation may be required before wide-scale implementation.The treatment of stage IIIB non-small cell lung cancer (NSCLC) is complicated, the best strategy is chosen individually and surgery is usually not recommended. A 50-year-old female was diagnosed with locally advanced lung adenocarcinoma (stage IIIB, T2bN3M0). Fluorescence in situ hybridization (FISH) analysis revealed an ALK rearrangement. Crizotinib was administered and progression was seen after five months. The patient then received ceritinib with a palliative intent, which led to downstaging (IIIA[N2]) with a radiological and metabolic response. Right lower lobe lobectomy was performed at 12 months post-surgery, and the patient is still disease-free according to the last computed tomography (CT) scan. selleckchem The unintended downstaging from ceritinib provided a chance for resection in our patient who had ALK-positive stage IIIB NSCLC after the failure of first-line crizotinib, indicating potential usage of ceritinib in the neoadjuvant setting. Future perspective trials are warranted to investigate the role of ceritinib in earlier stages as a primary drug.
Women with gestational diabetes (GDM) are at greatly increased risk of type 2 diabetes (T2DM). The UK guidance recommends screening for T2DM at around 6-week postpartum and annually thereafter. We evaluated conformity to this guidance in two separate time periods.
The proportion of tests performed within guidance was assessed using longitudinal plasma glucose and glycated haemoglobin data in two cohorts (1999-2007, n=251; 2015-2016, n=260) from hospital records on women previously diagnosed with GDM.
In the 1999-2007 and 2015-2016 cohorts, 59.8% and 35.0% of women had the recommended postpartum testing, respectively (P<.001); just 13.5% and 14.2%, respectively, underwent the first annual test on time. During long-term follow-up of the 1999-2007 cohort (median follow-up 12.3years), the proportion of women tested in any given year averaged 34.2% over a 17-year period; there was a progressive decline in the proportion of women receiving a yearly test with time since delivery (P=.002). Over the follow-upve approaches are needed to ensure effective follow-up of this high-risk group. To have an impact, interventions need to be tailored to a young, generally healthy group in which traditional approaches to follow-up may not be best suited.
Our study aimed to investigate the association between elevated carotid-intima media thickness (CIMT) and serum uric acid (SUA) levels in hypertensive patients attending primary care clinics in Sungai Buloh, Malaysia.
We conducted a cross-sectional study on 140 hypertensive patients attending outpatient follow-up in two primary care clinics in Sungai Buloh, Malaysia, using a convenient sampling method. SUA levels were measured and divided into four quartiles. Two radiologist specialists performed B mode ultrasonography to assess the thickness of the right and left carotid intima media in all participants.
Participants’ mean SUA level was 355.75±0.13. Their mean age was 53.44 (±9.90), with a blood pressure control of 137.09±13.22/81.89±8.95. Elevated CIMT taken at ≥75th percentile was 0.666 for the left and 0.633 for the right common carotid arteries. By using a hierarchical method of multiple logistic regression, compared with the first quartile of the SUA level as reference group, the odd of elevated CIMT in quartile 4 in the common carotid artery was (OR=2.00; 95% CI=0.64-6.27, P=.576) for the right and (OR=0.62; 95% CI=0.20-2.00, P=.594) for the left. Waist circumference (P=.001), body mass index (P=.013), triglycerides (P<.001), and high-density lipoprotein cholesterol (P=.001) were significantly associated with the SUA quartiles.
Although there was an increasing trend in the odd of elevated right CIMT across the SUA quartiles, this association, however, was not significant. Preventive effort to tackle the clustering effect of metabolic markers within this study population is needed to reduce the future risk of developing cardiovascular disease.
Although there was an increasing trend in the odd of elevated right CIMT across the SUA quartiles, this association, however, was not significant. Preventive effort to tackle the clustering effect of metabolic markers within this study population is needed to reduce the future risk of developing cardiovascular disease.
The aim of the study was to determine the effects of constipation symptoms and nutritional status on disease-related parameters, such as disease duration, spirometry test and quality of life, of chronic obstructive pulmonary disease (COPD) patients.
The research was performed with 48 COPD patients attending the centre from January 2019 to August 2019. Assessment of constipation symptoms was done by Constipation Severity Instrument (CSI), whereas for quality of life assessment, St. George’s Respiratory Questionnaire (SGRQ) was used. Patient’s nutritional status was determined by food frequency questionnaire. Body mass index (BMI) and fat-free mass index (FFMI) of the patients were identified with the bioelectrical impedance analysis (BIA) method. Statistical assessment of data was done with SPSS 22 program.
According to the relationship between CSI scores and COPD disease parameters, there was a weak positive correlation between the CSI obstructive defecation subscale and SGRQ activity score and weak positive correlation between CSI colonic inertia subscale and COPD duration from the diagnosis. We found a weak negative correlation between protein intake percentage and SGRQ impact score. As the disease duration increased, the total fat, polyunsaturated fatty acids and vitamin E intake of individuals were determined to reduce.
According to our results, there were some changes in the nutrient intake depending on the duration of COPD, and possible constipation in COPD patients may affect the quality of life.
According to our results, there were some changes in the nutrient intake depending on the duration of COPD, and possible constipation in COPD patients may affect the quality of life.