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Metabolic and Cardiovascular Comorbidities Among Clinically Stable HIV Patients on Long-Term ARV Therapy in Five Ambulatory Clinics in Lima-Callao, Peru

Author: Jose A Hidalgo

Abstract

Background:

There is scarcity of data about the prevalence of non-AIDS defining comorbidities among stable HIV-infected patients in Peru.

Objective:

We aimed to describe the most frequent cardiometabolic comorbidities found among ambulatory adults on ARV in Peru.

Methods:

A review of records for patients attending regular visits at 5 clinics in Lima-Callao in January-February 2016 is presented. Patients were adults on ARV for >6 months, with no recent AIDS-defining condition.

Results:

Three hundred and five medical charts were reviewed. Most patients were male (73.1%, n=223) with a mean age of 46.0 years. Mean time from HIV diagnosis was 9.41 yrs. and mean duration of ARV was 7.78 yrs. Most patients were on an NNRTI-based first line regimen (76.4%, n=233), and 12.1% (n=37) were on rescue regimens. Median CD4 count was 614.2 cells/µL and the proportion of patients with viral load <40 c/mL was 90.8% (n=277). Most frequent metabolic diagnoses were dyslipidemia (51.5%, n=157), obesity (11.1%, n=34), and diabetes mellitus (7.2%, n=22). Hypertension was diagnosed in 8.9% (n=27). Other diagnoses of cardiovascular disease were documented in 3.3% (n=10). Pharmacologic treatment was prescribed in 91.3% of patients with diabetes or hypertension, but in only 29.3% of patients with dyslipidemia.

Conclusion:

A high proportion of metabolic comorbidities was found, with dyslipidemia being the most frequent, followed by obesity and diabetes. In contrast, cardiovascular disease was documented less frequently. Medical treatment was started for only a third of dyslipidemia patients. HIV care policies need to consider proper management of chronic comorbidities to optimize long-term outcomes.

TOAIDJ-12-126_F1

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https://benthamopen.com/ABSTRACT/TOAIDJ-12-126

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Developing a Dashboard Software for the ICUs and Studying its Impact on Reducing the Ventilator-Associated Pneumonia

Author: Mohammad Fathi

Journal: The Open Medical Informatics Journal

Abstract

Objective:

Ventilator-Associated Pneumonia (VAP), a lung infection developing in patients on a ventilator in Intensive Care Units (ICU), is the second most common nosocomial infection and a leading cause of morbidity and mortality in ICUs. To reduce the incidence rate of VAP complication, many healthcare organizations have already developed certain strategies and guidelines. However, there are still high rates of VAP infections mainly due to: conflicting guidelines from different sources, implementing the guidelines at different times and conditions, different ICU caregivers at different shifts, and of course the human mistakes.

Methods:

The present study aimed to develop a dashboard to help reducing VAP incidences in ICUs. To achieve the objective of the research, first, the VAP prevention guidelines were compiled. The object-oriented analysis approach was adopted for designing of the dashboard software. To assess the impact of the developed dashboard on the reduction of VAP events, a pilot hospital was selected and a pilot project was prepared. For the dashboard usability assessment based on user satisfaction, a questionnaire was developed as the survey tool.

Conclusion:

The dashboard was developed and put into operation in a pilot ICU. The results from the t-test (with a probable error of 0.05 percent) indicated a meaningful difference between the number of VAP patients before and after the dashboard implementation with p-value ˂ 0.02. Also, the developed software was evaluated from a usability point of view based on user satisfaction, with health professionals and caregivers of the pilot ICU as the users of the software. The total score was equivalent to 95 percent, falling within the acceptable range of 75-100 percent.

TOMINFOJ-12-42_F1
The software provides the ICU staff with immediate and easy-to-grasp information on the unit’s situation through presenting real-time graphic (or combination of text and graph) reports.

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https://benthamopen.com/ABSTRACT/TOMINFOJ-12-42

Wearable Biomonitoring Platform for the Assessment of Stress and its Impact on Cognitive Performance of Firefighters: An Experimental Study

Author: Susana Rodrigues

Journal: Clinical Practice & Epidemiology in Mental Health

Capture 1.PNG

CPEMH-14-250_F1
System block diagram explaining the bio monitoring platform architecture.

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https://benthamopen.com/ABSTRACT/CPEMH-14-250

Assessing Treatment Outcomes of a Graduate Orthodontic Program

Author: Anastasia Pariskou

Journal: The Open Dentistry Journal

Abstract

Objectives:

To assess treatment outcomes of a graduate orthodontic program during two different periods.

Materials and Methods:

Consecutive orthodontic patients’ files were selected from the archives of the Graduate Orthodontic Program, Aristotle University of Thessaloniki, Greece. Following the application of certain inclusion criteria, the final sample consisted of 109 patients. The sample was allocated into two groups depending on the time of treatment [Group A: 1998-2003, (n=60); Group B: 2004-2009 (n=49)]. The first period started a few years after the inception of the program and the second 10 years later. All pre- and post-treatment dental casts were blindly assessed by one investigator using the Peer Assessment Rating (PAR) and the Index of Complexity, Outcome and Need (ICON). Statistical analysis included Student’s t-test, Mann-Whitney U test, Pearson Chi-Square test and Spearman correlation coefficient. The level of significance was set at p < 0.05.

Results:

In Group A, the mean PAR index changed from 28.6 before treatment to 5.5 after treatment and the mean ICON index changed from 71.9 to 23.5. In Group B, the mean PAR index changed from 23.6 before treatment to 4 after treatment and the mean ICON index changed from 62.8 to 19.8. The mean PAR score reduction was 78.4% for the 1st group and 81.4% for the 2nd group, respectively. Ninety percent of the cases of Group A and 89.8% of the cases of Group B had a post-treatment ICON score < 31. The severity of the initial malocclusion was found to be positively correlated with the treatment occlusal outcome. Out of the 109 cases, 68 were considered as substantially or greatly improved, 29 moderately improved, 8 showed minimal improvement and 4 cases were considered as not improved or worse. The mean PAR percentage improvement and the ICON score at the end of treatment were not correlated to the presence or absence of tooth extractions in the treatment plan. There was no correlation between the treatment outcome and the number of graduate residents involved in the therapy. The treatment outcomes were not correlated to the gender or age of patients.

Conclusion:

Patients treated by graduate orthodontic residents during 1998-2009 demonstrated significant improvement of their occlusion and the quality of the treatment remained constant throughout the years. The outcome of orthodontic treatment was not correlated to the gender and the age of patients, the number of postgraduate students performing the treatment, and the presence of tooth extractions in the treatment plan.

TODENTJ-12-896_F1.jpg

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https://benthamopen.com/ABSTRACT/TODENTJ-12-896

The Antitumor Immunity Mediated by NK Cells: The Role of The NCRs

Author: Mona Rady

Journal: The Open Cancer Immunology Journal

Abstract

Natural Killer (NK) cells are innate immune lymphocytes that are important for early and effective immune responses against infections and cancer. The antitumor immunity mediated by NK cells can be exerted through several direct or indirect “immunosurveillance” mechanisms that control tumor growth and prevent the rapid dissemination of metastatic tumors. NK cells express an array of activating and inhibitory receptors that enable them to recognize and bind non-self as well as self-ligands expressed on the surface of malignant or virally infected cells. The family of Natural Cytotoxicity Receptors (NCRs) comprises three activating receptors; NKp30, NKp44, and NKp46 that are important for the stimulation of NK cell effector functions. This review summarizes the mechanisms of antitumor immunity mediated by natural killer cells with focus on the role of the family of the NCRs and their tumor associated ligands.

TOCIJ-7-7_F1
Tumor associated ligands for NCRs. Schematic representation of tumor associated ligands expressed by tumor cells and their interaction with the NCRs, NKp30, NKp44 and NKp46 expressed on NK cells.

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https://benthamopen.com/ABSTRACT/TOCIJ-7-7

Polysorbate 80 Coated Solid Lipid Nanoparticles for the Delivery of Temozolomide Into the Brain

Author: Pawan Yadav

Abstract

Introduction:

Anti-angiogenic therapy can produce transient regression in tumor in case of Glioblastoma (GBM); however, no prolongation of patient survival rate had so far been achieved.

Methodology:

To address this problem, an effort was made to design and characterize a temozolomide loaded nanosystem for targeting the tumor vasculature in the brain using polymeric nanoparticles. It included the formation of Temozolomide (TMZ) loaded Solid-Lipid Nanoparticles (SLNs) and their conjugation with polysorbate-80 (P-80) which enhanced the penetration of drug to blood-brain barrier resulting in the enhancement of pro-apoptotic activity.

Results:

Conjugating nanoparticles with a tumor-penetrating polymer (P-80) further enhanced the therapeutic efficacy of the drug.

Conclusion:

The animal studies indicated the enhanced potential of the developed system in the effective treatment of glioblastoma.

TOPHARMJ-8-21_F1
Scanning electron microscopy of solid lipid nanoparticles

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Elastic Changes of the Coracohumeral Ligament Evaluated with Shear Wave Elastography

Author: Kenji Kanazawa

Abstract

Background:

Although the shoulder range of motion significantly decreases with advancing age, how the natural aging process affects the joint capsule, including the Coracohumeral Ligament (CHL), in healthy subjects is still unknown.

Objective

To use shear wave elastography to investigate the correlations between age, sex, and shoulder dominance, and elasticity of the CHL in healthy individuals.

Methods:

Eighty-four healthy volunteers (mean age: 42.6; 39 men) were included in this study. They were divided into five groups based on age: 20s (20–29, n = 19), 30s (30–39, n = 17), 40s (40–49, n = 20), 50s (50–59, n = 13), and 60s (60–69, n = 15) groups. The elasticity of the CHL in the bilateral shoulders was evaluated at the neutral and 30° external rotation (ER at 30°) positions with the arm at the side while laying supine.

Results:

The elastic modulus was significantly greater in ER at 30° than in the neutral position regardless of sex or shoulder dominance (P < 0.001). Significant positive correlations between age and elasticity of the CHL were observed in both the neutral and ER at 30° positions regardless of shoulder dominance. Elasticity of the CHL was significantly greater with increasing age in both the neutral and ER at 30° positions on the dominant (P = 0.0022, P < 0.001, respectively) and non-dominant sides (P = 0.0199, 0.0014).

Conclusion:

The elasticity of the CHL increased with age, and the ER at 30° position could demonstrate faint changes in CHL elasticity.

TOORTHJ-12-427_F1
Measurement area of the elastic modulus of the coracohumeral ligament using shear wave elastography.

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https://benthamopen.com/ABSTRACT/TOORTHJ-12-427

Lung-Cancer-Awareness-Month-bentham-ebook--text-banner-2.jpg

Transforming Growth Factor-Beta1 and Myeloid-Derived Suppressor Cells Interplay in Cancer

Author: Juan F. Santibanez

Abstract

Background:

Transforming growth factor-beta1 (TGF-β1) is a pleiotropic cytokine with a double role in cancer through its capacity to inhibit early stages of tumors while enhancing tumor progression at late stages of tumor progression. Moreover, TGF-β1 is a potent immunosuppressive cytokine within the tumor microenvironment that allows cancer cells to escape from immune surveillance, which largely contributes to the tumor progression.

Method:

It has been established that the cancer progression is commonly associated with increased number of Myeloid-derived suppressor cells (MDSC) that are a hallmark of cancer and a key mechanism of immune evasion.

Result:

MDSC represent a population of heterogeneous myeloid cells comprised of macrophages, granulocytes and dendritic cells at immature stages of development. MDSC promote tumor progression by regulating immune responses as well as tumor angiogenesis and cancer metastasis.

Conclusion:

In this review, we present an overview of the main key functions of both TGF-β1 and MDSC in cancer and in the immune system. Furthermore, the mutual contribution between TGF-β1 and MDSC in the regulation of immune system and cancer development will be analyzed.

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https://benthamopen.com/FULLTEXT/TOCIJ-6-1

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