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Coughlin posted an update 7 months, 2 weeks ago
While HIV programmes have started millions of persons on life-saving antiretroviral therapy in Africa, longitudinal health information systems are frail and, therefore, data about long-term survival is often inaccurate or unknown to HIV programmes. The ‘Better Information for Health in Zambia’ (BetterInfo) Study – a regional sampling-based survey to assess retention and mortality in HIV programmes in Zambia – found both retention and mortality to be higher than prevailing estimates from national surveillance systems. We sought to understand how Zambian health decision-makers at different health system levels would respond to these new data, with a view to informing research translation.
We interviewed 25 purposefully sampled health decision-makers from community, facility, district, provincial and national levels. During the interviews, we shared retention and mortality estimates from both routine programme surveillance and those generated by the study. Transcripts were analysed for inductive and deductivm to facilitate both policy and programmatic action.
Studies about the majority of the factors that may potentially influence the pubertal timing and menarche were controversial. The objective was to evaluate the association between factors related to the pregnancy, neonatal period, and the complications that may happen later in life and the menarcheal age in a sample of Lebanese girls admitted or not to the NICU at birth. Our secondary objective was to try to find, for the first time in literature, a correlation between respiratory distress at birth and the need of oxygen therapy with the age of the first menses in these girls.
It is a cross-sectional retrospective study, conducted between January and March 2019. Our sample included all the 2474 girls born in Notre-Dame-de-Secours hospital, between 2000 and 2005; the sample consisted of 297 girls (97 girls admitted to the NICU and 200 randomly chosen to participate in our study with a ratio of 12 (1 girl admitted to the NICU vs 2 girls born in the nursery).
Asthma later in life was significantly associated with lower age at menarche in girls, whereas a higher mother’s age at menarche and a higher gestational age were significantly associated with higher age at menarche in girls. When taking each cause of NICU admission as an independent variable, showed that a higher mother’s age at menarche was significantly associated with higher age at menarche in girls, whereas a higher number of days of phototherapy, a preeclampsia in the mother during pregnancy and asthma later in life in the girl were significantly associated with a lower age at menarche in girls.
The timing of menarche seems to be associated with many factors in Lebanese girls that should not be disregarded by physicians.
The timing of menarche seems to be associated with many factors in Lebanese girls that should not be disregarded by physicians.
Mid-regional pro-atrial natriuretic peptide (MR-proANP) is a useful biomarker in outpatients with type 2 diabetes (T2D) to diagnose heart failure (HF). Elevated B-type natriuretic peptides are included in the definition of HF with preserved ejection fraction (HFpEF) but little is known about the prognostic value of including A-type natriuretic peptides (MR-proANP) in the evaluation of patients with T2D.
We prospectively evaluated the risk of incident cardiovascular (CV) events in outpatients with T2D (n = 806, mean ± standard deviation age 64 ± 10years, 65% male, median [interquartile range] duration of diabetes 12 [6-17] years, 17.5% with symptomatic HFpEF) according to MR-proANP levels and stratified according to HF-status including further stratification according to a prespecified cut-off level of MR-proANP.
A total of 126 CV events occurred (median follow-up 4.8 [4.1-5.3] years). An elevated MR-proANP, with a cut-off of 60pmol/l or as a continuous variable, was associated with incident CV events (p < 0.001). Compared to patients without HF, patients with HFpEF and high MR-proANP (≥ 60pmol/l; median 124 [89-202] pmol/l) and patients with HF and reduced ejection fraction (HFrEF) had a higher risk of CV events (multivariable model; hazard ratio (HR) 2.56 [95% CI 1.64-4.00] and 3.32 [1.64-6.74], respectively). Conversely, patients with HFpEF and low MR-proANP (< 60pmol/l; median 46 [32-56] pmol/l) did not have an increased risk (HR 2.18 [0.78-6.14]).
Patients with T2D and HFpEF with high MR-proANPlevels had an increased risk for CV events compared to patients with HFpEF without elevated MR-proANP and compared to patients without HF, supporting the use of MR-proANP in the definition of HFpEF from a prognostic point-of-view.
Patients with T2D and HFpEF with high MR-proANP levels had an increased risk for CV events compared to patients with HFpEF without elevated MR-proANP and compared to patients without HF, supporting the use of MR-proANP in the definition of HFpEF from a prognostic point-of-view.Although acute gastroenteritis (AGE) has been reported as a common infectious disease in children, there is scarce information about enterovirus (EV) circulating associated with AGE cases in Brazil. The purpose of the present study was to identify and characterize the enteroviruses associated with AGE in children in Belém, Brazil. A total of 175 stool samples were obtained from children hospitalized revealing the presence of EV in 26.3% (46/175) of infections. EV type was identified in 78.3% (36/46) and EV-B species (61.1%; 22/36) was the most prevalent EV-detected followed by EV-C (25%; 9/36) and EV-A (13.9%; 5/36). This study has provided important information about the enterovirus circulation in Pará state, Northern Brazil.
To evaluate inter-fractional variations in bladder and rectum during prostate stereotactic body radiation therapy (SBRT) and determine dosimetric and clinical consequences.
Eighty-five patients with 510 computed tomography (CT) images were analyzed. Elimusertib Median prescription dose was 40Gy in 5 fractions. Patients were instructed to maintain a full bladder and empty rectum prior to simulation and each treatment. A single reviewer delineated organs at risk (OARs) on the simulation (Sim-CT) and Cone Beam CTs (CBCT) for analyses.
Bladder and rectum volume reductions were observed throughout the course of SBRT, with largest mean reductions of 86.9mL (19.0%) for bladder and 6.4mL (8.7%) for rectum noted at fraction #5 compared to Sim-CT (P < 0.01). Higher initial Sim-CT bladder volumes were predictive for greater reduction in absolute bladder volume during treatment (ρ = - 0.69; P < 0.01). Over the course of SBRT, there was a small but significant increase in bladder mean dose (+ 4.5 ± 12.8%; P < 0.01) but no significant change in the D2cc (+ 0.