Risultati per: Sindrome da immunodeficienza umana - AIDS

E’ la Esofagite eosinofila, malattia poco conosciuta. Attenzione ai sintomi

Objectives
Non-adherence to antipsychotics is the greatest obstacle to treating schizophrenia. We assessed the economic and clinical impacts of adherence to antipsychotics among people living with HIV/AIDS (PLWH) and schizophrenia in British Columbia, Canada.

Design and setting
A population-based cohort study in British Columbia, Canada.

Methods
Eligible PLWH were enrolled in the Seek and Treat for Optimal Prevention HIV/AIDS population-based cohort during 2001–2016, diagnosed with schizophrenia, on antipsychotics for ≥1 day, and followed for ≥1 year from schizophrenia diagnosis date or 1 January 2001, whichever occurred last.

Primary and secondary outcome measures
A two-part model assessed the marginal effect of adherence on healthcare costs (in 2016 Canadian dollar), while logistic regression examined the effect on virological failure, and generalised linear mixed models examined the effect on hospital readmissions within 30 days and length of hospital stay.

Results
Among 726 PLWH with schizophrenia, ≥80% adherence to antipsychotics increased from 25% (50/198) in 2001 to 41% (225/554) in 2016. In most years, we observed no difference in adherence to antipsychotics among those who used only injectables, only non-injectables, and a combination of both, or among those who have ever consumed typical/first-generation antipsychotics and who consumed only atypical/second-generation antipsychotics. Overall healthcare costs were higher in the non-adherent group ($C2185), driven by the average annual hospitalisation costs ($C5517), particularly among women ($C8806) and people who ever injected drugs (PWID) ($C5985). Non-adherent individuals also experienced higher hospital readmissions (adjusted odds ratio (aOR) 1.48, 95% CI 1.23 to 1.77), and longer hospital stays (adjusted mean ratio 1.23, 95% CI 1.13 to 1.35) in comparison to adherent individuals. We found no difference in virological failure by adherence groups, except when we stratified by gender where the aOR for women was 2.48 (95% CI 1.06 to 5.82).

Conclusions
Our results showed that implementing strategies and interventions to increase antipsychotic adherence, particularly among women and PWID, will be critical in addressing this public health challenge.

They compared favorably for typical mild-to-moderate hearing loss in a small randomized trial.

The number of people living with HIV worldwide who received antiretroviral therapy through the US President’s Emergency Plan for AIDS Relief (PEPFAR) has increased 300-fold since 2004, reaching 20 million individuals from 54 countries in 2022, according to a report from the US Centers for Disease Control and Prevention (CDC).

This Insights in the Women’s Health series describes the availability, timing, and risks of antiretroviral therapy (ART) in pregnant individuals who have HIV infection.

To the Editor A recent Viewpoint described over-the-counter (OTC) hearing aids as an opportunity to improve the health of millions of Americans with hearing loss. As a pharmacist and an audiologist, we believe that pharmacists will play an important role in ensuring the safe and effective use of OTC hearing aids.

In Reply The Letter from Drs Berenbrok and Mormer describes a care delivery model, versions of which are currently being promoted at the University of Pittsburgh, the University of Maryland, and elsewhere nationally, that involves educating and empowering pharmacists to serve as a front-line interface with consumers seeking hearing aids, and as a conduit for appropriate referrals to audiologists and otologists when needed.

Quasi 2 milioni di ragazzi rischiano di finire nel gorgo delle dipendenze con la possibile coda della depressione o dell’isolamento da amici e coetanei

Bambino Gesù,immunoglobuline per i casi complessi di regressione

Introduction
Cancer diagnosis and treatment can impair fertility, and younger female patients with cancer have a particularly strong need for fertility preservation. Fertility preservation decision aids are thought to help patients make proactive and informed treatment decisions. This systematic review aims to assess the effectiveness and feasibility of online fertility preservation decision aids for young female patients with cancer.

Methods and analysis
PubMed, Web of Science Core Collection, Embase, The Cochrane Central Register of Controlled Trials, PsycINFO and CHINAL, along with three grey literature sources (Google Scholar, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform), will be searched from each database’s establishment to 30 November 2022. Two trained reviewers will independently screen the articles, and the data extraction and methodological quality of eligible randomised controlled trials and quasiexperimental studies will be assessed. A meta-analysis will be performed using Review Manager V.5.4 (Cochrane Collaboration) software, and heterogeneity will be assessed using I² statistics. If a meta-analysis is not possible, a narrative synthesis will be done.

Ethics and dissemination
Since this systematic review is based on published data, no ethical approval is required. The study’s findings will be disseminated through peer-reviewed publications and conference presentations.

PROSPERO registration number
CRD42022363287.

Objectives
To assess access children with HIV have to comprehensive HIV care services, to longitudinally evaluate the implementation and scale-up of services, and to use site services and clinical cohort data to explore whether access to these services influences retention in care.

Methods
A cross-sectional standardised survey was completed in 2014–2015 by sites providing paediatric HIV care across regions of the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We developed a comprehensiveness score based on the WHO’s nine categories of essential services to categorise sites as ‘low’ (0–5), ‘medium’, (6–7) or ‘high’ (8–9). When available, comprehensiveness scores were compared with scores from a 2009 survey. We used patient-level data with site services to investigate the relationship between the comprehensiveness of services and retention.

Results
Survey data from 174 IeDEA sites in 32 countries were analysed. Of the WHO essential services, sites were most likely to offer antiretroviral therapy (ART) provision and counselling (n=173; 99%), co-trimoxazole prophylaxis (168; 97%), prevention of perinatal transmission services (167; 96%), outreach for patient engagement and follow-up (166; 95%), CD4 cell count testing (126; 88%), tuberculosis screening (151; 87%) and select immunisation services (126; 72%). Sites were less likely to offer nutrition/food support (97; 56%), viral load testing (99; 69%) and HIV counselling and testing (69; 40%). 10% of sites rated ‘low’, 59% ‘medium’ and 31% ‘high’ in the comprehensiveness score. The mean comprehensiveness of services score increased significantly from 5.6 in 2009 to 7.3 in 2014 (p

Pubblicato il documento approvato in Conferenza Stato Regioni

Introduction
Alcohol use is a global driver of HIV infection and disease progression, mediated through risky behaviour and poor antiretroviral adherence. Most studies about the burden of alcohol use among people living with HIV (PLWH)/AIDS have been done in adult populations, but less is known about young people with HIV, especially in low-income and middle-income countries (LMICs), despite the high level of alcohol use in these settings. The aim of this review is to collate evidence on the prevalence of, and factors associated with, alcohol use disorder (AUD) among young adults (aged 15–24 years) living with HIV/AIDS in LMICs.

Methods and analysis
Two experienced librarians will conduct an independent article search in PubMed, PsycINFO, Embase and Web of Science databases, using relevant Medical Subject Headings terms and Boolean operators (‘AND’, ‘OR’). We will include English-language articles that were published in peer-reviewed journals from 1 January 2000, to 25 July 2022, that documented the prevalence of AUD among young people (15–24 years) living with HIV in LMICs. We shall exclude systematic review articles and qualitative studies. Two independent reviewers will screen the articles for eligibility and data will be extracted onto a preset Excel spreadsheet. Data analysis will be done using Stata V.14.0. Heterogeneity will be assessed by use of the I2 statistic and data will be pooled in meta-analyses where appropriate. Publication bias will be assessed using the funnel plot.

Ethics and dissemination
Ethical approval is not needed as this systematic review will be based on published studies. Findings from this study will be disseminated via submission for publication in a peer-reviewed journal, at conference presentations, and made available to health professionals, scientists and policy makers. Our data set can be made available on request.

Registration details
PROSPERO, CRD42022308955

Introduction
Cochlear implant (CI) and hearing aid (HA) in a bimodal solution (CI+HA) is compared with bilateral HAs (HA+HA) to test if the bimodal solution results in better speech intelligibility and self-reported quality of life.

Methods and analysis
This randomised controlled trial is conducted in Odense University Hospital, Denmark. Sixty adult bilateral HA users referred for CI surgery are enrolled if eligible and undergo: audiometry, speech perception in noise (HINT: Hearing in Noise Test), Speech Identification Scores and video head impulse test. All participants will receive new replacement HAs. After 1 month they will be randomly assigned (1:1) to the intervention group (CI+HA) or to the delayed intervention control group (HA+HA). The intervention group (CI+HA) will receive a CI on the ear with a poorer speech recognition score and continue using the HA on the other ear. The control group (HA+HA) will receive a CI after a total of 4 months of bilateral HA use.
The primary outcome measures are speech intelligibility measured objectively with HINT (sentences in noise) and DANTALE I (words) and subjectively with the Speech, Spatial and Qualities of Hearing scale questionnaire. Secondary outcomes are patient reported Health-Related Quality of Life scores assessed with the Nijmegen Cochlear Implant Questionnaire, the Tinnitus Handicap Inventory and Dizziness Handicap Inventory. Third outcome is listening effort assessed with pupil dilation during HINT.
In conclusion, the purpose is to improve the clinical decision-making for CI candidacy and optimise bimodal solutions.

Ethics and dissemination
This study protocol was approved by the Ethics Committee Southern Denmark project ID S-20200074G. All participants are required to sign an informed consent form.
This study will be published on completion in peer-reviewed publications and scientific conferences.

Trial registration number
NCT04919928.

In this Viewpoint from officials at NIH and FDA, the authors discuss research collaborations between federal agencies and the private sector, using new regulations for over-the-counter hearing aids as an illustration.