58 research outputs found
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Tubular Secretory Solute Clearance and HIV Infection
BackgroundTubular secretion is an important kidney function responsible for the clearance of numerous medications, including antibiotics and antivirals. It is unknown whether persons living with HIV have lower secretion compared with HIV-uninfected persons, which might predispose them to the risk of progressive kidney disease or adverse drug events.Setting and methodsWe evaluated a panel of 6 endogenous secretory solutes in 199 women living with HIV (WLWH) and 100 women without HIV enrolled in the Women's Interagency HIV Study. Secretory clearance was estimated as the urine-to-plasma ratio of each solute, with adjustment for urine tonicity. Using multivariable linear regression analysis, we compared differences in levels of secretory solute clearance between women with and without HIV and evaluated characteristics associated with secretion.ResultsWLWH were older (median 40 vs. 38 years) but had similar estimated glomerular filtration rate (eGFR, 96 vs. 100 mL/minute/1.73 m 2 ) compared with those without HIV. African American and Latino race, diabetes, diastolic blood pressure, smoking, hepatitis C, peak HIV viral load, and current and nadir CD4 count were associated with differences in clearance of at least 1 marker after multivariable adjustment. The secretory clearance of 3 solutes (cinnamoylglycine, kynurenic acid, and pyridoxic acid) were on average 10%-15% lower among WLWH compared with those without HIV independent of eGFR, albuminuria and chronic kidney disease risk factors, including HCV, and injection drug use.ConclusionsHIV is associated with reduced secretion among women with preserved eGFR. The implications of these findings for drug dosing and adverse events need to be evaluated
Trends of and factors associated with live-birth and abortion rates among HIV-positive and HIV-negative women
Little is known about fertility choices and pregnancy outcome rates among HIV-infected women in the current combination ART era
T Cell Activation and Senescence Predict Subclinical Carotid Artery Disease in HIV-Infected Women
Background. Individuals infected with human immunodeficiency virus (HIV) have increased risk of cardiovascular events. It is unknown whether T cell activation and senescence, 2 immunologic sequelae of HIV infection, are associated with vascular disease among HIV-infected adults
Upregulated IL-32 expression and reduced gut short chain fatty acid caproic acid in people living with HIV with subclinical atherosclerosis
Despite the success of antiretroviral therapy (ART), people living with HIV (PLWH) are still at higher risk for cardiovascular diseases (CVDs) that are mediated by chronic inflammation. Identification of novel inflammatory mediators with the inherent potential to be used as CVD biomarkers and also as therapeutic targets is critically needed for better risk stratification and disease management in PLWH. Here, we investigated the expression and potential role of the multi-isoform proinflammatory cytokine IL-32 in subclinical atherosclerosis in PLWH (n=49 with subclinical atherosclerosis and n=30 without) and HIV- controls (n=25 with subclinical atherosclerosis and n=24 without). While expression of all tested IL-32 isoforms (α, β, γ, D, ϵ, and θ) was significantly higher in peripheral blood from PLWH compared to HIV- controls, IL-32D and IL-32θ isoforms were further upregulated in HIV+ individuals with coronary artery atherosclerosis compared to their counterparts without. Upregulation of these two isoforms was associated with increased plasma levels of IL-18 and IL-1β and downregulation of the atheroprotective protein TRAIL, which together composed a unique atherosclerotic inflammatory signature specific for PLWH compared to HIV- controls. Logistic regression analysis demonstrated that modulation of these inflammatory variables was independent of age, smoking, and statin treatment. Furthermore, our in vitro functional data linked IL-32 to macrophage activation and production of IL-18 and downregulation of TRAIL, a mechanism previously shown to be associated with impaired cholesterol metabolism and atherosclerosis. Finally, increased expression of IL-32 isoforms in PLWH with subclinical atherosclerosis was associated with altered gut microbiome (increased pathogenic bacteria; Rothia and Eggerthella species) and lower abundance of the gut metabolite short-chain fatty acid (SCFA) caproic acid, measured in fecal samples from the study participants. Importantly, caproic acid diminished the production of IL-32, IL-18, and IL-1β in human PBMCs in response to bacterial LPS stimulation. In conclusion, our studies identified an HIV-specific atherosclerotic inflammatory signature including specific IL-32 isoforms, which is regulated by the SCFA caproic acid and that may lead to new potential therapies to prevent CVD in ART-treated PLWH
Sign posting bushfire: expert knowledge and the loss of the meaning
The research project aimed to understand how experts involved in bush fire related activities use Fire Danger Ratings (FDR) to make decisions to deal with bush fire risk in different times. An interview-based case study was conducted including participants who are involved in bush fire research and management works in Victoria. The results indicated that expert's perception of risk is socially constructed like residents which motivated response towards risk event. Additionally, responsibility towards family members and precautionary measures taken in their property also influenced their decisions to leave early or to stay and defend. The research revealed further issues regarding lacking in current risk communication measure such as FDR. The FDR is applied widely even though originally it was designed for forest ecosystems. The FDR information without the Forest Fire Danger Index value is inadequate to inform the individuals regarding bush fire risk. Moreover, the language such as `Catastrophic' used in FDR is adding further confusion. Then political decisions regarding who will deliver the forecast, which method will be used to produce the forecasts, which areas are more vulnerable to bush fires- all these factors including lack of stake holders participation in bush fires risk communication- are creating distrust in the overall bush fire risk communication proces
How are the Surviving Workers of the Rana Plaza Factory Collapse in Bangladesh Doing: Quality of Life, Participation Restriction, Income and Occupation
Purpose: On April 24, 2013 a building called Rana Plaza that housed several garment factories collapsed in Bangladesh. Around 1134 people died and more than 2500 sustained serious injuries. This study evaluates the change in income and occupation of the Rana Plaza survivors as well as their level of community participation and quality of life two years after the incident. It also aimed to gain insight into these survivors\u27 success or failure in economic reintegration. Methods: A cross-sectional survey collected data from the injured garment workers using convenience sampling method. The Short Form 36 Items Questionnaire measured their quality of life, and the Participation Scale measured their community participation restriction level. Poor economic reintegration was defined when a survivor was not working or had an income less than 3000 Taka [US$36]/month. Results: Data were collected from 338 Rana Plaza survivors all of who were previously garment workers. Their income decreased substantially after the disaster. The majority were now engaged in earning livelihood from retail shop management and animal husbandry. A total of 124 survivors (36.6%) were found to be poorly economically reintegrated; females were found to be at greater odds (twice) of poor economic reintegration than males. Those with severe participation restriction scores had four times greater odds and who reported moderate restriction had two times greater odds of poor economic reintegration compared to those with no restriction. Conclusions: Survivors of Rana Plaza factory disaster were facing many health and economic challenges two years after the event. Implications for rehabilitation Rehabilitation service providers should document and describe the health status correctly to understand the burden and monitor the effectiveness of their intervention. Government needs to develop and strengthen rehabilitation capacity as more workers will be injured as the country rapidly industrializes. Factory owners should create light duty work opportunities and provide other workplace modification for injured workers to re-enter the workforce
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