Mortality in patients with successful initial response to highly active antiretroviral therapy is still higher than in non-HIV-infected individuals.

Mortality in HIV-infected patients has decreased dramatically since the introduction of highly active antiretroviral therapy (HAART). We analyzed progression to death in a population of 3678 antiretroviral treatment-naive patients from the ATHENA national observational cohort from 24 weeks after the start of HAART. Mortality was compared with that in the general population in the Netherlands matched by age and gender. Only log-transformed CD4 cell count (hazard ratio [HR] = 0.50, 95% confidence interval [CI]: 0.40 to 0.61 per unit increase) and plasma viral load (HR = 0.30, 95% CI: 0.15 to 0.60, HIV RNA level or = 100,000 copies/mL) measured at 24 weeks and infection via intravenous drug use (IDU) (HR = 0.16, 95% CI: 0.10 to 0.26, non-IDU vs. IDU) were significantly associated with progression to death. For non-IDU patients with 600 x 10 CD4 cells/L and an HIV RNA level <100,000 copies/mL at 24 weeks, mortality was predicted to be 5.3 (95% CI: 3.5 to 8.4) and 10.4 (95% CI: 6.4 to 17.4) times higher than in the general population for 25-year-old men and women, respectively, and 1.15 (95% CI: 1.08 to 1.25) and 1.29 (95% CI: 1.16 to 1.50) times higher for 65-year-old men and women, respectively. Hence, mortality in HIV-infected patients with a good initial response to HAART is still higher than in the general population

An observational study of mother-child interaction.

Thesis (M.S.)--Boston Universit

Survival after postoperative morbidity: a longitudinal observational cohort study

Prolonged morbidity after surgery is associated with a risk of premature death for a longer duration than perhaps is commonly thought; however, this risk falls with time. We suggest that prolonged postoperative morbidity measured in this way may be a valid indicator of the quality of surgical healthcare. Our findings reinforce the importance of research and quality improvement initiatives aimed at reducing the duration and severity of postoperative complication

Weight changes following lower limb arthroplasty : a prospective observational study

The aim of this study was to assess patterns of weight loss/gain following total hip or knee joint replacement. Four hundred and fifty primary lower limb arthroplasty patients, where the current surgery was the last limiting factor to improved mobility, were selected. Over a one year period 212 gained weight (mean 5.03kg), 92 remained static, and 146 lost weight. The median change was a weight gain of 0.50Kg (p=0.002). All patients had a significant improvement in Oxford outcome scores. Hip arthroplasty patients were statistically more likely to gain weight than knee arthroplasty patients. A successful arthroplasty, restoring a patient's mobility, does not necessarily lead to subsequent weight loss. The majority of patients put on weight with an overall net weight gain. No adverse effect on functional outcome was noted

Observational cosmology using characteristic numerical relativity

The characteristic formalism in numerical relativity, which has been developed to study gravitational waves, and the observer metric approach in observational cosmology both make use of coordinate systems based on null cones. In this paper, these coordinate systems are compared and it is then demonstrated how characteristic numerical relativity can be used to investigate problems in observational cosmology. In a numerical experiment using the characteristic formalism, it is shown how the historical evolution of a LTB universe compares to that of the $\Lambda$CDM model given identical observational data on a local observer's past null cone. It is demonstrated that, at an earlier epoch of the LTB model, the observational data would not be consistent with that of the $\Lambda$CDM model

Should eye protection be worn during dermatological surgery: prospective observational study

Background There is a potential risk of infection with blood-borne viruses if a doctor receives a blood splash to a mucous membrane. The quantification of facial contamination with blood has never been documented in the context of dermatological surgery. Objectives (i) To identify the number of facial blood splashes that occur during skin surgery and to identify the procedures that present higher risks for the operator and assistant. (ii) To assess the provision of eye protection and attitudes to its use in dermatological surgery in the U.K. Methods (i) Prospective, observational study in the skin surgery suite of a U.K. teaching hospital assessing 100 consecutive dermatological surgery procedures, plus 100 consecutive operations in which an assistant was present. Primary outcome: number of face-mask visors with at least one blood splash. Secondary outcomes: to identify if any of the following variables influenced the occurrence of a blood splash: grade of operator, site and type of procedure, and the use of electrocautery. (ii) A postal survey of all U.K.-based members of the British Society of Dermatological Surgery (BSDS) was conducted assessing facilities available and the attitudes of U.K.-based clinicians to the use of face masks during surgery. Results (i) In 33% of all surgical procedures there was at least one facial splash to the operator (range 1–75) and in 15% of procedures the assistant received at least one splash (range 1–11). Use of monopolar electrocautery was significantly less likely to result in splashes to the mask compared with bipolar electrocautery [odds ratio (OR) 0Æ04; 95% confidence interval (CI) 0Æ01–0Æ19]. Compared with the head/neck, operations on the body were significantly more likely to result in splashes to the mask (OR 6Æ52) (95% CI 1Æ7–25Æ07). The type of procedure and the status of the operator did not have a bearing on the likelihood of receiving a splash to the mask. (ii) From the survey, 33 of 159 (20Æ8%) of BSDS members had no face masks available and 54 of 159 (34Æ0%) did not wear any facial protection while operating. The majority (53Æ5%) thought they received a splash in £ 1% of procedures. Conclusions There is a substantial risk of a splash of blood coming into contact with the face during dermatological surgery for both the operator and assistant, regardless of the procedure. The risk of receiving a blood splash to the face may be substantially underestimated by U.K.-based dermatologists. The use of protective eyewear is advisable at all times, but particularly when using bipolar electrocautery, or when operating on high-risk individuals

Intrinsic scatter of caustic masses and hydrostatic bias: An observational study

All estimates of cluster mass have some intrinsic scatter and perhaps some bias with true mass even in the absence of measurement errors for example caused by cluster triaxiality and large scale structure. Knowledge of the bias and scatter values is fundamental for both cluster cosmology and astrophysics. In this paper we show that the intrinsic scatter of a mass proxy can be constrained by measurements of the gas fraction because masses with higher values of intrinsic scatter with true mass produce more scattered gas fractions. Moreover, the relative bias of two mass estimates can be constrained by comparing the mean gas fraction at the same (nominal) cluster mass. Our observational study addresses the scatter between caustic (i.e., dynamically estimated) and true masses, and the relative bias of caustic and hydrostatic masses. For these purposes, we used the X-ray Unbiased Cluster Sample, a cluster sample selected independently from the intracluster medium content with reliable masses: 34 galaxy clusters in the nearby ($0.050<z<0.135$) Universe, mostly with $14<\log M_{500}/M_\odot \lesssim 14.5$, and with caustic masses. We found a 35\% scatter between caustic and true masses. Furthermore, we found that the relative bias between caustic and hydrostatic masses is small, $0.06\pm0.05$ dex, improving upon past measurements. The small scatter found confirms our previous measurements of a highly variable amount of feedback from cluster to cluster, which is the cause of the observed large variety of core-excised X-ray luminosities and gas masses.Comment: A&A, in press, minor language changes from previous versio