60 research outputs found
Five years retrospective cohort analysis of treatment outcomes of TB-HIV patients at a PEPFAR/DOTS Centre in South Eastern Nigeria.
Background: Human immunodeficiency virus (HIV) associated tuberculosis
(TB) remains a major global public health challenge, with an estimated
1.4 million patients worldwide. Co-infection with HIV leads to
challenges in the diagnosis and treatment of patients. Objectives: The
aim of this study was to assess treatment outcomes of a cohort of smear
positive TB-HIV co-infected patients over a five-year study period.
Methods: A retrospective cohort study of 600 smear-positive
tuberculosis patients registered at the chest unit of the University of
Nigeria Teaching Hospital, Enugu from January 2008 to December 2012 was
done. The data was analyzed using SPSS Version 17. Results: One hundred
and three (17.2%) of the patients were co-infected with TB/HIV, while
398 (66.3%) and 99 (16.5%) were HIV negative and unknown respectively.
Among the co-infected patients, 45(43.7%) were cured as against
222(55.8%) in the TBHIV negatives (Z=4.53, p=0.000, 95%CI= 0.12-0.34).
Respectively in the TB-HIV co-infected and TB-HIV negative patients,
treatment completed were 21(20.4%) and 71(17.8%) (Z=9.15, p=0.000, 95%=
0.4035-0.60); defaulted 19(18.5%) vs 70 (17.6%) (Z=9.29, p=0.000,
95%CI=0.42-0.60), died 10(9.7%) vs. 6(1.5%) (Z=1.22, p=0.224, 95%CI=
-0.0286-0.1086), and failures were 1(0.9%) vs. 7(1.8%) (Z=2.48,
p=0.013, 95%CI=0.04-0.10). Treatment success rate was lower in TB-HIV
co-infected patients, 64.1% compared to TB-HIV negative patients with
73.6%. Also those that defaulted among the TB-HIV co-infected patients
(18.5%) were higher than 17.6% among TB-HIV negative patients, a
difference of 0.9%. Conclusion: Findings demonstrate that HIV
co-infection affects TB treatment outcomes adversely. Treatment
adherence, timely and sustained access to antiretroviral therapy for
TB/HIV co-infected patients are important
Fit to WHO weight standard of European infants over time
OBJECTIVES: The 2006 WHO growth charts were created to provide an international standard for optimal growth, based on healthy, breastfed populations, but it has been suggested that Northern European children fit them poorly. This study uses infant weight data spanning 50â
years to determine how well-nourished preschool children from different eras fit the WHO standard, and discuss the implications of deviations. DESIGN: Four longitudinal datasets from the UK and one from Finland were used comprising over 8000 children born between1959 and 2003. Weights from birth to 2â
years were converted to age-sex-adjusted Z scores using the WHO standard and summarised using Generalized Additive Models for Location, Scale and Shape. RESULTS: Weights showed a variable fit to the WHO standard. Mean weights for all cohorts were above the WHO median at birth, but dipped by up to 0.5 SD to a nadir at 8â
weeks before rising again. Birth weights increased in successive cohorts and the initial dip became slightly shallower. By age 1â
year, cohorts were up to 0.75 SD above the WHO median, but there was no consistent pattern by era. CONCLUSIONS: The WHO standard shows an acceptable, but variable fit for Northern European infants. While birth weights increased over time, there was, unexpectedly, no consistent variation by cohort beyond this initial period. Discrepancies in weight from the standard may reflect differences in measurement protocol and trends in infant feeding practice
Maternal risk factors for abnormal placental growth: The national collaborative perinatal project
<p>Abstract</p> <p>Background</p> <p>Previous studies of maternal risk factors for abnormal placental growth have focused on placental weight and placental ratio as measures of placental growth. We sought to identify maternal risk factors for placental weight and two neglected dimensions of placental growth: placental thickness and chorionic plate area.</p> <p>Methods</p> <p>We conducted an analysis of 24,135 mother-placenta pairs enrolled in the National Collaborative Perinatal Project, a prospective cohort study of pregnancy and child health. We defined growth restriction as < 10<sup>th </sup>percentile and hypertrophy as > 90<sup>th </sup>percentile for three placental growth dimensions: placental weight, placental thickness and chorionic plate area. We constructed parallel multinomial logistic regression analyses to identify (a) predictors of restricted growth (vs. normal) and (b) predictors of hypertrophic growth (vs. normal).</p> <p>Results</p> <p>Black race was associated with an increased likelihood of growth restriction for placental weight, thickness and chorionic plate area, but was associated with a reduced likelihood of hypertrophy for these three placental growth dimensions. We observed an increased likelihood of growth restriction for placental weight and chorionic plate area among mothers with hypertensive disease at 24 weeks or beyond. Anemia was associated with a reduced likelihood of growth restriction for placental weight and chorionic plate area. Pre-pregnancy BMI and pregnancy weight gain were associated with a reduced likelihood of growth restriction and an increased likelihood of hypertrophy for all three dimensions of placental growth.</p> <p>Conclusion</p> <p>Maternal risk factors are either associated with placental growth restriction or placental hypertrophy not both. Our findings suggest that the placenta may have compensatory responses to certain maternal risk factors suggesting different underlying biological mechanisms.</p
Risk factors for the increasing trend in low birth weight among live births born by vaginal delivery, Brazil
Analytical theory of nonlinear oscillations. VII. The periods of the periodic solutions of the equation áș + g(x) = 0
Cocktail Treatment (Combination of 5-FU + TAC) in the Treament of Hypertophic Scars and Keloids
- âŠ