17 research outputs found
Circulating levels of sclerostin are associated with cardiovascular mortality
Cardiovascular diseases are a health problem throughout the world, especially in people
with diabetes. The identification of cardiovascular disease biomarkers can improve risk
stratification. Sclerostin is a modulator of the Wnt/ÎČ-catenin signalling pathway in different
tissues, and it has recently been linked to vascular biology. The current study aimed to evaluate
the relationship between circulating sclerostin levels and cardiovascular and non-cardiovascular
mortality in individuals with and without type 2 diabetes. We followed up a
cohort of 130 participants (mean age 56.8 years; 48.5% females; 75 with type 2 diabetes;
46 with prevalent cardiovascular disease) in which serum sclerostin levels were measured
at the baseline. Time to death (both of cardiovascular and non-cardiovascular causes) was
assessed to establish the relationship between sclerostin and mortality. We found that
serum sclerostin concentrations were significantly higher in patients with prevalent cardiovascular
disease (p<0.001), and independently associated with cardiovascular mortality
(p = 0.008), showing sclerostin to be a stronger predictor of mortality than other classical
risk factors (area under the curve = 0.849 vs 0.823). The survival analysis showed that an
increase of 10 pmol/L in the serum sclerostin level resulted in a 31% increase in cardiovascular
mortality. However, no significant association was observed between sclerostin levels
and non-cardiovascular mortality (p = 0.346).
From these results, we conclude that high sclerostin levels are related to mortality due to
cardiovascular causes. The clinical implication of these findings is based on the possible
use of serum sclerostin as a new biomarker of cardiovascular mortality risk in order to establish
preventive strategies.The authors declare that this work was
support in part by ConsejerĂa de Salud y Bienestar
Social (Junta de AndalucĂa) Grants (PI0207-2016
to Dr. Beatriz GarcĂa-Fontana), and Fondo de
InvestigaciĂłn Sanitaria (Instituto de Salud Carlos
III) Grants (PI12/02141, PI15/01207 to Dr. Manuel Muñoz-Torres), with co-financing from FEDER. The
funders had no role in study design, data collection
and analysis, decision to publish, or preparation of
the manuscript and there was no additional
external funding received for this study
ACTG-HIV symptoms changes in patients switched to RPV/FTC/TDF due to previous intolerance to CART. Interim analysis of the PROSTR study
Introduction: Tolerability and convenience are crucial aspects for the long-term success of combined antiretroviral therapy
(cART). The aim of this study was to investigate the impact in routine clinical practice of switching to the single tablet regimen
(STR) RPV/FTC/TDF in patients with intolerance to previous cART, in terms of patientsâ well-being, assessed by several validated
measures.
Methods: Prospective, multicenter study. Adult HIV-infected patients with viral load under 1.000 copies/mL while receiving a
stable ART for at least the last three months and switched to RPV/FTC/TDF due to intolerance of previous regimen, were
included. Analyses were performed by ITT. Presence/magnitude of symptoms (ACTG-HIV Symptom Index), quality of life (EQ-5D,
EUROQoL & MOS-HIV), adherence (SMAQ), preference of treatment and perceived ease of medication (ESTAR) through 48
weeks were performed.
Results: Interim analysis of 125 patients with 16 weeks of follow up was performed. 100 (80%) were male, mean age 46 years.
Mean CD4 at baseline was 629.59307.29 and 123 (98.4%) had viral load B50 copies/mL; 15% were HCV co-infected. Ninety
two (73.6%) patients switched from a NNRTI (84.8% from EFV/FTC/TDF) and 33 (26.4%) from a PI/r. The most frequent reasons
for switching were psychiatric disorders (51.2%), CNS adverse events (40.8%), gastrointestinal (19.2%) and metabolic disorders
(19.2%). At the time of this analysis (week 16), four patients (3.2%) discontinued treatment: one due to adverse events, two
virologic failures and one with no data. A total of 104 patients (83.2%) were virologically suppressed (B50 copies/mL). The
average degree of discomfort in the ACTG-HIV Symptom Index significantly decreased from baseline (21915.55) to week 4
(10.89912.36) & week 16 (10.81912.62), pB0.001. In all the patients, quality of life tools showed a significant benefit in wellbeing
of the patients (Table 1). Adherence to therapy significantly and progressively increased (SMAQ) from baseline (54.4%) to
week 4 (68%), pB0.001 and to week 16 (72.0%), pB0.001.
Conclusions: Switching to RPV/FTC/TDF from another ARV regimen due to toxicity, significantly improved the quality of life of
HIV-infected patients, both in mental and physical components, and improved adherence to therapy while maintaining a good
immune and virological response
Non-occupational protein contact dermatitis induced by mango fruit
Immediate contact skin reactions are considered a subset of the contact urticaria syndrome, which includes contact urticaria and protein contact dermatitis (PCD). These entities clinically manifest as development of wheals, erythema, and/or eczema within minutes after contact with proteins or low-molecular-weight allergens. Herein, we report a case compatible with a PCD caused by exposure to mango fruit
ACTG-HIV symptoms changes in patients switched to RPV/FTC/TDF due to previous intolerance to CART. Interim analysis of the PRO-STR study
Introduction: Tolerability and convenience are crucial aspects for the long-term success of combined antiretroviral therapy (cART). The aim of this study was to investigate the impact in routine clinical practice of switching to the single tablet regimen (STR) RPV/FTC/TDF in patients with intolerance to previous cART, in terms of patientsâ well-being, assessed by several validated measures. Methods: Prospective, multicenter study. Adult HIV-infected patients with viral load under 1.000 copies/mL while receiving a stable ART for at least the last three months and switched to RPV/FTC/TDF due to intolerance of previous regimen, were included. Analyses were performed by ITT. Presence/magnitude of symptoms (ACTG-HIV Symptom Index), quality of life (EQ-5D, EUROQoL & MOS-HIV), adherence (SMAQ), preference of treatment and perceived ease of medication (ESTAR) through 48 weeks were performed. Results: Interim analysis of 125 patients with 16 weeks of follow up was performed. 100 (80%) were male, mean age 46 years. Mean CD4 at baseline was 629.5±307.29 and 123 (98.4%) had viral load <50 copies/mL; 15% were HCV co-infected. Ninety two (73.6%) patients switched from a NNRTI (84.8% from EFV/FTC/TDF) and 33 (26.4%) from a PI/r. The most frequent reasons for switching were psychiatric disorders (51.2%), CNS adverse events (40.8%), gastrointestinal (19.2%) and metabolic disorders (19.2%). At the time of this analysis (week 16), four patients (3.2%) discontinued treatment: one due to adverse events, two virologic failures and one with no data. A total of 104 patients (83.2%) were virologically suppressed (<50 copies/mL). The average degree of discomfort in the ACTG-HIV Symptom Index significantly decreased from baseline (21±15.55) to week 4 (10.89±12.36) & week 16 (10.81±12.62), p<0.001. In all the patients, quality of life tools showed a significant benefit in well-being of the patients (Table 1). Adherence to therapy significantly and progressively increased (SMAQ) from baseline (54.4%) to week 4 (68%), p<0.001 and to week 16 (72.0%), p<0.001. Conclusions: Switching to RPV/FTC/TDF from another ARV regimen due to toxicity, significantly improved the quality of life of HIV-infected patients, both in mental and physical components, and improved adherence to therapy while maintaining a good immune and virological response