Markers of inflammation and coagulation indicate a prothrombotic state in HIV-infected patients with long-term use of antiretroviral therapy with or without abacavir

Background: Abacavir (ABC) treatment has been associated with an increased incidence of myocardial infarction. The pathophysiological mechanism is unknown. In this study markers of inflammation and coagulation in HIV-infected patients using antiretroviral therapy with or without ABC were examined to pinpoint a pathogenic mechanism. Given the important role of high sensitivity C-reactive protein (hsCRP) levels in predicting cardiovascular risk, patient groups were also analyzed according to hsCRP levels.Method

Longitudinal Measurement Invariance of the Working Alliance Inventory Short form across Coaching Sessions

BACKGROUND: Throughout the psychotherapeutic and coaching literature, the client-therapist or coach-coachee working alliance has been highlighted as key force driving positive outcome. The Working Alliance Inventory Short form (WAI-S) for coaching charts the quality of working alliance throughout coaching sessions and is broadly applied in coaching research. Due to a shortfall in research on psychometric properties of the WAI-S, the purpose of this study was to examine (a) if the theorized three-factor structure of the 12-item WAI-S forms a solid representation of the dimensions of working alliance in coaching, and (b) longitudinal measurement invariance (LMI) of the WAI-S. METHOD: Data were collected in a two-wave study design comprising a main study sample of N = 690 Dutch coachees that completed the questionnaire at the first measurement, of which N = 490 also completed the questionnaire at the second measurement. Post hoc sensitivity analysis was performed based on the original sample, lacking additional information on covariates, and included both completers and dropouts, comprising N = 1986 respondents at T1, and N = 1020 respondents at T2. RESULTS: Confirmatory factor analyses evidenced best fit of the three-factor model in comparison to one-, and two-factor models at both time points. Despite the fact that multigroup confirmatory factor analysis detected non-invariant intercepts, our findings overall supported measurement invariance across coaching sessions. CONCLUSIONS: As decisions in both clinical and scientific practices generally rely on outcome assessment of interpersonal change in scores on the same measure over time, we believe our findings to be of contributing value to the consolidation of interpretation and accuracy of scorings on the WAI-S in coaching. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40359-022-00968-5

Tuberculosis in antiretroviral treatment programs in lower income countries: availability and use of diagnostics and screening.

In resource-constrained settings, tuberculosis (TB) is a common opportunistic infection and cause of death in HIV-infected persons. TB may be present at the start of antiretroviral therapy (ART), but it is often under-diagnosed. We describe approaches to TB diagnosis and screening of TB in ART programs in low- and middle-income countries

Early switching of antibiotic therapy from intravenous to oral using a combination of education, pocket-sized cards and switch advice: A practical intervention resulting in reduced length of hospital stay

Objectives: To assess the effectiveness of a combined intervention on the timing and rate of switching from intravenous (IV) to oral antibiotic therapy. Materials and methods: The study used a historically-controlled prospective intervention design. Interventions consisted of educating physicians, handing out pocket-sized cards and providing switch advice in the electronic patient record (EPR). All patients hospitalized at the surgery department who were treated with IV antibiotics for at least 24 h and who fulfilled the switch criteria within 72 h of IV treatment were included. Outcomes before and during the intervention were compared. Results: An early IV to oral switch took place in 35.4% (35/99) of the antibiotic courses in the baseline period and in 67.7% (42/62) of the antibiotic courses in the intervention period (odds ratio [OR] 3.84, 95% confidence interval [CI] 1.96–7.53). Duration of IV therapy was significantly reduced from 5 to 3 days (P<0.01). Length of hospitalization was reduced from 6 to 5 days (P<0.05). Conclusions: The interventions were effective in promoting an early IV to oral antibiotic switch by shortening the length of IV therapy and hospital stay

The effect of initiating combined antiretroviral therapy on endothelial cell activation and coagulation markers in South African HIV-infected individuals

An increased incidence of venous thromboembolism (VIE) is observed in human immunodeficiency virus (HIV)-infected patients. Only a limited number of studies described the effect of combined antiretroviral therapy (cART) on coagulation markers. In a prospective cohort study in cART-naive South African HIV-infected individuals the effect of initiating cART on markers of endothelial cell activation, coagulation and natural anticoagulation was studied. These markers were compared to the reference ranges for an HIV-uninfected control population recruited from hospital staff. A venous ultrasound of both legs was performed to detect asymptomatic deep venous thrombosis (DVT). A total number of 123 HIV-infected participants were included. The patients were predominantly black and severely immuno-compromised. The CD4 cell count increased and the HIV viral load decreased significantly after the initiation of cART (p <0.001). The median follow-up period was 7.2 (+/- 1.6) months. Laboratory testing before and after initiation of cART was completed by 86 patients. Before initiating CART significantly elevated von Willebrand factor and D-dimer levels, increased activated protein C sensitivity ratio (APCsr) and decreased total and free protein S and protein C levels were observed compared to HIV-negative controls. At follow-up all markers, except APCsr, improved towards the normal range for controls without showing complete normalisation. In a subgroup of 57 patients no asymptomatic DVT was found. Compared to the controls, abnormal levels of coagulation markers were observed in HIV-infected individuals before and after the initiation of cART. Most markers improved after starting cART, but remained significantly different from the controls, indicating a persistent disturbed haemostatic balanc

Two Cases of Mycobacterium microti-Induced Culture-Negative Tuberculosis▿

We present descriptions of two human Mycobacterium microti infections: one of a patient with pulmonary disease and one of a patient with osteomyelitis of the hip. Both patients had acid-fast bacilli and a positive Mycobacterium tuberculosis complex PCR from clinical specimens, but mycobacterial cultures remained negative. The microbiological diagnosis was established by molecular methods

High Prevalence of Human Papillomavirus Infections in Urine Samples from Human Immunodeficiency Virus-Infected Men

Infection with human immunodeficiency virus (HIV) and the resulting immunosuppression are associated with an increased risk for human papillomavirus (HPV) persistence and related malignancies. In the present study we investigated the prevalence of HPV in urine samples from 104 HIV-infected men with low CD4(+) cell counts (<100 per mm(3)) and 115 urine samples from HIV-negative men. A high prevalence of HPV DNA (39.4%) was found in the HIV patients. Most of the HPV types were high risk (81.4%), with HPV 52 as the most prevalent type (12.5%), followed by HPV 18 (6.7%), HPV 35 (5.8%), and HPV 70 (4.8%). Multiple HPV genotypes were observed in 17 (41%) of the 41 HPV- and HIV-positive men. In contrast, only 11 (9.6%) HPV DNA-positive cases were observed among the 115 HIV-uninfected men, and 3 (27.3%) contained multiple genotypes. Quantitative analyses indicated that the HPV viral load, as measured in urine samples, is significantly higher in HIV-positive men compared to HIV-negative men. In the present study we show that urine samples are useful for detecting HPV DNA, there is a high prevalence of HPV in HIV-positive men, and the HPV viral load is substantially higher in HIV-positive than in HIV-negative men. More studies are needed to evaluate the risk and natural development of HPV-related malignancies in HIV-positive men

Longitudinal measurement invariance of the Working Alliance Inventory - Short form across coaching sessions

BACKGROUND: Throughout the psychotherapeutic and coaching literature, the client-therapist or coach-coachee working alliance has been highlighted as key force driving positive outcome. The Working Alliance Inventory Short form (WAI-S) for coaching charts the quality of working alliance throughout coaching sessions and is broadly applied in coaching research. Due to a shortfall in research on psychometric properties of the WAI-S, the purpose of this study was to examine (a) if the theorized three-factor structure of the 12-item WAI-S forms a solid representation of the dimensions of working alliance in coaching, and (b) longitudinal measurement invariance (LMI) of the WAI-S. METHOD: Data were collected in a two-wave study design comprising a main study sample of N = 690 Dutch coachees that completed the questionnaire at the first measurement, of which N = 490 also completed the questionnaire at the second measurement. Post hoc sensitivity analysis was performed based on the original sample, lacking additional information on covariates, and included both completers and dropouts, comprising N = 1986 respondents at T1, and N = 1020 respondents at T2. RESULTS: Confirmatory factor analyses evidenced best fit of the three-factor model in comparison to one-, and two-factor models at both time points. Despite the fact that multigroup confirmatory factor analysis detected non-invariant intercepts, our findings overall supported measurement invariance across coaching sessions. CONCLUSIONS: As decisions in both clinical and scientific practices generally rely on outcome assessment of interpersonal change in scores on the same measure over time, we believe our findings to be of contributing value to the consolidation of interpretation and accuracy of scorings on the WAI-S in coaching

Longitudinal measurement invariance of the Working Alliance Inventory - Short form across coaching sessions

BACKGROUND: Throughout the psychotherapeutic and coaching literature, the client-therapist or coach-coachee working alliance has been highlighted as key force driving positive outcome. The Working Alliance Inventory Short form (WAI-S) for coaching charts the quality of working alliance throughout coaching sessions and is broadly applied in coaching research. Due to a shortfall in research on psychometric properties of the WAI-S, the purpose of this study was to examine (a) if the theorized three-factor structure of the 12-item WAI-S forms a solid representation of the dimensions of working alliance in coaching, and (b) longitudinal measurement invariance (LMI) of the WAI-S. METHOD: Data were collected in a two-wave study design comprising a main study sample of N = 690 Dutch coachees that completed the questionnaire at the first measurement, of which N = 490 also completed the questionnaire at the second measurement. Post hoc sensitivity analysis was performed based on the original sample, lacking additional information on covariates, and included both completers and dropouts, comprising N = 1986 respondents at T1, and N = 1020 respondents at T2. RESULTS: Confirmatory factor analyses evidenced best fit of the three-factor model in comparison to one-, and two-factor models at both time points. Despite the fact that multigroup confirmatory factor analysis detected non-invariant intercepts, our findings overall supported measurement invariance across coaching sessions. CONCLUSIONS: As decisions in both clinical and scientific practices generally rely on outcome assessment of interpersonal change in scores on the same measure over time, we believe our findings to be of contributing value to the consolidation of interpretation and accuracy of scorings on the WAI-S in coaching. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40359-022-00968-5