An investigation of factors associated with the health and well-being of HIV-infected or HIV-affected older people in rural South Africa

BackgroundDespite the severe impact of HIV in sub-Saharan Africa, the health of older people aged 50+ is often overlooked owing to the dearth of data on the direct and indirect effects of HIV on older people's health status and well-being. The aim of this study was to examine correlates of health and well-being of HIV-infected older people relative to HIV-affected people in rural South Africa, defined as participants with an HIV-infected or death of an adult child due to HIV-related cause. MethodsData were collected within the Africa Centre surveillance area using instruments adapted from the World Health Organization (WHO) Study on global AGEing and adult health (SAGE). A stratified random sample of 422 people aged 50+ participated. We compared the health correlates of HIV-infected to HIV-affected participants using ordered logistic regressions. Health status was measured using three instruments: disability index, quality of life and composite health score. ResultsMedian age of the sample was 60 years (range 50-94). Women HIV-infected (aOR 0.15, 95% confidence interval (CI) 0.08-0.29) and HIV-affected (aOR 0.20, 95% CI 0.08-0.50), were significantly less likely than men to be in good functional ability. Women's adjusted odds of being in good overall health state were similarly lower than men's; while income and household wealth status were stronger correlates of quality of life. HIV-infected participants reported better functional ability, quality of life and overall health state than HIV-affected participants. Discussion and Conclusions The enhanced healthcare received as part of anti-retroviral treatment as well as the considerable resources devoted to HIV care appear to benefit the overall well-being of HIV-infected older people; whereas similar resources have not been devoted to the general health needs of HIV uninfected older people. Given increasing numbers of older people, policy and programme interventions are urgently needed to holistically meet the health and well-being needs of older people beyond the HIV-related care system. <br/

South African Rheumatism and Arthritis Association 2024 guidelines for the management of peripheral spondyloarthritis

Peripheral spondyloarthritis (SpA) includes psoriatic arthritis (PsA), inflammatory bowel disease (IBD)-associated arthritis, reactive arthritis and undifferentiated peripheral SpA. These South African guidelines offer information on diagnosis, assessment and therapy of peripheral SpA. Emphasis is placed on a multidisciplinary team, and a treat-to-target strategy with escalation of therapy if the target of minimal or very low disease activity is achieved. Screening for and treatment of comorbidities are paramount

South African Rheumatism and Arthritis Association 2024 guidelines for the management of axial spondyloarthritis

Early diagnosis and prompt treatment initiation are essential in the management of axial spondyloarthritis (axSpA), also known as ankylosing spondylitis, remembering that underdiagnosis and overdiagnosis of axSpA are common. These South African guidelines offer screening tools and details of useful investigations, including imaging. Care of the axSpA patient requires a multidisciplinary holistic approach emphasising lifestyle interventions, particularly exercise, smoking cessation and psychosocial support. The ankylosing spondylitis disease activity score is recommended as a measure of disease activity, and a stepwise algorithm for therapy is provided. Screening for comorbidities and vaccination is advised

Quality of life and satisfaction with life in SLE patients—the importance of clinical manifestations

To assess the correlation between quality of life (QoL) and satisfaction with life (SL) in SLE patients and correlate both with clinical symptoms of the disease. The study was performed in 83 patients. QoL was assessed by Short Form 36, and SL was assessed by the Satisfaction with Life Scale. Clinical manifestations presented at the time of examination were taken into consideration. SLE patients assessed their QoL and SL as rather low. Those with photosensitivity as well as neurological symptoms presented lower QoL in particular domains, while those with renal manifestation of SLE assessed their QoL as higher. Similar observations were made for SL only in relation to neurological symptoms. Moreover, our findings show that although SL is a part of QoL, both these parameters should be distinguished in order to fully assess the state of the patient

Long-term persistence with rituximab in patients with rheumatoid arthritis

Objectives. To investigate the long term persistence of rituximab (RTX) in a large observational RA cohort, investigate persistence of RTX when used as a first or second line biologic DMARD (bDMARD), to characterize subsequent bDMARD treatment following RTX. Methods. Patients with RA starting treatment with RTX (MabThera) between 2008 and 2011 were recruited into the British Society for Rheumatology Biologics Register for RA. Duration of RTX treatment over the first 4 years after initiation was estimated via Kaplan-Meier estimates and the reason for discontinuation was ascertained. Subsequent bDMARD use following RTX discontinuation was characterised. Treatment survival in bDMARD-naive (first line RTX use) and experienced (second line RTX use) cohorts was described. Results. One thousand six hundred and twenty-nine patients were recruited (1371 bDMARD-experienced and 258 bDMARD-naïve). Sixty percent of the whole cohort remained on RTX after 4 years. Ineffectiveness (46%) and death (24%) were the most common reason for RTX discontinuation. RTX discontinuation was associated with RF negativity for the bDMARD-experienced cohort. Of those that discontinued RTX, 46% initiated treatment with another bDMARD, with tocilizumab being the most common. Conclusion. This large study of patients initiating RTX treatment for severe RA found that 60% persisted with treatment after 4 years. This study also identified that RTX is tolerated well when used as a first or second line bDMARD

Effective utilization and characterization of carbon derived from non-biodegradable waste based electrical switches for supercapacitor applications: A green approach

Abstract This work describes the utilization of carbon (Char) held after the slow pyrolysis of Disposed Electric Switches made of Thermoset Plastic (DESTP) as a high-capacity electrode material for supercapacitor applications. Char is prepared by pyrolysis strategy and exposed to severe milling in high energy planetary ball mill for size reduction. By suspending the pulverised DESTP in silver (Ag) nanoparticles dispersed solution obtained by reducing AgNO3 with hydrazine hydrate as a reducing agent, the DESTP is loaded with Ag nanoparticles. The Energy Dispersive X-Ray Analysis (EDAX) validates the elemental makeup of the manufactured char. The DESTP and Ag@DESTP are coated separately on a low-cost etched brass substrate, and their electrochemical charge-storage properties are investigated using an electrochemical workstation. The specific capacitance of DESTP and Ag@DESTP electrodes are discovered to be 32 Fg-1and 67 Fg-1, respectively. The fabricated electrodes provide a maximum volumetric capacitance of 93 mFcm-3and 21 mFcm-3 with a current density of 5 mA for Ag@DESTP and DESTP electrodes respectively. This work gives a great model of repurposing the e-waste advertising with good electrochemical energy storage applications.</jats:p

Case analysis and systematic review of aspergilloma

&lt;p class="abstract"&gt;Among various fungal pathogens, &lt;em&gt;Aspergillus fumigatus&lt;/em&gt; is the most prevalent human pathogen reported to cause human disease such as aspergilloma or aspergillosis. Aspergillomas are commonly seen in a poorly drained and avascular cavitary space which evokes an inflammatory reaction. Most commonly involving paranasal sinuses especially maxillary sinus. For the past 2 decades incidence of aspergillosis has increased substantially. The main objective of this systematic review was to evaluate the cases reported to be aspergilloma of maxillary sinus and to determine the percentage of cases involving aspergilloma of maxillary sinus in healthy individuals. After the final full text review, 16 articles were included in this systematic review. Data were extracted from the full text articles and reviewed and extracted content. About 83% had a history of dental procedures, with 42% of those being due to infection from previous extraction sockets and 41% due to RCT. About 43% of the patients in this study were immunocompromised, while 56% were healthy and had no known predisposing conditions. The aspergillus fungal infections affecting the paranasal sinuses are common which can affect apparently healthy as well as immunocompromised individuals. Aspergilloma is the most common fungal infection involving maxillary sinus with iatrogenic dentogenic factors being the most predominant factor for the initiation and progression of aspergillus fungal infection. About 43% of the patients in this review were immunocompromised patients whereas 56% of the patients were healthy without any known predisposing conditions. The progression and prognosis of these diseases depends on the location and immunologic status of the patient. So, it is very important for the dentists to be more cautious while performing any dental procedures so as not to initiate any iatrogenic infections.&lt;/p&gt;</jats:p