Loss of HIV-infected patients on potent antiretroviral therapy programs in Togo: risk factors and the fate of these patients

Introduction: National programs are facing challenges of loss to follow-up of people living with HIV/AIDS (PLWHA) on antiretroviral therapy (ART). We sought to identify risk factors associated with early loss to follow-up among HIV-infected patients on ART in Togo and the outcome of such patients. Methods: This was a retrospective cross-sectional study using medical records of all patients older than age 15 years enrolled at 28 treatment centers who were on ART programs and who were lost to follow-up from 2008 to 2011. Results: Of the 16,617 patients on ART, 1,216 (7.3%) were lost to follow-up. Most (94.1%) were infected with HIV-1 and 32.6% were in WHO stage III or IV. The median CD4 count was 118/mm3 (IQR: 58-178 cells/mm3). No telephone number was mentioned in the medical records of 212 patients. Of the 1004 patients whose phone number was listed, 802 patients (79.9%) were not reachable on the recorded number, 114 patients (11.4%) were alive and 88 patients (8.8%) had died. In multivariate analysis, factors associated with loss to follow-up during the first 6 months of ART were: age below 35 years (OR=1.6; 95%CI: 1.2-2.2), female sex (OR=1.8; 95%CI: 1.3-2.5), WHO stage III or IV (OR=1.7; 95%CI: 1.3-2.2), existence of an opportunistic infection (OR=2.3; 95%CI: 1.5-3.1), and follow-up in a public centre (OR=1.9; 95%CI: 1.2-3.3). Conclusion: This study identified several factors associated with lost to follow-up during the first 6 months of ART, and confirmed high mortality among these patients. The National AIDS Program should strengthen medical support of PLWHA in Togo including active case follow-up.Key words: Africa, HIV, human immunodeficiency virus, lost to follow-up, people living with HIV, Tog

Estudo do comportamento da dilatação térmica do compósito Mg-B(20%)

O compósito de Mg-B(20%) apresenta aplicações relacionadas à área aeronáutica/aeroespacial, conforme seus históricos de utilização relatados e avaliados por alguns autores, devido a suas propriedades, em especial a relação resistência /peso. O foco do estudo realizado foi levantar pormenorizadamente seu comportamento de expansão térmica para taxas controladas de adição de calor e ciclos térmicos de trabalho. Os resultados mostraram-se dentro do esperado para esta espécie de material, ou seja, as fibras são mais solicitadas numa faixa de temperatura e orientações e a matriz passa a ter maior predomínio global em outras faixas e orienta- ções, o que é comprovado no decorrer deste estudo experimental

Sleep deprivation increases oleoylethanolamide in human cerebrospinal fluid

This study investigated the role of two fatty acid ethanolamides, the endogenous cannabinoid anandamide and its structural analog oleoylethanolamide in sleep deprivation of human volunteers. Serum and cerebrospinal fluid (CSF) samples were obtained from 20 healthy volunteers before and after a night of sleep deprivation with an interval of about 12 months. We found increased levels of oleoylethanolamide in CSF (P = 0.011) but not in serum (P = 0.068) after 24 h of sleep deprivation. Oleoylethanolamide is an endogenous lipid messenger that is released after neural injury and activates peroxisome proliferator-activated receptor-α (PPAR-α) with nanomolar potency. Exogenous PPAR-α agonists, such as hypolipidemic fibrates and oleoylethanolamide, exert both neuroprotective and neurotrophic effects. Thus, our results suggest that oleoylethanolamide release may represent an endogenous neuroprotective signal during sleep deprivation

Diagnosing mucopolysaccharidosis IVA

Mucopolysaccharidosis IVA (MPS IVA; Morquio A syndrome) is an autosomal recessive lysosomal storage disorder resulting from a deficiency of N-acetylgalactosamine-6-sulfate sulfatase (GALNS) activity. Diagnosis can be challenging and requires agreement of clinical, radiographic, and laboratory findings. A group of biochemical genetics laboratory directors and clinicians involved in the diagnosis of MPS IVA, convened by BioMarin Pharmaceutical Inc., met to develop recommendations for diagnosis. The following conclusions were reached. Due to the wide variation and subtleties of radiographic findings, imaging of multiple body regions is recommended. Urinary glycosaminoglycan analysis is particularly problematic for MPS IVA and it is strongly recommended to proceed to enzyme activity testing even if urine appears normal when there is clinical suspicion of MPS IVA. Enzyme activity testing of GALNS is essential in diagnosing MPS IVA. Additional analyses to confirm sample integrity and rule out MPS IVB, multiple sulfatase deficiency, and mucolipidoses types II/III are critical as part of enzyme activity testing. Leukocytes or cultured dermal fibroblasts are strongly recommended for enzyme activity testing to confirm screening results. Molecular testing may also be used to confirm the diagnosis in many patients. However, two known or probable causative mutations may not be identified in all cases of MPS IVA. A diagnostic testing algorithm is presented which attempts to streamline this complex testing process

An overview of burst, buckling, durability and corrosion analysis of lightweight FRP composite pipes and their applicability

© 2019 Elsevier Ltd. All rights reserved.The main aim of this review article was to address the performance of filament wound fibre reinforced polymer (FRP) composite pipes and their critical properties, such as burst, buckling, durability and corrosion. The importance of process parameters concerning merits and demerits of the manufacturing methods was discussed for the better-quality performance. Burst analysis revealed that the winding angle of ±55° was observed to be optimum with minimum failure mechanisms, such as matrix cracking, whitening, leakage and fracture. The reduction of buckling effect was reported in case of lower hoop stress value in the hoop to axial stress ratio against axial, compression and torsion. A significant improvement in energy absorption was observed in the hybrid composite pipes with the effect of thermal treatment. However, the varying winding angle in FRP pipe fabrication was reported as an influencing factor affecting all the aforementioned properties. Almost 90% of the reviewed studies was done using E-glass/epoxy materials for the composite pipe production. By overcoming associated limitations, such as replacing synthetic materials, designing new material combinations and cost-benefit analysis, the production cost of the lightweight FRP composite pipes can be decreased for the real-time applications.Peer reviewe