A site to transform Pubmed publications into these bibliographic reference formats: ADS, BibTeX, EndNote, ISI used by the Web of Knowledge, RIS, MEDLINE, Microsoft's Word 2007 XML.

patients on ART - Top 30 Publications

Use of the endometriosis fertility index in daily practice: A prospective evaluation.

To perform a prospective evaluation of postoperative fertility management using the endometriosis fertility index (EFI).

The Art of Healing through Narrative Medicine in Clinical Practice: A Reflection.

The art of medicine has roots that lie deep in developing the biopsychosocial connection. Understanding a human body (both its physiology and pathology) along with components of emotional and spiritual cores can lead to provision of excellent medical care and better outcomes. The harmonization of psychosocial consequences of a biological disease is helpful not just for health care professionals but also for patients. Where it keeps the empathy and compassion alive and results in greater patient satisfaction, it also helps boost the physician's morale.Our objective is to reflect on the impact of narrative medicine on physician-patient dynamics for health care professionals in a clinical setting. This article was written after synthesizing the findings of evidence-based literature, retrieved from different sources, along with our own reflections on our encounters with patients.One could infer from the evidence-based research that the practice of narrative medicine improves one's concern and understanding toward the patient. This requires more time from the clinician, but medical care without compassion and humaneness causes high rates of dissatisfaction among both patients and health care practitioners, along with the risk of recurrent ailments. Our own patient encounters provide a testimony to this inference. The biopsychosocial model carries the same holistic approach toward patients. The mainstay of treatment in any domain of medicine should contain thoughtfulness for the sufferer rather than sole consideration of the suffering.

CD4(+) T Memory Stem Cells Correlate with Disease Progression in Chronically HIV-1-Infected Patients.

Recently identified T memory stem (Tscm) cells have stem-cell-like properties, including long lifespan, self-renewal capacity, and multipotency to differentiate into other memory T cell types. In the study of simian immunodeficiency virus (SIV) infection, selective depletion of CCR5(+)CD4(+) Tscm cells and the high proliferation rate of these cells are believed to be responsible for the pathogenesis of SIV-infected rhesus macaques. Here, we conducted a cohort study to investigate the influence of chronic human immunodeficiency virus (HIV)-1 infection on CD4(+) Tscm cell homeostasis, and the effect of antiretroviral therapy (ART) on CD4(+) Tscm cells. Chronic HIV-1 infection resulted in a decrease of the CD4(+) Tscm cell proportion in HIV-1 patients. The decreased number of CD4(+) Tscm cells in HIV-1 patients correlated positively with that of circulating CD4(+) T cells. Further, the depletion of CD4(+) Tscm cells was inversely correlated with an increased level of T cell immune activation during chronic HIV-1 infection. Prolonged ART recovered the CD4(+) Tscm cells, and the dynamic change of CD4(+) Tscm cells was in parallel with CD4(+) T cell restoration and a decrease in the level of T cell immune activation. We propose that the abnormity of CD4(+) Tscm cells may contribute to the pathogenesis and disease progression in HIV-1-infected individuals.

Identification of autism spectrum disorder using deep learning and the ABIDE dataset.

The goal of the present study was to apply deep learning algorithms to identify autism spectrum disorder (ASD) patients from large brain imaging dataset, based solely on the patients brain activation patterns. We investigated ASD patients brain imaging data from a world-wide multi-site database known as ABIDE (Autism Brain Imaging Data Exchange). ASD is a brain-based disorder characterized by social deficits and repetitive behaviors. According to recent Centers for Disease Control data, ASD affects one in 68 children in the United States. We investigated patterns of functional connectivity that objectively identify ASD participants from functional brain imaging data, and attempted to unveil the neural patterns that emerged from the classification. The results improved the state-of-the-art by achieving 70% accuracy in identification of ASD versus control patients in the dataset. The patterns that emerged from the classification show an anticorrelation of brain function between anterior and posterior areas of the brain; the anticorrelation corroborates current empirical evidence of anterior-posterior disruption in brain connectivity in ASD. We present the results and identify the areas of the brain that contributed most to differentiating ASD from typically developing controls as per our deep learning model.

Separation of sperm cells from samples containing high concentrations of white blood cells using a spiral channel.

Microfluidic technology has potential to separate sperm cells from unwanted debris while improving the effectiveness of assisted reproductive technologies (ART). Current clinical protocol limitations regarding the separation of sperm cells from other cells/cellular debris can lead to low sperm recovery when the sample contains a low concentration of mostly low motility sperm cells and a high concentration of unwanted cells/cellular debris, such as in semen samples from patients with pyospermia [high white blood cell (WBC) semen]. This study demonstrates label-free separation of sperm cells from such semen samples using inertial microfluidics. The approach does not require any externally applied forces except the movement of the fluid sample through the instrument. Using this approach, it was possible to recover not only any motile sperm, but also viable less-motile and non-motile sperm cells with high recovery rates. Our results demonstrate the ability of inertial microfluidics to significantly reduce WBC concentration by flow focusing of target WBCs within a spiral channel flow. The estimated sample process time was more rapid (∼5 min) and autonomous than the conventional method (gradient centrifuge sperm wash; ∼1 h). A mixture of sperm/WBC was injected as the device input and 83% of sperm cells and 93% of WBCs were collected separately from two distinct outlets. The results show promise for enhancing sperm samples through inertial flow processing of WBCs and sperm cells that can provide an advantage to ART procedures such as sample preparation for intrauterine insemination.

Onabotulinum toxin A in the treatment of chronic migraine: patient selection and special considerations.

Discovered by serendipity, onabotulinum toxin A (BoNT-A) is the only US Food and Drug Administration-approved treatment for the prevention of chronic migraine (CM), one of the most disabling and burdensome human conditions. Its efficacy, safety and tolerability, proved by the largest and longest migraine therapeutic trial (the Phase III Research Evaluating Migraine Prophylaxis Therapy program [PREEMPT]), have been replicated by various real-life studies also in the presence of medication overuse. The benefit of BoNT-A prophylaxis is likely due to its ability to counteract peripheral and central nociceptive sensitization through reversible chemical denervation of pericranial sensitive afferents. Its efficacy increases considerably over time during long-term treatments, significantly varying among patients. The present review focuses on the state-of-the art of current knowledge on putative instrumental, biochemical and clinical predictors of BoNT-A responsiveness, outlining the need for a thorough characterization of the full phenotypic migraine picture when trying to predict good responders. Available evidence suggests that disentangling the BoNT-A responsiveness puzzle requires 1) a reappraisal of easy-obtainable clinical details (eg, site and quality of pain, presence of cranial autonomic symptoms), 2) a proper stratification of patients with CM according to their headache frequency, 3) the evaluation of potential synergistic effects of concomitant prophylaxis/treatment and 4) a detailed assessment of modifiable risk factors evolution during treatment.

Adverse drug reaction monitoring in patients on antiretroviral therapy in a tertiary care hospital in Eastern India.

Besides unparalleled benefits, highly active antiretroviral therapy is also associated with wide range of potential adverse drug reactions (ADRs), which hinders treatment adherence. The present study was thus designed to monitor and explore the pattern of occurrence of ADRs to various antiretroviral therapy (ART) regimens in a tertiary care ART setup.

Image guided adaptive external beam radiation therapy for cervix cancer: Evaluation of a clinically implemented plan-of-the-day technique.

Radiotherapy for cervix cancer is challenging in patients exhibiting large daily changes in the pelvic anatomy, therefore adaptive treatments (ART) have been proposed. The aim of this study was the clinical implementation and subsequent evaluation of plan-of-the-day (POTD)-ART for cervix cancer in supine positioning. The described workflow was based on standard commercial equipment and current quality assurance (QA) methods.

Percutaneous treatment of hepatocellular carcinoma: state of the art and innovations.

Percutaneous treatment of hepatocellular carcinoma (HCC) encompasses a vast range of techniques, including monopolar radiofrequency ablation (RFA), multibipolar RFA, microwave ablation, cryoablation and irreversible electroporation. RFA is considered to be one of the main curative treatments for HCC of less than 5 cm developing on cirrhosis, together with surgical resection and liver transplantation. However, controversies exist concerning the respective roles of ablation and liver resection for HCC of less than 3 to 5 cm on cirrhosis. In line with the therapeutic algorithm of early HCC, percutaneous ablation could also be used as a bridge to liver transplantation or in a sequence of upfront percutaneous treatment, followed by transplantation if tumor relapses. Moreover, several innovations in ablation methods may help to efficiently treat early HCC initially considered as "non-ablatable", and might, in some cases, extend ablation criteria beyond early HCC in order to treat the largest number of patients using a curative approach.

Do cancer patients with high levels of distress benefit more than less distressed patients from outpatient art therapy?

Several studies have evaluated the effectiveness of art therapy for cancer patients. Our aim was to determine the effects of outpatient art therapy on the quality of life (QoL) of highly vs. less distressed cancer patients.

Artesunate induces apoptosis via inhibition of STAT3 in THP-1 cells.

Our objective was to explore STAT3 expression in patients with acute myeloid leukaemia (AML), assess the anti-proliferative effects of artesunate (ART) on THP-1 cells in vivo and in vitro, and investigate the underlying mechanisms.

The effect of plasma auto-IgGs on CD4(+) T cell apoptosis and recovery in HIV-infected patients under antiretroviral therapy.

Although effective antiretroviral therapy (ART) suppresses HIV viral replication, prevents AIDS-related complications, and prolongs life, a proportion of patients fails to restore the patients' CD4(+) T cell number to the level of healthy individuals. Increased mortality and morbidity have been observed in these patients. In the current study, we have investigated the role of auto-IgGs in CD4(+) T cell apoptosis and recovery in a cross-sectional study. All HIV(+) subjects were on viral-suppressive ART treatment with a different degree of CD4(+) T cell reconstitution. Total auto-IgG binding on CD4(+) T cell surfaces and its associated apoptosis and CD4(+) T cell recovery were analyzed by flow cytometry ex vivo. Total IgGs from plasma were tested for their binding capacities to CD4(+) T cell surfaces and their mediation to CD4(+) T cell death through NK cell cytotoxicity in vitro. HIV(+) subjects had increased surface binding of auto-IgGs on CD4(+) T cells compared with healthy controls, and IgG binding was associated with elevated CD4(+) T cell apoptosis in HIV(+) subjects but not in healthy controls. Plasma IgGs from HIV(+) subjects bound to CD4(+) T cells and induced cell apoptosis through NK cytotoxicity in vitro. Soluble CD4 (sCD4) preincubation prevented NK cell-mediated CD4(+) T cell death. Our results suggest that plasma autoantibodies may play a role in some HIV(+) patients with poor CD4(+) T cell recovery under viral-suppressive ART.

Renal manifestations of HIV during the antiretroviral era in South Africa: a systematic scoping review.

It is estimated that 650,000 patients may develop human immunodeficiency virus (HIV)-related renal disease in South Africa. South Africa has recently adopted WHO policy, stipulating that all HIV-infected patients have access to antiretroviral treatment (ART) irrespective of CD4 cell count.

Varying intervals of antiretroviral medication dispensing to improve outcomes for HIV patients (The INTERVAL Study): study protocol for a randomized controlled trial.

Requirements for frequent dispensing of antiretroviral therapy (ART) place demands on health systems and can lead to suboptimal adherence and disengagement in care for patients due to the time and cost of frequent clinic visits. Rigorous data are needed to define optimal ART dispensing strategies and to evaluate the impact of a longer medication supply on retention and virologic suppression and determine whether this strategy lowers costs for both the patient and the health system. To date, no randomized studies have tested the benefits of 6-month dispensing of ART compared to 3-month and standard of care approaches.

Drug resistance patterns following pharmacy stock shortage in Nigerian Antiretroviral Treatment Program.

For patients on antiretroviral therapy (ART), treatment interruptions can impact patient outcomes and result in the accumulation of drug resistance mutations leading to virologic failure. There are minimal published data on the impact of an ART stock shortage on development of drug resistance mutations (DRMs). In this report, we evaluate data from patients enrolled in the Government of Nigeria National ART Program that were receiving treatment at the time of a national drug shortage in late 2003.

The epidermal growth factor network: role in oocyte growth, maturation and developmental competence.

The LH surge induces great physiological changes within the preovulatory follicle, which culminate in the ovulation of a mature oocyte that is capable of supporting embryo and foetal development. However, unlike mural granulosa cells, the oocyte and its surrounding cumulus cells are not directly responsive to LH, indicating that the LH signal is mediated by secondary factors produced by the granulosa cells. The mechanisms by which the oocyte senses the ovulatory LH signal and hence prepares for ovulation has been a subject of considerable controversy for the past four decades. Within the last 15 years several significant insights have been made into the molecular mechanisms orchestrating oocyte development, maturation and ovulation. These findings centre on the epidermal growth factor (EGF) pathway and the role it plays in the complex signalling network that finely regulates oocyte maturation and ovulation.

Benjamin Button Effect: Recognizable Rejuvenation.

<p>The "Benjamin Button" effect inspired by the popular motion picture, is used to describe the goal of achieving a clearly younger and more attractive, yet still natural appearance utilizing noninvasive and minimally invasive therapies and procedures. Due to high patient demand for enhancement and rejuvenation of the face and body with minimal downtime, there is an ever-increasing number of companies developing products and devices, variety of indications, and field of practitioners offering them. Each option, including topicals, injectables, and devices, promises near magical results. Despite that, a brief review of online discussions and media resources reveals both patients complaining of inadequate results and celebrities with extreme appearances. For clinical practitioners, it is critical to understand the art, science, and economics of noninvasive rejuvenation in order to properly evaluate potential patients, set appropriate expectations, develop, and provide an effective noninvasive rejuvenation plan to achieve a true "Benjamin Button" effect for patients.</p> <p><em>J Drugs Dermatol. 2017;16(6 Suppl):s74-76.</em></p>.

Immunologic response to ART by age among treatment-naïve patients in sub-Saharan Africa.

To estimate the association between age at antiretroviral therapy (ART) initiation and immunologic response over time by stratum of baseline CD4 cell counts.

Clustering of Morphological Features for Identifying Femur Cavity Subtypes with Difficulties of Intramedullary Nail Implantation.

Intramedullary (IM) nail implantation is currently the standard treatment for femoral intertrochanteric fractures. However, individual differences in femur cavity bring a challenge in designing well-matched IM nails and cause difficulties in IM nail implantation. Therefore, there is an intense need to analyze femur cavities to predict difficulties in IM nail implantation to assist the design of IM nails. This study proposed a method to automatically identify subtypes of femur cavities that exhibit differences in potential difficulties in nail implantation by clustering the morphological features of femur models. The unsupervised subtype extraction method offers a scientific approach to stratify patients for designing and choosing well-matched IM nails. First, the quantitative morphological features of 422 femur cavities were extracted from computed tomography patient models. Second, 422 femur cavities were clustered into three distinct subtypes using a density peak-based k-means clustering method to provide a possible solution for the scientific design of IM nails. The effectiveness of the identified subtypes was validated by comparing subtype differences associated with IM nail implantation and the natural attributes of the patient. Quantitative evaluation of the mismatch degree and real clinical cases confirmed that the clustering results were clinically effective, with clear differences in the subtypes. Therefore, particular IM nails designed from the identified subtypes will potentially facilitate IM nail implantation and reduce complications. Compared with state-of-the-art methods, we used the largest-scale dataset and unsupervised clustering to achieve subtype identification of femur cavities with clinical significance.

Identifying condition-specific modules by clustering multiple networks.

Condition-specific modules in multiple networks must be determined to reveal the underlying molecular mechanisms of diseases. Current algorithms exhibit limitations such as low accuracy and high sensitivity to the number of networks because these algorithms discover condition-specific modules in multiple networks by separating specificity and modularity of modules. To overcome these limitations, we characterize condition-specific module as a group of genes whose connectivity is strong in the corresponding network and weak in other networks; this strategy can accurately depict the topological structure of condition-specific modules. We then transform the condition-specific module discovery problem into a clustering problem in multiple networks. We develop an efficient heuristic algorithm for the Specific Modules in Multiple Networks (SMMN), which discovers the condition-specific modules by considering multiple networks. By using the artificial networks, we demonstrate that SMMN outperforms state-of-the-art methods. In breast cancer networks, stage-specific modules discovered by SMMN are more discriminative in predicting cancer stages than those obtained by other techniques. In pan-cancer networks, cancer-specific modules are more likely to associate with survival time of patients, which is critical for cancer therapy.

The influence of ovulation induction and assisted conception on maternal and perinatal outcomes of twin pregnancies.

To compare obstetrical and neonatal outcomes of twin pregnancies conceived via assisted reproductive technology (ART) with those of naturally conceived ones and to investigate the influence of the ART procedure type on these parameters.

Psychological distress in post-partum women after non-invasive prenatal testing (NIPT) in Japan.

The purpose of this study was to clarify the characteristics of psychological mental distress in post-partum women after non-invasive prenatal testing (NIPT) in Japan.

Preoperative Ultrasonographic Assessment of the Anterior Pelvic Plane for Personalized Total Hip Replacement.

Correct positioning of the acetabular component is a key factor in minimizing the risk of dislocation after total hip replacement (THR) surgery. A "safe" orientation of the cup is usually defined by 2 angles measured between its geometric axis and the anterior pelvic plane. However, in the current state-of-the-art approach to THR surgery, the intraoperative orientation of the anterior pelvic plane cannot be measured. Even less is known about the functional orientation of the pelvis, which determines the postoperative orientation of the cup during the patient's everyday activities. The aim of this article is to present an original approach to personalized THR surgery, in which the necessary measurements are done preoperatively without interfering with the surgical work flow, and the individual orientation of the cup is obtained without navigation using standard tools that are available in the operating room.

Developing a patient-reported outcome measure for HIV care on perceived barriers to antiretroviral adherence: assessing the needs of HIV clinicians through qualitative analysis.

To identify HIV clinicians' needs for the clinical use of a new patient-reported outcome measure (PRO) on barriers to antiretroviral therapy (ART) adherence.

Causes of HIV Drug Non-Adherence in Korea: Korea HIV/AIDS Cohort Study, 2006-2015.

We aimed to determine the initial adherence of HIV cohort patients to ART (antiretroviral therapy), and reasons for non-adherence. Patients who received ART at the time of enrollment in the Korea HIV/AIDS Cohort were included in this study. Treatment adherence was determined at the baseline interview by self-reported questionnaire. Eight-hundred thirty two HIV-infected patients received ART. Of these, 253 (30.4%) patients skipped ART more than once a month. The most common reason of skipping medication was "simply forgot" (60.4%).

An eFTD-VP framework for efficiently generating patient-specific anatomically detailed facial soft tissue FE mesh for craniomaxillofacial surgery simulation.

Accurate surgical planning and prediction of craniomaxillofacial surgery outcome requires simulation of soft tissue changes following osteotomy. This can only be achieved by using an anatomically detailed facial soft tissue model. The current state-of-the-art of model generation is not appropriate to clinical applications due to the time-intensive nature of manual segmentation and volumetric mesh generation. The conventional patient-specific finite element (FE) mesh generation methods are to deform a template FE mesh to match the shape of a patient based on registration. However, these methods commonly produce element distortion. Additionally, the mesh density for patients depends on that of the template model. It could not be adjusted to conduct mesh density sensitivity analysis. In this study, we propose a new framework of patient-specific facial soft tissue FE mesh generation. The goal of the developed method is to efficiently generate a high-quality patient-specific hexahedral FE mesh with adjustable mesh density while preserving the accuracy in anatomical structure correspondence. Our FE mesh is generated by eFace template deformation followed by volumetric parametrization. First, the patient-specific anatomically detailed facial soft tissue model (including skin, mucosa, and muscles) is generated by deforming an eFace template model. The adaptation of the eFace template model is achieved by using a hybrid landmark-based morphing and dense surface fitting approach followed by a thin-plate spline interpolation. Then, high-quality hexahedral mesh is constructed by using volumetric parameterization. The user can control the resolution of hexahedron mesh to best reflect clinicians' need. Our approach was validated using 30 patient models and 4 visible human datasets. The generated patient-specific FE mesh showed high surface matching accuracy, element quality, and internal structure matching accuracy. They can be directly and effectively used for clinical simulation of facial soft tissue change.

Tuberculosis among HIV-infected population: incidence and risk factors in rural Tanzania.

The incidence of tuberculosis among HIV-infected populations with high CD4 count in high burden countries has not been well studied.

Long-Term Potassium Monitoring and Dynamics in Heart Failure and Risk of Mortality.

Background -The prognostic value of long-term potassium monitoring and dynamics in heart failure (HF) has not been characterized completely. We sought to determine the association between serum potassium values collected at follow-up with all-cause mortality in a prospective and consecutive cohort of patients discharged from a previous acute HF admission. Methods -Serum potassium was measured at every physician-patient encounter, including hospital admissions and ambulatory settings. The multivariable-adjusted association of serum potassium with mortality was assessed using comprehensive state-of-the-art regression methods that can accommodate time-dependent exposure modeling. Results -The study sample included 2164 patients with a total of 16,116 potassium observations. Mean potassium at discharge was 4.3±0.48 mEq/L. Hypokalemia (<3.5 mEq/L), normokalemia (3.5 to 5.0 mEq/L), and hyperkalemia (>5 mEq/L) were observed at the index admission in 77 (3.6%), 1965 (90.8%), and 122 (5.6%) patients, respectively. At a median follow-up of 2.8 years (range=0.03-12.8 years), 1090 patients died (50.4%). On a continuous scale, the multivariable-adjusted association of potassium values and mortality revealed a non-linear association (U-shaped) with higher risk at both ends of its distribution (omnibus p-value=0.001). Likewise, the adjusted hazard ratios (HRs) for hypokalemia and hyperkalemia - normokalemia as reference - were 2.35 (95% confidence interval [CI]:1.40-3.93; p=0.001) and 1.55 (95% CI:1.11-2.16; p=0.011), respectively (omnibus p-value=0.0003). Furthermore, dynamic changes in potassium were independently associated with substantial differences in mortality risk. Potassium normalization was independently associated with lower mortality risk (p=0.001). Conclusions -Either modeled continuously or categorically, serum potassium levels during long-term monitoring were independently associated with mortality in patients with HF. Likewise, persistence of abnormal potassium levels was linked to higher risk of death compared with patients who maintained or returned to normal values.

SOHO State of the Art Update and Next Questions: Biology and Treatment of Myelodysplastic Syndromes.

Myelodysplastic syndromes (MDS) are a heterogeneous group of myeloid neoplasms characterized by clonal hematopoiesis leading to bone marrow dysplasia and cytopenias. Recently, significant advancements have been made in understanding the pathogenic mechanisms of this disease. In particular, how a wide array of somatic mutations can induce a common clinical phenotype has been investigated. Specifically, activation of innate immune signaling (i.e. myeloid derived suppressor cells) and the NLRP3 inflammasome in hematopoietic stem/progenitor cells play a central role in the biology of MDS, leading to pyroptotic cell death and clonal expansion. Additionally, deciphering the molecular drivers of MDS using next-generation sequencing has rapidly expanded our understanding of MDS with profound implications for prognosis, treatment decisions, and future clinical investigations. Together, unraveling of the role of innate immunity/pyroptosis in the clinical phenotype of MDS patients and comprehensive molecular characterization has identified novel therapeutic strategies that offer significant promise.

Effect of isoniazid preventive therapy on risk of death in west African, HIV-infected adults with high CD4 cell counts: long-term follow-up of the Temprano ANRS 12136 trial.

Temprano ANRS 12136 was a factorial 2 × 2 trial that assessed the benefits of early antiretroviral therapy (ART; ie, in patients who had not reached the CD4 cell count threshold used to recommend starting ART, as per the WHO guidelines that were the standard during the study period) and 6-month isoniazid preventive therapy (IPT) in HIV-infected adults in Côte d'Ivoire. Early ART and IPT were shown to independently reduce the risk of severe morbidity at 30 months. Here, we present the efficacy of IPT in reducing mortality from the long-term follow-up of Temprano.