Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:1.2.7.5 (AOR)
 1,763 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Universal nevirapine (NVP) therapy (provision of the drug without HIV testing) has been suggested as potentially superior to targeted NVP therapy (provision of the drug to seropositive patients identified through voluntary HIV counseling and testing [VCT]) for perinatal HIV prevention in low-resource, high-prevalence settings. The authors postulated that uptake (the proportion of women who accept the strategy when offered) may be higher for universal therapy, since it does not require a woman to learn her serostatus; they further postulated that adherence (the proportion of women who actually ingest the NVP tablet at labor onset) may be higher for targeted therapy, since knowledge of serostatus could motivate better adherence. Two clinics in Lusaka, Zambia were assigned to provide either the targeted or universal strategy. Halfway through the study period, the approach offered at each clinic was crossed over. Adherence was assessed by liquid chromatographic assay for NVP of cord blood. Regarding uptake, 1524 pregnant women were offered participation, and 1025 (67%) accepted. Of 694 women offered enrollment in the universal strategy, 496 (71%) accepted; of 830 women offered enrollment in the targeted strategy, 529 (64%) accepted (p <.01). Uptake was similar at both clinics for the universal strategy: 250 of 339 (74%) at clinic A and 246 of 355 (69%) at clinic B (p =.2), but differed significantly between clinics for the targeted strategy: 229 of 316 (72%) at clinic A and 300 of 514 (58%) at clinic B (RR, 1.51; 95% CI, 1.23, 1.86). Increased uptake correlated with having been offered the universal rather than the targeted strategy (AOR, 1.5; 95% CI, 1.1, 2.1), attendance at clinic A (AOR, 1.4; 95% CI, 1.01, 2.0), and maternal report of a prior fetal or infant death (AOR, 1.6; 95% CI, 1.1, 2.5). Regarding adherence, in the universal strategy, 40 of 103 women (39%) were nonadherent compared with 25 of 98 women (26%) in the targeted strategy (RR, 1.5; 95% CI, 1.004, 2.3). Failure to adhere correlated with participation in the universal strategy (AOR, 2.0; 95% CI, 1.04, 4.2) and illiteracy (AOR, 2.6; 95% CI, 1.2, 5.3). In high-prevalence settings with adequate VCT services, uptake of NVP using the universal or targeted approach appears comparable. However, the universal strategy may result in better uptake in clinics with less well-functioning VCT services (as with clinic B). Adherence to the single-dose NVP intervention was lower among women who did not learn their HIV status. Programs that seek to save the greatest possible number of infants from perinatal HIV acquisition should consider a combination approach, in which women who desire HIV testing can access NVP through a targeted strategy, and women who do not desire testing can access NVP through a universal strategy.
 ...
PMID:Comparison of two strategies for administering nevirapine to prevent perinatal HIV transmission in high-prevalence, resource-poor settings. 1267 2

Injection drug users who continue to use drugs may not respond to highly active antiretroviral therapy (HAART) as well as other HIV-infected individuals, even after adjusting for a reliable measure of adherence. We therefore compared the virologic response among participants in a population-based HIV/AIDS Drug Treatment Program in British Columbia, Canada, by injection drug use activity. Participants who were HIV infected and naive to antiretroviral therapy and who were prescribed antiretroviral treatment between August 1996 and December 2000 were eligible for this study. They were classified as current, former, or non-injection drug users. The main outcome was having two consecutive HIV-1 RNA levels less than 500 copies/mL. We used logistic regression to adjust for baseline HIV-1 RNA, type of antiretroviral regimen (2 nucleosides + nonnucleoside reverse transcriptase inhibitor versus 2 nucleosides + protease inhibitor), duration of therapy (months), adherence (derived from refill compliance data), and age. A total of 578 participants were first prescribed HAART during the study period. Among them, 78 (13%) were current injection drug users, 96 (17%) were former injection drug users, and 404 (70%) never injected drugs. In the multivariable logistic regression, relative to non-drug users, current injection drug users were significantly less likely to suppress their HIV-1 RNA (adjusted OR [AOR] = 0.30, 95% CI: 0.13-0.67), and former injection drug users were not significantly different from non-drug users (AOR = 0.56, 95% CI: 0.24-1.34). There was a significant interaction between drug use and adherence. In the analyses stratified by drug use, the adherence of former and non-drug users was positively associated with HIV-1 RNA suppression (AOR = 1.33, 95% CI: 1.14-1.55), whereas for current drug users, it was not (AOR = 1.07, 95% CI: 0.87-1.33). Current injection drug users were less likely to achieve HIV-1 RNA suppression compared with non-drug users. Adherence as measured by pharmacy refill compliance was not a reliable measure in this subpopulation.
 ...
PMID:Impaired virologic response to highly active antiretroviral therapy associated with ongoing injection drug use. 1267 4

To describe prevalence of fatigue and its correlates among persons with HIV infection, we abstracted medical records of 13,768 persons in care for HIV in >100 US clinics. The prevalence of fatigue (defined as fatigue, malaise, or weakness that was the primary reason for a medical visit, was persistent, or was severe enough to preclude work) was 37%. Fatigue was more common among persons with clinical AIDS (adjusted odds ratio [AOR] 1.3, CI 1.1-1.5); depression (AOR 2.4, CI 2.1-2.7); and hemoglobin concentrations <8, 8-10, and 10-12 g/dL (AORs 3.3 [CI 2.4-4.6], 2.7 [CI 2.2-3.2], and 1.5 [CI 1.3-1.7], respectively). Fatigue was not associated with viral load or CD4 cell count <200/microl. Fatigue cannot be viewed solely as a constitutional symptom of progressive HIV disease. Physicians should seek underlying, treatable causes for fatigue such as depression and anemia and treat these conditions when they are found.
 ...
PMID:Prevalence and correlates of fatigue among persons with HIV infection. 1269 84

To identify the frequency of and factors associated with early detection of HIV infection in Los Angeles County, data were evaluated from interviews of a population-based sample of adult persons with AIDS. Early detection was defined as greater than 5 years between the first reported positive HIV test and an AIDS diagnosis. The associations between early detection and sociodemographic and behavioral factors were assessed for the period January 1997 through June 2002. Over the study period, only 20% (253/1268) of persons interviewed met the criterion for early detection. Early HIV detection was less likely for women (adjusted odds ratio [AOR] = 0.6, 95% confidence interval [CI]: 0.4, 0.9), blacks (AOR = 0.5, 95% CI: 0.4, 0.8), foreign-born Latinos (AOR = 0.2, 95% CI: 0.1, 0.3), U.S.-born Latinos (AOR = 0.3, 95% CI: 0.2, 0.6, and heterosexuals (AOR = 0.5, 95% CI: 0.3, 0.7). Trends of increasing early detection with older age groups (p < 0.001) and higher educational levels (p < 0.001) were also observed. Our findings indicate an overall low level of early HIV detection and suggest that major sociodemographic and risk group disparities exist in the likelihood of early detection among HIV-infected persons in Los Angeles. These differences have important implications for reducing the level of community HIV transmission and for improving individual health outcomes among people with HIV. Aggressive efforts are needed to expand HIV testing and early detection for women, minorities, heterosexuals, younger age groups, and persons of lower education. Links to treatment and behavioral intervention programs should accompany such expanded testing efforts.
 ...
PMID:Frequent failed early HIV detection in a high prevalence area: implications for prevention. 1288 Apr 91

To determine the association between sexual exposure and hepatitis C virus (HCV) infection in urban Chennai, India, a random sample of adults who live in a slum community completed interviews and provided samples to test for HCV, herpes simplex virus type 2 (HSV-2), and other sexually transmitted infections (STIs). All analyses excluded recent and current injection drug users. HCV infection was not associated with the reported number of sex partners for men or women. Women were more likely to be HCV infected if they reported previous genital ulcer disease (adjusted odds ratio [AOR], 3.88; 95% confidence interval [95% CI], 0.94-16.0; marginally statistically significant). Men were more likely to be HCV infected if they were HSV-2 infected (AOR, 3.85; 95% CI, 1.18-12.6) or reported having had sex with men (AOR, 3.61; 95% CI, 1.00-13.1). Sexual transmission of HCV infection may be facilitated by ulcerative STIs and male-male sexual practices, but it appears to occur infrequently in this population.
 ...
PMID:Association of hepatitis C virus infection with sexual exposure in southern India. 1290 35

In Vancouver, British Columbia, Canada, difficulty accessing syringes at night has been shown to be strongly associated with human immunodeficiency virus (HIV) risk behavior among the city's injection drug users (IDUs). On September 1, 2001, the Vancouver Area Network of Drug Users (VANDU) initiated an unsanctioned all-night needle-exchange program on a street corner in the heart of the neighborhood where many of the city's IDUs are concentrated. An external evaluation of the population reached by the VANDU exchange was performed through the Vancouver Injection Drug User's Study, a prospective cohort study of IDUs begun in 1996. Persons accessing syringes through the exchange were compared to those active injectors who acquired their syringes from other sources, including the city's fixed site exchange, which closes at 8:00 PM. Overall, 587 active IDUs were seen during the period September 2001 to June 2002; of these individuals, 165 (28.1%) reported using the VANDU exchange. In multivariate analyses, participants who used the VANDU table were more likely to frequently inject cocaine (adjusted odds ratio [AOR]=1.56; 95% confidence interval [CI]=1.00-2.44), inject in public (AOR=2.71; 95% CI=1.62-4.53), and require help injecting (OR=2.13; 95% CI=1.33-3.42). Interestingly, use of the table was also independently associated with safer syringe disposal (AOR=2.69; 95% CI=1.38-5.21). Results indicate that the unsanctioned exchange appears to have reached those IDUs at highest risk of HIV infection. Although the cross-sectional nature of the study design warrants caution, we also found that use of the nighttime exchange was strongly associated with higher rates of safe syringe disposal. The data suggest that drug user organizations can play a major role in reducing harm among their peers by reaching the highest risk drug users with harm reduction services. The findings also suggest that other forms of syringe-exchange programs should consider the benefits of offering fixed site nighttime service.
 ...
PMID:An external evaluation of a peer-run "unsanctioned" syringe exchange program. 1293 Aug 83

High school students frequently work long hours during the school year, increasing their risk of injury. Few studies have examined the relation between work injury and weekly work hours. This paper describes injuries among students in South Texas, where economically disadvantaged Hispanic students are heavily represented. Anonymous surveys were collected from 3565 secondary students in 23 schools. Self-reported data included weekly work hours and type of injury and job when injured. A dose-response effect was observed: increasing weekly work hours were related to injury (1-10 hours, adjusted odds ratio [AOR] = 1.0; 11-20 hours, 1.4; 21+ hours, 1.5), P < .000. The AOR for restaurant work was 3.2; for construction, 3.0; for factory, office, or skilled labor, 2.9; for agriculture, 2.8; for yard work, 2.0; and for babysitting (1.0). Males (OR = 1.5) were more prone to injury. High-intensity weekly work increased the likelihood of injury. Prevention efforts should be targeted to youth to reduce work injuries.
 ...
PMID:The prevalence and patterns of occupational injury among south Texas high school students. 1296 48

This study compared pain assessment and management in the last 48 hours of life for hospice and nonhospice nursing home residents. Included were 209 hospice and 172 nonhospice residents in 28 nursing homes in six geographic areas. Hospice patients were considered short-stay (seven days or less) (n=51), or longer-stay (over seven days) (n=158). Of residents not in a hospital or a coma (n=265), 33% of nonhospice residents, 6% of short-stay and 7% of longer-stay hospice residents had no documented pain assessment (P<0.05). For those with pain documented (n=93), longer-stay hospice residents, compared to nonhospice residents, had a significantly greater likelihood of having received an opioid (adjusted odds ratio [AOR] 5.4; 95% CI 1.3, 21.7), and an opioid at least twice a day (AOR 2.7; 95% CI 0.9, 7.7; P=0.07). Study results suggest that hospice enrollment improves pain assessment and management for nursing home residents; they also document the need for continued improvement of pain management in nursing homes.
 ...
PMID:Hospice enrollment and pain assessment and management in nursing homes. 1296 28

Bar and hotel workers (n=519) in Moshi, Tanzania were interviewed to obtain information about potential predictors of condom use. Samples were collected for the diagnosis of sexually transmitted diseases (STDs), including HIV. Consistent condom use was defined as always using condoms with sexual partners in the past five years. Overall consistent condom use in this population was 14.1%. In multivariate analyses, consistent condom use was inversely associated with low condom self-efficacy (adjusted odds ratio [AOR], 0.20; 95% confidence interval (CI), 0.06-0.71), low condom knowledge (AOR, 0.11; CI, 0.01-0.80), and having more than three children (AOR, 0.23; 95% CI, 0.09-0.54). Other significant predictors included perceived condom acceptability and using condoms when last exchanged sex for money or gift. These results indicate that increased specific condom knowledge, improved self-efficacy, and reduced social stigma could be effective strategies in the promotion of condom use in this population.
 ...
PMID:Social and behavioural determinants of consistent condom use among hotel and bar workers in Northern Tanzania. 1459 73

The clinical significance and virulence potential of Enterococcus casseliflavus/flavescens and Enterococcus gallinarum are still uncertain. We retrospectively analyzed 56 cases of significant bacteremia caused by E. casseliflavus or E. gallinarum. Of these cases, 25 (44.6%) were associated with polymicrobial bacteremia, and 43 (76.8%) were associated with entry via the biliary tract. Resistance to vancomycin was observed in 17 (30.4%) of these 56 patients, and this resistance was significantly associated with E. gallinarum bacteremia (adjusted odds ratio [AOR], 10.56; 95% confidence interval [CI], 2.41-46.27) and bacteremia without biliary tract origin (AOR, 6.74; 95% CI, 1.44-31.67). The crude mortality rate was 13%, and the bacteremia-related mortality rate was 1.9%. In conclusion, bacteremia due to E. casseliflavus and E. gallinarum is commonly associated with biliary tract disease and may be associated with a low risk of mortality.
 ...
PMID:Clinical features and outcomes of bacteremia caused by Enterococcus casseliflavus and Enterococcus gallinarum: analysis of 56 cases. 1467 48


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>