scholarly journals Integrase Strand Transfer Inhibitors & Weight Gain in Children with Perinatal HIV

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Gianna Fernandez ◽  
Alka Khaitan
Keyword(s):  
Weight Gain ◽  
Pediatric Population ◽  
Adult Population ◽  
Weight Maintenance ◽  
Strand Transfer ◽  
Cross Sectional ◽  
Perinatal Hiv ◽  
Number Of Patients ◽  
Significant Difference ◽  
Integrase Strand Transfer Inhibitors

Background: In the past, HIV infection was associated with weight loss due to metabolic wasting. Now with early initiation of antiretroviral therapy (ART) an increasing number of patients are being classified as overweight/ obese both prior to initiation and during the course of ART. Certain integrase strand transfer inhibitors (INSTIs) have been associated with weight gain in the adult population, but data in the pediatric population is lacking. This study explores the association of ART with an INSTI backbone and changes in weight and body mass index (BMI) in children with perinatal HIV who are followed in the HIV clinic at Riley Hospital. Methods: We performed a retrospective review of 59 patients with perinatally acquired HIV from 2016 to 2021. Weight, BMI, z-score, blood pressure (BP) percentiles, and lipid panels were recorded from the patients’ most recent visit. BMI and BP percentiles were compared between patients on Bictegravir, Dolutegravir, and Elvitegravir. For patients currently on an INSTI-backbone ART regimen, BMI was compared before and up to 5 years after INSTI initiation. Results: In our cross-sectional analysis between patients on Bictegravir, Dolutegravir, and Elvitegravir there was no significant difference in BMI (p=0.859), systolic BP percentile (p=0.188), or diastolic BP percentile (p=0.541). In our longitudinal analysis, we observed a significant increase in BMI over 3 years compared to pre-INSTI initiation (p=0.049). In addition, we observed an upwards trend with patients on Bictegravir (p=0.094) and Elvitegravir (p=0.121). Conclusion/Impact: Our study suggests that ART regimens with an INSTI backbone are associated with greater increases in BMIs. Our study is limited by a small n, but provides pilot data to direct future studies. It also illustrates that emphasis on healthy body weight maintenance may be necessary when patients are placed on ART regimens with INSTI backbones.

scholarly journals ULTRASOUND;

2012 ◽  
Vol 19 (02) ◽  
pp. 187-192
Author(s):  
EJAZ HUSSAIN SIDDIQUI ◽  
SAAD SIDDIQUI ◽  
NOREEN SHAH
Keyword(s):  
Pediatric Population ◽  
Adult Population ◽  
Age Groups ◽  
X Rays ◽  
Geriatric Population ◽  
Cross Sectional ◽  
Study Results ◽  
Significant Difference ◽  
Ultrasound Findings ◽  
Hepatobiliary Diseases

Objectives: To assess common presenting features and the role of Ultrasound in evaluation of Hepatobiliary diseases in ourpopulation. Design: Cross sectional study. Setting: Khyber X rays, Khyber Medical Centre, Peshawar. Period: August 2010 to December2010. Material and Methods: Data from patients presenting for evaluation of Hepatobiliary diseases was analyzed for presenting complaintsand ultrasound findings according to objectives of the study. Results: In total 197 cases were included in the study. The age wise categorizationincluded pediatric population (6.1%) adult population (87.3%) and geriatric population (6.6%). Upper abdominal pain was the most commonpresenting feature in all age groups as well as in both genders. Cholelithiasis with or without cholecystitis was the most common ultrasoundfinding in all age groups. No statistically significant difference was found between presenting features or ultrasound findings in different agegroups as well as across gender. Conclusions: Hepatobiliary diseases are among major illnesses in our region. Ultrasound is a sensitive anduseful tool for screening and evaluation of Hepatobiliary disorders.

scholarly journals Integrase Strand Transfer Inhibitors and Weight Gain in Children and Youth with Perinatal HIV in the DC Cohort

2021 ◽  
Author(s):  
Wei Li A Koay ◽  
Sahera Dirajlal-Fargo ◽  
Matthew E Levy ◽  
Paige Kulie ◽  
Anne Monroe ◽  
...  
Keyword(s):  
United States ◽  
Weight Gain ◽  
The United States ◽  
Rate Of Change ◽  
Children And Youth ◽  
Strand Transfer ◽  
Z Score ◽  
Perinatal Hiv ◽  
Integrase Strand Transfer Inhibitors

Abstract We conducted a retrospective analysis of 38 children and youth with HIV (aged 0-<20 years) in the United States and report an increased rate of change of BMI-for-age z-score after initiating integrase strand transfer inhibitors (+0.19 z-score units/year, 95% CI 0.01, 0.37, p=0.036) for a median follow-up of 527.5 days.

scholarly journals Switching to Integrase Inhibitors Unlinked to Weight Increase in Perinatally HIV-Infected Young Adults and Adolescents: A 10-Year Observational Study

2020 ◽  
Vol 8 (6) ◽  
pp. 864
Author(s):  
Lucia Taramasso ◽  
Antonio Di Biagio ◽  
Francesca Bovis ◽  
Federica Forlanini ◽  
Elena Albani ◽  
...  
Keyword(s):  
Weight Gain ◽  
Strand Transfer ◽  
Outpatient Services ◽  
Weight Changes ◽  
Mixed Effect ◽  
Mixed Effect Models ◽  
Significant Difference ◽  
Integrase Strand Transfer Inhibitors ◽  
Control Study

An unexpected increase in weight gain has recently been reported in the course of integrase strand transfer inhibitors (INSTI) treatment. The possibility of this effect in people who are perinatally infected with HIV (PHIV) and thus exposed to lifelong therapy needs to be explored. This is a retrospective multicenter case-control study. Adults with PHIV followed between 2010 and 2019 in two outpatient services in Northern Italy were included if they had at least two weight measures in two successive years of observation. Patients were considered as cases if they were switched to INSTI (INSTI group), or controls if they were never exposed to INSTI (non-INSTI group). The date of the switch in cases was considered to be the baseline (T0), while it was randomly selected in controls. Mixed effect models were used to assess the weight changes in INSTI and non-INSTI groups. A total of 66 participants, 50.0% women, 92.4% Caucasian, were included. Median follow-up was 9 years (range 2–10): 4 years (range 1–8) before and 3 (range 1–9) after-T0. Mean age at the last study visit was 27.3 (±4.8) years, and mean CD4+ T-cells were 820.8 (±323.6) cells/mm3. Forty-five patients were switched to INSTI during the study, while 21 remained in the non-INSTI group. The INSTI group experienced a mean increase (pre-post T0) in bodyweight of 0.28 kg/year (95% CI − 0.29; 0.85, p = 0.338), while in the non-INSTI group, the mean increase was 0.36 kg/year (95% CI − 0.47; 1.20, p = 0.391), without a significant difference between groups (p for interaction between time and treatment regimen = 0.868). Among patients on INSTI, the weight gain after T0 was higher than pre-T0, amounting to +0.28 kg/year (95% CI − 0.29; 0.85), although this difference did not reach significance (p = 0.337). PHIV switched to an INSTI-based regimen did not experience an excessive weight gain compared to those who were treated with a non-INSTI based regimen in our cohort.

scholarly journals UROLITHIASIS

2011 ◽  
Vol 18 (03) ◽  
pp. 380-385
Author(s):  
EJAZ HUSSAIN SIDDIQUI ◽  
SAAD SIDDIQUI ◽  
ABDUL MUNIM ◽  
Noreen Shah
Keyword(s):  
Pediatric Population ◽  
Adult Population ◽  
Age Groups ◽  
Renal Calculi ◽  
X Rays ◽  
Geriatric Population ◽  
Cross Sectional ◽  
Study Results ◽  
Significant Difference ◽  
Ultrasound Findings

Objectives: (1)To assess the common presenting features of urolithiasis. (2) To assess the role of Ultrasonography in its evaluation. Design: Cross sectional study. Setting: Khyber X rays, Khyber Medical Centre, Peshawar. Period: March 2010 to June 2010. Material and Methods: Data from patients presenting with urolithiasis for an ultrasound examination was analyzed for presenting complaints and ultrasound findings according to objectives of the study. Results: A total of 210 cases of urolithiasis were analyzed. The age wise categorization included pediatric population (9.5%), adult population (82.4%) and geriatric population (8.1%). Pain was the most common presenting complaint in all three age groups. Kidney was the most common site for renal calculi followed by ureter, bladder and urethra in descending order. Accompanying dysuria was present in 20% cases. Mild hydronephrosis was noted in 44.8%. Statistically significant difference was present between ultrasound findings in geriatric population and overall results. Conclusions: Urolithiasis continues to be a major cause of morbidity among population of all age groups. Overall trend of Ultrasonographic findings was applicable to pediatric and adult population. There has been significant difference of ultrasound findings among geriatric population from normal trend. 

scholarly journals 1043. The impact of integrase strand transfer inhibitors (InSTIs) on weight gain among adults with HIV in clinical care

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S551-S551
Author(s):  
Sneha Thatipelli ◽  
Chad Achenbach ◽  
Shannon Galvin
Keyword(s):  
Weight Gain ◽  
Weight Change ◽  
Metabolic Diseases ◽  
Clinical Care ◽  
First Year ◽  
Strand Transfer ◽  
Art Initiation ◽  
Integrase Strand Transfer Inhibitors ◽  
Clinically Significant ◽  
The Impact

Abstract Background Integrase strand transfer inhibitors (InSTIs) as ART for HIV has been associated with clinically significant weight gain, in addition to the “return to health phenomenon”. Methods We conducted a cohort study on adults over 18 with HIV, who had baseline weights and an additional weight at least 6 months later. Individuals with malignancies, thyroid disorders, and disseminated tuberculosis or mycobacterium avium complex were excluded. To understand the impact of InSTIs on chronic vs. recently infected persons, we divided the cohort into four groups: (1) well-controlled on non-InSTI ART [WN] (2) well-controlled on InSTI ART [WI] (3) uncontrolled on non-InSTI ART [UN], and (4) uncontrolled on InSTI ART [UI]. Well-controlled persons (viral load < 2000) were proxies for chronic infection on long-term ART and uncontrolled for recently infected and initiated on ART. New diagnoses of diabetes, hyperlipidemia, and hypertension were determined by ICD10 codes. Participants with a weight change more than 10 kg in 6 months were excluded. Results 612 of the initial 910 participants in the cohort met the inclusion criteria. Comparing those who remained on the designated regimen throughout the study led to 86 WN, 153 WI, 166 UN, and 145 UI. Mean weight change at 6 months for WN was +0.22 kg (95% CI [-0.86, 1.3]), at 1 year was -0.86 kg (95% CI [-2.94, 1.22]), and at 2 years was +0.026 kg (95% CI [-2.347, 2.399]). For WI, mean weight change at 6 months was +0.21 kg (95% CI [-0.79, 1.21]), at 1 year was -0.50 kg (95% CI [-2.02, 1.04]), and at 2 years was +0.43 kg (95% CI [-1.35, 2.21]). UN gained weight until the first year (+1.74 kg at 6 mo (95% CI [0.24, 3.24]) and +3.84 kg at 1 year (95% CI [1.57, 6.11])), but plateaued at 2 years (+2.42 kg (95% CI [-0.44, 5.28])). At 6 months mean weight gain for UI was +0.78 kg (95% CI [-0.15, 1.71]), at 1 year was +2.33 kg (95% CI [1.02, 3.64]), and at 2 years was +3.04 kg (95% CI [1.2, 4.85]). WI had a higher incidence of diabetes (37% vs. 32%, p=0.40), hyperlipidemia (32% vs. 29%, p=0.66), and hypertension (34% vs. 26%, p=0.19) compared to WN. Conclusion InSTIs may confer a larger and more sustained weight gain among individuals in the first two years after ART initiation. Well controlled individuals did not have statistically significant weight change, but those on Insti-based ART had more metabolic diseases. Disclosures All Authors: No reported disclosures

scholarly journals The impact of COVID-19 quarantine on dietary habits and physical activity in Saudi Arabia: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Manar Abduljalil Bakhsh ◽  
Jomana Khawandanah ◽  
Rouba Khalil Naaman ◽  
Shoug Alashmali
Keyword(s):  
Physical Activity ◽  
Body Weight ◽  
Weight Gain ◽  
Dietary Habits ◽  
Negative Impact ◽  
Adult Population ◽  
Cross Sectional Study ◽  
Future Health ◽  
Cross Sectional ◽  
The Impact

Abstract Background The COVID-19 pandemic has forced governments around the world to impose strict hygiene and national lockdown measures, which in turn has changed the dietary and lifestyle habits of the world’s population. Thus, the aim of this study is to evaluate whether dietary and physical activity behaviors of Saudi Arabia’s adult population changed during the COVID-19 quarantine. Methods An electronic questionnaire which assessed changes in body weight, dietary habits, and physical activity of Saudi Arabia’s adult population (n = 2255) during the COVID-19 quarantine was distributed on social media between June and July 2020. To test the differences between changes in dietary and physical activity behaviors in relation to changes in body weight a Chi-square test was used. Results Over 40 and 45% of participants reported eating and snacking more, respectively, which led to weight gain in around 28%. Most participants reported that they consumed home-cooked (73%) and healthy meals (47%), while only 7% reported that they consumed foods from restaurants. Feelings of boredom and emptiness (44%) and the availability of time for preparing meals (40%) were the main reasons for changing dietary habits. Honey (43%) and vitamin C (50%) were the most consumed immune-boosting food and dietary supplement, respectively. COVID-19 also had a negative impact on physical activity, lowering the practice in 52% subjects, which was associated with significant weight gain (p < 0.001). Conclusion Assessing the changes to the population’s dietary habits and physical activity during the lockdown will help predict the outcome of the population’s future health and wellbeing after the pandemic.

PREVALENCE OF ESSENTIAL ARTERIAL HYPERTENSION IN CHILDREN AND ADOLESCENTS OF DAGESTAN AND THE CONTENT OF Mg, K, Ca, Zn, Pb IN SOILS AND NATURAL WATERS OF THE TERRITORY

2021 ◽  
Vol 100 (5) ◽  
pp. 203-208
Author(s):  
Sh.K. Salikhov ◽  
◽  
D.Z. Alieva ◽  
U.A. Magomedova ◽  
S.О. Abdulkadyrova ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Natural Waters ◽  
Chemical Elements ◽  
The Body ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Significant Difference ◽  
Geochemical Factors ◽  
Essential Arterial Hypertension ◽  
The Republic

The aim of the study is to determine the role of geochemical factors (the content of Mg, K, Ca, Zn, Pb in soils and natural waters of the plain zone of Dagestan) in the prevalence of essential arterial hypertension (EAH) among the population of children. Materials and methods of research: an observational cross-sectional (one-step) study of the prevalence of EAH in the child population was carried out. The prevalence rates of EAH among children in the plain zone of the Republic of Dagestan are calculated for 100,000 children 0–17 years old, without taking into account gender differences. The content of elements (Mg, K, Ca, Zn, Pb) in the environment (soil, natural waters) was determined by atomic absorption spectroscopy. Results: one-way analysis of variance (One-Way ANOVA) of indicators of the content of metals (Mg, K, Ca, Zn, Pb) in the regions and objects (soils, natural waters) of the study revealed a statistically significant difference in the data (for soils: F=81,06772, p<0,0002; for natural waters: F=58,86451, p<0,00001). The dependence of children's EAH on the content of chemical elements in the objects of the biosphere of Dagestan was determined, which was expressed in an increase in the number of patients with EAH when Pb content exceeded (r=+ 0,576, r=+ 0,759) and with the decrease of Mg (r=–0,668, r=–0,173), K (r=–0,440, r=–0,636), Ca (r=–0,693, r=–0,533), Zn (r=–0,051, r=–0,827) in soils and natural waters. Conclusion: when assessing the pathogenesis of EAH in the population of children, the content of Mg, K, Ca, Zn, Pb in soil and water should be taken into account, since these microelements, entering the body with water and food, affect the elemental status of child's body.

scholarly journals perbandingan kadar HDL dan LDL akseptor Depo Medroksi Progesteron Asetat dengan IUD

2019 ◽  
Vol 7 (2) ◽  
pp. 47-51
Author(s):  
Suci Syahril ◽  
Meldafia Idaman ◽  
Dewi Fransisca
Keyword(s):  
Weight Gain ◽  
Lipid Profile ◽  
Medroxyprogesterone Acetate ◽  
Colorimetric Method ◽  
Cross Sectional Study ◽  
First Year ◽  
Sectional Study ◽  
Normal Range ◽  
Cross Sectional ◽  
Significant Difference

Abstract The use of contraceptive depot medroxyprogesterone acetate (DMPA) increasing lately, but some studies suggest has the side effects of weight gain and contraceptives that have side effect in lipid metabolism. Therefore, about 35% of acceptors of DMPA in the first year to stop the use of DMPA. The objective of this study was to determine the differences of lipid profile between acceptors DMPA with acceptors IUD. This was a obcervational study with cross sectional study. The study wasdone at health center Lubuk Buaya in Padang and at laboratory of Biochemistry Departement in Medical Faculty of Andalas University from Januari until September 2016. The subjects were consisted of two groups, each group had 26 subjects. The examination for LDL and HDL used an enzymatic colorimetric method CHOD-PAP.  Data was analyzed using analysis of t-test with p < 0.05 was considered to be significantly different. HDL levels average in Depo Medroxyprogesterone Acetate was 87,54±14,28 mg/dl and IUD was 75,90±8,67 mg/dl with p < 0.05 (significantly difference). Levels of  LDL means there is no significantly difference between DMPA and IUD acceptors (p> 0.05). This research concluded that there isa significant difference on average levels of HDL in the Depo Medroxyprogesterone Acetate and IUD but levels of LDL there is no significantly difference. The clinically lipid profile in the two groups is in normal range.  

scholarly journals Accelerometric Gait Analysis Devices in Children—Will They Accept Them? Results From the AVAPed Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Isabella Wiedmann ◽  
Marcello Grassi ◽  
Ibrahim Duran ◽  
Ricardo Lavrador ◽  
Evelyn Alberg ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Real World ◽  
Gait Speed ◽  
Daily Living ◽  
Walking Speed ◽  
Pediatric Population ◽  
Rehabilitation Medicine ◽  
Cross Sectional ◽  
Laboratory Conditions ◽  
Significant Difference

Aims: To assess children's acceptance to wear a 3D-accelerometer which is attached to the waist under real-world conditions, and also to compare gait speed during supervised testing with the non-supervised gait speed in every-day life.Methods: In a controlled observational, cross sectional study thirty subjects with cerebral palsy (CP), with level I&amp;II of the Gross Motor Function Classification System (GMFCS) and 30 healthy control children (Ctrl), aged 3–12 years, were asked to perform a 1-min-walking test (1 mwt) under laboratory conditions, and to wear an accelerometric device for a 1-week wearing home measurement (1 WHM). Acceptance was measured via wearing time, and by a questionnaire in which subjects rated restrictions in their daily living and wearing comfort. In addition, validity of 3D-accelerometric gait speed was checked through gold standard assessment of gait speed with a mobile perambulator.Results: Wearing time amounted to 10.3 (SD 3.4) hours per day, which was comparable between groups (T = 1.10, P = 0.3). Mode for wearing comfort [CP 1, Range (1,4), Ctrl 1, Range (1,6)] and restriction of daily living [CP 1, Range (1,3), Ctrl 1, Range (1,4)] was comparable between groups. Under laboratory conditions, Ctrl walked faster in the 1 mwt than CP (Ctrl 1.72 ± 0.29 m/s, CP 1.48 ± 0.41 m/s, P = 0.018). Similarly, a statistically significant difference was found when comparing real-world walking speed and laboratory walking speed (CP: 1 mwt 1.48 ± 0.41 m/s, 1 WHM 0.89 ± 0.09 m/s, P = 0.012; Ctrl: 1mwt 1.72 ± 0.29, 1 WHM 0.97 ± 0.06, P &lt; 0.001).Conclusion: 3D-accelerometry is well-enough accepted in a pediatric population of patients with CP and a Ctrl group to allow valid assessments. Assessment outside the laboratory environment yields information about real world activity that was not captured by routine clinical tests. This suggests that assessment of habitual activities by wearable devices reflects the functioning of children in their home environment. This novel information constitutes an important goal for rehabilitation medicine. The study is registered at the German Register of Clinical Trials with the title “Acceptance and Validity of 3D Accelerometric Gait Analysis in Pediatric Patients” (AVAPed; DRKS00011919).

scholarly journals Cross-Cultural Adaptation and Quantitative Evaluation of Dysfunctional Voiding and Incontinence Scoring System in Pediatric Serbian Population

Medicina ◽  
2019 ◽  
Vol 55 (4) ◽  
pp. 100
Author(s):  
Dragana Cirovic ◽  
Ivana Petronic ◽  
Jasna Stojkovic ◽  
Ivan Soldatovic ◽  
Polina Pavicevic ◽  
...  
Keyword(s):  
Scoring System ◽  
Pediatric Population ◽  
Scoring Systems ◽  
Cross Sectional Study ◽  
Repeated Measurements ◽  
Receiver Operating Curve ◽  
Dysfunctional Voiding ◽  
Cross Sectional ◽  
Significant Difference ◽  
Test Retest Reliability

Background and objective: Dysfunctional voiding (DV) presents relatively frequent problem in pediatric urologist practice. The necessity for implementation of DV evaluation in the pediatric population is of particular importance, since there is no clear consensus on the clinical assessment of such condition. The aims of our study were to evaluate the test/retest reliability and reproducibility of dysfunctional voiding and incontinence scoring system: Serbian version (DVISSSR) in patients with voiding and incontinence dysfunctions without structural deformities, and to estimate cut-off value for DVISSSR. Methods: The cross-sectional study included 57 children with voiding and incontinence dysfunctions and 30 healthy pediatric controls. For the evaluation of voiding and incontinence dysfunction we used DVISS. The forward–backward method was applied for translation of the DVISS questionnaire from English into Serbian language. Reproducibility was analyzed by Interclass Correlation Coefficient (ICC). Sensitivity and specificity of DVISSSR scores was done by receiver operating curve (ROC) curve. Results: There was a significant difference in DVISSSR score between patients and controls (p < 0.001). For reliability and reproducibility of the questionnaire, there was no significant difference between repeated measurements (p = 0.141), and strong reliability (ICC = 0.957; p < 0.001). Conclusion: We have demonstrated successful translation and validation of the DVISSSR score. Moreover, a reliable scoring system of children with voiding dysfunctions should include evaluations of symptom scoring systems at the multicentric level.

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