BACKGROUND Direct-acting antivirals(DAAs)are recommended for the treatment of hepatitis C virus(HCV)infection in patients treated with methadone or buprenorphine.AIM To assess HCV treatment rates in an Opioid Treatmen...BACKGROUND Direct-acting antivirals(DAAs)are recommended for the treatment of hepatitis C virus(HCV)infection in patients treated with methadone or buprenorphine.AIM To assess HCV treatment rates in an Opioid Treatment Program(OTP).METHODS This longitudinal study included 501 patients(81.4%men,median age:45 years;interquartile range:39-50 years)enrolled in an OTP between October 2015 and September 2017.Patients were followed until September 2019.Data on sociodemographics,substance use,HCV infection,human immunodeficiency virus(HIV)infection and laboratory parameters were collected at entry.We analyzed medical records to evaluate HCV treatment.Kaplan-Meier methods and Cox regression models were used to analyze the DAA treatment uptake and to identify treatment predictors.RESULTS Prevalence of HCV and HIV infection was 70%and 34%,respectively.Among anti-HCV-positive(n=336)patients,47.2%,41.3%,and 31.9%used alcohol,cannabis,and cocaine,respectively.HCV-RNA tests were positive in 233(69.3%)patients.Twentyeight patients(8.3%)cleared the infection,and 59/308(19.1%)had received interferon-based treatment regimens before 2015.Among 249 patients eligible,111(44.6%)received DAAs.Treatment rates significantly increased over time from 7.8/100 person-years(p-y)(95%CI:5.0-12.3)in 2015 to 18.9/100 p-y(95%CI:11.7-30.3)in 2019.In a multivariate analysis,patients with HIV co-infection were twice as likely to receive DAAs(HR=1.94,95%CI:1.21-3.12)than patients with HCV mono-infection.Current drug use was an independent risk factor for not receiving treatment against infection(HR=0.48,95%CI:0.29-0.80).CONCLUSION HCV treatment is evolving in patients with HCV-HIV co-infection.Ongoing drug use while in an OTP might negatively impact the readiness to treat infection.展开更多
The global commitment to providing antiretroviral therapy （ART） to people living with human immunodeficiency virus/acquired immunodeficiency syndrome （HIV/AIDS） in low-income countries has raised hope that the inc...The global commitment to providing antiretroviral therapy （ART） to people living with human immunodeficiency virus/acquired immunodeficiency syndrome （HIV/AIDS） in low-income countries has raised hope that the increasing momentum in the fight against the worldwide HIV/AIDS pandemic will be sufficient to control it. However, improved availability of subsidized antiretroviral （ARV） treatments in low-income .countries raises complex ethical issues. In many resource-constrained countries the number of individuals infected with HIV in need of treatment far exceeds the supply of ARV medication. Resource allocation decisions can be made on the basis of many epidemiological, ethical, or preferential treatment priority criteria. Healthcare systems and funding in low-income countries are limited, requiring a step-by-step approach to scaling- up programs to reach their stated aims.展开更多
Prostate cancer is a common malignant tumor of the urinary system in men,and the incidence and detection rate of prostate cancer have been rising significantly in recent years.Androgens play an important role in the o...Prostate cancer is a common malignant tumor of the urinary system in men,and the incidence and detection rate of prostate cancer have been rising significantly in recent years.Androgens play an important role in the occurrence and development of prostate cancer,so hormone deprivation therapy has become an essential means of prostate cancer treatment.Abiraterone acetate is a therapeutic agent for prostate cancer by inhibiting the enzyme activity of CYP17,thereby blocking androgen biosynthesis.In this paper,we present a review of the current mechanism of action of abiraterone acetate for prostate cancer treatment,research progress,and its side effects and limitations.It is expected to provide help for further research on the treatment of prostate cancer.展开更多
Water-Decision Support System (DSS) tools enhance decision-makings towards improved water supply in a given region. The rigours of manual design of the conventional water treatment plants are easily eliminated with th...Water-Decision Support System (DSS) tools enhance decision-makings towards improved water supply in a given region. The rigours of manual design of the conventional water treatment plants are easily eliminated with the use of softwares as in the case of DSS. Therefore, this paper focuses on the development of a Water-DSS for design of treatment plant in Karkala Town, Udupi District of India. A four-decade population projection was made using the baseline data of 1971 till date. The manual computation for water demand, unit operations and adjoining facilities was carried out and later coded in C-programming language for development of a DSS for easier design and process selection. Data validation was done and results from the two approaches were compared. With the C-programming technique, a decision support tool for design and process selection of drinking water treatment plant using conventional method has been developed and named Water-DSS1. The designed tool is simple, accurate, flexible, efficient and universal, easily adaptable to any similar conventional treatment plant. Water-DSS1 is thus recommended for general use in ultimately alleviating water supply challenges.展开更多
Increased availability of antiretroviral treatment for HIV makes the goal of universal access attainable. However, in most resource constrained settings where existing health systems are?largely dysfunctional, major b...Increased availability of antiretroviral treatment for HIV makes the goal of universal access attainable. However, in most resource constrained settings where existing health systems are?largely dysfunctional, major barriers to achieving this goal remain. While treatments with antiretroviral drugs (ART) are the focal point of HIV management, it is increasingly recognized that ART alone will not be sufficient to adequately deal with the lifelong consequences of the disease. In addition, the current global economic downturn will continue to impact on funding for HIV care and support, making the search for sustainable solutions more urgent. This article reviews the current evidence base on the impact of community-based programs on HIV/AIDS treatment and general health outcomes, as well as their contribution to ensuring sustained care for HIV-positive people. Our findings suggest that these programs overall have a positive impact on various dimensions of HIV treatment and care, and make a significant contribution to health and HIV outcomes. The authors argue that better use of community platforms for HIV treatment and care programs could be critical for attaining desired goals and should be prioritized at all levels of program design, implementation, and monitoring and evaluation.展开更多
Length of stay in treatment is thought to be the best predictors for long-term recovery from substance use disorders. The objective of this study was to examine the relationship between participation in mind-body-spir...Length of stay in treatment is thought to be the best predictors for long-term recovery from substance use disorders. The objective of this study was to examine the relationship between participation in mind-body-spirit (MBS) therapeutic programs and length of stay in a residential treatment facility. A retrospective analysis of data from 1719 subjects who were admitted to a 30-day residential program for substance use disorders (SUD) was conducted. Subjects participated in MBS programs that included yoga, acupuncture and meditation. We examined the effects of subject participation in MBS programs for subjects who left against staff advice (ASA) and those who successfully completed the residential program. A higher percentage of subjects with severe heroin use disorder left ASA compared with subjects with severe alcohol use disorder (16% vs. 9%, respectively). Most subjects from both substance groups who failed to complete the 30-day treatment program, left within the first two weeks of stay (59% of alcohol group and 75% of heroin group);however, again, the percentage of heroin users leaving during the first two weeks was significantly greater compared with that of alcohol subjects. We found a highly significant, positive correlation (r = 0.56, p < 0.01) and a statistically significant increase in LOS for all subjects, regardless of the substance type, and the number of MBS program sessions attended showing an association between MBS participation and increased LOS. These data support the inclusion of MBS programs as part of a comprehensive treatment strategy for SUD in combination with traditional counseling to help develop a sustainable long-term recovery.展开更多
基金Supported by the Ministry of Science,Innovation and Universities,CarlosⅢHealth Institute(ISCⅢ),European Fund for Regional Development(FEDER),Network for Cooperative Research in Health(RETICS),Spain(No.RD16/0017/0003,PI17/00174,INT19/00026,CD19/00019)the Ministry of Health,National Plan on Drugs(PNSD),Spain(No.2018/020)+4 种基金the European Commission(806996-JUSTSO-JUST2017-AG-DRUG)the Gilead Fellowship Program,Gilead Sciences(No.GLD17/187)the Ministry of Education,Spain(No.PRX18/00245)the Agency for Management of University and Research Grants,Government of Catalonia(No.2017SGR316)and the Municipal Institute of Personal。
文摘BACKGROUND Direct-acting antivirals(DAAs)are recommended for the treatment of hepatitis C virus(HCV)infection in patients treated with methadone or buprenorphine.AIM To assess HCV treatment rates in an Opioid Treatment Program(OTP).METHODS This longitudinal study included 501 patients(81.4%men,median age:45 years;interquartile range:39-50 years)enrolled in an OTP between October 2015 and September 2017.Patients were followed until September 2019.Data on sociodemographics,substance use,HCV infection,human immunodeficiency virus(HIV)infection and laboratory parameters were collected at entry.We analyzed medical records to evaluate HCV treatment.Kaplan-Meier methods and Cox regression models were used to analyze the DAA treatment uptake and to identify treatment predictors.RESULTS Prevalence of HCV and HIV infection was 70%and 34%,respectively.Among anti-HCV-positive(n=336)patients,47.2%,41.3%,and 31.9%used alcohol,cannabis,and cocaine,respectively.HCV-RNA tests were positive in 233(69.3%)patients.Twentyeight patients(8.3%)cleared the infection,and 59/308(19.1%)had received interferon-based treatment regimens before 2015.Among 249 patients eligible,111(44.6%)received DAAs.Treatment rates significantly increased over time from 7.8/100 person-years(p-y)(95%CI:5.0-12.3)in 2015 to 18.9/100 p-y(95%CI:11.7-30.3)in 2019.In a multivariate analysis,patients with HIV co-infection were twice as likely to receive DAAs(HR=1.94,95%CI:1.21-3.12)than patients with HCV mono-infection.Current drug use was an independent risk factor for not receiving treatment against infection(HR=0.48,95%CI:0.29-0.80).CONCLUSION HCV treatment is evolving in patients with HCV-HIV co-infection.Ongoing drug use while in an OTP might negatively impact the readiness to treat infection.
文摘The global commitment to providing antiretroviral therapy （ART） to people living with human immunodeficiency virus/acquired immunodeficiency syndrome （HIV/AIDS） in low-income countries has raised hope that the increasing momentum in the fight against the worldwide HIV/AIDS pandemic will be sufficient to control it. However, improved availability of subsidized antiretroviral （ARV） treatments in low-income .countries raises complex ethical issues. In many resource-constrained countries the number of individuals infected with HIV in need of treatment far exceeds the supply of ARV medication. Resource allocation decisions can be made on the basis of many epidemiological, ethical, or preferential treatment priority criteria. Healthcare systems and funding in low-income countries are limited, requiring a step-by-step approach to scaling- up programs to reach their stated aims.
文摘Prostate cancer is a common malignant tumor of the urinary system in men,and the incidence and detection rate of prostate cancer have been rising significantly in recent years.Androgens play an important role in the occurrence and development of prostate cancer,so hormone deprivation therapy has become an essential means of prostate cancer treatment.Abiraterone acetate is a therapeutic agent for prostate cancer by inhibiting the enzyme activity of CYP17,thereby blocking androgen biosynthesis.In this paper,we present a review of the current mechanism of action of abiraterone acetate for prostate cancer treatment,research progress,and its side effects and limitations.It is expected to provide help for further research on the treatment of prostate cancer.
文摘Water-Decision Support System (DSS) tools enhance decision-makings towards improved water supply in a given region. The rigours of manual design of the conventional water treatment plants are easily eliminated with the use of softwares as in the case of DSS. Therefore, this paper focuses on the development of a Water-DSS for design of treatment plant in Karkala Town, Udupi District of India. A four-decade population projection was made using the baseline data of 1971 till date. The manual computation for water demand, unit operations and adjoining facilities was carried out and later coded in C-programming language for development of a DSS for easier design and process selection. Data validation was done and results from the two approaches were compared. With the C-programming technique, a decision support tool for design and process selection of drinking water treatment plant using conventional method has been developed and named Water-DSS1. The designed tool is simple, accurate, flexible, efficient and universal, easily adaptable to any similar conventional treatment plant. Water-DSS1 is thus recommended for general use in ultimately alleviating water supply challenges.
文摘Increased availability of antiretroviral treatment for HIV makes the goal of universal access attainable. However, in most resource constrained settings where existing health systems are?largely dysfunctional, major barriers to achieving this goal remain. While treatments with antiretroviral drugs (ART) are the focal point of HIV management, it is increasingly recognized that ART alone will not be sufficient to adequately deal with the lifelong consequences of the disease. In addition, the current global economic downturn will continue to impact on funding for HIV care and support, making the search for sustainable solutions more urgent. This article reviews the current evidence base on the impact of community-based programs on HIV/AIDS treatment and general health outcomes, as well as their contribution to ensuring sustained care for HIV-positive people. Our findings suggest that these programs overall have a positive impact on various dimensions of HIV treatment and care, and make a significant contribution to health and HIV outcomes. The authors argue that better use of community platforms for HIV treatment and care programs could be critical for attaining desired goals and should be prioritized at all levels of program design, implementation, and monitoring and evaluation.
文摘Length of stay in treatment is thought to be the best predictors for long-term recovery from substance use disorders. The objective of this study was to examine the relationship between participation in mind-body-spirit (MBS) therapeutic programs and length of stay in a residential treatment facility. A retrospective analysis of data from 1719 subjects who were admitted to a 30-day residential program for substance use disorders (SUD) was conducted. Subjects participated in MBS programs that included yoga, acupuncture and meditation. We examined the effects of subject participation in MBS programs for subjects who left against staff advice (ASA) and those who successfully completed the residential program. A higher percentage of subjects with severe heroin use disorder left ASA compared with subjects with severe alcohol use disorder (16% vs. 9%, respectively). Most subjects from both substance groups who failed to complete the 30-day treatment program, left within the first two weeks of stay (59% of alcohol group and 75% of heroin group);however, again, the percentage of heroin users leaving during the first two weeks was significantly greater compared with that of alcohol subjects. We found a highly significant, positive correlation (r = 0.56, p < 0.01) and a statistically significant increase in LOS for all subjects, regardless of the substance type, and the number of MBS program sessions attended showing an association between MBS participation and increased LOS. These data support the inclusion of MBS programs as part of a comprehensive treatment strategy for SUD in combination with traditional counseling to help develop a sustainable long-term recovery.
