157 results match your criteria intensification visit

Effectiveness of adalimumab for ulcerative colitis: A multicentre, retrospective study of clinical practice in Italy.

Dig Liver Dis 2021 Sep 16. Epub 2021 Sep 16.

Gastroenterology Unit, Mauriziano Hospital, Turin, Italy. Electronic address:

Background: Adalimumab is used to treat ulcerative colitis, but additional effectiveness and safety data are needed.

Patients And Methods: This retrospective study considered adults with ulcerative colitis treated with adalimumab at 19 hospitals. Clinical data were collected from the start of treatment, after 2, 6 and 12 months, and at the last visit. Read More

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September 2021

Effect of Empagliflozin on Worsening Heart Failure Events in Patients with Heart Failure and a Preserved Ejection Fraction: The EMPEROR-Preserved Trial.

Circulation 2021 Aug 29. Epub 2021 Aug 29.

Department of Cardiology (CVK), and Berlin Institute of Health Center for Regenerative Therapies, German Centre for Cardiovascular Research Partner Site Berlin, Charité Universitätsmedizin, Berlin, Germany.

Empagliflozin reduces the risk of cardiovascular death or hospitalization for heart failure in patients with heart failure and a preserved ejection fraction, but additional data are needed about its effect on inpatient and outpatient heart failure events. We randomly assigned 5988 patients with class II-IV heart failure with an ejection fraction of >40% to double-blind treatment with placebo or empagliflozin (10 mg once daily), in addition to usual therapy, for a median of 26 months. We prospectively collected information on inpatient and outpatient events reflecting worsening heart failure and prespecified their analysis in individual and composite endpoints. Read More

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Blood Pressure Visit Intensification in Treatment (BP-Visit) Findings: a Pragmatic Stepped Wedge Cluster Randomized Trial.

J Gen Intern Med 2021 Aug 11. Epub 2021 Aug 11.

Tulane University, New Orleans, LA, USA.

Background: Shortening time between office visits for patients with uncontrolled hypertension represents a potential strategy for improving blood pressure (BP).

Objective: We evaluated the impact of multimodal strategies on time between visits and on improvement in systolic BP (SBP) among patients with uncontrolled hypertension.

Design: We used a stepped-wedge cluster randomized controlled trial with three wedges involving 12 federally qualified health centers with three study periods: pre-intervention, intervention, and post-intervention. Read More

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Effectiveness of IGlarLixi, a Fixed-Ratio Combination of Insulin Glargine 100 U/mL and Lixisenatide, in People with Type 2 Diabetes.

Diabetes Ther 2021 Sep 6;12(9):2517-2529. Epub 2021 Aug 6.

Syreon Research Institute, Budapest, Hungary.

Introduction: The latest Position Statement of the American Diabetes Association/European Association for the Study of Diabetes proposes the use of a fixed-ratio combination (FRC) of a long-acting basal insulin and a glucagon-like peptide-1 receptor agonist as part of treatment intensification. This study aimed to assess the effectiveness of the insulin glargine + lixisenatide (iGlarLixi) FRC on glycaemic control and hypoglycaemia in real-life settings.

Methods: This non-interventional, 26-week study included participants aged 18-80 years with suboptimally controlled type 2 diabetes (T2D) using oral antidiabetics (OADs) ± basal insulin therapy. Read More

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September 2021

Challenges and opportunities during the COVID-19 pandemic: Treating patients for substance use disorders during the perinatal period.

Prev Med 2021 Jul 22:106742. Epub 2021 Jul 22.

Vermont Center on Behavior and Health, Departments of Psychiatry and Psychological Science, University of Vermont, Burlington, VT, United States of America.

The United States of America faces an opioid use disorder epidemic and growing rates of alcohol and other substance use disorders within the coronavirus disease 2019 (COVID-19) pandemic. Pregnant and post-pregnant individuals are also adversely affected by the substance use disoder epidemic in a pandemic. Physical safety measures preventing COVID-19 also trigger initiation, resumption or intensification of alcohol and other substance use among some individuals, including pregnant and post-pregnant people. Read More

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Efficacy of a Combination of Metformin and Vildagliptin in Comparison to Metformin Alone in Type 2 Diabetes Mellitus: A Multicentre, Retrospective, Real-World Evidence Study.

Diabetes Metab Syndr Obes 2021 29;14:2925-2933. Epub 2021 Jun 29.

Department of Medical Affairs, Dr Reddy's Laboratories Ltd, Hyderabad, Telangana, India.

Background: Early use of combination therapy in diabetes patients may lead to sustained glycemic control and thereby reduce the progression of diabetic complications. Given the limitation of the traditional stepwise intensification strategy, early combination therapy can be an effective approach. Therefore, this study aims to assess the real-world efficacy of a combination of metformin and vildagliptin in comparison to metformin alone in type 2 diabetes mellitus (T2DM) patients in India. Read More

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Heat Exposure and Multiple Sclerosis-A Regional and Temporal Analysis.

Int J Environ Res Public Health 2021 06 2;18(11). Epub 2021 Jun 2.

Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA.

Multiple sclerosis (MS) is a neurological disorder that progressively distorts the myelination of axons within the central nervous system (CNS). Increased core body temperature or metabolism as a result of exercise are common causes of short-term exacerbations of neurological symptoms in MS. About 60-80% of patients with MS experience a worsening of their symptoms when exposed to heat. Read More

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Factors That Cause Concerns after Cardioverter Defibrillator Implantation.

Int J Environ Res Public Health 2021 06 5;18(11). Epub 2021 Jun 5.

Department of Gerontology and Geriatric Nursing, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-635 Katowice, Poland.

Background And Objectives: The aim of the study was to assess the factors that influence the occurrence of concerns and their intensification after the implantation of a cardioverter defibrillator.

Materials And Methods: This was a prospective and observational study including 158 patients. The study was conducted in two stages: stage I before implantable cardioverter defibrillator (ICD) implantation and stage II follow-up visit six months after ICD implantation. Read More

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Patient Awareness and Clinical Inertia: Obstacles to Hypertension Control in Rural Communities in the Dominican Republic.

Am J Hypertens 2021 Sep;34(9):939-947

Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.

Background: Many obstacles exist for adequate hypertension control, including low individual awareness and clinical inertia (CI). In this study, we aimed to determine hypertension prevalence, awareness, treatment, and control among community residents of rural areas of Peravia in Dominican Republic (DR), followed by an assessment of CI in their primary care clinics (PCCs).

Methods: We interviewed 827 adults from 8 rural communities of Peravia. Read More

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September 2021

Effect of Professional CGM (pCGM) on Glucose Management in Type 2 Diabetes Patients in Primary Care.

J Diabetes Sci Technol 2021 05 10;15(3):539-545. Epub 2021 Mar 10.

International Diabetes Center at Park Nicollet, HealthPartners Institute, Minneapolis, MN, USA.

Background: Little data exists regarding the impact of continuous glucose monitoring (CGM) in the primary care management of type 2 diabetes (T2D). We initiated a quality improvement (QI) project in a large healthcare system to determine the effect of professional CGM (pCGM) on glucose management. We evaluated both an MD and RN/Certified Diabetes Care and Education Specialist (CDCES) Care Model. Read More

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Subjective and Objective Measures in Assessing Neck Disability and Pain in Head and Neck Cancer.

Laryngoscope 2021 09 3;131(9):2015-2022. Epub 2021 Mar 3.

Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.

Objective/hypothesis: The intensification of treatment for head and neck cancers (HNCs) has created a cohort of patients living with short- and long-term comorbidities and functional deficits. This study aimed to determine whether there is a relationship between patient-reported outcomes (PROs) and objective measures of neck function in survivors of HNCs.

Study Design: Cross-sectional study. Read More

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September 2021

HIV incidence in a multinational cohort of men and transgender women who have sex with men in sub-Saharan Africa: Findings from HPTN 075.

PLoS One 2021 25;16(2):e0247195. Epub 2021 Feb 25.

Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.

Few studies have assessed HIV incidence in men who have sex with men (MSM) and transgender women (TGW) in sub-Saharan Africa (SSA). We assessed HIV incidence and its correlates among MSM and TGW in SSA enrolled in the prospective, multi-country HIV Prevention Trials Network (HPTN) 075 study, conducted from 2015 to 2017. Participants were enrolled at four sites in SSA (Kisumu, Kenya; Blantyre, Malawi; Cape Town and Soweto, South Africa). Read More

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Lipid Management and 2-Year Clinical Outcomes in Japanese Patients with Acute Coronary Syndrome: EXPLORE-J.

J Atheroscler Thromb 2021 Feb 21. Epub 2021 Feb 21.

Department of Molecular Innovation in Lipidology, National Cerebral & Cardiovascular Center Research Institute.

Aim: The prevalence of atherosclerotic cardiovascular (CV) disease has risen in Japan due to increasing metabolic risk factors, including dyslipidemia. A positive linear correlation between low-density lipoprotein cholesterol (LDL-C) levels, incidence of CV events, and preventive effects of lipid-lowering therapy (LLT) is well established; however, data in Japan are limited. This analysis evaluated current lipid management practices and risk of recurrent CV events in Japanese post-acute coronary syndrome (ACS) patients. Read More

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February 2021

Association of NT-ProBNP, Blood Pressure, and Cardiovascular Events: The ARIC Study.

J Am Coll Cardiol 2021 02;77(5):559-571

Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA; Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA; Center for Cardiometabolic Disease Prevention, Baylor College of Medicine, Houston, Texas, USA; Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA. Electronic address:

Background: Although intensive blood pressure reduction has cardiovascular benefits, the absolute benefit is greater in those at higher cardiovascular disease (CVD) risk.

Objectives: This study examined whether N-terminal pro-B-type natriuretic peptide (NT-proBNP) helps identify subjects at higher risk for CVD events across systolic blood pressure (SBP), diastolic blood pressure (DBP), or pulse pressure (PP) categories.

Methods: Participants from the ARIC (Atherosclerosis Risk In Communities) study visit 4 (1996 to 98) were grouped according to SBP, DBP, or PP categories and further stratified by NT-proBNP categories. Read More

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February 2021

Outcome of refractory to conventional and/or biologic treatment adult Still's disease following canakinumab treatment: Countrywide data in 50 patients.

Semin Arthritis Rheum 2021 02 19;51(1):137-143. Epub 2020 Dec 19.

Private rheumatologist, Thessaloniki, Greece.

Objective: To assess the efficacy and safety of the IL-1b inhibitor canakinumab in all adults with refractory Still's disease identified from the National Organization For Medicines for off-label drug use.

Methods: In a retrospective longitudinal multicenter cohort of 50 patients (median age 39 years) with active Still's disease despite treatment with corticosteroids (n = 11), conventional and synthetic (n = 34) and/or biologic disease modifying anti-rheumatic drugs (n = 30), we assessed the efficacy of canakinumab 150-300 mg administered every 4 (n = 47) or 8 weeks (n = 3) as combination therapy or monotherapy (n = 7) during a median follow-up of 27 (3-84) months.

Results: Α complete response was initially observed in 78% of patients within 3 months (median), irrespective of age at disease onset. Read More

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February 2021

Incidence of recently acquired hepatitis C virus infection among HIV-infected patients in southern Spain.

HIV Med 2021 May 26;22(5):379-386. Epub 2020 Dec 26.

Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen de Valme, Sevilla, Spain.

Objectives: Spain is close to HCV microelimination, so rates of recently acquired HCV infection (RAHC) should decrease. Nowadays, men who have sex with men (MSM) carry the highest risk of HCV acquisition. Our aim was to estimate the incidence of and the factors associated with RAHC, together with reinfection rates, among patients sexually infected by HIV. Read More

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Semen quality in non-Hodgkin lymphoma survivors: a monocentric retrospective study.

Hum Reprod 2021 01;36(1):16-25

Laboratory of Seminology - Sperm Bank 'Loredana Gandini', Department of Experimental Medicine, 'Sapienza' University of Rome, Rome, Italy.

Study Question: How is semen quality affected by treatment in survivors of non-Hodgkin lymphoma (NHL)?

Summary Answer: Before cancer treatment, most NHL subjects were normozoospermic and, while standard first-line treatments seemed compatible with post-treatment recovery after 18 months, salvage therapy followed by haematopoietic stem cell transplant caused permanent damage to spermatogenesis in many cases, with 66% azoospermic subjects in the long term.

What Is Known Already: Testicular function has been widely investigated in relation to the most common malignancies in men of reproductive age, such as testicular cancer and Hodgkin lymphoma, but NHL has been somewhat under-investigated. The available reports generally show a post-treatment worsening of semen parameters in NHL survivors, but they involved small caseloads or a subgroup of broader caseloads, and their results are not comparable. Read More

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January 2021

An Electronically Delivered Patient-Activation Tool for Intensification of Medications for Chronic Heart Failure With Reduced Ejection Fraction: The EPIC-HF Trial.

Circulation 2021 Feb 17;143(5):427-437. Epub 2020 Nov 17.

University of Colorado School of Medicine, Aurora (L.A.A., G.V., C.K.M., C.E.K., L.J.H., P.K., P.N.P., K.P., G.H., J.S.T., K.E.T., D.P.K., D.J.M., P.M.B., D.D.M.).

Background: Major gaps exist in the routine initiation and dose up-titration of guideline-directed medical therapies (GDMT) for patients with heart failure with reduced ejection fraction. Without novel approaches to improve prescribing, the cumulative benefits of heart failure with reduced ejection fraction treatment will be largely unrealized. Direct-to-consumer marketing and shared decision making reflect a culture where patients are increasingly involved in treatment choices, creating opportunities for prescribing interventions that engage patients. Read More

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February 2021

Effect of Empagliflozin on the Clinical Stability of Patients With Heart Failure and a Reduced Ejection Fraction: The EMPEROR-Reduced Trial.

Circulation 2021 Jan 21;143(4):326-336. Epub 2020 Oct 21.

Université de Lorraine, Inserm INI-CRCT, CHRU, Nancy, France (J.P.F., F.Z.).

Background: Empagliflozin reduces the risk of cardiovascular death or hospitalization for heart failure in patients with heart failure and a reduced ejection fraction, with or without diabetes, but additional data are needed about the effect of the drug on inpatient and outpatient events that reflect worsening heart failure.

Methods: We randomly assigned 3730 patients with class II to IV heart failure with an ejection fraction of ≤40% to double-blind treatment with placebo or empagliflozin (10 mg once daily), in addition to recommended treatments for heart failure, for a median of 16 months. We prospectively collected information on inpatient and outpatient events reflecting worsening heart failure and prespecified their analysis in individual and composite end points. Read More

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January 2021

Rationale and design of a multicenter, randomized, patients-blinded two-stage clinical trial on effects of endothelial function test in patients with non-obstructive coronary artery disease (ENDOFIND).

Int J Cardiol 2021 02 16;325:16-22. Epub 2020 Oct 16.

Vascular Medicine Center, Peking University Shougang Hospital, Beijing, PR China; Vascular Health Research Center of Peking University Health Science Center(VHRC-PKUHSC), Beijing, PR China; Peking University Clinical Research Institute, Peking University Health Science Center, Beijing, PR China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, PR China. Electronic address:

Abnormal peripheral and coronary endothelial function has been associated with increased risk of major adverse cardiovascular events (MACE) in cross-sectional retrospective and observational studies. However, prognostic value of routine clinical evaluation, diagnosis and treatment of endothelial dysfunction on incident MACE in patients with non-obstructive coronary artery disease (NOCAD) remains unknown. Endothelial Function Guided Management in Patients with NOCAD (ENDOFIND) is a multicenter, randomized, patients-blinded, parallel-controlled, two-stage clinical trial evaluating the impact of routine clinical peripheral endothelial function testing on initiation and/or intensification of cardiovascular preventive therapies in Stage I, and on the risk of MACE in Stage II in patients with NOCAD. Read More

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February 2021

Long-term Follow-up of 14 Eyes With Bilateral and Multiple Ciliary Body Cysts: Prognosis of this Rare Entity.

J Glaucoma 2021 01;30(1):e13-e17

Marie-Therese Health Center, Saint-Joseph Hospital.

Purpose: To describe the long-term outcomes of eyes with bilateral and multiple ciliary body cysts (CBC).

Methods: This retrospective study included patients with multiple and bilateral CBC diagnosed by high-resolution ultrasound biomicroscopy and followed by a single glaucoma specialist from 2000 to 2020. All patients underwent complete ophthalmic examination including dynamic indentation gonioscopy, retinal nerve fiber layer (RNFL) measurement by optic coherence tomography and automated perimetry. Read More

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January 2021

Association Between Pain, Blood Pressure, and Medication Intensification in Primary Care: an Observational Study.

J Gen Intern Med 2020 12 21;35(12):3549-3555. Epub 2020 Sep 21.

Center for Value-Based Care Research, Cleveland Clinic Community Care, Cleveland Clinic, 9500 Euclid Avenue, G10, Cleveland, OH, 44195, USA.

Background: Treating hypertension is important but physicians often do not intensify blood pressure (BP) treatment in the setting of pain.

Objective: To identify whether reporting pain is associated with (1) elevated BP at the same visit, (2) medication intensification, and (3) elevated BP at the subsequent visit.

Design: Retrospective cohort SETTING: Integrated health system PARTICIPANTS: Adults seen in primary care EXPOSURE: Pain status based on numerical scale: mild (1-3), moderate (4-6), or severe (≥ 7). Read More

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December 2020

Laser Flare Photometry: A Useful Tool for Monitoring Patients with Juvenile Idiopathic Arthritis-associated Uveitis.

Ocul Immunol Inflamm 2020 Aug 24:1-11. Epub 2020 Aug 24.

Department of Ophthalmology, La Pitié-Salpétrière Hospital, DHU View Restore, Paris, France.

Purpose: We evaluated laser flare photometry (LFP) values in patients with juvenile idiopathic arthritis (JIA)-associated uveitis.

Methods: Retrospective study. A decrease of the LFP value between baseline visit and 1 month after anti-inflammatory treatment intensification allowed us to define two groups of patients: group 1 (decreased LFP value ≥50%) and group 2 (<50%). Read More

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Association of Low-Dose Triple Combination Therapy With Therapeutic Inertia and Prescribing Patterns in Patients With Hypertension: A Secondary Analysis of the TRIUMPH Trial.

JAMA Cardiol 2020 11;5(11):1219-1226

The George Institute for Global Health, The University of New South Wales, Sydney, Australia.

Importance: Fixed-dose combination (FDC) therapies are being increasingly recommended for initial or early management of patients with hypertension, as they reduce treatment complexity and potentially reduce therapeutic inertia.

Objective: To investigate the association of antihypertensive triple drug FDC therapy with therapeutic inertia and prescribing patterns compared with usual care.

Design, Setting, And Participants: A post hoc analysis of the Triple Pill vs Usual Care Management for Patients With Mild-to-Moderate Hypertension (TRIUMPH) study, a randomized clinical trial of 700 patients with hypertension, was conducted. Read More

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November 2020

Télépied Study: A Single-Centre Trial in Diabetic Subjects Comparing Total Duration of Hospitalization Over a 1-Year Period Required for Complete Healing of a Foot Ulcer Using Telemedicine Management and a Referral Nurse Versus the Standard Care Pathway.

Diabetes Ther 2020 Jun 7;11(6):1419-1427. Epub 2020 May 7.

Diabetology Department, Centre Hospitalier Sud Francilien, 40 Avenue Serge Dassault, 91106, Corbeil-Essonnes, France.

Purpose: The aim of this study is to demonstrate that the total number of days in hospital required for healing of a de novo diabetes-related foot ulcer (DFU) is lower in patients followed up using a telemedicine platform (Télépied Follow-Up group [Group 2]) than in patients followed up using standard care (Standard Follow-Up control group [Group 1]). Patients are assigned to either Group 1 or Group 2 depending on whether their first inclusion visit is during an even or odd week. Patients included in Group 1 are to be followed at spaced intervals during day hospital visits by the investigator assisted by a specialized referral nurse as part of the regular follow-up procedure (dressing changes + ulcer monitoring). Read More

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Remote blood pressure monitoring and behavioral intensification for stroke: A randomized controlled feasibility trial.

PLoS One 2020 11;15(3):e0229483. Epub 2020 Mar 11.

Department of Neurology and Cerebrovascular Center, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

Measuring blood pressure (BP) at home and remote monitoring can improve the patient's adherence to BP control and vascular outcomes. This study evaluated the feasibility of a trial regarding the effects of an intensive mobile BP management strategy versus usual care in acute ischemic stroke patients. A feasibility-testing, randomized, open-labeled controlled trial was conducted. Read More

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Impact of Lipid Monitoring on Treatment Intensification of Cholesterol Lowering Therapies (from the Veterans Affairs Healthcare System).

Am J Cardiol 2020 03 27;125(6):874-879. Epub 2019 Dec 27.

Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas; Health Policy, Quality & Informatics Program, Michael E. DeBakey Veterans Affairs Medical, Center Health Services Research and Development Center for Innovations, Houston, Texas; Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas. Electronic address:

Treatment guidelines recommend monitoring of lipids to assess efficacy and adherence to lipid lowering therapy. We assessed whether lipid profile monitoring is associated with intensification of cholesterol lowering therapy. Patients from the Veterans Affairs (VA) healthcare system with atherosclerotic cardiovascular disease and at least one primary care visit between October 2013 and September 2014 were included (n = 1,061,753). Read More

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How relevant is the HIV low level viremia and how is its management changing in the era of modern ART? A large cohort analysis.

J Clin Virol 2020 02 26;123:104255. Epub 2019 Dec 26.

Department of Health Sciences (DiSSal), University of Genoa, Italy; Infectious Diseases, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

Background: It is still unclear what might be the best management of people living with HIV (PLWHIV) with low level viremia (LLV) despite being on antiretroviral treatment (ART).

Objectives: Aim of our study is to describe the clinical management of PLWHIV with LLV followed in a large cohort.

Study Design: Retrospective cohort study. Read More

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February 2020

A study on risk factors for macroscopic gut abnormalities in intensively reared broiler chickens.

Avian Pathol 2020 Apr 29;49(2):193-201. Epub 2020 Jan 29.

Department of Reproduction, Obstetrics and Herd Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

Intensification of broiler production has coincided with an increase in enteric disorders. Enteric syndromes of unknown aetiology are often associated with an increased feed conversion ratio and are given the general term "dysbiosis". Despite the importance of dysbiosis, information on factors contributing to this condition are scarce. Read More

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