Background:The use of readily available biochemical investigations to predict the CD4 cell count in HIV-infected patients may provide clinicians with insight regarding disease severity at first contact. The aims of the study were to determine the relationship of calculated globulin and white cell count (WCC) with CD4 cell count. Methods: Data were collected prospectively from ambulatory HIV-infected, anti-retro viral therapy (ART) naive patients at the HIV clinic of King Edward Hospital, Durban, between 2010 and 2012. Results: The mean age of the participants was 39 ± 9.53 years and 70% were female. Median calculated globulin and WCC was 49 g/l and 4.74 × 10 9 cells/l respectively, whilst the CD4 cell count was 244 cells/mm 3 . A significant positive correlation was demonstrated between CD4 cell count and WCC (r = 0.25, p < 0.001). WCC and albumin were identified as potential surrogate markers for CD4 count ≤ 200 cells/mm 3 . Combination of WCC with either albumin or globulin predicts a CD4 count of less than 200 cells/ mm 3 with moderate accuracy. Conclusion:The use of combined biomarkers may influence initiation of Pneumocystis jiroveci pneumonia prophylaxis in resource-limited settings. Further evaluation is warranted to assess the role of these markers in disease progression and ART.
Background: The use of readily available biochemical investigations to predict the CD4 cell count in HIV-infected patients may provide clinicians with insight regarding disease severity at first contact. The aims of the study were to determine the relationship of calculated globulin and white cell count (WCC) with CD4 cell count.Methods: Data were collected prospectively from ambulatory HIV-infected, anti-retro viral therapy (ART) naive patients at the HIV clinic of King Edward Hospital, Durban, between 2010 and 2012.Results: The mean age of the participants was 39 ± 9.53 years and 70% were female. Median calculated globulin and WCC was 49 g/l and 4.74 × 109 cells/l respectively, whilst the CD4 cell count was 244 cells/mm3. A significant positive correlation was demonstrated between CD4 cell count and WCC (r = 0.25, p 0.001). WCC and albumin were identified as potential surrogate markers for CD4 count ≤ 200 cells/mm3. Combination of WCC with either albumin or globulin predicts a CD4 count of less than 200 cells/ mm3 with moderate accuracy.Conclusion: The use of combined biomarkers may influence initiation of Pneumocystis jiroveci pneumonia prophylaxis in resource-limited settings. Further evaluation is warranted to assess the role of these markers in disease progression and ART.
A delusional, agitated middle-aged man presented to hospital with a tenacious psychotic episode. Upon appropriate therapy for neurosyphilis, dramatic resolution of this brief episode ensued, prompting a literature review of psychosis associated with neurosyphilis.
Background/Aims: In today's information era, patients often seek information regarding health using the internet. We assessed reliability and validity of internet information regarding ‘prostate cancer'. Methods: Search term ‘prostate cancer' used on Google website (June 2017). Critical analysis was performed on first 100 hits using JAMA benchmarks, DISCERN score, Health on the Net. Results: 33 500 000 hits returned. Top 100 hits were critically analyzed. Ten links [duplicate links (n = 7), book reviews (n = 1), dead sites (n = 2)] were excluded, therefore 90 were analyzed. Subcategories assessed included: commercial (53.33%), university/medical center (24.44%), government (13.33%); non-governmental/ non-profit organizations (8.89%). Sub-type of information content assessed included: factual (74.44%), clinical trials (18.89%); stories (5.56%); question and answer (1.11%). Website rated as HONcode seal positive (14,44%) or seal negative (85,56%). Website content based on JAMA benchmarks: 0 benchmarks (4.44%), 1 benchmark (16.67%), 2 benchmarks (34.44%), 3 benchmarks (27.78%), 4 benchmarks (16.67%). DISCERN score rated: ‘low' score (16-32) = 12 websites (13.33%), ‘moderate' score (33-64 points) = 68 websites (75.56%), ‘high' score (≥ 65 points) = 10 websites (11.11%). Conclusion: Critical assessment of ‘Prostate Cancer' information on the internet, showed that overall quality was observed to be accurate, however majority of individual websites are unreliable as a source of information by itself for patients. Doctors and patients need to be aware of this ‘quality vs quantity' discrepancy when sourcing PCa information on the internet.
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