The Experts below are selected from a list of 118332 Experts worldwide ranked by ideXlab platform

Robin Wood - One of the best experts on this subject based on the ideXlab platform.

  • tuberculosis associated immune reconstitution disease incidence risk factors and impact in an antiretroviral treatment service in south africa
    AIDS, 2007
    Co-Authors: Stephen D Lawn, Landon Myer, Lindagail Bekker, Robin Wood
    Abstract:

    The objective was to determine the burden and impact of immune reconstitution disease (IRD) associated with tuberculosis (TB) among patients initiating antiretroviral treatment (ART) in sub-Saharan Africa. Retrospective analysis of a study cohort enrolled over 3 years within a community-based ART service in South Africa. Patients receiving treatment for TB at the time ART was initiated (n = 160) were studied. Cases of TB-associated IRD during the first 4 months of ART were ascertained. The median baseline CD4 cell count was 68 cells/ml [interquartile range (IQR) 29-133 cells/microl) and ART was initiated after a median of 105 days (IQR 61-164 days) from TB diagnosis. Although IRD was diagnosed in just 12% (n = 19) of patients overall IRD developed in 32% (n = 12) of those who started ART within 2 months of TB diagnosis. Pulmonary involvement was observed in 84% (n = 16) and intra-abdominal manifestations were also common (37%). Overall 4% (n = 7) of the cohort required Secondary level Health-Care for IRD and two (1%) patients died. In multivariate analysis risk of IRD was strongly associated with early ART initiation and low baseline CD4 cell count. Of patients with CD4 counts 120 days of TB diagnosis were 100% 33% 14% 7% and 0% respectively. The risk of TB-associated IRD in this setting is very high for those with low baseline CD4 cell counts initiating ART early in the course of antituberculosis treatment. However most cases were self-limiting; overall Secondary Health-Care utilization and mortality risk from IRD were low. (authors)

  • tuberculosis associated immune reconstitution disease incidence risk factors and impact in an antiretroviral treatment service in south africa
    AIDS, 2007
    Co-Authors: Stephen D Lawn, Landon Myer, Lindagail Bekker, Robin Wood
    Abstract:

    OBJECTIVE: To determine the burden and impact of immune reconstitution disease (IRD) associated with tuberculosis (TB) among patients initiating antiretroviral treatment (ART) in sub-Saharan Africa. DESIGN: Retrospective analysis of a study cohort enrolled over 3 years within a community-based ART service in South Africa. METHODS: Patients receiving treatment for TB at the time ART was initiated (n = 160) were studied. Cases of TB-associated IRD during the first 4 months of ART were ascertained. RESULTS: The median baseline CD4 cell count was 68 cells/microl [interquartile range (IQR), 29-133 cells/microl) and ART was initiated after a median of 105 days (IQR, 61-164 days) from TB diagnosis. Although IRD was diagnosed in just 12% (n = 19) of patients overall, IRD developed in 32% (n = 12) of those who started ART within 2 months of TB diagnosis. Pulmonary involvement was observed in 84% (n = 16) and intra-abdominal manifestations were also common (37%). Overall, 4% (n = 7) of the cohort required Secondary level Health-Care for IRD and two (1%) patients died. In multivariate analysis, risk of IRD was strongly associated with early ART initiation and low baseline CD4 cell count. Of patients with CD4 counts 120 days of TB diagnosis were 100%, 33%, 14%, 7% and 0%, respectively. CONCLUSIONS: The risk of TB-associated IRD in this setting is very high for those with low baseline CD4 cell counts initiating ART early in the course of antituberculosis treatment. However, most cases were self-limiting; overall Secondary Health-Care utilization and mortality risk from IRD were low.

Stephen D Lawn - One of the best experts on this subject based on the ideXlab platform.

  • tuberculosis associated immune reconstitution disease incidence risk factors and impact in an antiretroviral treatment service in south africa
    AIDS, 2007
    Co-Authors: Stephen D Lawn, Landon Myer, Lindagail Bekker, Robin Wood
    Abstract:

    The objective was to determine the burden and impact of immune reconstitution disease (IRD) associated with tuberculosis (TB) among patients initiating antiretroviral treatment (ART) in sub-Saharan Africa. Retrospective analysis of a study cohort enrolled over 3 years within a community-based ART service in South Africa. Patients receiving treatment for TB at the time ART was initiated (n = 160) were studied. Cases of TB-associated IRD during the first 4 months of ART were ascertained. The median baseline CD4 cell count was 68 cells/ml [interquartile range (IQR) 29-133 cells/microl) and ART was initiated after a median of 105 days (IQR 61-164 days) from TB diagnosis. Although IRD was diagnosed in just 12% (n = 19) of patients overall IRD developed in 32% (n = 12) of those who started ART within 2 months of TB diagnosis. Pulmonary involvement was observed in 84% (n = 16) and intra-abdominal manifestations were also common (37%). Overall 4% (n = 7) of the cohort required Secondary level Health-Care for IRD and two (1%) patients died. In multivariate analysis risk of IRD was strongly associated with early ART initiation and low baseline CD4 cell count. Of patients with CD4 counts 120 days of TB diagnosis were 100% 33% 14% 7% and 0% respectively. The risk of TB-associated IRD in this setting is very high for those with low baseline CD4 cell counts initiating ART early in the course of antituberculosis treatment. However most cases were self-limiting; overall Secondary Health-Care utilization and mortality risk from IRD were low. (authors)

  • tuberculosis associated immune reconstitution disease incidence risk factors and impact in an antiretroviral treatment service in south africa
    AIDS, 2007
    Co-Authors: Stephen D Lawn, Landon Myer, Lindagail Bekker, Robin Wood
    Abstract:

    OBJECTIVE: To determine the burden and impact of immune reconstitution disease (IRD) associated with tuberculosis (TB) among patients initiating antiretroviral treatment (ART) in sub-Saharan Africa. DESIGN: Retrospective analysis of a study cohort enrolled over 3 years within a community-based ART service in South Africa. METHODS: Patients receiving treatment for TB at the time ART was initiated (n = 160) were studied. Cases of TB-associated IRD during the first 4 months of ART were ascertained. RESULTS: The median baseline CD4 cell count was 68 cells/microl [interquartile range (IQR), 29-133 cells/microl) and ART was initiated after a median of 105 days (IQR, 61-164 days) from TB diagnosis. Although IRD was diagnosed in just 12% (n = 19) of patients overall, IRD developed in 32% (n = 12) of those who started ART within 2 months of TB diagnosis. Pulmonary involvement was observed in 84% (n = 16) and intra-abdominal manifestations were also common (37%). Overall, 4% (n = 7) of the cohort required Secondary level Health-Care for IRD and two (1%) patients died. In multivariate analysis, risk of IRD was strongly associated with early ART initiation and low baseline CD4 cell count. Of patients with CD4 counts 120 days of TB diagnosis were 100%, 33%, 14%, 7% and 0%, respectively. CONCLUSIONS: The risk of TB-associated IRD in this setting is very high for those with low baseline CD4 cell counts initiating ART early in the course of antituberculosis treatment. However, most cases were self-limiting; overall Secondary Health-Care utilization and mortality risk from IRD were low.

Landon Myer - One of the best experts on this subject based on the ideXlab platform.

  • tuberculosis associated immune reconstitution disease incidence risk factors and impact in an antiretroviral treatment service in south africa
    AIDS, 2007
    Co-Authors: Stephen D Lawn, Landon Myer, Lindagail Bekker, Robin Wood
    Abstract:

    The objective was to determine the burden and impact of immune reconstitution disease (IRD) associated with tuberculosis (TB) among patients initiating antiretroviral treatment (ART) in sub-Saharan Africa. Retrospective analysis of a study cohort enrolled over 3 years within a community-based ART service in South Africa. Patients receiving treatment for TB at the time ART was initiated (n = 160) were studied. Cases of TB-associated IRD during the first 4 months of ART were ascertained. The median baseline CD4 cell count was 68 cells/ml [interquartile range (IQR) 29-133 cells/microl) and ART was initiated after a median of 105 days (IQR 61-164 days) from TB diagnosis. Although IRD was diagnosed in just 12% (n = 19) of patients overall IRD developed in 32% (n = 12) of those who started ART within 2 months of TB diagnosis. Pulmonary involvement was observed in 84% (n = 16) and intra-abdominal manifestations were also common (37%). Overall 4% (n = 7) of the cohort required Secondary level Health-Care for IRD and two (1%) patients died. In multivariate analysis risk of IRD was strongly associated with early ART initiation and low baseline CD4 cell count. Of patients with CD4 counts 120 days of TB diagnosis were 100% 33% 14% 7% and 0% respectively. The risk of TB-associated IRD in this setting is very high for those with low baseline CD4 cell counts initiating ART early in the course of antituberculosis treatment. However most cases were self-limiting; overall Secondary Health-Care utilization and mortality risk from IRD were low. (authors)

  • tuberculosis associated immune reconstitution disease incidence risk factors and impact in an antiretroviral treatment service in south africa
    AIDS, 2007
    Co-Authors: Stephen D Lawn, Landon Myer, Lindagail Bekker, Robin Wood
    Abstract:

    OBJECTIVE: To determine the burden and impact of immune reconstitution disease (IRD) associated with tuberculosis (TB) among patients initiating antiretroviral treatment (ART) in sub-Saharan Africa. DESIGN: Retrospective analysis of a study cohort enrolled over 3 years within a community-based ART service in South Africa. METHODS: Patients receiving treatment for TB at the time ART was initiated (n = 160) were studied. Cases of TB-associated IRD during the first 4 months of ART were ascertained. RESULTS: The median baseline CD4 cell count was 68 cells/microl [interquartile range (IQR), 29-133 cells/microl) and ART was initiated after a median of 105 days (IQR, 61-164 days) from TB diagnosis. Although IRD was diagnosed in just 12% (n = 19) of patients overall, IRD developed in 32% (n = 12) of those who started ART within 2 months of TB diagnosis. Pulmonary involvement was observed in 84% (n = 16) and intra-abdominal manifestations were also common (37%). Overall, 4% (n = 7) of the cohort required Secondary level Health-Care for IRD and two (1%) patients died. In multivariate analysis, risk of IRD was strongly associated with early ART initiation and low baseline CD4 cell count. Of patients with CD4 counts 120 days of TB diagnosis were 100%, 33%, 14%, 7% and 0%, respectively. CONCLUSIONS: The risk of TB-associated IRD in this setting is very high for those with low baseline CD4 cell counts initiating ART early in the course of antituberculosis treatment. However, most cases were self-limiting; overall Secondary Health-Care utilization and mortality risk from IRD were low.

Lindagail Bekker - One of the best experts on this subject based on the ideXlab platform.

  • tuberculosis associated immune reconstitution disease incidence risk factors and impact in an antiretroviral treatment service in south africa
    AIDS, 2007
    Co-Authors: Stephen D Lawn, Landon Myer, Lindagail Bekker, Robin Wood
    Abstract:

    The objective was to determine the burden and impact of immune reconstitution disease (IRD) associated with tuberculosis (TB) among patients initiating antiretroviral treatment (ART) in sub-Saharan Africa. Retrospective analysis of a study cohort enrolled over 3 years within a community-based ART service in South Africa. Patients receiving treatment for TB at the time ART was initiated (n = 160) were studied. Cases of TB-associated IRD during the first 4 months of ART were ascertained. The median baseline CD4 cell count was 68 cells/ml [interquartile range (IQR) 29-133 cells/microl) and ART was initiated after a median of 105 days (IQR 61-164 days) from TB diagnosis. Although IRD was diagnosed in just 12% (n = 19) of patients overall IRD developed in 32% (n = 12) of those who started ART within 2 months of TB diagnosis. Pulmonary involvement was observed in 84% (n = 16) and intra-abdominal manifestations were also common (37%). Overall 4% (n = 7) of the cohort required Secondary level Health-Care for IRD and two (1%) patients died. In multivariate analysis risk of IRD was strongly associated with early ART initiation and low baseline CD4 cell count. Of patients with CD4 counts 120 days of TB diagnosis were 100% 33% 14% 7% and 0% respectively. The risk of TB-associated IRD in this setting is very high for those with low baseline CD4 cell counts initiating ART early in the course of antituberculosis treatment. However most cases were self-limiting; overall Secondary Health-Care utilization and mortality risk from IRD were low. (authors)

  • tuberculosis associated immune reconstitution disease incidence risk factors and impact in an antiretroviral treatment service in south africa
    AIDS, 2007
    Co-Authors: Stephen D Lawn, Landon Myer, Lindagail Bekker, Robin Wood
    Abstract:

    OBJECTIVE: To determine the burden and impact of immune reconstitution disease (IRD) associated with tuberculosis (TB) among patients initiating antiretroviral treatment (ART) in sub-Saharan Africa. DESIGN: Retrospective analysis of a study cohort enrolled over 3 years within a community-based ART service in South Africa. METHODS: Patients receiving treatment for TB at the time ART was initiated (n = 160) were studied. Cases of TB-associated IRD during the first 4 months of ART were ascertained. RESULTS: The median baseline CD4 cell count was 68 cells/microl [interquartile range (IQR), 29-133 cells/microl) and ART was initiated after a median of 105 days (IQR, 61-164 days) from TB diagnosis. Although IRD was diagnosed in just 12% (n = 19) of patients overall, IRD developed in 32% (n = 12) of those who started ART within 2 months of TB diagnosis. Pulmonary involvement was observed in 84% (n = 16) and intra-abdominal manifestations were also common (37%). Overall, 4% (n = 7) of the cohort required Secondary level Health-Care for IRD and two (1%) patients died. In multivariate analysis, risk of IRD was strongly associated with early ART initiation and low baseline CD4 cell count. Of patients with CD4 counts 120 days of TB diagnosis were 100%, 33%, 14%, 7% and 0%, respectively. CONCLUSIONS: The risk of TB-associated IRD in this setting is very high for those with low baseline CD4 cell counts initiating ART early in the course of antituberculosis treatment. However, most cases were self-limiting; overall Secondary Health-Care utilization and mortality risk from IRD were low.

D M Clark - One of the best experts on this subject based on the ideXlab platform.

  • the employment and mental Health impact of integrated improving access to psychological therapies services evidence on Secondary Health Care utilization from a pragmatic trial in three english counties
    Journal of Health Services Research & Policy, 2021
    Co-Authors: V Toffolutti, David Stuckler, Martin Mckee, I Wolsey, J Chapman, J Ryder, H Salt, Theo John Pimm, D M Clark
    Abstract:

    ObjectivePatients with a combination of long-term physical Health problems can face barriers in obtaining appropriate treatment for co-existing mental Health problems. This paper evaluates the impa...

  • the employment and mental Health impact of integrated improving access to psychological therapies services evidence on Secondary Health Care utilization from a pragmatic trial in three english counties
    Journal of Health Services Research & Policy, 2021
    Co-Authors: D M Clark, V Toffolutti, David Stuckler, Martin Mckee, I Wolsey, J Chapman, J Pimm, J Ryder, H Salt
    Abstract:

    OBJECTIVE Patients with a combination of long-term physical Health problems can face barriers in obtaining appropriate treatment for co-existing mental Health problems. This paper evaluates the impact of integrating the improving access to psychological therapies services (IAPT) model with services addressing physical Health problems. We ask whether such services can reduce Secondary Health Care utilization costs and improve the employment prospects of those so affected. METHODS We used a stepped-wedge design of two cohorts of a total of 1,096 patients with depression and/or anxiety and comorbid long-term physical Health conditions from three counties within the Thames Valley from March to August 2017. Panels were balanced. Difference-in-difference models were employed in an intention-to-treat analysis. RESULTS The new Integrated-IAPT was associated with a decrease of 6.15 (95% CI: -6.84 to -5.45) [4.83 (95% CI: -5.47 to -4.19]) points in the Patient Health Questionnaire-9 [generalized anxiety disorder-7] and £360 (95% CI: -£559 to -£162) in terms of Secondary Health Care utilization costs per person in the first three months of treatment. The Integrated-IAPT was also associated with an 8.44% (95% CI: 1.93% to 14.9%) increased probability that those who were unemployed transitioned to employment. CONCLUSIONS Mental Health treatment in Care model with Integrated-IAPT seems to have significantly reduced Secondary Health Care utilization costs among persons with long-term physical Health conditions and increased their probability of employment.