RESUMEN
BACKGROUND: There are currently over 38 million individuals around the globe living with the HIV and AIDS. As many HIV prevention and care services emerging for public use services become available to a wider audience, there is a growing need for more information about willingness to engage in these care and services. Stated preference research methods have been shown to be useful methods to help predict factors that influence health behaviours in the future. RESEARCH QUESTION: This is a systematic review of findings from stated preference studies regarding the choices of people living with HIV or people at risk of contracting HIV to engage in HIV prevention or care. METHODS: Our team plans to compile stated preference studies studying the choice to engage in HIV prevention or care services. Studies will be included from 1 January 2018 until 28 October 2022. There will be no restrictions on the language or location of the study. We will search databases including PubMed, PsycINFO, Embase, Scopus, Tufts CEA registry and CINAHL. Two researchers will review each article's title, abstract, then full-text and finally extract relevant data based on a predetermined process. Data will be presented in a narrative review and in an exploratory meta-analysis by subgroups of studies. ETHICS AND DISSEMINATION OF RESEARCH: There is no need for an ethical review process of this study since all data used is available publicly. The findings of this study will be reported in relevant conferences and submitted for publication in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42023397785.
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Infecciones por VIH , Revisiones Sistemáticas como Asunto , Humanos , Infecciones por VIH/prevención & control , Proyectos de Investigación , Prioridad del Paciente , Salud GlobalRESUMEN
INTRODUCTION: In Mexico, CAPD survival has been analyzed in few studies from the center of the country. However, there are concerns that such results may not represent what occurs in other province centers of our country, particularly in our geographical area. AIM: To evaluate the patient and technique survival on CAPD of a single center of the west of Mexico, and compare them with other reported series. DESIGN: Retrospective cohort study. SETTING: Tertiary care, teaching hospital located in Guadalajara, Jalisco. PATIENTS: Patients from our CAPD program (1999-2002) were retrospectively studied. Interventions. Clinical and biochemical variables at the start of dialysis and at the end of the follow-up were recorded and considered in the analysis of risk factors. MAIN OUTCOME MEASURES: Endpoints were patient (alive, dead or lost to follow-up) and technique status at the end of the study (June 2002). RESULTS: 49 patients were included. Mean patient survival (+/- SE) was 3.32 +/- 0.22 years (CI 95%: 2.9-3.8 years). Patients in the present study were younger (39 +/- 17yrs), had larger body surface area (1.72 +/- 0.22 m2), lower hematocrit (25.4 +/- 5.2%), albumin (2.6 +/- 0.6g/dL), and cholesterol (173 +/- 44 mg/dL), and higher urea (300 +/- 93 mg/dL) and creatinine (14.9 +/- 5.6 mg/ dL) than those in other Mexican series. In univariate analysis, the following variables were associated (p < 0.05) to mortality: pre-dialysis age and creatinine clearance, and serum albumin and cholesterol at the end of follow-up. In multivariate analysis, only pre-dialysis creatinine clearance (RR 0.66, p = 0.03) and age (RR 1.08, p = 0.005) significantly predicted mortality. Mean technique survival was 2.83 +/- 0.24 years (CI 95%: 2.4-3.3). Pre-dialysis age (p < 0.05), peritonitis rate (p < 0.05), and serum phosphorus at the end of follow-up (p < 0.05) were associated with technique failure in univariate analysis, while in multivariate analysis, only pre-dialysis age (RR 1.07, p = 0.001) and peritonitis rate (RR 481, p < 0.0001) were technique failure predictors. CONCLUSIONS: Patients from this single center of the west of Mexico were younger, had higher body surface area and initiated peritoneal dialysis with a more deteriorated general status than patients reported in other Mexican series; in spite of the latter, patient and technique survival were not different. In our setting, pre-dialysis older age and lower CrCl significantly predicted mortality, while older predialysis age and higher peritonitis rate predicted technique failure.
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Fallo Renal Crónico/terapia , Diálisis Peritoneal Ambulatoria Continua/estadística & datos numéricos , Adulto , Colesterol/sangre , Estudios de Cohortes , Creatinina/sangre , Falla de Equipo/estadística & datos numéricos , Femenino , Hematócrito , Humanos , Estimación de Kaplan-Meier , Fallo Renal Crónico/sangre , Fallo Renal Crónico/mortalidad , Masculino , México/epidemiología , Persona de Mediana Edad , Diálisis Peritoneal Ambulatoria Continua/efectos adversos , Peritonitis/epidemiología , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Factores de Riesgo , Albúmina Sérica/análisis , Análisis de SupervivenciaRESUMEN
A total of 1,356 kidney transplants has been performed in the Hospital de Especialidades del Centro Médico Nacional de Occidente, IMSS, in Guadalajara Mexico, including 935 in the past 8 years. This represents an important increase of this activity in our country. Of the total transplants, 1,218 (90%) were from living donors and only 138 (10%) were from cadaveric donors, a number that we hope to increase. Most recipients were young adults, with an average age of 31 years old. The overall one-year graft and patient survival rates for living-donor kidney recipients were 90% and 82%, and for cadaveric kidney recipients they were 80% and 70%, respectively. Acute rejections occurred in 17% and chronic allograft nephropathy was diagnosed in 7% of our kidney transplant recipients. The main cause of patient death was infection, frequently invasive CMV. Cardiovascular complications were a relatively infrequent cause of death as has been seen in other international series. Hepatitis B and C have been widley studied. Hepatitis C is the most prevalent viral infection in our population. Both living and cadaveric donors in our series were young, which may explain the good results. We have had very few complications among living donors and no mortality. Two donors developed chronic renal insufficiency after the kidney donation (0.001%). This excellent safety record reflects the experience of our team. We hope to increase the number of cadaveric transplant donors with the renewed interest in enlarging the transplantation programs in Mexico while maintaining our high percentage of living donors in order to benefit more patients.