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1.
AIDS Care ; 35(12): 1891-1903, 2023 12.
Article in English | MEDLINE | ID: mdl-37001113

ABSTRACT

We estimate the effectiveness of antiretroviral therapy (ART) among individuals receiving HIV care in Rio de Janeiro, Brazil. Adults (18y+) initiating ART between Jan/2008 and Dec/2018 (follow-up through Dec/2020) were included. First-line ART (two nucleoside reverse transcriptase inhibitors plus one antiretroviral from another class) was categorized into four categories: non-nucleoside reverse transcriptase inhibitor/NNRTI-based, protease inhibitor/PI-based, integrase strand transfer inhibitor/INSTI-based, and single-tablet regimen (STR, Tenofovir 300mg + Lamivudine 300mg + Efavirenz 600mg). Effectiveness (viral load ≤50 copies/µL) was evaluated at 6(3-9) and 12(9-15) months from ART initiation. Bayesian logistic regression models were used to quantify the association between exposure and outcomes while accounting for missing data. Overall, 1863(57%), 652(19.9%), 412(12.6%), and 342(10.5%) individuals used, respectively, NNRTI-based, PI-based, INSTI-based regimens, and STR. Compared to NNRTIs, the odds of viral suppression with INSTI-based regimens was 76% higher (adjusted OR:1.76, 95%CI:1.23-2.51) at six months but no higher at 12 months. Older age, higher education, CD4 count ≥500 cells/mm3 and viral load <100,000 copies/µL at ART initiation increased the odds of viral suppression. Viral suppression at six months was the strongest predictor of viral suppression at 12 months. These results highlight population groups that could benefit from close monitoring during the first year of ART.


Subject(s)
Anti-HIV Agents , HIV Infections , Adult , Humans , Cohort Studies , Anti-HIV Agents/therapeutic use , Antiretroviral Therapy, Highly Active/methods , HIV Infections/epidemiology , Bayes Theorem , Brazil/epidemiology , Reverse Transcriptase Inhibitors/therapeutic use , Anti-Retroviral Agents/therapeutic use , Viral Load , World Health Organization
2.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 2(3): 1048-1061, jul.-set. 2010.
Article in Portuguese | BDENF - Nursing | ID: biblio-1029677

ABSTRACT

Avaliar como a família é afetada pela descoberta de um caso de cardiopatia congênita em um de seus membros e; discutir a intervenção de enfermagem direcionada à família de criança portadora de cardiopatia congênita. Métodos: Estudo descritivo, de abordagem qualitativa, executado através de um estudo de caso e utilização do método de análise de conteúdo, adotando como referencial teórico o Modelo Calgary de Avaliação e Intervenção na Família. Foram realizadas entrevistas semi-estruturadas e gravadas com 28 familiares de crianças portadoras de cardiopatia congênita em tratamento ambulatorial pré-cirúrgico em uma instituição hospitalar especializada em cardiopediatria no município do Rio de Janeiro. Resultados: Os dados apontam que há uma reconfiguração sócio-econômica das famílias para adaptarem-se ao processo terapêutico e que a religião e a espiritualidade constituem o suporte para enfrentar esta situação. Conclusão: A integralidade do cuidado à criança enferma demanda que o enfermeiro atente para as relações familiares que interferem no processo terapêutico, incluindo sua influência tanto no cuidado físico quanto no emocional à criança portadora de cardiopatia congênita.


Objective: To assess how the family is affected by the discovery of a case of congenital heart disease in one of its members and discuss the nursing intervention directed to families of children with congenital heart defect. Methods: A descriptive study of qualitative approach, implemented through a case study and use the method of content analysis, adopting the theoretical Calgary model of assessment and Family Intervention. Interviews were conducted semi-structured recorded with 28 families of children with congenital heart disease and pré-surgical otpatient treatment in a hospital specializing in Cardiopediatric in Rio de Janeiro. Results: The data indicate there is a reconfiguration of families socio-economic status to adapt to the therapeutic process and the religion and spirituality provide support for addressing this situation. Conclusion: Compreensive health care to the sick child demand that nurses pay attention to family relationships that interfere with the therapeutic process, including its influence both physical and emotional care to children with congenital heart disease.


Evaluar cómo la familia es afectada por el descubrimiento de un caso de cardiopatía congénita en uno de sus miembros y; discutir la intervención de la enfermería direccionada a la familia del niño portador de cardiopatía congénita. Métodos: Estudio descriptivo, de abordaje cualitativo, realizado a través de un estudio de caso y del uso del método de análisis de contenido, adoptando como referencia teórica al Modelo Calgary de Evaluação e Intervención en la Familia. Fueron realizadas entrevistas semiestructuradas y gravadas con 28 familiares de niños portadores de cardiopatía congénita y en tratamiento ambulatorial prequirúrgico, en una institución hospitalar especializada en cardiopediatría en el municipio de Río de Janeiro. Resultados: Los datos indican que hay uma reconfiguración de la situación sócio-económica de las famílias para adaptarse a las terapias y la religión y la espiritualidad prestan el soporte necesario para hacer frente a esta situación. Conclusión: Atención integral de salud para el niño enfermo requiere que la visión del enfermero debe ser ampliada para las relaciones familiares que interferen con el proceso terapêutico incluyendo su influyencia en el cuidado físico y el emocional al niño portador de cardiopatía congénita.


Subject(s)
Humans , Child , Heart Defects, Congenital/nursing , Child Care , Family Relations
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