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Larger-scale clinical trials are needed to give credence to definitive clinical recommendations.

Anergy reduces the sensitivity of the tuberculin skin test (TST) to detect Mycobacterium tuberculosis infection in people living with HIV. Antiretroviral treatment (ART) can reverse TST anergy, but data is scarce.

To estimate TST conversion rates and factors associated with TST conversion, TST was placed at ART initiation, and 6 and 12 months thereafter (if TST negative at prior assessment).

Of 328 ART-eligible participants, 70% (231/328) had a valid TST result of whom 78% (180/231) were TST negative. At 6-month follow up, 22% (24/109, 95% CI 15%, 31%) of participants on ART, without incident TB, and with a valid TST result converted to a positive TST. Of these 109 individuals, those with baseline CD4 count >250 cells/mm3 were more likely to TST convert compared to those with baseline CD4 ≤250 cells/mm3 (OR 3.54, 95% CI 1.29, 11.47). At 12 months post-ART initiation, an additional 12% (9/78, 95% CI 6, 20) of participants on ART, without incident TB and with a valid TST result experienced TST conversion. After 1 year on ART, TST conversion rate was 38 per 100 person-years (95% CI 26, 52), and lower in individuals with baseline CD4 ≤250 cells/mm3 (23/100 person-years, 95% CI 11, 41) compared to those with baseline CD4 > 250 cells/mm3 (50/100 person-years, 95% CI 32, 73).

TST conversion rate in the first year of ART is high, especially among people with CD4 count >250 cells/mm3. A TST-based eligibility strategy at ART initiation may underestimate eligibility for preventive therapy for tuberculosis.

250 cells/mm3. TGX-221 ic50 A TST-based eligibility strategy at ART initiation may underestimate eligibility for preventive therapy for tuberculosis.

Anal cancer disproportionately affects people with HIV (PWH). High-grade squamous intraepithelial lesions (HSIL) are cancer precursors and treating might prevent anal cancer. Data on adherence to HSIL treatment and surveillance is limited but needed to identify deficiencies of screening strategies.

We collected data on high-resolution anoscopy (HRA) attendance and outcomes from 2009-2019 in a large urban anal cancer screening program. Patients with an initial HSIL diagnosis were followed for return for HSIL electrocautery ablation (EA) within 6 months of index HSIL diagnosis; and follow-up HRA within 18 months of index HSIL diagnosis. We also evaluated predictors of these outcomes in univariable and multivariable analyses.

1,179 unique patients with an anal HSIL diagnosis were identified and 684 (58%) returned for EA. Of those treated only 174 (25%) and only 9% of untreated HSIL patients (47/495) underwent surveillance HRA within 18 months of index HSIL diagnosis. In multivariable analyses, Black patients and PWH regardless of virologic control were less likely to undergo HSIL ablation within 6 months of HSIL diagnosis whereas patients with commercial insurance were more likely to be treated within 6 months of diagnosis. Among treated HSIL patients, PWH with viremia had a lower likelihood of engaging in post-treatment surveillance within 18 months of HSIL diagnosis.

Even in large specialized anal cancer screening programs adherence to HSIL treatment and surveillance is low. Psychosocial and economic determinants of health may impact retention in care. Addressing both personal and structural barriers to patient engagement may improve the effectiveness of anal cancer screening.

Even in large specialized anal cancer screening programs adherence to HSIL treatment and surveillance is low. Psychosocial and economic determinants of health may impact retention in care. Addressing both personal and structural barriers to patient engagement may improve the effectiveness of anal cancer screening.

A 40-year-old man presented with limited in range of motion, pain, and tenderness over the medial joint line after an open reduction and internal fixation (ORIF) because of a bicondylar tibial plateau fracture (TPF). The cause of his pain was inconclusive on Magnetic Resonance Image (MRI), so arthroscopy was performed and identified an incarcerated medial meniscus at the fracture site. An osteotomy with medial joint elevation was performed followed by a meniscus release, with excellent results at the 1-year follow-up.

To our knowledge, this is the first case reporting a trapped/incarcerated meniscus in a healed TPF after ORIF.

To our knowledge, this is the first case reporting a trapped/incarcerated meniscus in a healed TPF after ORIF.In anatomic total shoulder arthroplasty (TSA), subscapularis repair is essential for shoulder stability and function postoperatively; however, the role of subscapularis repair in reverse TSA remains unclear. Some evidence suggests that subscapularis repair is associated with improved postoperative stability and range of motion, whereas other evidence indicates that repair is unnecessary and has no effect on clinical outcomes. In this review, we will analyze the existing literature addressing subscapularis repair during reverse TSA and discuss the effect of medialized and lateralized prosthesis designs on the utility of tendon repair.

The Janus kinase-signal transducers and activators of transcription (JAK-STAT) signaling proteins represent a group of intracellular kinase molecules that play a central role in the signaling pathways induced by cytokines, chemokines, and certain growth factors associated with systemic and local inflammation of autoimmune diseases including in Spondyloarthritis (SpA). Here, we will discuss (i) the functional significance of the JAK-STAT kinase cascades in the inflammatory-proliferative processes of SpA and its cellular/molecular mechanisms (ii) progress in the development of oral synthetic JAK inhibitors (JAKi) and their therapeutic efficacies in SpA.

Development JAKi is a fast-moving field in the medical science. Several new-generation JAKi are being identified for psoriatic arthritis and ankylosing spondylitis. It is expected these JAKi likely to have higher potency and less adverse effects.

Here, we are providing an updated review on the significance of JAK-STAT signaling proteins in SpA with an emphasis on new-generation of JAK-STAT inhibitors for the treatment of SpA.