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Cosmetic Surgery for HIV Patients: A Path to Empowerment and Well-being at Cayra Clinic, Turkey The landscape of cosmetic surgery is evolving to embrace inclusivity, and Cayra Clinic, a leading provider in Turkey, is at the forefront of this movement. We recognize the unique needs and desires of HIV individuals who seek to enhance their aesthetic appearance and reclaim their confidence. While living with HIV presents unique health considerations, it does not preclude individuals from undergoing cosmetic procedures such as liposuction, Brazilian butt lifts (BBL), or tummy tucks. Advances in medical technology and treatment protocols have made it possible for HIV patients to safely undergo these procedures with positive outcomes. At Cayra Clinic, we prioritize the safety and well-being of all our patients, including those living with HIV. Our multidisciplinary team of specialists, including plastic surgeons, infectious disease experts, and anesthesiologists, collaborates to create a comprehensive and individualized treatment plan for each patient. Before any procedure, a thorough medical evaluation is conducted to assess the patient's overall health status, viral load, and CD4 count. This allows us to tailor the surgical approach and optimize post-operative care to minimize risks and promote optimal healing. We understand that for many HIV individuals, cosmetic surgery is not just about aesthetics; it's about reclaiming control over their bodies and enhancing their quality of life. Whether it's addressing body contouring concerns or restoring a sense of normalcy after significant weight loss, these procedures can have a profound impact on a person's self-esteem and overall well-being. Cayra Clinic is committed to providing a safe, supportive, and inclusive environment for all patients seeking cosmetic surgery. Our state-of-the-art facilities, experienced surgical team, and adherence to international safety standards ensure a positive and empowering experience for our HIV patients. If you are living with HIV and considering cosmetic surgery, we invite you to explore the possibilities at Cayra Clinic. Our compassionate team of professionals is dedicated to helping you achieve your aesthetic goals while prioritizing your safety and well-being. #cosmeticsurgery #HIV #inclusivity #patientcenteredcare #Turkey #CayraClinic #liposuction #BBL #tummytuck #health #wellbeing #empowerment #plasticsurgery https://lnkd.in/dRPN84gq

Tesamorelin: A New Horizon in HIV-Related Lipodystrophy Treatment: Tesamorelin, a synthetic form of the human Growth Hormone-Releasing Hormone (GHRH), has emerged as a pivotal treatment in managing lipodystrophy associated with HIV therapy. Its introduction marked a significant advancement in addressing the challenges of fat accumulation and redistribution problems that many HIV patients face as a side effect of antiretroviral therapy. This article delves into the development, mechanism, and therapeutic benefits of tesamorelin, highlighting its role in improving the quality of life for those living with HIV. Development and Approval Developed by Theratechnologies, tesamorelin was approved by the U.S. Food and Drug Administration (FDA) in 2010 for the treatment of HIV-related lipodystrophy, specifically for reducing excess abdominal fat in HIV-infected patients. The approval came after clinical trials demonstrated its efficacy in reducing visceral adipose tissue (VAT) in the abdomen, a common and distressing side effect of long-term antiretroviral therapy that can lead to increased risks of cardiovascular disease and metabolic disturbances. Mechanism of Action Tesamorelin works by stimulating the pituitary gland to release growth hormone (GH), thereby indirectly increasing the levels of Insulin-like Growth Factor 1 (IGF-1) in the body. This process plays a crucial role in regulating fat metabolism and distribution. By enhancing the body’s natural GH secretion, tesamorelin effectively reduces visceral fat accumulation without significantly affecting subcutaneous fat, which is essential for protecting internal organs and providing energy. Therapeutic Benefits Reduction of Visceral Fat: The primary benefit of tesamorelin is its ability to significantly reduce visceral adiposity, which is linked to cardiovascular risk factors such as insulin resistance, dyslipidemia, and hypertension. Clinical studies have shown that tesamorelin can reduce VAT by approximately 15-20% from baseline in HIV-infected patients with lipodystrophy. Metabolic Improvements: Beyond its effects on fat distribution, tesamorelin has been observed to have a positive impact on various metabolic parameters, including cholesterol levels and insulin sensitivity, further contributing to the reduction of cardiovascular risk in patients. Quality of Life: For many patients, the physical changes associated with HIV-related lipodystrophy can lead to psychological distress and a negative self-image. By addressing these physical changes, tesamorelin also helps improve the psychological well-being and quality of life for those affected. Administration and Treatment Regimen Tesamorelin is administered via subcutaneous injection, typically around the abdomen, once daily. Treatment duration may vary depending on the individual’s response and clinical goals, with… #healthcarenews #DoctorsBusinessNetwork #medicalnews

📃Scientific paper: Frontal lobe microglia, neurodegenerative protein accumulation, and cognitive function in people with HIV Abstract: Microglia are implicated in Alzheimer’s Disease \(AD\) pathogenesis. In a middle-aged cohort enriched for neuroinflammation, we asked whether microgliosis was related to neocortical amyloid beta \(A $$\upbeta$$ β \) deposition and neuronal phosphorylated tau \(p-tau\), and whether microgliosis predicted cognition. Frontal lobe tissue from 191 individuals autopsied with detectable \(HIV-D\) and undetectable \(HIV-U\) HIV infection, and 63 age-matched controls were examined. Immunohistochemistry \(IHC\) was used to evaluate A $$\upbeta$$ β plaques and neuronal p-tau, and quantitate microgliosis with markers Iba1, CD163, and CD68 in large regions of cortex. Glia in the A $$\upbeta$$ β plaque microenvironment were quantitated by immunofluorescence \(IF\). The relationship of microgliosis to cognition was evaluated. No relationship between A $$\upbeta$$ β or p-tau accumulation and overall severity of microgliosis was discerned. Individuals with uncontrolled HIV had the greatest microgliosis, but fewer A $$\upbeta$$ β plaques; they also had higher prevalence of APOE $$\upvarepsilon$$ ε 4 alleles, but died earlier than other groups. HIV group status was the only variable predicting microgliosis over large frontal regions. In contrast, in the A $$\upbeta$$ β plaque microenvironment, APOE $$\upvarepsilon$$ ε 4 status and sex were dominant predictors of glial infiltrates, with smaller contributions of HIV status. Cognition correlated with large-scale microgliosis in HIV-D, but not HIV-U,... Discover the rest of the scientific article on es/iode ➡️https://etcse.fr/D2ub

📃Scientific paper: Adverse perinatal outcomes associated with prenatal exposure to protease-inhibitor-based versus non-nucleoside reverse transcriptase inhibitor-based antiretroviral combinations in pregnant women with HIV infection: a systematic review and meta-analysis Abstract: Background About 1.3 million pregnant women lived with HIV and were eligible to receive antiretroviral therapy (ART) worldwide in 2021. The World Health Organization recommends protease inhibitors (PI)-based regimen as second or third-line during pregnancy. With remaining pregnant women exposed to PIs, there is still an interest to assess whether this treatment affects perinatal outcomes. Adverse perinatal outcomes after prenatal exposure to PI-based ART remain conflicting: some studies report an increased risk of preterm birth (PTB) and low-birth-weight (LBW), while others do not find these results. We assessed adverse perinatal outcomes associated with prenatal exposure to PI-based compared with non-nucleoside reverse transcriptase (NNRTI)-based ART. Methods We performed a systematic review searching PubMed, Reprotox, Clinical Trial Registry (clinicaltrials.gov) and abstracts of HIV conferences between 01/01/2002 and 29/10/2021. We used Oxford and Newcastle-Ottawa scales to assess the methodological quality. Studied perinatal outcomes were spontaneous abortion, stillbirth, congenital abnormalities, PTB (< 37 weeks of gestation), very preterm birth (VPTB, < 32 weeks of gestation), LBW (< 2500 grs), very low-birth-weight (VLBW, < 1500 g), small for gestational age (SGA) and very small for gestational age (VSGA). The association between prenatal exposure to PI-based compared to NNRTI-based ART was measured for each adverse perinatal outcome using random-effect meta-a... Discover the rest of the scientific article on es/iode ➡️https://etcse.fr/cVkn

📃Scientific paper: The association between benzodiazepine use and greater risk of neurocognitive impairment is moderated by medical burden in people with HIV Abstract: Benzodiazepine use is linked to neurocognitive impairment (NCI) in the general population and people with HIV (PWH); however, this relationship may depend on age-related factors such as medical comorbidities, which occur at an elevated rate and manifest earlier in PWH. We retrospectively examined whether chronological age or medical burden, a clinical marker for aging, moderated the relationship between benzodiazepine use and NCI in PWH. Participants were 435 PWH on antiretroviral therapy who underwent neurocognitive and medical evaluations, including self-reported current benzodiazepine use. A medical burden index score (proportion of accumulated multisystem deficits) was calculated from 28 medical deficits. Demographically corrected cognitive deficit scores from 15 neuropsychological tests were used to calculate global and domain-specific NCI based on established cut-offs. Logistic regressions separately modeled global and domain-specific NCI as a function of benzodiazepine x age and benzodiazepine x medical burden interactions, adjusting for current affective symptoms and HIV disease characteristics. A statistically significant benzodiazepine x medical burden interaction ( p  = .006) revealed that current benzodiazepine use increased odds of global NCI only among those who had a high medical burden (index score > 0.3 as indicated by the Johnson–Neyman analysis), which was driven by the domains of processing speed, motor, and verbal fluency. No age x benzodiazepine... Discover the rest of the scientific article on es/iode ➡️https://etcse.fr/jlRz

"People with HIV who have non-alcoholic fatty liver disease have a higher risk of serious cardiovascular outcomes including heart attack, heart failure and stroke, a large study of people with HIV in the United States has found." "To investigate the relationship between non-alcoholic fatty liver disease and cardiovascular disease in people with HIV, US researchers identified everyone with HIV receiving care between 2008 and 2020 in 25 healthcare organisations in the United States through the TriNetX electronic medical records database." "The researchers compared the risk of four cardiovascular outcomes in people with NAFLD and matched controls. People with NAFLD were at higher risk of myocardial infarction (heart attack) (111 events, hazard ratio 1.49), major cardiovascular event (heart attack, heart failure, unstable angina or clinical intervention) (298 events, HR 1.49), heart failure (188 events, HR 1.73) and any cerebrovascular event (stroke, transient ischemic attack or clinical intervention) (294 events, HR 1.25)." References: Krishnan A et al. Risks of adverse cardiovascular outcomes among people with HIV and nonalcoholic fatty liver disease. AIDS, 37: 1209-16, 2023.

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Evaluation of Cardiovascular Risk Factors and Metabolic Abnormalities in HIV Subjects on Therapy. The study recruited 154 HIV seropositive subjects visiting HIV Clinic at Abia State University Teaching Hospital, Aba. They were stratified into four groups. Group 1 and 2 were made up of 25 males and 62 females HIV seropositive subjects who were not yet on antiretroviral therapy, while group 3 and 4 are made up of 26 males and 41 females who were already on routine antiretroviral therapy (a combination of Lamivudine 150 mg, Zidovudine 300 mg and Nevirapine 200 mg) at least for the past 12 months. The age range of the study subjects was 15 to 55 years. Also, a total of 50 HIV seronegative subjects, made up of 20 males and 30 females participated in the study. They served as controls. The age range was 18 to 50 years. The study evaluated the cardiovascular risk factors and metabolic abnormalities in HIV seropositive subjects on therapy was categorized into biomarkers namely: Cardiovascular, metabolic, immunologic, renal function and haematologic markers. The cardiovascular markers evaluated include; serum lipids and high sensitivity c-reactive protein. HIV seropositive subjects who were not on therapy (non-ART) had decreased serum levels of total cholesterol (P < 0.001), no significant decreased serum levels of low-density lipoprotein and high-density lipoprotein cholesterols, as well as elevated mean ± SEM serum levels of triglyceride (P < 0.001) and high sensitivity C-reactive protein (P < 0.001) compared with HIV naïve subjects were observed. On the other hand, HIV seropositive subjects on antiretroviral therapy (ART) showed hypercholesterolemia, hypertriglyceridemia and elevated high sensitivity C-reactive protein (P < 0.001). LDL-cholesterol was not significantly increased and HDL-cholesterol was not significantly decreased. Upon comparison of cardiovascular markers in nonART and ART subjects in both genders, in male ART subjects, results showed increased serum levels of total cholesterol (251.160 ± 9.106 mg/dl vs 238.76 ± 7.538 mg/dl), LDL-C (96.60 ± 5.584 mg/dl vs 88.20 ± 5.652 mg/dl), HDL-C (62.75 ± 2.725 mg/dl vs 56.52 ± 2.546 mg/dl), triglyceride (420.36 ± 30.184 mg/dl vs 398.64 ± 23.693 mg/dl) and high sensitivity c-reactive protein (3.616 ± 0.516 mg/dl vs 1.92 ± 0.601 mg/dl). The female subjects recorded similar result pattern with the male. The metabolic markers evaluated serum glucose, insulin, electrolytes and aminotransferases. In both genders, hyperinsulinemia was revealed in ART subjects with normoglycemia in both ART and non-ART subjects. Mean ± SEM serum electrolyte levels were not significantly reduced in non-ART subjects compared with ART subjects. However, they were all within the normal reference range. In male non-ART subjects, mean ± SEM serum levels of ALT (53.64 ± 3.768 iu/L) and AST (60.16 ± 3.432 iu/L) were not significantly increased when compared with ART subjects, ALT (42.52 ± 5.596 iu/L) and AST (46.24 ± 5.100 iu/L).

📃Scientific paper: An enhanced participant information leaflet and multimedia intervention to improve the quality of informed consent to a randomised clinical trial enrolling people living with HIV and obesity: a protocol for a Study Within A Trial (SWAT) Abstract: Background It is the investigator’s responsibility to communicate the relevant information about a clinical trial to participants before they provide informed consent to take part. Systematic reviews indicate that participants often have a poor understanding of the concepts which are key to ensuring valid informed consent, such as randomisation and risks/discomforts. Paper-based participant information leaflets and informed consent forms (PIL/ICFs) are becoming longer and are often too complex for many participants. Multimedia interventions and enhanced PIL/ICFs have been trialled in an attempt to improve participants’ understanding of various aspects of research studies. However, there is insufficient empirical evidence to determine how effective such interventions are. This protocol describes a study to evaluate whether an enhanced PIL/ICF and website help research participants to understand important information about a human immunodeficiency virus (HIV) randomised clinical trial. Methods This Study Within A Trial (SWAT) is a prospective, multi-centre, randomised, controlled, parallel-group study embedded in a host clinical trial. The host trial (the SWIFT trial; EudraCT: 2019-002314-39) is a prospective, multi-centre, randomised, open-label, controlled trial investigating if semaglutide along with dietary advice assists individuals with HIV and obesity to lose weight, compared to dietary advice alone. For the SWAT, participants will be randomised in a 1:1 ratio ... Discover the rest of the scientific article on es/iode ➡️https://etcse.fr/zb

📃Scientific paper: An enhanced participant information leaflet and multimedia intervention to improve the quality of informed consent to a randomised clinical trial enrolling people living with HIV and obesity: a protocol for a Study Within A Trial (SWAT) Abstract: Background It is the investigator’s responsibility to communicate the relevant information about a clinical trial to participants before they provide informed consent to take part. Systematic reviews indicate that participants often have a poor understanding of the concepts which are key to ensuring valid informed consent, such as randomisation and risks/discomforts. Paper-based participant information leaflets and informed consent forms (PIL/ICFs) are becoming longer and are often too complex for many participants. Multimedia interventions and enhanced PIL/ICFs have been trialled in an attempt to improve participants’ understanding of various aspects of research studies. However, there is insufficient empirical evidence to determine how effective such interventions are. This protocol describes a study to evaluate whether an enhanced PIL/ICF and website help research participants to understand important information about a human immunodeficiency virus (HIV) randomised clinical trial. Methods This Study Within A Trial (SWAT) is a prospective, multi-centre, randomised, controlled, parallel-group study embedded in a host clinical trial. The host trial (the SWIFT trial; EudraCT: 2019-002314-39) is a prospective, multi-centre, randomised, open-label, controlled trial investigating if semaglutide along with dietary advice assists individuals with HIV and obesity to lose weight, compared to dietary advice alone. For the SWAT, participants will be randomised in a 1:1 ratio ... Discover the rest of the scientific article on es/iode ➡️https://etcse.fr/3a