Search

BACKGROUND: In patients co-infected with HIV and tuberculosis, antiretroviral therapy options are limited due to drug—drug interactions with rifampicin. A previous phase 2 trial indicated that raltegravir 400 mg twice a day or efavirenz 600 mg once a day might have similar virological efficacy in patients given rifampicin. In this phase 3 trial, we assessed the non-inferiority of raltegravir to efavirenz. METHODS: We did a multicentre, open-label, non-inferiority, randomised, phase 3 trial at six sites in Côte d'Ivoire, Brazil, France, Mozambique, and Vietnam. We included antiretroviral therapy (ART)-naive adults (aged ≥18 years) with confirmed HIV-1 infection and bacteriologically confirmed or clinically diagnosed tuberculosis who had initiated rifampicin-containing tuberculosis treatment within the past 8 weeks. Using computerised random numbers, we randomly assigned participants (1:1; stratified by country) to receive raltegravir 400 mg twice daily or efavirenz 600 mg once daily, both in combination with tenofovir and lamivudine. The primary outcome was the proportion of patients with virological suppression at week 48 (defined as plasma HIV RNA concentration

Background In people with human immunodeficiency virus [HIV] presenting with advanced disease, rates of virologic success may be lower than expected. The Reflate TB2 trial did not show non-inferiority of raltegravir versus efavirenz in people with HIV (PWH) treated for tuberculosis. We aimed to identify factors associated with virologic success and higher adherence in the trial. Methods In this analysis, we included participants enrolled in the Reflate TB2 trial with adherence data available. The primary outcome was virologic success (HIV-1 ribonucleic acid [RNA] Results Four hundred forty-four participants were included in the present analysis. Over the 48-week follow-up period, 290 of 444 (65%) participants had a pill count adherence ratio ≥95%. At week 48, 288 of 444 (65%) participants were in virologic success. In the multivariate analysis, female sex (adjusted odds ratio [aOR], 1.77; 95% confidence interval [CI], 1.16–2.72; P = .0084), lower baseline HIV-1 RNA levels ( Conclusions In PWH with tuberculosis receiving raltegravir or efavirenz-based regimens, female sex, optimal adherence, and baseline HIV-1 RNA

Submitted by RODRIGO ESCADA MATHIAS null (rodrigo.escada.mathias@gmail.com) on 2016-10-31T18:16:18Z No. of bitstreams: 1 DISSERTAÇÃO_MESTRADO_RODRIGO_MATHIAS_Revisão_Final.pdf: 1664343 bytes, checksum: cab844e66361d8607aa397acbedcf0c1 (MD5) Approved for entry into archive by Felipe Augusto Arakaki (arakaki@reitoria.unesp.br) on 2016-11-07T19:55:46Z (GMT) No. of bitstreams: 1 mathias_re_me_guara.pdf: 1662746 bytes, checksum: 954b916c500d16709c82f21f90f55277 (MD5) Made available in DSpace on 2016-11-07T19:55:46Z (GMT). No. of bitstreams: 1 mathias_re_me_guara.pdf: 1662746 bytes, checksum: 954b916c500d16709c82f21f90f55277 (MD5) Previous issue date: 2016-09-01 No atual contexto energético mundial, a busca pela mitigação e, sempre que possível, a substituição de combustíveis fósseis por fontes renováveis, são a pauta de diversas instituições e empresas, pois a disponibilidade de recursos não é proporcional ao crescimento do consumo. Este trabalho tem por objetivo a redução do uso de gás natural para geração de vapor nos processos de cocção de cozinha industrial. Foi realizado a caracterização do processo e dos equipamentos, identificando o fluxo de vapor ao longo de todo o processo. De modo comparativo, desenvolveu-se propostas utilizando energia renovável para redução do uso de combustível fóssil. Para suportar essa atividade foram realizadas modelagens termodinâmica do sistema atual comparando-a aos sistemas propostos, mostrando o comportamento e definindo qual proposta teria a maior colaboração na redução do consumo de combustível. Por fim, foi estudado a viabilidade financeira de cada proposta através do método do VPL e payback. O presente trabalho gerou oito propostas, entre energia solar, produção de biogás a partir de resíduos orgânicos e efluentes de estação de tratamento de esgoto, geração de energia elétrica por meio de microturbina a gás e motor de combustão interna. Conclui-se que das oito propostas, três apresentaram potencial energético capaz de substituir em 100 % a vazão mássica de gás natural demandada na cozinha industrial, além de obterem viabilidade financeira satisfatória para seguir em frente com implementação do projeto. A substituição do gás natural pelo biogás gerado a partir de efluentes da estação de tratamento foi a proposta que apresentou o melhor desempenho, a mesma foi capaz de substituir 100 % da vazão mássica de gás natural utilizado para gerar vapor aos vasos de pressão da cozinha industrial, sendo 199.741 kWh de potencial energético e um VPL positivo de R$ 2.473.966,15, com retorno dos investimentos em menos de um ano. In the current global energy context of mitigation of non-renewable fuels and whenever it is possible, replacing fossil fuels by renewable sources are the agenda of the most of institutions and companies, because the availability of resources is not proportional to the growth of consumption. This work has as target to reduce the use of natural gas for steam generation in the cooking process of industrial kitchen. It was performed a process and equipment characterization, identifying the steam flow along the whole process. In a comparative way, it has developed proposals using renewable energy for reducing the use of fossil fuel. To support that, it was done a thermodynamic modeling of the current system compared with the proposed ones, showing the behavior and defining which proposal had the larger collaboration in terms of fuel consumption reduction. Finally, it was analyzed the financial feasibility of each alternatives by NPV and payback method. The present work has created eight proposals, such as solar energy, biogas production from organic waste and from wastewater of sewage treatment station, electric energy from gas micro turbine and internal combustion engine. Concludes that from eight proposals, three presented energetic potential able to replace in 100 % the natural gas mass flow demanded in the industrial kitchen, beyond to get satisfactory financial viability to move forwards with the project implementation. The replacement of natural gas by generated biogas from wastewater of sewage treatment station was the proposal that presented the best performance, this ones was able to replace 100 % of the natural gas mass flow used to generate steam to the pressure vessel of industrial kitchen, where 199.741 kWh of energetic potential and a NPV of R$ 2.473.966,15, with an investment return less than one year.