Greenelehmann2629

HIV testing and treatment in a high-prevalence setting. Maintaining these coverage levels over the next decade could substantially reduce HIV transmission and potentially eliminate the epidemic in these areas. Funding US President's Emergency Plan for AIDS Relief through the Centers for Disease Control and Prevention.Background In the primary week-48 analyses of two phase 3 studies, coformulated bictegravir, emtricitabine, and tenofovir alafenamide was non-inferior to a dolutegravir-containing regimen in treatment-naive people with HIV. We report week-144 efficacy and safety results from these studies. Methods We did two double-blind, active-controlled studies (now in open-label extension phase). Study 1 randomly assigned (11) HLA-B*5701-negative adults without hepatitis B virus co-infection to receive coformulated bictegravir 50 mg, emtricitabine 200 mg, and tenofovir alafenamide 25 mg, or coformulated dolutegravir 50 mg, abacavir 600 mg, and lamivudine 300 mg once daily. Study 2 randomly assigned (11) adults to bictegravir, emtricitabine, and tenofovir alafenamide, or dolutegravir 50 mg given with coformulated emtricitabine 200 mg and tenofovir alafenamide 25 mg. We previously reported non-inferiority at the primary endpoint. Here, we report the week-144 secondary outcome of proportion of participants with plasma HIV-1 L ratio (-0·1 vs -0·3; p=0·007) at week 144; no differences were observed between groups in study 2. Weight gain was seen across all treatment groups in both studies, with no differences in median changes from baseline in weight at week 144 for either study. Interpretation These long-term data support the use of bictegravir, emtricitabine, and tenofovir alafenamide as a safe, well tolerated, and durable treatment for people with HIV, with no emergent resistance. Funding Gilead Sciences.Background Third-trimester scans are increasingly used to try to prevent adverse outcomes associated with abnormalities of fetal growth. Unexpected fetal malformations detected at third-trimester growth scans are rarely reported. VB124 Objective To determine the incidence and type of fetal malformations detected in women attending a routine third-trimester growth scan. Study design This was a population-based study of all women with singleton pregnancy attending antenatal care over a 2-year period in Oxfordshire, UK. Women who had a viable singleton pregnancy at dating scan were included. Women had standard obstetric care including the offer of a routine dating scan and combined screening for trisomies; a routine anomaly scan at 18-22 weeks; and a routine third-trimester growth scan at 36 weeks. The third-trimester scan comprises assessment of fetal presentation, amniotic fluid, biometry, umbilical and middle cerebral artery Dopplers, but no formal anatomical assessment is undertaken. Scans are performed by certifisplenic cyst (1), skeletal dysplasia (1), and cutaneous lymphangioma (1). The majority of the urinary tract anomalies were renal pelvic dilatation, which showed spontaneous resolution in 57% of the cases. Conclusion When undertaking a program of routine third-trimester growth scans in women who have had prior screening scans, an unexpected congenital malformation is detected in approximately 1 in 300 women.Objectives The objective of this study was to compare the clinical presentation, outcomes, complications and diverticulum recurrence rates in women who underwent urethral diverticulectomy with versus without a concurrent pubovaginal sling. Study design This multi-center retrospective cohort study included women who underwent urethral diverticulectomy between Jan 1, 2000 - Dec 31, 2016. Subjects were identified by Current Procedure Terminology code and records reviewed for demographics, medical/surgical history, symptoms, preoperative testing, concomitant surgeries, and postoperative outcomes. Symptoms, recurrence rates and complications were compared between women with and without a concomitant pubovaginal sling. The primary outcome was the presence of postoperative stress urinary incontinence symptoms. Based on a stress urinary incontinence rate of 50% with no pubovaginal sling and 10% with pubovaginal sling, we needed 141 diverticulectomy alone and 8 with pubovaginal sling to achieve 83% power with p 6 weeks) (aOR 6.98, 95% CI 2.20-22.11, p=0.001) as well as recurrent urinary tract infection (aOR 3.27, 95% CI 1.26-7.76, p=0.013). There was no significant risk to develop de novo overactive bladder (aOR 1.48, 95% CI 0.56-3.91, p=0.423) or urgency urinary incontinence (aOR 1.47, 95% CI 0.71-3.06, p=0.30). It was not protective against recurrent diverticulum (aOR 1.38, 95% CI 0.67-2.82, p=0.374). Overall diverticulum recurrence rate was 10.1% and did not differ between groups. Conclusion This large retrospective cohort study demonstrates greater resolution of stress urinary incontinence with the addition of a pubovaginal sling at the time of urethral diverticulectomy. There was a significant risk of postoperative urinary retention and recurrent urinary tract infection in the pubovaginal sling group.Purpose To estimate the incidence of patients presenting to emergency departments (EDs) as a result of facial trauma sustained from skateboarding. Patients and methods The National Electronic Injury Surveillance System (NEISS) database was queried for skateboard-related head and face fractures, contusions, abrasions, and lacerations from 2009 through 2018. We identified 2,519 reported injuries, extrapolating to a national incidence of 100,201 injuries. Fractures accounted for 14.1% of these visits. There were 355 ED visits for fractures, extrapolating to an estimated 11,893 visits nationally. Entries were tabulated for demographic information, fracture type, mechanism of injury, and disposition. Results Patients sustaining injury to the head and face were aged 16 years, on average, and predominantly male patients (85.9%). Most patients sustaining fractures were male patients (87.9%), with a mean age of 18 years. The most common fracture types included unspecified skull fractures (31%), nasal fractures (29%), and mandibular fractures (18%). The most common mechanism of injury was falling off the skateboard while riding (76.9%). Collisions with motor vehicles also accounted for a substantial proportion of the injuries (7.3%). Conclusions A substantial number of ED visits were a result of skateboarding-related facial trauma. Given the neurologic outcomes of head trauma and functional consequences of facial fractures, especially among adolescents, our findings suggest that injury prevention programs and more aggressive helmet use may be necessary to reduce morbidity and hospitalization.