"The main objective of this paper is to evaluate the impact of the large remittances made by Egyptian migrants to their home country on the Egyptian economy. In order to study this impact, we use the implications of the standard Keynesian model. We estimated the structural equations of the model using annual data for the Egyptian economy over the period from 1970 to 1984.... The results suggest that remittances have had a strong positive impact on GNP in Egypt." The authors note that remittances especially affect private consumption spending. Policy implications concerning labor migration are discussed. (SUMMARY IN FRE AND SPA)
Objective
Previous reports show conflicting results regarding hepatitis B virus (HBV) vaccine efficacy in Hepatitis C virus (HCV) infected individuals and in those with isolated hepatitis B core antibodies (HBcAb). We aimed to evaluate the effectiveness of HBV vaccine and identify possible factors that may contribute to hyporesponsivness in HCV‐treated patients, including those with isolated HBcAb.
Methods
We conducted a prospective study with 118 enrolled chronic HCV patients who followed a 12‐week regimen of direct acting antivirals (DAAs) and were evaluated for HBV serological markers. Eventually, 98 received appropriate HBV vaccination and were assessed for response.
Results
A total of 57.1% were vaccine responders although only 5.1% achieved a seroprotective level of HBsAb titre. The response rate was significantly lower among treated HCV patients with isolated HBcAb [2 (5.6%) vs. 40 (64.5%) respectively]. On multivariate analysis, advanced age [OR (95% CI) = 1.09 (1.02–1.17)] and presence of isolated HbcAb [OR (95% CI) = 39.59 (7.98–196.63)] were predictors of vaccine non‐response. In our cost‐effectiveness models, the cost of HBV serological screening was less than the nationally adopted non‐screening approach. A model ratifying reinforced vaccination in non‐responder HBcAb seropositive HCV patients would incur extra cost.
Conclusion
Hyporesponsiveness to the HBV vaccination is frequent in chronic HCV patients even after achieving SVR following DAAs. Although there is no consensus on the clinical management of patients with isolated HBcAb, our cost‐effectiveness options may support decision‐making for better clinical benefit and proper health investments.
Background
The diagnosis of meningitis in HIV patients is challenging due to altered immune responses. Diagnostic scoring systems were recently proposed for use in research settings to help prompt and easy differential diagnosis. The objective of this study was to create a clinical prediction rule (CPR) for meningitis in HIV-infected patients and to address the enigma of differentiating bacterial (BM), TB (TBM) and cryptococcal (CCM) meningitis based on clinical features alone, which may be enhanced by easy-to-obtain laboratory testing.
Methods
We retrospectively enrolled 352 HIV patients presenting with neurological manifestations suggesting meningitis over the last 18 y (2000–2018). Relevant clinical and laboratory information were retrieved from inpatient records. The features independently predicting meningitis or its different types in microbiologically proven meningitis cases were modelled by multivariate logistic regression to create a CPR in an exploratory data set. The performance of the meningitis diagnostic score was assessed and validated in a subset of retrospective data.
Results
AIDS clinical stage, injecting drug use, jaundice and cryptococcal antigen seropositivity were equally important as classic meningitic symptoms in predicting meningitis. Arthralgia and elevated cerebrospinal fluid Lactate dehydrogenase (LDH) were strong predictors of BM. Patients with cryptococcal antigenemia had 25 times the probability of having CCM, whereas neurological deficits were highly suggestive of TBM.
Conclusion
The proposed CPRs have good diagnostic potential and would support decision-making in resource-poor settings.
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