A5067946818- Cutaneous Melanoma Detection and Management
- Skin Protection and Aging
- HIV-related health complications and treatments
- HIV/AIDS Research and Interventions
- Nonmelanoma Skin Cancer Studies
- Tuberculosis Research and Epidemiology
- Genetic Associations and Epidemiology
- Melanoma and MAPK Pathways
- Pneumocystis jirovecii pneumonia detection and treatment
- Hepatitis B Virus Studies
- Cervical Cancer and HPV Research
- HIV Research and Treatment
- HIV/AIDS drug development and treatment
- Viral-associated cancers and disorders
- Cancer Genomics and Diagnostics
- Cancer and Skin Lesions
- AI in cancer detection
- melanin and skin pigmentation
- Inflammatory mediators and NSAID effects
- Child Nutrition and Water Access
- Genital Health and Disease
- Nutrition and Health in Aging
- Hair Growth and Disorders
- Sex and Gender in Healthcare
- NF-κB Signaling Pathways
QIMR Berghofer Medical Research Institute
2017-2024
Montefiore Medical Center
2024
Albert Einstein College of Medicine
2011-2024
Montefiore Einstein Comprehensive Cancer Center
2024
The University of Queensland
2017-2020
Hudson Institute
2019
Rwanda Military Hospital
2018
University of Global Health Equity
2013-2016
Regional Alliance for Sustainable Development
2013-2016
Rwanda Development Board
2015-2016
Cutaneous melanomas are common cancers in white-skinned populations, and early detection is promoted as a means of reducing morbidity mortality. There concern that increased skin screening leading to overdiagnosis indolent with low risk lethality. The extent melanoma associated unknown.To estimate possible by comparing subsequent incidence biopsy rates among people subjected those who were not.We recruited 43 762 residents Queensland, Australia, aged 40-69 years, no prior history melanoma,...
Sunlight is the principal environmental risk factor for keratinocyte cancers, but other carcinogens have also been implicated, including tobacco smoke. Findings conflicting, however. We investigated associations between cigarette smoking and incidence of basal cell carcinoma (BCC) or squamous (SCC) in QSkin, a prospective study skin cancer (N = 43,794). Smoking history was self-reported at baseline; newly diagnosed BCCs SCCs were ascertained through data linkage verified by histopathology...
Risk stratification can improve the efficacy and cost-efficiency of screening programs for early detection cancer. We sought to derive a risk tool melanoma that was suitable general population using only self-reported information. used factor information collected at baseline from QSKIN, prospective cohort study Queensland adults age 40 69 years recruitment (n = 41 954). examined two separate outcomes: 1) invasive melanomas 2) all (invasive + in situ) obtained through data linkage cancer...
Although haematological abnormalities are common manifestations of HIV infection, few studies on parameters in HIV-infected persons have been undertaken sub-Saharan Africa. The authors assessed factors associated with antiretroviral-naïve and HIV-uninfected Rwandan women.Cross-sectional analysis a longitudinal cohort.Community-based women's associations.710 (HIV+) 226 (HIV-) women from the Rwanda Women's Interassociation Study Assessment. Haematological categorised as (abnormal vs normal)...
Initiation of antiretroviral therapy (ART) in the advanced stages HIV infection remains a major challenge sub-Saharan Africa. This study was conducted to better understand barriers and enablers timely ART initiation Rwanda where coverage is high national eligibility guidelines first expanded 2007-2008.Using data on 6326 patients (≥15 years) at five Rwandan clinics, we assessed trends correlates CD4 cell count proportion initiating with disease (CD4 <200 cells/μl or WHO stage IV).Out...
World Health Organization advocates for integration of HIV-tuberculosis (TB) services and recommends intensive case finding (ICF), isoniazid preventive therapy (IPT), infection control ("Three I's") TB prevention among persons living with HIV.To assess the implementation "Three I's" TB-control at HIV treatment sites in lower income countries.Survey conducted between March-July, 2012 47 26 countries: 6 (13%) Asia Pacific, 7 (15%), Caribbean, Central South America, 5 (10%) Africa, 8 (17%) East...
Survival after diagnosis is a fundamental concern in cancer epidemiology. In resource-rich settings, ambient clinical databases, municipal data and registries make survival estimation real-world populations relatively straightforward. resource-poor given the deficiencies variety of health-related systems, it less clear how well we can determine from data.We addressed this issue sub-Saharan Africa for Kaposi's sarcoma (KS), which incidence has exploded with HIV epidemic but region may be...
Male-pattern baldness (MPB) is related to dysregulation of androgens such as testosterone. A previously observed relationship between MPB and skin cancer may be due greater exposure ultraviolet radiation or indicate a role for androgenic pathways in the pathogenesis cancers. We dissected this via Mendelian randomization (MR) analyses, using genetic data from recent male-only meta-analyses cutaneous melanoma (12,232 cases; 20,566 controls) keratinocyte cancers (KCs) (up 17,512 >100,000...
New World Health Organization guidelines recommend high-risk human papillomavirus (hrHPV) screen-and-treat strategies for cervical cancer prevention. We describe risk of, and factors for, testing hrHPV positive in a pilot study of conducted Rwanda. A total 2,964 women, 1,289 HIV-infected (HIV [+]) 1,675 HIV-uninfected [-]), aged 30-60 years living Rwanda were enrolled 2010. Cervical specimens collected tested by careHPV, DNA test pool 14 types. Prevalence with binomial 95% confidence...
The relationship between body mass index (BMI) and melanoma other skin cancers remains unclear. objective of this study was to employ the Mendelian randomization (MR) approach evaluate effects genetically predicted childhood adiposity on risk developing cancer later in life. Two-sample MR analyses were conducted using summary data from genome-wide association (GWAS) meta-analyses BMI, melanoma, cutaneous squamous cell carcinoma (cSCC), basal (BCC). We used inverse-variance-weighted (IVW)...
In resource-constrained settings, tuberculosis (TB) is a common opportunistic infection and cause of death in HIV-infected persons. TB may be present at the start antiretroviral therapy (ART), but it often under-diagnosed. We describe approaches to diagnosis screening ART programs low- middle-income countries.We surveyed treating adults sub-Saharan Africa, Asia Latin America 2012 using online questionnaires collect program-level patient-level data. Forty-seven sites from 26 countries...
Nonsteroidal anti-inflammatory drugs (NSAIDs) have been postulated as chemopreventive agents for basal cell carcinoma (BCC) and squamous (SCC), but findings from observational studies inconsistent, clinical trial data are scant.To examine the association between aspirin NSAID (nonaspirin) use risk of BCC SCC in a large cohort specifically designed skin cancer outcomes.We used QSkin Study, prospective 43 764 residents Queensland, Australia (34 630 were included this study 23 581 our primary...
We determined the associations of HIV infection/CD4 count with markers hepatocellular damage [elevated aspartate aminotransferase (AST) and alanine (ALT)] liver synthetic function (decreased albumin) in HIV-infected (HIV+) antiretroviral therapy (ART)-naive uninfected (HIV−) Rwandan women. In 2005, 710 HIV+ ART-naive 226 HIV− women enrolled Rwanda Women's Interassociation Study Assessment. Liver enzymes were measured abnormality defined as either AST or ALT ≥1.25 times upper limit normal....
Introduction The objectives of this study are to address if and how albumin can be used as an indication malnutrition in HIV infected uninfected Africans. Methods In 2005, 710 HIV-infected 226 HIV-uninfected women enrolled a cohort study. Clinical/demographic parameters, CD4 count, albumin, liver transaminases; anthropometric measurements Bioelectrical Impedance Analysis (BIA) were performed. Malnutrition outcomes defined body mass index (BMI), Fat-free (FFMI) Fat (FMI). Separate linear...
To describe the clinical settings in which keratinocyte cancers are excised Queensland and types of practitioners who excise them; to examine costs; identify predictors hospital admission.We used linked data for participants from QSkin study (n = 43 794), including Medicare claims admissions relating treatment episodes incident July 2011 June 2015. We multinomial logistic regression measure associations between demographic characteristics setting. The median costs (AU$) were...
The global burden of childhood tuberculosis (TB) is estimated to be 0.5 million new cases per year. Human immunodeficiency virus (HIV)-infected children are at high risk for TB. Diagnosis TB in HIV-infected remains a major challenge.We describe diagnosis and screening practices pediatric antiretroviral treatment (ART) programs Africa, Asia, the Caribbean, Central South America. We used web-based questionnaires collect data on ART patients seen from March July 2012. Forty-three treating 23...
African women are disproportionately affected by HIV infection and may experience non-AIDS-related complications associated with inflammation. High-sensitivity C-reactive protein (hsCRP), d-dimer transthyretin have been examined as inflammatory markers elsewhere, but it is unclear how they change over time in HIV-negative or HIV-positive without antiretroviral therapy (ART) initiation.We hsCRP, levels at baseline follow-up of ≥2 years 185 510 Rwandan who were ART naïve study entry....
Assessing the risk of cancer among people living with HIV (PLHIV) in current era antiretroviral therapy (ART) is crucial, given their increased susceptibility to many types and prolonged survival due ART exposure. Our study aims compare association between infection specific sites Rwanda. Population-based registry data were used identify cases both PLHIV HIV-negative persons. A probabilistic record linkage approach registries was supplement status ascertainment registry. Associations...
Introduction The optimal method(s) for screening HIV-infected women, especially those living in sub-Saharan Africa, cervical precancer and early cancer has yet to be established. Methods analysis A convenience sample of >5000 Rwandan ages 30–54 years with HIV infection, is being consented enroled into a cross-sectional study strategies. Participants are completing an administered short risk factor questionnaire screened high-risk human papillomavirus (hrHPV) using the Xpert HPV assay...
Background Body mass index (BMI) independently predicts mortality in studies of HIV infected patients initiating antiretroviral therapy (ART). We hypothesized that poorer nutritional status would be associated with smaller gains CD4 count Rwandan women ART. Methods and Findings The Women's Interassociation Study Assessment, enrolled 710 ART-naïve HIV-positive 226 HIV-negative 2005 follow-up every 6 months. outcome assessed this study was change at 6, 12, 24 months after ART initiation....
Background We longitudinally assessed predictors of insulin resistance (IR) change among HIV-uninfected and HIV-infected (ART-initiators ART-non-initiators) Rwandan women. Methodology (HIV+) uninfected (HIV-) women provided demographic clinical measures: age, body mass index (BMI) in Kg/(height meters)2, Fat-Mass (FMI) Fat-Free-Mass (FFMI) index, fasting serum glucose insulin. Homeostasis Model Assessment (HOMA) was calculated to estimate IR over time log10 transformed HOMA measured at study...
Drug resistance threatens tuberculosis (TB) control, particularly among human immunodeficiency virus (HIV) infected persons.To describe practices in the prevention and management of drug-resistant TB under antiretroviral therapy (ART) programs lower-income countries.We used online questionnaires to collect program-level data on 47 ART Southern Africa (n = 14), East 8), West 7), Central 5), Latin America 7) Asia-Pacific 6 programs) 2012. Patient-level were collected 1002 adult patients seen...
Abstract Observational studies have suggested that smoking may increase the risk of cutaneous squamous cell carcinoma (cSCC) while decreasing risks basal (BCC), and melanoma. However, it remains possible confounding by other factors explain these associations. The aim this investigation was to use Mendelian randomization (MR) test whether is associated with skin cancer, independently factors. Two-sample MR analyses were conducted determine causal effect measures on cancer using genome-wide...