Medicine
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Comparative Study
Comparing HIV risk-related behaviors between 2 RDS national samples of MSM in Brazil, 2009 and 2016.
Periodic monitoring of sociobehavior characteristics at a national level is an essential component of understanding the dynamics the human immunodeficiency virus (HIV) epidemic worldwide, including Brazil. ⋯ Our results indicate a worrisome risk behavior trend among Brazilian MSM, especially among younger ones. These results can contribute for a better understanding of the HIV epidemics in Brazil, with timely shift in strategies so improved effectiveness in public health prevention efforts can be achieved.
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Case Reports
Rare ectopic metastasis from clear cell renal cell carcinoma to the chest wall after 10 years: A case report.
Clear cell renal cell carcinoma (CCRCC) is an aggressive tumor associated with a high risk of metastasis and very low survival rate. In addition, it can cause extensive blood metastasis to the lungs, bones, and other organs. Chest wall metastatic tumors from primary CCRCC are rare. ⋯ Our patient developed a metastatic chest wall tumor that originated from a CCRCC for which right nephrectomy had been performed 10 years previously. Although as per the literature, chest wall metastasis from CCRCC is very rare, it is important to consider tumor metastasis after several years of treatment for precise diagnosis and proper treatment.
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Case Reports
Delayed intracranial subdural empyema following burr hole drainage: Case series and literature review.
A subdural empyema (SDE) following burr hole drainage of a chronic subdural hematoma (CSDH) can be difficult to distinguish from a recurrence of the CSDH, especially when imaging data is limited to a computed tomography (CT) scan. ⋯ Neurosurgeons should consider the possibility of infection if recurrence of CSDH occurs within 1 month following drainage of a subdural hematoma. A contrast-enhanced MRI with DWI should be performed to differentiate SDE from CSDH. In addition, surgical evacuation of the empyema via wide craniotomy is preferred to burr hole drainage.
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B lymphoblastic lymphoma (B-LBL) is a rare type of lymphoma that originates from precursor lymphocytes. B-BLB in adults with brain metastases is extremely rare as the disease mainly affects children and adults. Therefore, such a seldom-seen case can easily trigger a dispute regarding clinical diagnosis and treatment.This paper reports the case of a 22-year-old man hospitalized for a head injury that resulted from a physical altercation. Upon admission to the hospital, the patient was diagnosed with a diffuse axonal injury (DAI). Accordingly, the patient receiving follow-up treatments, but died 30 days later. After a systematic necropsy, immunohistochemical staining, radiological consultation, and a complete review of the clinical dates, we defined the case as a brain metastasis of B lymphoblastic lymphoma. Imaging results of the intracranial lymphoma were nearly indistinguishable from DAI during the acute phase, which led to misdiagnosis and incorrect treatment for B-LBL. ⋯ We present this case to broaden the scope of pathologic and clinical diagnosis for intracranial tumors and to inform physicians, general neurologists, and even medical examiners with an added degree of differential awareness in dealing with the clinical materials before further diacrisis and disposal.
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Randomized Controlled Trial
A new strategy for enteral nutrition using a deflection flexible visual gastric tube: A randomized crossover manikin trial.
Enteral nutrition via gastric tube insertion is a routine clinical practice for critically ill patients, although complications due to blind manipulation are occasionally reported. ⋯ Results of this manikin model demonstrate that it is feasible to use the deflection flexible visual gastric tube to create a route for enteral nutrition and that such a procedure decreases placement time and procedure-related complications compared to the conventional procedure. These findings may point to a new strategy for gastric tube insertion in the future.