Medicine
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Since 1996, the Brazilian Department of Sexually Transmitted Infections (STI), AIDS and Viral Hepatitis (Departamento de Vigilância, Prevenção e Controle das IST, do HIV, AIDS e Hepatites Virais, Secretaria de Vigilância em Saúde, Ministério da Saúde) in collaboration with the Brazilian Ministry of Defense has conducted periodic and anonymous probability sample surveys to determine the human immunodeficiency virus (HIV) prevalence, the sexual and risk behaviors among conscripts of the Brazilian army. This study aimed to estimate the HIV seroprevalence of conscripts in Brazil by geographic region and to describe behavior in relation to the risk of HIV transmission by analyzing data from the Brazilian Conscripts Survey 8th edition performed in 2016. Conscripts were selected with a 2-stage sampling method stratified by geographical region. ⋯ The independent factors associated with HIV infection were: MSM status (odds ratio [OR] = 14.62; P = .000) and having more than 10 partners over their lifetime (OR = 3.32; P = .028). Our data suggest that the HIV prevalence among young men in Brazil remains stable except for the north region, and MSM continue to be associated with a high risk for HIV infection at a rate that is approximately 13-fold higher than the rate among men without a history of sex with another man. Our findings confirm the need to scale up combination HIV prevention for young men, including MSM, in Brazil.
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This study is to investigate the effects of slow breathing on heart rate variability (HRV) and arterial baroreflex sensitivity in essential hypertension. We studied 60 patients with essential hypertension and 60 healthy controls. All subjects underwent controlled breathing at 8 and 16 breaths per minute. ⋯ Slow breathing can increase HF power and decrease LF power and LF/HF ratio in essential hypertension. Besides, slow breathing increased baroreflex sensitivity in hypertensive subjects. These demonstrate slow breathing is indeed capable of shifting sympatho-vagal balance toward vagal activities and increasing baroreflex sensitivity, suggesting a safe, therapeutic approach for essential hypertension.
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Observational Study
Preventable hospitalizations, barriers to care, and disability.
The AHRQ's Prevention Quality Indicators assume inpatient hospitalizations for certain conditions, referred as ambulatory-care sensitive (ACS) conditions, are potentially preventable and may indicate reduced access to and a lower quality of ambulatory care. Using a cohort drawn from the Medicare Current Beneficiary Survey (MCBS) linked to Medicare claims, we examined the extent to which barriers to healthcare are associated with ACS hospitalizations and related costs, and whether these associations differ by beneficiaries' disability status. Our results indicate that the regression-adjusted cost of ACS hospitalizations for elderly Medicare beneficiaries with no disabilities was $799. ⋯ Persons reporting having foregone or delayed needed medical care because of financial difficulties (+$2082, P = .05), those experiencing low satisfaction with care coordination (+$1714, P = .01), and those reporting low satisfaction with access to care (+$1237, P = .02) also incurred significant excess ACS hospitalization costs relative to persons reporting no such barriers. This pattern held true for those with and without a disability, but were especially marked among persons with no functional limitations. These findings suggest that a better understanding of how public policy might effectively improve care coordination and reduce financial barriers to care is essential to formulating programs that reduce excess hospitalizations among the large and growing number of elderly Medicare beneficiaries.
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Observational Study
Association of Foxp3 promoter polymorphisms with susceptibility to endometrial cancer in the Chinese Han women.
To evaluate the association between Foxp3 gene polymorphisms (rs3761548 and rs5902434) and susceptibility to endometrial cancer (EC), we report a hospital case-control study involving 602 women, consisting of 269 patients with EC and 333 healthy controls. Genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism. ⋯ Moreover, ATT/ATT genotype (rs5902434) was conferred a lower risk of EC in the recessive model (adjusted OR 0.58, 95% CI: 0.35-0.96, P = .031). From the data generated, we conclude that Foxp3 promoter polymorphisms are associated with susceptibility to EC in Chinese Han women.
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Although an ototoxicity is well-known as adverse event of the radiotherapy, it is not widely known that immunosuppressed patients who underwent radiotherapy in head and neck region have risk of malignant external otitis. ⋯ Physicians should raise awareness of malignant external otitis in immunosuppressed patients with oral cancer after radiotherapy.