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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Observational Study
Study of the evolution and variability of nontraumatic orthopedic surgeries in Brazil-9 years of follow-up: A database study.
In Brazil, there are no epidemiological statistics that map nontraumatic orthopedic injuries, their rate of variability, distribution by specialty, fatality rate, and the economic impact that these lesions and their consequences can bring to the country. The objective of this study was to evaluate the rates of variability for skills, deaths, mortality, and the economic impact of nontraumatic orthopedic surgeries in Brazil from 2008 to 2016. This is a descriptive study conducted through the analysis of data relating to the indicators of hospital production regarding orthopedic procedures of the Department of Informatics of the Unified Health System (Departamento de Informática do Sistema Único de saúde-DATASUS) between 2008 and 2016. ⋯ In general, there is a national increase in the number of orthopedic surgeries performed, accompanied by a concomitant increase in the number of deaths and mortality of the population exposed. We observed a growing demand for hospitalization with a consequent increase in lethality and deaths. We can conclude that between 2008 and 2016, the number of hospitalizations for elective nontraumatic orthopedic surgical procedures increased significantly, driven mainly by lower limb surgeries, along with the cost of the Unified Health System (Sistema Único de Saúde-SUS) for these surgeries.
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Observational Study
Clinical impact of the alpha-galactosidase A gene single nucleotide polymorphism -10C>T: A single-center observational study.
Single nucleotide polymorphisms (SNPs) in the alpha-galactosidase A gene region (GLA) have been discussed as potential cause of symptoms and organ manifestations similarly to those seen in Fabry disease (FD). However, due to scarce data, clinical implications remain limited. The aim of the present study was to investigate the clinical impact of -10C>T SNP in the GLA. ⋯ Presence of isolated heterozygous -10C >T SNP is not associated with clinically relevant symptoms or organ manifestations as seen in FD. Respective polymorphisms might, however, play a role in modifying disease severity in FD. Great care has to be taken in respective subjects suspected to suffer from nonclassical FD in order to prevent unnecessary Fabry-specific therapy.
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Observational Study
The plethysmographic variability index does not predict fluid responsiveness estimated by esophageal Doppler during kidney transplantation: A controlled study.
Research is ongoing to find a noninvasive method of monitoring, which can predict fluid responsiveness in patients undergoing kidney transplantation. To compare the responses to fluid challenges with the Pleth Variability Index, a noninvasive dynamic index derived from plethysmographic variability (Radical 7 pulse oximeter; Masimo Corporation, Irvine, CA), and the esophageal Doppler, the criterion standard. Observational study. ⋯ Fluid challenges were associated with a significant decrease in Pleth Variability Index in overall cases (12 [8-14] vs 10 [6-17], P = .050), but it was not able to discriminate between responders (12 [8-15] vs 10 [5-15], P = .650) and nonresponders (11 [6-16] vs 8 [5-14], P = .047). The area under the Receiver Operating Characteristic curve for Pleth Variability Index was 0.49 (0.36-0.62). Pleth Variability Index is not an accurate predictor of fluid responsiveness during kidney transplantation.
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Acute phlegmonous gastritis (PG) is a rare and often fatal condition mainly characterized by severe bacterial infection of the gastric wall. Case reports of PG over the past century average about 1 per year. Early diagnosis and immediate treatment are crucial to achieve positive outcomes. ⋯ Acute PG is a rare infection of the gastric wall especially after antibiotic treatment. Given the fast progression of this disease, early recognition and immediate action are crucial to achieve positive outcomes.