São Paulo medical journal = Revista paulista de medicina
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Obstructive jaundice may lead to ominous complications and requires complex diagnostic evaluations and therapies that are not widely available. ⋯ There is a deficiency in the official referral routes for patients with obstructive jaundice. The accuracy of the clinical diagnosis of acute cholangitis was poor. Wider dissemination of the Tokyo criteria is essential.
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Nonadherence to antiretroviral therapy (ART) may lead to viral replication and development of antiretroviral resistance. ⋯ Encouragement of adherence to antiretroviral therapy is one of the fundamental pillars of treatment for HIV-infected patients. The high proportion of nonadherence (28.4%) and the predictive factors related to this indicate that it is necessary to improve patients' adherence to antiretroviral therapy.
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Fungi are ubiquitous in the environment. They are able to grow in water and many of them may be opportunistic pathogens. ⋯ Both RWs and NRWs are potential reservoirs for many types of fungi. Many of these may become opportunistic pathogens if they infect immunosuppressed individuals. Furthermore, this study confirms that fungi are able to grow even when chlorine and pH parameters are within the standards recommended.
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Observational Study
Tocilizumab for juvenile idiopathic arthritis: a single-center case series.
Juvenile idiopathic arthritis (JIA) is the commonest chronic rheumatic disease among children. When not treated effectively, JIA can lead to functional disability, due to joint damage, along with long-term morbidities. ⋯ Tocilizumab therapy should be considered for treating patients with diagnoses of pJIA or sJIA who are resistant to non-biological DMARDs and/or other biological therapies.
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Findings regarding the effects of hyperuricemia on renal function and mortality have been inconsistent. ⋯ In patients with CKD in stages 3-5, hyperuricemia was associated with higher risk of incident renal replacement therapy and all-cause mortality. Whether treatment with uric acid-lowering drugs in these patients would improve their outcomes merits further investigation.