ABSTRACT
Introduction: Children living with HIV/AIDS require specialized care. Objective: To describe clinical and epidemiological characteristics of patients living with HIV/AIDS. Methods: Observational, descriptive study using medical records data of patients with HIV/AIDS under 14 years of age. Approved by the institution's Ethics Committee under number 1,432,517. Results: 60 cases were included; the median follow-up duration was 6.8 years; 50.0% were male; 88.3% were white; 75.0% were from the capital and metropolitan region. Prenatal records were available for 51 cases, but only 44.6% received antiretroviral therapy (ART) during pregnancy (mean duration of 3.3 months). HIV diagnosis was based on clinical symptoms in 28.3% of the cases, occurring in similar proportions for both childhood common infections and opportunistic infections. According to the CDC clinical classification (1994), at the start of follow-up, 56.6% of patients had moderate or severe symptoms, which would be reduced to only 18.3% upon reclassification at the last visit (p=0.016). Initially, 41.7% showed evidence of immunosuppression, compared to 19.9% at the time of the study (p=0.5). Only 6.6% remained asymptomatic. A decrease in the average number of hospitalizations was observed during follow-up. Conclusion: Among the cases diagnosed based on clinical symptoms, half were attributed to common childhood infections and lacked immunosuppression
Introdução: Crianças que vivem com o vírus da imunodeficiência humana HIV/AIDS requerem atendimento especializado. Objetivo: Descrever características clínicas e epidemiológicas de pacientes que vivem com HIV/AIDS. Métodos: Estudo observacional, descritivo, com dados de prontuários de pacientes com HIV/AIDS de até 14 anos de idade incompletos, aprovado pelo Comitê de Ética em Pesquisa da instituição sob o número 1.432.517. Resultados: Foram incluídos 60 casos. A mediana de acompanhamento foi de 6,8 anos; 50,0% eram do sexo masculino; 88,3% brancos; 75,0% naturais da capital e região metropolitana. Em 51 prontuários havia descrição de pré-natal, porém apenas 44,6% fizeram uso de terapia antirretroviral (TARV) na gestação (tempo médio de 3,3 meses). Em 28,3% o HIV foi pesquisado por sintomas clínicos, que ocorreram em proporções similares tanto por infecções habituais da infância como por oportunistas. De acordo com a classificação clínica dos Centers for Disease Control and Prevention CDC (1994), ao início do acompanhamento, 56,6% dos pacientes apresentavam sintomas moderados ou graves e, na última consulta, se fossem reclassificados, seriam apenas 18,3% (p=0,016). Incialmente, 41,7% apresentavam evidência de imunossupressão, comparativamente aos 19,9% na ocasião do estudo (p=0,5). Apenas 6,6% permaneceram assintomáticos. Com o acompanhamento, verificou-se diminuição na média do número de hospitalizações. Conclusão: Dos casos que apresentaram seu diagnóstico por sintomas clínicos, metade foi por infecções habituais da infância e sem imunossupressão
Subject(s)
Humans , Male , Female , Child , HIV Infections/therapy , Child Health Services , Comprehensive Health Care , Brazil , Retrospective StudiesABSTRACT
Notarchirico (Southern Italy) has yielded the earliest evidence of Acheulean settlement in Italy and four older occupation levels have recently been unearthed, including one with bifaces, extending the roots of the Acheulean in Italy even further back in time. New 40Ar/39Ar on tephras and ESR dates on bleached quartz securely and accurately place these occupations between 695 and 670 ka (MIS 17), penecontemporaneous with the Moulin-Quignon and la Noira sites (France). These new data demonstrate a very rapid expansion of shared traditions over Western Europe during a period of highly variable climatic conditions, including interglacial and glacial episodes, between 670 and 650 (i.e., MIS17/MIS16 transition). The diversity of tools and activities observed in these three sites shows that Western Europe was populated by adaptable hominins during this time. These conclusions question the existence of refuge areas during intense glacial stages and raise questions concerning understudied migration pathways, such as the Sicilian route.
ABSTRACT
Injection nerve palsy (INP) in the median nerve is an iatrogenic peripheral nerve injury that can be inflicted by a faulty intramuscular injection in the median nerve area. The literature reports a 2% incidence of INP among all peripheral nerve injuries. The incidence of INP in developed countries has decreased significantly during the past decade, but the injury appears to remain prevalent in developing countries. A deep understanding of the anatomy of the peripheral nerves, and a precise intramuscular injection technique, have been shown to be vital for preventing INP in the median nerve. Debates continue regarding what, if any, intervention is necessary for injection palsies; and if it is needed, when it should be carried out. In this article, we will review the literature related to median injection nerve palsy and recommended methods of prevention.
ABSTRACT
Transomental hernias (TOHs) are a rare finding, constituting a fraction of all intestinal hernias. Here, we report the cadaveric discovery of a spontaneous TOH involving the sigmoid colon in an 82-year-old female and discuss the relevant literature. To our knowledge, a TOH involving the sigmoid colon has not been previously reported.
