Covid-19: como a disseminação de fake news pode influenciar a população durante a pandemia / COVID-19: how fake news can influence the population during the pandemic

Introdução: O novo coronavírus e a pandemia de Covid-19 têm mostrado que o ceticismo, a disseminação de fake news e a desvalorização da ciência podem formar uma tríade capaz de causar impactos significantes no enfrentamento da pandemia. Objetivo: Identificar as notícias falsas classificadas pelo Ministério da Saúde (MS) como fake news inseridas na temática sobre coronavírus e Covid-19, publicadas e compartilhadas através das mídias sociais durante um perí odo específico, e observar sua influência na população. Método: A busca das notícias foi realizada através do banco de dados do MS sobre fake news, sendo utilizado o filtro de busca por tema "Covid-19", no período de 01 de janeiro de 2020 a 01 de junho de 2020. Resultado: Foram encontrados 36 registros sobre o assunto. As notícias constituíram seis categorias, analisadas e contra-argumentadas com base em literaturas de natureza científica. Os dados encontrados foram tabulados e organizados por data de publicação, categoria, título da notícia e veículo de informação. As categorias que mais resultaram em fake news foram "tratamento/cura" e "prevenção'". Sobre as mídias empregadas como veiculadoras das notícias, o WhatsApp apresentou-se como o mais utilizado, totalizando 18 registros. Sobre as datas de divulgação das notícias, o mês de março foi o que mais apresentou publicação de fake news, totalizando 19 notícias. Considerações Finais: O compartilhamento de informações sobre medidas preventivas ineficazes, utilização de alimentos e medicamentos sem embasamento científico, e a divulgação de número de casos divergente do divulgado pelas autoridades sanitárias em saúde podem, portanto, influir em prejuízos à saúde da população.

Introduction: The new coronavirus and the Covid-19 pandemic have shown that skepticism, the spread of fake news, and the devaluation of science can make a triad able to cause significant impacts to face the pandemic. Objective: Identify false pieces of news classified by the Brazilian Health Ministry (MS) as fake news on the theme about Coronavirus and Covid-19, published and shared through social media during a specific period, and observe its influence in the population. Method: The search was carried out through the Brazilian Health Ministry database on fake news, using the search filter with the theme "Covid-19", from January 1, 2020 to June 1, 2020. Result: There were 36 records about the topic. The pieces of news were classified into six categories, analyzed, and discussed by scientific literature. Data found were classified and organized by date of publication, category, news headline, and information broadcaster. The topics that most resulted in fake news were "treatment/cure" and "prevention". Referring to the media used as news channels, WhatsApp was the most used, with a total of 18 pieces of news transmitted through it. Regarding the news release dates, March was the month that most presented fake news publications, reaching a total of 19. Final Considerations: The sharing of information on ineffective preventive measures, the use of food and medicine without a proven scientific foundation, and the dissemination of case numbers different of the one informed by sanitary authorities in health can, therefore, cause damage to the health of the population.

Fissuras Labiopalatais Congênitas: uma análise dos comportamentos e enfrentamentos paternos / Congenital Cleft lip and Palate: an analysis of paternal behaviors and confrontations

Introdução: Fissuras labiopalatais são as mais comuns entre as malformações congênitas craniofaciais e, no Brasil, segundo o Ministério da Saúde, há uma incidência estimada de um para cada 650 nascimentos. O diagnóstico inicial de fissuras causa um grande impacto familiar, resultando em um desequilibrio emocional tanto dos familiares quanto da própria criança, revelando, assim, diferentes formas de reações e enfrentamento dos progenitores, dentre as quais se destacam: choque, luto, negação, culpa, esperança, vergonha, rejeição e até aceitação. Objetivos: Avaliar os indicadores de qualidade de vida dos familiares de crianças com fissuras labiopalatais e analisar seus comportamentos e enfrentamentos frente a essa problemática, bem como, seus primeiros sentimentos, reações e planos de cuidados para uma criança com essa anomalia. Método: Foi realizado um estudo transversal retrospectivo, descritivo e analítico com pais de crianças com fissuras labiopalatais que estavam em tratamento para correção de anomalias craniofaciais no Hospital de Reabilitação de Anomalias Craniofaciais (HRAC), em Bauru, a fim de identificar os padrões de comportamento e a qualidade de vida a partir do questionário The World Health Organization Quality of Life ­ Bref (WHOQOL ­ bref), elaborado pela Organização Mundial de Saúde (OMS). Resultados: Foram avaliados 11 pais de crianças com fissuras labiopalatais, sendo que a maioria era do sexo feminino. Os participantes demonstraram diferentes posicionamentos frente à problemática e foram observadas variações de domínios nas respostas do questionário WHOQOL ­ bref, resultando em uma grande modificação no bem estar dos familiares envolvidos. Considerações finais: As famílias passam por uma lenta adaptação com uma criança fissurada, mas apesar das modificações da qualidade de vida, a maioria consegue superar os sentimentos negativos.

Introduction: Cleft lip and palate are the most common among the congenital craniofacial malformations, and, according to the Brazilian Health Ministry, in Brazil, it has an estimated incidence of 1 to every 650 children born. Its initial diagnostic causes a considerable impact on the family and results in an emotional imbalance both in the family and in the children themselves, revealing different ways of reactions and confrontation of the progenitors, which are: chock, mourning, denial, guilt, hope, shame, rejection, and even acceptance. Goals: This study aimed to evaluate the quality of life indicators of the relatives of kids with cleft lip and palate and analyze their behavior and how they face these issues such as their first feelings, reactions, and care plans created for a child with this anomaly. Method: A retrospective, descriptive, and analytical crosssectional study was conducted with the parents of children with cleft lip and palate, who were undergoing treatment for the correction of craniofacial anomalies at the Hospital de Reabilitação de Anomalias Craniofaciais (HRAC) in Bauru to identify patterns of behavior and the quality of life from the questionnaire The World Health Organization Quality of Life ­ Bref (WHOQOL ­ bref), created by the World Health Organization (WHO). Results: Eleven parents of children with cleft lip and palate, mostly female, were evaluated. The participants demonstrated different positions regarding the problem and domain variations observed in the answers to the WHOQOL - bref questionnaire, resulting in a considerable change in the well-being of the family members involved. Final considerations: Families go through a slow adaptation with a fissured child, but despite the alterations in quality of life, most manage to overcome negative feelings.

Uso da cloroquina e da hidroxicloroquina no tratamento da COVID-19: riscos e benefícios segundo uma revisão integrativa / Use of chlorochine and hydroxychlorocchine in the treatment of COVID-19 risks and benefits according to an integrative review

Introdução: Responsável pela doença COVID-19, o novo corona-vírus, denominado SARS-CoV-2, foi descoberto na China. A sua rápida propagação causou espanto e preocupação e ocasionou uma das maiores pandemias já registradas na história. Para o tratamento da infecção, alguns profissionais sugerem o uso da Cloroquina e da Hidroxicloroquina, medicamentos utilizados para o tratamento de diversas doenças há mais de 70 anos. Entretanto, a efetividade des-ses medicamentos no controle da COVID-19 ainda não foi confir-mada. Objetivos: Identificar na literatura científica os riscos e bene-fícios da Cloroquina e da Hidroxicloroquina utilizados como terapia medicamentosa para pacientes com COVID-19. Método: Revisão integrativa da literatura, utilizando três bancos de dados on-line (LILACS, SCIELO e PUBMED) a fim de descrever os efeitos da Cloroquina e da Hidroxicloroquina quando usadas no tratamento da doença, permitindo a avaliação crítica de determinado conhecimen-to sobre o assunto e reunindo múltiplos estudos e suas principais considerações. Resultados: Foram analisados dez estudos científi-cos acerca da temática, focando na relação riscos e benefícios que os medicamentos Cloroquina e Hidroxicloroquina, associados ou não a outros medicamentos, possam apresentar no combate à infec-ção. Os dados in vitro apresentaram resultados promissores quan-to ao uso dos medicamentos, porém não demonstraram eficácia no combate à COVID-19 quando utilizados em pacientes. Considera-ções finais: Conclui-se que a utilização de Cloroquina e Hidroxi-cloroquina no tratamento da COVID-19 mostra-se ineficaz e com riscos para quem faz uso. Nota-se uma concordância com relação à necessidade de cautela no momento, com destaque para os riscos cardíacos para o usuário.

Introduction: Responsible for the disease COVID-19, the new coronavirus, called SARS-CoV-2, was discovered in China. Its rapid spread caused astonishment and concern in the population, and it ended up causing one of the largest pandemics ever recorded in history. Some professionals suggest using Chloroquine and Hydroxychloroquine, medicines that have been used to fight various diseases for more than 70 years, to treat this infection. Their effectiveness in controlling COVID-19 has not been confirmed, though. Objectives: This study aims to collect information in the scientific literature on the risks and benefits of the drugs Chloroquine and Hydroxychloroquine used as drug therapy for patients affected by the disease. Method: An integrative literature review was carried out, on three online databases (LILACS, SCIELO, and PUBMED) to describe the effects of Chloroquine and Hydroxychloroquine when used in the treatment of the disease, allowing the critical evaluation of certain knowledge on the subject, and gathering multiple studies and their main outcomes. Results: Ten scientific studies on the theme were analyzed, focusing on the relationship between risks and benefits that the medicines Chloroquine and Hydroxychloroquine, associated or not with other medicines may present in the fight against the infection. In vitro data showed promising results regarding the use of the drugs, but the medicines did not demonstrate efficiency in combating COVID-19 when used in patients. Final considerations: The use of Chloroquine and Hydroxychloroquine in the treatment of COVID-19 proves to be ineffective and it brings risks for those who use them. There is an agreement regarding the need for caution now, emphasizing heart risk to the user.

Análise das Políticas Públicas destinadas a deficientes auditivos: um estudo qualitativo / Analysis of public policies for the hearing impaired: a qualitative study

Objetivo: identificar as normatizações que efetivam as Políticas Públicas voltadas ao Deficiente Auditivo e analisar seus focos de atuação. Métodos: foi realizado um estudo qualitativo, descritivo e comparativo sobre as legislações relacionadas ao deficiente auditivo no Brasil, entre janeiro e junho de 2019, sendo todas de acesso público e disponíveis no portal do Planalto e do Ministério da Saúde. O período de identificação dessas legislações foi entre os anos 2000 e 2019. Dentro de cada base, a palavra-chave utilizada foi "deficiência auditiva" e a separação foi feita manualmente após a leitura da ementa de cada norma. Resultados: foram encontrados 11 arquivos diferentes, após a leitura exploratória dos documentos relacionados a legislações aplicáveis a deficientes auditivos, sendo três leis, um decreto e sete portarias. Conclusão: apesar de existir um número significativo de normas voltadas especificamente a esse assunto, a legislação vigente não alcança toda a população nacional na prática. Contudo, com a instituição das normas elencadas no presente estudo, é possível perceber a mobilização do Poder Público a fim de instituir Políticas Públicas, abrindo caminho para a efetivação de direitos dos Deficientes Auditivos.

Goal: identify the norms that effect the Public Policies aimed at the Hearing Impaired and analyze their focus of action. Methods: a qualitative, descriptive, and comparative study on legislation related to the hearing impaired in Brazil was conducted between January and June of 2019. All of them were publicly available on the Planalto and Ministry of Health databases. The identification period of these laws was between the years 2000 and 2019. In each base, the keywords used were "hearing impairment" (deficiência auditiva) and the separation was carried out manually after reading the proposal of each norm. Results: there were 11 different files after exploratory reading of the documents related to legislation applicable to the hearing impaired. These files included three laws, one decree and seven ordinances. Conclusion: although there is a significant number of norms specifically addressed to this subject, the current legislation does not reach the entire national population in practice. However, with the institution of the standards listed in the present study, it is possible to perceive the mobilization of the Public Power in order to institute Public Policies, allowing the realization of the Rights of the Hearing Impaired.

Conhecimento dos profissionais de enfermagem acerca de fitoterápicos a base de canabinoides: Uma revisão integrativa / Knowledge of nursing professionals about canabinoid based phytotherapes: an integrative review

Introdução: Considerada a primeira planta cultivada pelo homem, a Cannabis apresenta registros históricos datados de 4000 a.C. Acredita-se que tenha origem das regiões temperadas e tropicais da Ásia. Com o decorrer do tempo, a planta vem se destacando devido ao seu alto potencial terapêutico para diversas patologias, levando assim a uma necessidade de compreensão, por parte dos profissionais de saúde, em relação a suas aplicações, focando na qualidade do cuidado oferecido ao paciente que faz uso de seus fitoterápicos, sendo eles a base dos principais canabinoides da planta, Canabidiol (CBD) e Tetrahidrocanabinol (THC). Objetivo: Revisar a literatura científica sobre o conhecimento dos profissionais de enfermagem relaciona do ao cuidado de pacientes que utilizam à terapia medicamentosa a base de canabinoides. Métodos: Revisão integrativa de literatura, buscando reunir resultados e desenvolver uma explicação sobre o tema, com os descritores "Cannabis", "Maconha" ou "CBD/THC", combinados com "Enfermagem" ou "Nurse". Resultados: A amostra final contou com 13 artigos, divididos em dois tópicos, sendo o primeiro relacionado ao conhecimento dos profissionais da enfermagem e, o segundo, apresentando a visão dos profissionais sobre o uso da Cannabis como tratamento medicinal. Conclusão: Notou-se uma concordância entre estudos revisados em ambos os tópicos, principalmente relacionados à necessidade de ampliar o conhecimento especifico dos profissionais sobre Cannabis para fins terapêuticos. Fornecer uma melhoria na qualidade do ensino relacionado à Cannabis medicinal, assim como cursos complementares para profissionais já formados, buscando garantir uma melhora na qualidade do cuidado para com os pacientes.

Introduction: Considered the first plant cultivated by man, Cannabis has historical records dating from 4000 B.C. It is believed to have originated in the temperate and tropical regions of Asia. Over time, the plant has stood out due to its high therapeutic potential for various pathologies, thus leading to a need for health professionals to understand its applications, focusing on the quality of care offered to the patient that makes use of its phytotherapics, being they the base of the main cannabinoids of the plant, Cannabidiol (CBD) and Tetrahydrocannabinol (THC). Objective: To review the scientific literature on the knowledge of nursing professionals related to the care of patients who use cannabinoid-based drug therapy. Methods: Integrative literature review, seeking to gather results and develop an explanation on the topic, with the keywords "Cannabis", "Marijuana" or "CBD / THC", combined with "Nursing" or "Nurse". Results: The final sample consisted of 13 articles, divided into two topics, the first related to the knowledge of nursing professionals and the second, presenting the professionals' view on the use of Cannabis as a medicinal treatment. Conclusion: There was an agreement between studies reviewed on both topics, mainly related to the need to expand the specific knowledge of professionals about Cannabis for therapeutic purposes. Provide an improvement in the quality of teaching related to medical Cannabis, as well as complementary courses for trained professionals, seeking to ensure an improvement in the quality of care for patients.

Hanseníase: conhecimentos teóricos e práticos de profissionais de enfermagem que atuam na atenção básica / Hansen's disease: theoretical and practical knowledge of nursing professionalsworking in primary care

Introdução: A hanseníase é uma doença que necessita de busca ati-va de novos casos, diagnóstico precoce, tratamento adequado, con-trole e monitoramento. Deste modo, é de vital importância que os profissionais estejam preparados para reconhecê-la e tratá-la de for-ma adequada e eficaz. O Objetivo do estudo foi identificar o nível de informação dos enfermeiros que atuam nas unidades de saúde de Bauru/SP, acerca da hanseníase. A pesquisa foi realizada por meio da aplicação de um questionário com 6 questões que dispôs sobre as formas clínicas, diagnóstico, exames, tratamento e busca de no-vos casos da hanseníase. Para o tratamento dos dados, utilizou-se método de estatística descritiva e de associação, no qual foi reali-zada a análise individual e da amostra conjunta, observando-se a quantidade e a qualidade do nível de informação. Foram analisados 42 questionários respondidos pelos profissionais. Destes, somente 4 (9,54%) enfermeiros acertaram as 5 perguntas referentes à patologia, sendo a sexta pergunta referente à ação da unidade com relação à busca ativa. Sobre a categoria formas clínicas, 35 (83,33%) sabem quais são as corretas; na categoria diagnóstico, 19 (45,23%) sabem que ele é clínico e na categoria tratamento, 31 (73,80%) não sabem a diferença entre os paucibacilares e os multibacilares. Na categoria Busca Ativa, 18 (56,25%) não possuem conhecimento suficiente para realizá-la com qualidade. Considerações finais: Os enfermeiros (as) das Unidades Básicas de Saúde e Estratégias de Saúde da Família de Bauru/SP não possuem nível de informação suficiente para realizar um atendimento de qualidade aos pacientes acerca da patologia, ne-cessitando, assim, de uma capacitação para obterem o domínio que os possibilite prestar uma assistência adequada.

Introduction: Leprosy is a disease that requires an active search for new cases, early diagnosis, appropriate treatment, control, and monitoring. Therefore, it is of vital importance that professionals be prepared to recognize and treat it properly and effectively. The objective of the study was to identify the level of information about leprosy among nurses working in health units in Bauru/SP. The research was carried out by the application of a questionnaire comprised of six questions about clinical forms, diagnosis, tests, treatment, and search for new cases of leprosy. A method of descriptive statistics and association with individual and joint sample analysis was used to treat data, observing the quantity and quality of the level of information. Forty-twoquestionnaires answered by professionals were analyzed. Out of these, only 4 (9.54%) nurses answered correctly the 5 questions regarding pathology. Regarding the category of clinical forms, 35 (83.33%); regarding the diagnosis, 19 (45.23%) know that it is performed clinically; and the treatment, 31 (73.80%) do not know the difference between paucibacillary and multibacillary. In the Active Search category, 18 (56.25%) do not have enough knowledge to perform it with quality. Final considerations: The nurses of the Basic Units of Health and Family Health Strategies of Bauru/SP do not have enough level of information to perform quality service to patients about the pathology. Thus, they need the training to obtain the domain that allows them to provide adequate assistance

Depression and Coping Are Associated with Failure of Adherence to Antiretroviral Therapy Among People Living with HIV/AIDS.

Sustained adherence to antiretroviral therapy (ART) is critical in the prevention of drug resistance, disease progression, and death. We aimed to assess the level of ART adherence among 112 people living with HIV/AIDS (PLWHA) and to determine associated factors with that. The socioeconomic aspects were evaluated by medical records; the adherence, depression, and coping by specific questionnaires. Although most patients have undetectable viral load (79%) and CD4+ T count >500 cells/mm3 (65%), two-third (66%) of them exhibited a lower adherence, which was directly associated with some signs of depression (p = .006) presented by 65% of them. Some risk factors to presence of depression were female gender (p = .008) and low income (p = .013). In addition, most participants who reported tobacco (33%) and alcohol (29%) consumption had a low or intermediate adherence score. Among the coping strategies, self-control (p = .029), social support (p = .006), problem solving (p = .013), and positive reappraisal (p = .049) led to an improvement in adherence.

Correlation between chronic venous ulcer exudate proteins and clinical profile: A cross-sectional study.

Chronic venous ulcers affect the quality of life of patients around the world. The aims of this study were to identify the proteins expressed in chronic venous ulcer exudates, to categorize them according to their roles and to correlate them with the clinical and epidemiological aspects of the disease. The study population consisted of 37 ulcers from 28 patients, and the inflammatory exudates of these thirty-seven ulcers were subjected to tryptic digestion and mass spectrometry analysis. Twenty-three patients were female (62.2%), and five (37.8%) were male. The patients had a mean age of 70 (±10.1) years. Of the patients, 73% adhered to compression and rest, 81.1% reported a history of primary varices, 54.1% reported a history of systemic arterial hypertension, 54.1% reported a history of devitalized tissue in the wound bed and 64.9% reported ulcers with more than ten years of evolution. Seventy-six proteins were identified, and they were grouped according to their primary role in the healing process. Eight correlations between clinical and epidemiological data and protein expression were noteworthy: diabetes mellitus vs. Ig gamma-2 and apolipoprotein-A1 and albumin; congestive heart failure vs. Ig lambda-2; colonization vs. actin; compressive therapy vs. Ig kappa; systemic arterial hypertension vs. alpha-2-macroglobulin and apolipoprotein-A1; area of ulcer vs. apolipoprotein-A1; race vs. heavy chain Ig and Ig γ-1 chain; age and race vs. Ig γ-1 chain. These associations may help to elucidate the prognosis and chronicity of chronic venous ulcers based on secreted proteins.

Asymptomatic HIV People Present Different Profiles of sCD14, sRAGE, DNA Damage, and Vitamins, according to the Use of cART and CD4+ T Cell Restoration.

We aimed to analyze markers of immune activation, inflammation, and oxidative stress in 92 asymptomatic HIV-infected patients according to the adequate (AR, >500 cells/mm3) or inadequate (IR, <500 cells/mm3) CD4+ T recovery and the presence or absence of antiretroviral treatment (cART). In relation to those newly diagnosed, they were divided into two groups, cART-naïve IR (nIR) and cART-naïve AR (nAR). Among those diagnosed more than five years ago, the following division was made: the cART-naïve long-term nonprogressors (LTNP); patient under cART and AR (tAR); and patients under cART and IR (tIR). We investigated the expression of soluble receptor for advanced glycation end products (sRAGE), high-mobility group-box protein -1 (HMGB1), soluble CD14 (sCD14), IL-8, IL-10, 8-isoprostane, vitamins, and DNA damage. We observed higher levels of sRAGE in tAR as compared to nIR, nAR, LTNP, and more sCD14 than in nIR and nAR. As for IL-10 levels, we found nIR > nAR > LTNP > tAR > tIR. Higher levels of 8-isoprostane were observed in nIR. LTNP presented a higher retinol dosage than tAR and less genotoxic damage induced by oxidative stress than the other groups. We suggest that the therapy, despite being related to lesser immune activation and inflammation, alters the vitamin profile and consequently increases the oxidative stress of patients. In addition, the lowest genotoxic index for LTNP indicates that both VL and cART could be responsible for the increased DNA damage. More studies are needed to understand the influence of cART on persistent immune activation and inflammation.

Quality of life in men diagnosed with anogenital warts.

Anogenital warts are a worldwide public health problem. They consist of epithelial proliferations caused by HPV, whose transmission occurs mainly through sexual intercourse. In this study, we evaluated their impact on the quality of life of adult males. We interviewed 88 men in an outpatient clinic for sexually transmitted diseases at a Brazilian public institution, using the DLQI-BRA questionnaire. Most patients (81%) presented mild or no impairment of quality of life. The main dimensions affected were sex life, symptoms, and embarrassment. The low impact on quality of life may well justify the delay in seeking medical treatment, favoring the spread of the disease.

Quality of life in men diagnosed with anogenital warts

Abstract Anogenital warts are a worldwide public health problem. They consist of epithelial proliferations caused by HPV, whose transmission occurs mainly through sexual intercourse. In this study, we evaluated their impact on the quality of life of adult males. We interviewed 88 men in an outpatient clinic for sexually transmitted diseases at a Brazilian public institution, using the DLQI-BRA questionnaire. Most patients (81%) presented mild or no impairment of quality of life. The main dimensions affected were sex life, symptoms, and embarrassment. The low impact on quality of life may well justify the delay in seeking medical treatment, favoring the spread of the disease.

Antiretroviral Therapy Initiation Alters the Redox System of Asymptomatic HIV-Infected Individuals: A Longitudinal Study.

Background. The combination antiretroviral therapy (cART) increases the oxidative stress in HIV-infected people, which in turn favors the onset and aggravation of non-AIDS comorbidities, a common situation affecting these individuals. We aimed to evaluate the influence of cART initiation on oxidative stress parameters. This is a longitudinal study including 30 asymptomatic patients divided according to their CD4+ T cell count (G1: <500 cell/mL; G2: >500 cell/mL) before (M0) and after (M1) cART initiation. We analyzed total antioxidant capacity (TAC), fat-soluble vitamins, malondialdehyde, 8-isoprostane, and DNA damage. Results. Results showed a decrease in TAC, retinol, α-tocopherol, and some carotenoids, in addition to a significant increase in DNA damage at M1. These changes were more evident in G2 subjects. Moreover, there was a significant 8-isoprostane increase at M1 in individuals belonging to G1. Conclusion. The results indicate that cART interfered in the redox system, mainly by reducing the antioxidant defenses. In addition, patients who had CD4+ T counts higher than 500 cells/mm3 showed more susceptibility to genotoxicity, while patients with less CD4+ T counts displayed more damage triggered by lipoperoxidation. Considering the early beginning of cART, its chronic use, and its capacity to alter the redox status, further long-term studies on larger cohorts are needed to define the best time to initiate therapy and to investigate new strategies to delay the development of non-AIDS diseases.

The Initial Months of Antiretroviral Therapy and Its Influence on AGEs, HMGB1, and sRAGE Levels in Asymptomatic HIV-Infected Individuals.

The development of the typical comorbidities of aging which currently affects people living with HIV/AIDS (PLWHA) can be partially ascribed to the persistent immune activation and chronic inflammation characterizing these individuals. The aim of this study was to analyze the effect exerted by combined antiretroviral therapy (cART) administration on plasma levels of HMGB1 (high mobility group box protein-1), AGEs (advanced glycation end products), their soluble receptor sRAGE, cytokines, C-reactive protein (CRP), and some metabolic markers in asymptomatic PLWHA. Analyses were performed longitudinally in 30 PLWHA, before and about 6-12 months after cART initiation. We observed that lower levels of AGEs in post-cART group were accompanied by an increase of CRP and triglyceride levels already in the early months of therapy. Because of the current ever-earlier recommendations to start cART and its prolonged use, these and other markers should be investigated in order to monitor and postpone the appearance of non-AIDS comorbidities in PLWHA.

Prevalence of Anogenital Warts in Men with HIV/AIDS and Associated Factors.

BACKGROUND: Infection with human papilloma virus (HPV) is the most common sexually transmitted disease in the world. Among the 630 million new cases of HPV that occur each year, 30 million develop anogenital warts. Although subclinical infection with HPV is the most common cause, genital warts are also associated with immunosuppression caused by HIV. In view of the high prevalence of HPV/HIV co-infection particularly among men who have sex with men, the objectives of this study were to determine the prevalence of anogenital warts in men with HIV/AIDS and to identify associated factors. METHODS: A cross-sectional study was conducted on 159 men with HIV/AIDS consecutively selected at a referral service in Botucatu, São Paulo, Brazil, in which the association between sociodemographic, behavioral and clinical variables and the presence of anogenital warts was evaluated. After hierarchical analysis of the data, variables presenting a p value ≤ 0.2 were entered into an unconditional multivariate logistic regression model. RESULTS: Forty-nine (31%) of the HIV-positive patients had anogenital warts. The mean age was 44.6 ± 9.6 years. The main factors associated with the presence of anogenital warts were irregular antiretroviral treatment and genital herpes(HSV). CONCLUSION: The present study demonstrate that anogenital warts occur in almost one-third of the male population infected with HIV and factors associated with a higher risk of being diagnosed with anogenital warts were irregular cART use and co-infection with HSV, other variables could not be associated.

A prospective, open, comparative study of 5% potassium hydroxide solution versus cryotherapy in the treatment of genital warts in men.

BACKGROUND: Genital warts are caused by human papillomavirus infection and represent one of the most common sexually transmitted diseases. Many infections are transient but the virus may recur, persist, or become latent. To date, there is no effective antiviral treatment to eliminate HPV infection and most therapies are aimed at the destruction of visible lesions. Potassium hydroxide is a strong alkali that has been shown to be safe and effective for the treatment of genital warts and molluscum contagiosum. Cryotherapy is considered one of the most established treatments for genital warts. No comparative trials have been reported to date on the use of potassium hydroxide for genital warts. OBJECTIVE: A prospective, open-label, randomized clinical trial was conducted to compare topical potassium hydroxide versus cryotherapy in the treatment of genital warts affecting immunocompetent, sexually active men. METHODS: Over a period of 10 months, 48 patients were enrolled. They were randomly divided into two groups and selected on an alternative basis for either potassium hydroxide therapy or cryotherapy. While response to therapy did not differ substantially between both treatment modalities, side effects such as local pain and post-treatment hypopigmentation were considerably more prevalent in the groups treated using cryotherapy. RESULT: In our study, potassium hydroxide therapy proved to be at least as effective as cryotherapy and offered the benefit of a better safety profile. CONCLUSION: Topical 5% potassium hydroxide presents an effective, safe, and low-cost treatment modality for genital warts in men and should be included in the spectrum of therapies for genital warts.

A prospective, open, comparative study of 5% potassium hydroxide solution versus cryotherapy in the treatment of genital warts in men

BACKGROUND: Genital warts are caused by human papillomavirus infection and represent one of the most common sexually transmitted diseases. Many infections are transient but the virus may recur, persist, or become latent. To date, there is no effective antiviral treatment to eliminate HPV infection and most therapies are aimed at the destruction of visible lesions. Potassium hydroxide is a strong alkali that has been shown to be safe and effective for the treatment of genital warts and molluscum contagiosum. Cryotherapy is considered one of the most established treatments for genital warts. No comparative trials have been reported to date on the use of potassium hydroxide for genital warts. OBJECTIVE: A prospective, open-label, randomized clinical trial was conducted to compare topical potassium hydroxide versus cryotherapy in the treatment of genital warts affecting immunocompetent, sexually active men. METHODS: Over a period of 10 months, 48 patients were enrolled. They were randomly divided into two groups and selected on an alternative basis for either potassium hydroxide therapy or cryotherapy. While response to therapy did not differ substantially between both treatment modalities, side effects such as local pain and post-treatment hypopigmentation were considerably more prevalent in the groups treated using cryotherapy. Result: In our study, potassium hydroxide therapy proved to be at least as effective as cryotherapy and offered the benefit of a better safety profile. CONCLUSION: Topical 5% potassium hydroxide presents an effective, safe, and low-cost treatment modality for genital warts in men and should be included in the spectrum of therapies for genital warts. .

Fragmentos da história da medicina e da cirurgia / Fragments of the history of medicine and surgery

Atarefados com nossas aulas de todos os dias, poucas vezes nos lembramos que a medicina, suas técnicas, suas doutrinas e sua ética, começaram a ser criadas há muitos e muitos anos, na Grécia Clássica de Hipócrates de Cós e seus discípulos, ou mesmo antes, na Mesopotâmia dos assírios...