Sexual risk behaviours and HIV seroprevalence among male sex workers who have sex with men and non-sex workers in Campinas, Brazil.

OBJECTIVES: To compare population-based prevalence estimates of sexual risk behaviours and HIV seroprevalence of male sex workers who have sex with men (MSM) and those not engaged in sex work in Campinas, Brazil. METHODS: MSM (n = 658) were recruited for a cross-sectional study through respondent-driven sampling. Audio-assisted computer self-interview was used to collect information on sexual behaviours and HIV testing (optional) was performed. Population-based prevalence estimates with 95% CI of characteristics and behaviours of MSM sex workers and non-sex workers are reported. RESULTS: One-quarter reported ever receiving payment for sex and 14.8% (95% CI 11.1 to 19.0) had been paid in the previous 2 months; most exclusively with men. MSM sex workers were significantly more likely than non-sex workers to report being transgendered (40.5% vs 8.1%), to practise unprotected receptive (22.4% vs 4.6%) and insertive (20.5% vs 5.0%) anal intercourse with > or =2 male partners and to have unprotected vaginal sex with women (22.7% vs 5.6%). MSM sex workers experienced significantly greater rates of psychological abuse (80.9% vs 58.4%) and physical abuse (48.2% vs 15.2%). CONCLUSIONS: MSM sex workers have higher sexual risk behaviours as well as social vulnerabilities than the general population of MSM. HIV/sexually transmitted infection prevention efforts should be targeted to this riskier subgroup. Programmes should be transgender sensitive, should recognise that MSM sex workers have sex with men and women and address other factors that influence risk, such as homophobic abuse.

Early post-procedural migraine attack predicts migraine resolution after patent foramen ovale transcatheter closure.

AIM: In patients with patent foramen ovale-related migraine, the procedure of transcatheter closure itself is likely to cause a migraine attack. Our study is aimed to evaluate the incidence of migraine attacks immediately after closure procedure and their clinical and potential prognostic significance. METHODS: We reviewed our database from January 2005 to April 2007 searching for patients with severe disabling migraine despite anti-headache therapy who were submitted to transcatheter closure of patent foramen ovale (PFO). Medical records of these patients were carefully reviewed in order to record migraine episodes immediately (0 to 6 h) after closure procedure. RESULTS: Twenty-one patients with previous stroke and migraine underwent PFO closure: the procedure was successful in all of the patients with no perioperative and in-hospital complications. Ten patients (47.6%) experienced a migraine attack of mean duration 3.5+/-2.4 h immediately after the closure procedure. Those patients had the same procedure time compared with other patients, but had larger PFO: patients with migraine attack immediately after closure had higher rate of complete abolition of migraine in the follow-up. CONCLUSION: Although more larger studies are needed to evaluate the exact relationships between migraine and PFO, in patients with a tight correlation between migraine and PFO, a prolonged opening of the PFO, as during closure procedure, may cause a migraine attack immediately after the closure. This fact can be considered a positive prognostic factor for migraine abolishment in the follow-up.

HIV-related stigma, service utilization, and status disclosure among truck drivers crossing the Southern borders in Brazil.

HIV-related stigma and discrimination (S&D) have been shown to impede prevention, care and treatment. Yet, few quantitative studies have tested the associations between stigma, service utilization and status disclosure, especially in countries with concentrated HIV epidemics. Surveys, administered to a random sample of 1,775 truck drivers crossing Southern borders in Brazil, included items on multiple conceptual domains of S&D, such as fear of casual contact and blame towards people living with HIV/AIDS. Pearson's chi-square tests and logistic regression were used to examine correlations. Less stigma (both individual items and grouped as a scale) was significantly correlated with VCT use (p

Clinical features and neurophysiological follow-up in a case of Brown-Vialetto-Van Laere syndrome.

Brown-Vialetto-Van Laere syndrome is a rare disease of unknown origin commonly considered as part of the large group of motor neuron diseases. The course is quite variable: it may be quickly fatal or protracted, with relapsing phases followed by periods of arrest and even partial improvement. We describe a case of Brown-Vialetto-Van Laere syndrome with strong family history for sensorineural hearing impairment. The patient came to our medical attention for severe respiratory failure and leg weakness. The clinical conditions partially improved with recovery of spontaneous respiration and mild increase in muscle strength. The neurophysiological studies performed on our patient showed evidence of nerve damage with subsequent improvement. Our study raises the possibility that the disorder is due to primary nerve damage, which can better justify the intermittent course of the disease, the partial clinical regression and the neurophysiological improvement, never detected in typical motor neuron disorders.