Complication Rates in Patients Using Intracavernosal Injection Therapy for Erectile Dysfunction With or Without Concurrent Anticoagulant Use-A Single-Center, Retrospective Pilot Study.

BACKGROUND: Intracavernosal injection therapy (ICI) is an effective intervention used to treat erectile dysfunction (ED). It has been proposed that caution should be exercised when prescribing ICI to patients currently taking anticoagulants (AC) due to the theoretical increased risk of bleeding, however, there is limited literature describing complication rates of actively anticoagulated patients utilizing ICI. AIM: We sought to determine whether there was a difference in bleeding and other complications in a cohort of patients using ICI therapy with or without concurrent AC use. METHODS: We reviewed our institutional electronic health record and identified 168 patients who were seen in our clinic from January to August 2020 who had either currently or previously utilized ICI therapy for ED treatment. These patients were surveyed regarding their ICI therapy as well as given the erectile dysfunction inventory for treatment satisfaction questionnaire. Data from 85 patients was obtained; 43 concurrently using AC during ICI therapy and 42 with no AC use. Fisher's exact test for categorical variables and a 2-tailed t-test were used with P < .05 considered to be significant. OUTCOME: Documented bleeding events (eg, bruising, hematoma), complications, and mean erectile dysfunction inventory for treatment satisfaction scores were compared between the 2 groups. RESULTS: There were more absolute bleeding complications in the AC group vs the no AC group, with 3 of 43 AC patients (7%, 95% confidence interval: 2.4-18.6) and 0/42 no AC patients (0%, 95% confidence interval: 0-8.4) experiencing some type of bleeding complication on ICI. However, there was no statistically significant difference found in overall or stratified documented bleeding events and complications between the 2 groups. CLINICAL IMPLICATIONS: Patients with concurrent AC usage on ICI therapy reported a higher rate of absolute bleeding complications than our non-AC group. STRENGTHS AND LIMITATIONS: The strength of this study is addressing question of safety of ICI therapy in patients with concurrent AC usage. Limitations include single-center retrospective study design and underpowered sample size limiting confidence with which conclusions from data should guide future patient counseling regarding ICI risks. CONCLUSION: Findings from a single-center cohort of patients suggest that ICI therapy may be a safe and effective treatment modality for ED in patients with concurrent anticoagulant usage, however, given the higher rate of absolute bleeding events in our AC cohort, future assessment in a higher-powered study is warranted in determining a more accurate estimation of risk or propensity for bleeding complications in patients on AC using ICI therapy. Blum KA, Mehr JP, Green T, et al. Complication Rates in Patients Using Intracavernosal Injection Therapy for Erectile Dysfunction With or Without Concurrent Anticoagulant Use-A Single-Center, Retrospective Pilot Study. Sex Med 2022;10:100535.

Risk factors for nonaccidental burns in children.

BACKGROUND: The relative influences of baseline risk factors for pediatric nonaccidental burns have not been well described. We evaluated baseline characteristics of pediatric nonaccidental burn patients and their primary caretakers. METHODS: A single-center retrospective cohort study was conducted of pediatric (age < 17) burn patients from July 1, 2013, to June 30, 2018. The primary outcome was nonaccidental burn, defined as burn secondary to abuse or neglect as determined by the inpatient child protection team or Child Protective Services. Univariate and multivariate analyses were performed. RESULTS: Of 489 burn patients, 47 (9.6%) suffered nonaccidental burns. Nonaccidental burn patients more frequently had a history of Child Protective Services involvement (48.9% vs 9.7%, P < .001), as did their primary caretakers (59.6% vs 10.9%, P < .001). Non-Hispanic black children had higher rates of Child Protective Services referral (50.7% vs 26.7%, P < .001) and nonaccidental burn diagnosis (18.9% vs 5.6%, P < .001) than children of other races/ethnicities. On multivariate analysis, caretaker involvement with CPS (odds ratio 7.53, 95% confidence interval 3.38-16.77) and non-Hispanic black race/ethnicity (odds ratio 3.28, 95% confidence interval 1.29-8.36) were associated with nonaccidental burn. CONCLUSION: Caretaker history of Child Protective Services involvement and non-Hispanic black race/ethnicity were associated with increased odds of pediatric nonaccidental burn. Prospective research is necessary to determine whether these represent true risk factors for nonaccidental burn or are the result of other confounders, such as socioeconomic status.

Percepção do enfermeiro da atenção básica acerca do atendimento à gestante soropositiva / Perception of the nurse of basic attention about the soropositive pregnant

Introdução: Gestantes portadoras do vírus HIV devem ser acompanhadas durante todo o pré-natal, pelo enfermeiro, pelo médico-obstetra e pelo infectologista. Objetivo: Descrever a percepção dos enfermeiros que atuam na atenção básica diante do atendimento a uma gestante soropositiva. Método: Estudo descritivo com abordagem qualitativa e pesquisa de campo realizado com 14 enfermeiros e dados das notificações do setor de vigilância epidemiológica de Cacoal-RO. Resultados: Atuam, no município, enfermeiros de ambos os sexos, a média de idades foi 31 anos (DP±5,19), referente ao tempo de profissão, a média foi 5 anos (DP±2,64). Foram registrados 10 casos de soropositividade em gestantes no município de Cacoal no período de 2013 a 2017. Quanto ao atendimento à gestante soropositiva 8 (57,14%) nunca realizaram esse atendimento, ainda assim 12 (85,71%) autoavaliaram-se capazes. O sentimento das gestantes, diante da notícia da soropositividade, mais percebido pelos enfermeiros foi nervosismo seguido de choro, 3 (21,43%). Todos os enfermeiros entrevistados afirmaram que o seguimento da gestante soropositiva deve ocorrer concomitantemente à atenção básica e ao serviço ambulatorial especializado. Classificaram-se capazes de orientar quanto aos riscos e à prevenção da Transmissão vertical 85,71% dos profissionais. Conclusão: Inferiu-se que os enfermeiros, seguindo os preceitos, éticos e científicos são capazes de realizar o atendimento às gestantes, bem como realizar orientações quanto aos riscos de transmissão vertical e acerca da terapêutica recomendada; porém, devido ao pouco contato com essa clientela eles se percebem deficientes de capacitações que visem à melhoria da assistência prestada por não se tratar de rotina de trabalho.(AU)

Introduction: The nurse, the obstetrician and the infectologist should follow HIV-positive pregnant women throughout the prenatal care. Objective: To describe the perception of nurses who work in basic care when attending to a seropositive pregnant woman. Method: A descriptive, documental study with qualitative approach and field research conducted with 14 nurses and data from the notifications of the epidemiological surveillance sector of Cacoal-RO. Results: Nurses of both sexes had a mean age of 31 years (SD ± 5.19), with a mean of 5 years (SD ± 2.64). Ten cases of seropositivity were registered in pregnant women in the municipality of Cacoal in the period from 2013 to 2017. Regarding the care given to pregnant women, 8 (57.14%) never attended this service, 12 (85.71%) self-reported capable. The feeling of the pregnant women, faced with the news of seropositivity, mostly perceived by the nurses were nervousness followed by crying, 3 (21.43%). All the nurses interviewed stated that the follow-up of the seropositive pregnant woman should occur concurrently with the basic care and specialized outpatient service. They were able to guide the risks and prevention of vertical transmission 85.71% of professionals. Conclusion: It was inferred that nurses, following the ethical and scientific precepts, are able to perform care for pregnant women, as well as to provide guidance on the risks of vertical transmission and about the recommended therapy, but due to the low contact with this clientele, they consider themselves to be defficient in training aimed at improving the care provided because it is not a work routine.(AU)

Optimization of fluorescence enhancement for silicon-based microarrays.

An optical technique for the enhancement of fluorescence detection sensitivity on planar samples is presented. Such a technique is based on the simultaneous optimization of excitation and light collection by properly combining interference and reflectance from the sample holder. Comparative tests have been performed in microarray applications, by evaluating the proposed solution against commercial glass-based devices, using popular labeling dyes, such as Cy3 and Cy5. The proposed technique is implemented on a substrate built with standard silicon technology and is therefore well suited for integrated micro total analysis systems (microTAS) applications.