RESUMO
INTRODUCTION: The study was performed to estimate the prevalence and determinants of occurrence of sexually transmitted infections (STIs) in paratroopers and navy soldiers by anonymously analyzing medical records from the medical departments of two large German barracks in order to assess the need for medical STI prevention. METHODS: Medical records from 80 paratroopers and 80 navy soldiers were screened for records of STI. Results were anonymously collected next to information on risk factors, as well as diagnostic and therapeutic management, and comparatively assessed. RESULTS: Proportions of suspected STIs were 17.5% and 20%, and proportions of diagnosed STIs were 13.9% and 11.3% for paratroopers and navy soldiers, respectively. Chlamydia trachomatis, human papillomavirus, and genital scabies were observed in paratroopers and navy soldiers, while Gardnerella vaginalis, herpes simplex virus, Molluscum contagiosum virus, Neisseria gonorrhoeae, and Trichomonas vaginalis were additionally identified in navy soldiers. CONCLUSIONS: Although clinical hints for STIs were frequently observed, clinical management was usually restricted to syndrome-based antibiotic treatment without detailed diagnostic workup, leaving room for procedural improvement. Ongoing need for medical STI prevention in the military could be confirmed.
RESUMO
Objectives: Endovascular treatment (ET), in addition to a therapy with intravenous recombinant tissue plasminogen activator IV rt-PA in patients with acute ischemic stroke, has been found to improve outcome. However, data about ET in patients who have not received therapy with rt-PA due to contraindications for IV rt-PA are sparse. Comparison of ET with IV rt-PA versus ET alone in patients with stroke is done using a proximal intracranial arterial occlusion (internal carotid artery, middle cerebral artery (M1-Segment)). Methods: During a 5-year period (2011-2016), 236 patients (mean age, 69 ± 14 years; 46% women; median NIHSS score 13 ± 5) who were treated at the Department of Neurology and Neuroradiology at the University of Lübeck, undergoing ET with or without IV rt-PA were included and analyzed. Results: A total of 144 patients (61%) underwent ET + IV rt-PA, and 92 patients (39%) underwent ET only. The ET with IV rt-PA is associated with a higher rate of favorable functional outcomes (mRS≤2) at discharge from hospital (51.4% vs. 23.1%, p < .001) and lower rate of in-hospital mortality (9% vs. 19.6%, p = .019) and symptomatic intracerebral hemorrhage [sICH] (2.1% vs. 8.7%; p = .019) compared to ET, whereas the modified treatment in cerebral infarction score (mTICI) did not differ between the groups.In the adjusted logistic regression analysis, the ET + IV rt-PA was associated with an increased probability of favorable functional outcome (OR, 4.3; 95% confidence interval [CI], 2.2-8.5; p < .001). For the in-hospital mortality (OR, 0.74; 95% CI, 0.29-1.9; p = .76) and sICH (OR, 0.3; 95% CI, 0.07-1.2; p = .09), no differences were found. Conclusion: Recanalization results after endovascular treatment are not relevantly improved in patients receiving rt-PA. However, an additional therapy with IV rt-PA has a positive impact on functional outcome.