Latino STYLE: Preliminary Findings From an HIV Prevention RCT Among Latino Youth.

OBJECTIVE: Latino STYLE is a family-centered, HIV-focused intervention (HIV) emphasizing cultural factors and parent-adolescent communication. We hypothesized that, compared with a general health promotion (HP) intervention, the HIV arm would improve caregiver and adolescent HIV knowledge, attitudes, parental monitoring, sexual communication, and family relationships after a 3-month postintervention period. This article reports on the short-term findings of the longer trial. METHODS: A single-site, two-arm, parallel, family-based, randomized, controlled trial was conducted; eligible participants were Latino adolescents aged 14-17 and their primary caregiver. The study was conducted at the University of South Florida with 227 adolescent-caregiver dyads allocated to the HIV (n = 117) or HP (n = 110) intervention after completing a baseline assessment. Interim measures at 3-month follow-up included demographics, HIV knowledge, self-efficacy, parental monitoring, sexual communication, family relationships, and adolescent sexual behavior. RESULTS: Adolescents in the HIV group reported small effects in parental permissiveness and the HP group reported small effects for family support. Caregivers in both groups reported decreases in all outcomes. Incidence of past 90-day sexual intercourse decreased in both treatment arms. Among those who were sexually active over the past 90 days, the number of sex acts decreased from baseline, particularly in the HIV group. The percentage of condom-protected sex acts increased in the HIV group and decreased in the HP group, but did not reach statistical significance. CONCLUSIONS: The HIV Latino STYLE intervention was not efficacious in improving hypothesized outcomes over a 3-month period. However, exploratory analyses revealed moderate effects for decreases in adolescent sexual risk behavior, particularly in the HIV group.

One-year outcomes from the TAXUS express stent versus cypher stent.

We compared 1-year outcomes in patients treated with paclitaxel-eluting stents (PESs) or sirolimus-eluting stents (SESs) in "real-world" clinical practice. Clinical outcomes were evaluated in 1,558 consecutive, unselected, retrospectively collected patients treated with drug-eluting stents (DESs; PES = 816, SES = 742) at 19 United States centers. The primary end point was 1-year target vessel revascularization (TVR). The study included a prespecified diabetic cohort (PES = 289, SES = 247), for which efficacy comparisons between DESs were analyzed according to vessel diameter and presence of chronic kidney disease. Baseline demographic, angiographic, and procedural characteristics were similar between patients treated with PESs and those treated with SESs. At 1 year, there were no overall statistical differences in death, myocardial infarction, TVR, or stent thrombosis. In the diabetic cohort, however, the cumulative incidence of TVR was significantly lower for patients treated with PESs (3%) compared with SESs (9%, p <0.01), which persisted after adjustment for baseline differences (hazard ratio 0.29, 95% confidence interval 0.12 to 0.67). This decrease in TVR with PES was similar in insulin- and noninsulin-requiring diabetic patients. In multivariate analysis, independent predictors of TVR included diabetes, bifurcation stenting, and overlapping stents; in the diabetic cohort, treatment with SESs was also a multivariate predictor of TVR. In conclusion, in this observational, retrospective analysis of DES-treated patients, PESs and SESs demonstrated similar overall safety and efficacy, but PESs were associated with a significant decrease in 1-year TVR rates in diabetic patients.

Ultrasonido transrectal en pacientes con azoospermia obstructiva / Transrectal ultrasonography in patients with obstrictive azoospermia

Con el afán de establecer estudios de gabinete no invasores en pacientes con azoospermia obstructiva, se realizó ultrasonido transrectal (USGTR) a 12 pacientes diagnosticados en la clínica de infertilidad del Hospital General de México, SS. En la evaluación imagenológica se encuentran quistes y calcificaciones del conducto eyeculador, así como hipoplasia de vesículas seminales. Se piensa que el USGTR es el estudio ideal en la definición de alteraciones del conducto eyaculador, y la deferentovesiculografía (DGV) juega un papel importante en la evaluación del conducto deferente y en la permeabilidad del conducto eyaculador. El USGTR tiene una sensibilidad de 83.3 por ciento. Se realizan algunas consideraciones terapéuticas.

Biopsia transrectal de próstata guiada por ultrasonido / Ultrasound guided prostatic biopsy

La biopsia de la próstata representa un procedimiento complementario y frecuentemente concluyente para el diagnóstico del cáncer prostático. La guía transrectal resulta en mayor facilidad para su ejecución y menores molestias para el paciente. Al ser un procedimiento invasor deben tenerse precauciones en la preparación del paciente y su manejo posterior para evitar complicaciones las que afortunadamente sólo ocurren en un pequeño porcentaje. Se discuten algunos aspectos técnicos del procedimiento y la instrumentación utilizada.