Behind Prep Decisions: Understanding User Patterns and Discontinuation Factors in Real-World.

This study aimed to characterize the epidemiological aspects of PrEP use and barriers to accessing this prophylaxis. This cross-sectional study was conducted between January 2021 and April 2022, encompassing 140 PrEP users treated at the Testing and Counseling Center (CTA) in Campo Grande, Mato Grosso do Sul. Data on sociodemographic characteristics and factors associated with PrEP discontinuation were obtained using a standardized questionnaire. Most PrEP users were cisgender men (92.00%), predominantly white (51.00%), over 30 years of age (56.50%), homosexual-oriented (76.50%), and had a minimum of 12 years of education (77.50%). Approximately 60.00% admitted to inconsistent condom use in recent sexual encounters, primarily involving anal intercourse. Approximately 88.00% perceived themselves as at risk of contracting STIs in the upcoming year. Regarding new presentation forms, 54.00% indicated a willingness to use "on-demand PrEP," and 92.00% expressed interest in using "injectable PrEP." After 6 months of follow-up, 43.60% (95.00% CI: 35.50-52.00) discontinued PrEP use, primarily due to changes in sexual behavior (38.30%) and difficulties accessing healthcare services (21.28%). This study underscores the need to involve diverse key populations and highlights the significance of PrEP as an ongoing monitoring strategy for HIV/STI prevention in addition to the importance of incorporating new formulations such as daily oral PrEP into the Brazilian National Health System (SUS).

A Simple Formula to Estimate Parathyroid Weight on 4D-CT, Predict Pathologic Weight, and Diagnose Parathyroid Adenoma in Patients with Primary Hyperparathyroidism.

BACKGROUND AND PURPOSE: Parathyroid gland weight is a clinically relevant parameter used to diagnose parathyroid adenomas intraoperatively. We evaluated the accuracy of a formula to estimate parathyroid weight on preoperative 4D-CT. MATERIALS AND METHODS: A single-institution retrospective study was performed in patients with primary hyperparathyroidism who underwent 4D-CT between January 2013 and December 2014 with subsequent parathyroidectomy and surgical cure. All patients had correct localization of a solitary parathyroid adenoma. The longest 3 dimensions of all identified parathyroid glands were measured on CT, and weight was estimated using the formula: weight4D-CT (mg) = 1 mg/mm3 × Length (mm) × Width (mm) × Height (mm) × π/6. We correlated weight4D-CT with pathology specimen weight (weightpathology). Using receiver operating characteristic analysis, we estimated the performance of weight4D-CT to discriminate a parathyroid adenoma from normal glands on 4D-CT and determined the optimal threshold based on the Youden index. RESULTS: One hundred sixteen patients (85 women, 31 men) were evaluated. Weight4D-CT was shown to be strongly correlated with weightpathology as demonstrated by Spearman ρ = 0.73 (P < .01), concordance correlation coefficient = 0.92 (95% CI, 0.89-0.94), and Cronbach α = 0.96. The performance of weight4D-CT for the diagnosis of parathyroid adenoma was excellent, with an area under the curve of 0.955 (95% CI, 0.925-0.985; P < .001). Based on the Youden index, the optimal threshold was >50 mg, with a sensitivity of 96.7% and a specificity of 95.7%. CONCLUSIONS: Radiologists can accurately estimate parathyroid adenoma weight on 4D-CT. This metric is highly correlated with pathologic weight, and a threshold cutoff of >50 mg can be used to distinguish parathyroid adenoma from normal glands.

Prevalence, incidence and associated factors for HBV infection among male and female prisoners in Central Brazil: A multicenter study.

BACKGROUND: Prison populations are at high risk for hepatitis B virus (HBV) infection. The aim of this study was to assess the prevalence, incidence, HBV associated factors and circulating genotypes/subtypes. METHODS: A total of 3,368 prisoners from 12 closed prisons were randomly recruited for a cross-sectional study. In addition, a cohort study was conducted 12 months later and included 1,656 individuals. Participants underwent an interview and blood collection for the detection of HBV serological markers and HBV-DNA phylogenetic analysis. RESULTS: HBV exposure (anti-HBc+) was 9.8% (95% CI: 8.8-10.8); 11.2% were female and 9.6% were male. HBsAg+ was 0.6%. Only 31.4% of the participants had HBV vaccination-like profile (anti-HBs+ alone; 30.4% male vs. 36.8% female; p=0.004). Most individuals were susceptible to HBV (60.2% female vs. 52.2% male, p=0.001). HBV isolates were classified as genotypes A (45.4%), D (27.3%) and F (27.3%). In males, HBV exposure was associated with increased age. Male prisoners had more evidence of HCV/HBV co-infection (10.7%) than females (3.4%) and the frequency of Treponema pallidum infection among prisoners who had been exposed to HBV was higher in female prisoners when compared with male (39.7% vs. 19.1%). The incidence of HBV was 0.18/100 person-years (95% CI: 0.12%-0.25%). CONCLUSIONS: Our results indicate a high prevalence of HBV exposure in prisoners. Despite the low incidence of this infection, the occurrence of new cases indicates the need to implement preventive measures.

Use of synthetic oligonucleotides for determination of HTLV-1 proviral load by real-time PCR: a helpful alternative approach in the clinical management.

AIMS: To evaluate the potential use of synthetic oligonucleotides as a standard curve for proviral load (PVL) of human T-cell leukaemia virus type 1 (HTLV-1) quantification in peripheral blood mononuclear cells (PBMC) of HTLV-1-infected individuals by quantitative real-time polymerase chain reaction (qPCR) analysis. METHODS AND RESULTS: Synthetic oligonucleotides based on HTLV-1 genome were customized to use as a standard curve. Twelve anti-HTLV-1-positive samples with known HTLV-1 PVL, previously quantified by qPCR assay using TARL-2 cells as a conventional standard curve, were submitted to the new protocol. The proviral quantification levels had a high concordance with qPCR results using a conventional standard curve. The results demonstrate that the conventional standard curve can be replaced by a synthetic standard curve due to its ability to quantification based on the linearity and qPCR efficiency and similar results with a validated qPCR assay using a conventional standard curve. CONCLUSIONS: Synthetic oligonucleotides standard curves could be a very useful tool on HTLV-1 diagnosis and absolute HTLV-1 PVL quantification. SIGNIFICANCE AND IMPACT OF THE STUDY: HTLV-1 PVL determination using synthetic oligonucleotides standard curve by qPCR could be a helpful alternative for the laboratories that monitor infected patients as an important prognostic factor in HTLV-1-associated diseases progression. Also, it can decrease costs and overcome the biological limitations of the plasmid curve.

PTH and bone material strength in hypoparathyroidism as measured by impact microindentation.

PTH levels might be associated with bone material strength as measured by impact microindentation. Resistance to microfracture is decreased in hypoparathyroidism and appears to be associated with more severe disease and to improve with PTH replacement. INTRODUCTION: PTH is a key regulator of bone structure and remodeling. When PTH is absent in hypoparathyroidism (HypoPT), bone mass is increased and remodeling is decreased. In addition to bone structure and remodeling, bone material properties contribute to fracture resistance. Yet little is known about the relationship between PTH and bone material properties. Impact microindentation provides a clinical assessment of microfracture resistance, measured as the bone material strength index (BMSi). METHODS: Case-control cross-sectional study of PTH levels and in vivo BMSi measurement by impact microindentation at the anterior tibia in HypoPT patients (n = 17) and in controls matched for age, sex, and menopausal status (n = 17), with follow-up in a subgroup of HypoPT patients (n = 5) after recombinant human parathyroid hormone (1-84) [rhPTH(1-84)] treatment. RESULTS: BMSi was positively associated with PTH levels in controls (r = 0.58, p = 0.02) and was 11% lower (p = 0.01) in HypoPT patients as compared with controls. In HypoPT, lower BMSi was associated with a trend toward greater supplemental calcium doses (p = 0.07). BMSi increased after rhPTH(1-84) treatment in the HypoPT patients who underwent repeat microindentation. CONCLUSIONS: PTH levels might be associated with bone material strength, although other factors might be contributory. In HypoPT, resistance to microfracture is decreased and may be associated with greater supplemental calcium doses and might increase with PTH replacement. It remains to be determined whether changes in bone remodeling and microarchitecture contribute to the effects of PTH on microfracture resistance.

Development of microsatellite markers in Annona crassiflora Mart., a Brazilian Cerrado fruit tree species.

Annona crassiflora Mart. (Annonaceae) is a native fruit species of the region of Brazilian Cerrado with a high agronomic potential, although without any traces of domestication. A set of 10 microsatellite primer pairs was developed from an enriched genome library (TC13). An average of 19.3 alleles per locus was detected. Observed heterozygosity estimates were consistently lower than those obtained for gene diversity, evidencing a departure from Hardy-Weinberg expected proportions. The reported set of markers showed to be highly informative and constitutes a powerful tool for the development of genetic characterization studies in A. crassiflora.

[Gender representations and morality in the nursing profession]. / Representações de gênero e moralidade na prática profissional da enfermagem.

This text is part of a dialogue between the authorserlating to two research projects: one on "The professional ambiguities, work conditions and the citizenship of nurses--a comparative study in the Federal District and São Paulo" and the other on "The impact of work conditions on the nurses in the Hospital São Paulo as to sexual and reproductive life". Nursing occupies a singular place in the health professions. Is is differentiated by numeric importance as well as by a professional practice which is almost exclusively feminine. Culturally, to care is attributed as a woman's task (nurse, mother teacher, social worker, etc.); to treat is a man's task (doctor, father, provider, etc.) The dichotomy between caring and treating denies other conflicts, relations of power, and of hierarchies established in the professional practice of nursing. These conflicts may be associated with: a) the founding myth of the origin of nursing, generator of a morality and a competence which condition htis professional practice; b) feminity, mothering, the administration of intimacy and body care, that is, the social representations of nursing with respect to gender; c) the androcentric character of power relations and those of sexuality which subsume the professional space of nursing.

Utilizacao de um modelo como estimulo composto discriminativo na aquisicao do comportamento verbal de uma crianca autista

O objetivo deste trabalho e comparar tres procedimentos terapeuticos para se instalar comportamentos verbais ecoico e de designacao de objetos em uma adolescencia de 17 anos, que apresentava interrupcao da fala desde os dois anos e meio de idade: o reforcamento positivo, a modelacao e o emparelhamento de estimulos discriminativos, acompanhado de reforco. Para avaliacao dos resultados obtidos e comparacao dos tres procedimentos, foi utilizado um delineamento de caso unico do tipo A-B, adaptado para incluir as tres intervencoes. Os resultados mostram que nas fases de reforcamento positivo e de modelacao, nao se observa aumento de frequencia do comportamento verbal. Somente apos introducao do procedimento de emparelhamento de estimulos, observa-se aumento da frequencia de respostas, atingindo-se 100 por cento de respostas ecoicas corretas, apos 19 sessoes e o mesmo ocorrendo com respostas de designacao de objetos apos 33 sessoes. O presente trabalho mostra que quando o comportamento ecolatico do sujeito esta circunscrito a um unico modelo, torna-se necessario emparelhar os estimulos deste modelo ao do terapeuta para se obter a transferencia do controle de estimulo verbais e assim se obter a aquisicao dos comportamentos-alvo.