RESUMO
Black sexual minority men who have sex with men (MSM) in the United States are at disparate risk for contracting HIV infection, but pre-exposure prophylaxis (PrEP) use is suboptimal. Social network methods were used to recruit a community sample of racial minority MSM and transgender women (TGW) in two Midwestern US cities. 250 PrEP-eligible (HIV-negative) participants completed measures assessing current and intended PrEP use; demographic characteristics; PrEP knowledge, attitudes, norms, stigma, and self-efficacy; and structural barriers to PrEP. Multivariate analyses established predictors of current and intended PrEP use. Only 12% of participants reported currently using PrEP, which was associated with greater PrEP knowledge and not having a main partner, with trends for greater PrEP use by younger participants and those with partners living with HIV. Among participants not currently on PrEP, strength of PrEP use intentions was associated with higher PrEP knowledge, PrEP descriptive social norms, and PrEP use self-efficacy. This study is among few to directly compare Black who have adopted PrEP with those who have not. Its findings underscore the potential benefits of employing social network approaches for strengthening PrEP use peer norms, increasing PrEP knowledge and self-efficacy, and optimizing PrEP uptake among racial minority MSM and TGW.
Assuntos
Negro ou Afro-Americano , Infecções por HIV , Conhecimentos, Atitudes e Prática em Saúde , Homossexualidade Masculina , Profilaxia Pré-Exposição , Pessoas Transgênero , Humanos , Masculino , Profilaxia Pré-Exposição/estatística & dados numéricos , Adulto , Pessoas Transgênero/estatística & dados numéricos , Pessoas Transgênero/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/etnologia , Infecções por HIV/prevenção & controle , Infecções por HIV/etnologia , Negro ou Afro-Americano/estatística & dados numéricos , Negro ou Afro-Americano/psicologia , Feminino , Meio-Oeste dos Estados Unidos , Pessoa de Meia-Idade , Adulto Jovem , Fármacos Anti-HIV/uso terapêutico , Estigma Social , Minorias Sexuais e de Gênero/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Parceiros Sexuais/psicologia , Adolescente , AutoeficáciaAssuntos
Humanos , Feminino , Pessoa de Meia-Idade , /diagnóstico , /etiologia , Temperatura Alta/efeitos adversosRESUMO
Se revisó la historia clínica de 6 pacientes diagnosticados de síndrome de Williams-Beuren en la edad pediátrica. Todos los pacientes presentaron la facies de elfo característica y anomalías cardiovasculares. Todos presentaron buena agudeza visual, excepto un caso de ambliopía unilateral. El error refractivo más frecuente fue la hipermetropía (n=6; 100%) y el astigmatismo (n=5; 83,3%). En 2 pacientes se encontraron alteraciones de la motilidad ocular (un caso de exoforia con hiperfunción de oblicuo inferior derecho y otro de endotropía congénita con hiperfunción del oblicuo inferior bilateral). Cognitivamente un 66,7% (n=4) tenía alteraciones visoperceptivas. Otros hallazgos fueron epicantus (n=6; 100%) y obstrucción congénita del conducto nasolagrimal con epífora unilateral (n=1; 16,7%). El síndrome de Williams-Beuren es un trastorno poco frecuente con manifestaciones oftalmológicas y sistémicas complejas. Por ello, es recomendable realizar un seguimiento oftalmológico a estos niños (AU)
Medical history of 6 patients diagnosed with Williams-Beuren Syndrome (SWB) in pediatric age was revised. All the patients presented characteristic elf facies and cardiovascular abnormalities. All presented good visual acuity, except one case of unilateral amblyopia. The most frequent refractive error was hyperopia (n=6; 100%) and astigmatism (n=5; 83.3%). Ocular motility alterations were found in 2 patients (1 case of exophoria with hyperfunction of right inferior oblique and another of congenital endotropia with bilateral hyperfunction of inferior oblique). On the cognitive function, 66.7% (n=4) had visoperceptive disorders. Other findings were epicanthus (n=6; 100%) and congenital obstruction of the nasolacrimal duct with unilateral epiphora (n=1; 16.7%). SWB is a rare disorder with complex ophthalmological and systemic manifestations. For this reason, ophthalmological follow-up of these children is recommended (AU)
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Síndrome de Williams/complicações , Síndrome de Williams/diagnóstico , Hiperopia/etiologia , Ambliopia/etiologia , Astigmatismo/etiologiaRESUMO
Medical history of 6 patients diagnosed with Williams-Beuren Syndrome (SWB) in pediatric age was revised. All the patients presented characteristic elf facies and cardiovascular abnormalities. All presented good visual acuity, except one case of unilateral amblyopia. The most frequent refractive error was hyperopia (nâ¯=â¯6; 100%) and astigmatism (nâ¯=â¯5; 83.3%). Ocular motility alterations were found in 2 patients (1 case of exophoria with hyperfunction of right inferior oblique and another of congenital endotropia with bilateral hyperfunction of inferior oblique). On the cognitive function, 66.7% (nâ¯=â¯4) had visoperceptive disorders. Other findings were epicanthus (nâ¯=â¯6; 100%) and congenital obstruction of the nasolacrimal duct with unilateral epiphora (nâ¯=â¯1; 16.7%). SWB is a rare disorder with complex ophthalmological and systemic manifestations. For this reason, ophthalmological follow-up of these children is recommended.
Assuntos
Ambliopia , Astigmatismo , Hiperopia , Erros de Refração , Síndrome de Williams , Ambliopia/diagnóstico , Ambliopia/etiologia , Criança , Humanos , Síndrome de Williams/complicações , Síndrome de Williams/diagnósticoRESUMO
Septo-optic dysplasia (SOD) is a rare congenital condition of unknown cause, with a characteristic triad that includes optic nerve hypoplasia, pituitary function abnormalities and midline brain defects, in addition to a broad spectrum of symptoms and associations. A total of five clinical cases are presented, four of which met the complete classic triad. All of them showed a wide variety of ophthalmological, endocrinological and neurological alterations. Within the ophthalmological spectrum of SOD, papillary hypoplasia and ocular motility alterations (nystagmus, strabismus) stand out. Other less frequent ones may also appear, such as pupillary alterations, microphthalmia and coloboma. Given the suspicion of SOD, brain MRI scan should be performed, as well as consultation with the paediatric department in order to complete the study and indicate, if necessary, systemic treatment.
Assuntos
Anormalidades do Olho , Displasia Septo-Óptica , Encéfalo , Criança , Humanos , Imageamento por Ressonância Magnética , Displasia Septo-Óptica/diagnósticoRESUMO
La displasia septoóptica (DSO) es una entidad congénita, rara, de causa desconocida, con una tríada característica que incluye hipoplasia de nervio óptico, anomalías en la función hipofisaria y defectos en la línea media cerebral, además de un amplio espectro de manifestaciones y asociaciones.Se presenta una serie de cinco casos clínicos, de los cuales cuatro presentaron la tríada clásica completa. Todos mostraron gran variedad de alteraciones oftalmológicas, endocrinológicas y neurológicas.Dentro del espectro oftalmológico de la DSO, destacan la hipoplasia papilar y las alteraciones de la motilidad ocular (nistagmos estrabismo). También pueden aparecer otras menos frecuentes, como son alteraciones pupilares, microftalmia y coloboma.Ante la sospecha de DSO, conviene realizar una resonancia magnética cerebral y una interconsulta con el servicio de pediatría para completar el estudio e indicar, si fuera preciso, tratamiento sistémico.
Septo-optic dysplasia (SOD) is a rare congenital condition of unknown cause, with a characteristic triad that includes optic nerve hypoplasia, pituitary function abnormalities and midline brain defects, in addition to a broad spectrum of symptoms and associations.A total of five clinical cases are presented, four of which met the complete classic triad. All of them showed a wide variety of ophthalmological, endocrinological and neurological alterations.Within the ophthalmological spectrum of SOD, papillary hypoplasia and ocular motility alterations (nystagmus, strabismus) stand out. Other less frequent ones may also appear, such as pupillary alterations, microphthalmia and coloboma.Given the suspicion of SOD, brain MRI scan should be performed, as well as consultation with the paediatric department in order to complete the study and indicate, if necessary, systemic treatment.
Assuntos
Humanos , Ciências da Saúde , Oftalmologia , Displasia Septo-Óptica , Baixa Visão/congênitoRESUMO
This study aimed to explore how contextual variables associated with the period of confinement during pandemic can differentiate symptoms of anxiety, depression, and stress. It also intended to understand the concerns that were experienced by athletes when resuming their sport practice and how these could be associated with psychopathological indicators. The sample comprised 265 athletes who completed self-reported questionnaires. Results demonstrated that there were differences in psychopathological indicators in terms of hours of training per week, and the type of contact that athletes have with their coach. Athletes reported concerns regarding the resumption of sport practice, and that were associated with anxiety, depression, and stress symptoms. This study may contribute in warning the sports community about the impact of contextual variables-related to critical moments of this pandemic. Sports communities should encourage the preservation of the athlete's physical activities, as well as supporting coaches in continuing to guide athlete's training. (AU)
Este estudio tuvo como objetivo explorar como las variables contextuales asociadas con el período de confinamiento de la pandemia pueden discriminar los síntomas de ansiedad, depresión y estrés. También se pretendió comprender las preocupaciones al retomar práctica deportiva y como estas podrían estar asociadas con indicadores psicopatológicos. La muestra incluyó 265 deportistas que completaron cuestionarios de autorespuesta. Los resultados demostraron que existen diferencias en los indicadores psicopatológicos en las horas de entrenamiento y el tipo de contacto que los deportistas tienen con su entrenador. Los atletas reportaron preocupaciones con respecto a la reanudación de la práctica deportiva después del período de confinamiento social, que se asociaron con síntomas de ansiedad, depresión y estrés. Este estudio puede contribuir a advertir a la comunidad deportiva sobre el impacto de las variables contextuales relacionadas con esta pandemia. Las comunidades deportivas deben fomentar la preservación de las actividades físicas, y apoyar a los entrenadores para que sigan guiando el entrenamiento de sus atletas. (AU)
O objetivo deste estudo foi explorar como é que variáveis contextuais associadas ao período de confinamento resultante da pandemia COVID-19 podem discriminar sintomas de ansiedade, depressão e stress em atletas. Adicionalmente, pretendeu-se explorar as preocupações mais experienciadas pelos atletas aquando da retoma da sua prática desportiva, e como é que estas se associam a indicadores psicopatológicos. Participaram neste estudo 265 atletas que completaram medidas de autorrelato. Os resultados demonstraram que existem diferenças nos indicadores psicopatológicos em termos de horas de treino por semana e do tipo de contacto que os atletas mantiveram com o treinador. Este estudo demonstrou que os atletas reportam preocupações relativamente à retoma da sua prática após o período de confinamento, e que estas preocupações foram associadas a sintomas de ansiedade, depressão e stress. Este estudo tem importantes implicações práticas, alertando a comunidade desportiva para o impacto de variáveis contextuais associadas à pandemia. As comunidades desportivas devem encorajar a preservação das rotinas dos atletas, e incentivar os treinadores a continuarem a orientar o treino dos seus atletas. (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pandemias , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Atletas , Saúde Mental , Inquéritos e Questionários , Portugal , AutorrelatoAssuntos
Urticária , Humanos , Urticária/diagnóstico , Urticária/etiologia , Urticária Crônica InduzidaRESUMO
La enfermedad autoinflamatoria de la queratización (AiKD, por sus siglas en inglés) es un concepto clínico novedoso que engloba a las enfermedades que presentan antecedentes genéticos, así como mecanismos patogénicos mixtos de autoinflamación y autoinmunidad, lo que en su conjunto se traducirá en una queratinización aberrante de la piel. Los recientes avances han revelado causas genéticas y/o factores predisponentes para una serie de AiKD, dentro de los que se pueden enumerar la presencia de las mutaciones en el IL36RN, en relación con la psoriasis pustulosa, la acrodermatitis continua y la hidradenitis supurativa; en el CARD14, en relación con la pitiriasis rubra pilaris tipo V y algunas formas de psoriasis pustulosa, y en el NLRP1 en relación con la queratosis liquenoide crónica familiar (KLC, por sus siglas en inglés). Se sospecha que la fisiopatología de la AiKD también estaría presente en algunos trastornos no monogénicos. Se debe de comprender que existe una relación bidireccional entre la inflamación y la queratinización para poder determinar un tratamiento óptimo; así mismo para poder desarrollar nuevos fármacos ambos factores deben de tenerse en cuenta. Probablemente en los próximos años nuevas enfermedades inflamatorias de la queratinización serán incluidas dentro del grupo de las AiKD (AU)
Autoinflammatory keratinization disease (AiKD) is a novel clinical concept encompassing diseases with a genetic background and mixed pathogenic mechanisms of autoinflammation and autoimmunity, leading to an aberrant keratinization of the skin. Recent advances in medical genetics have revealed genetic causes and/or predisposing factors for a number of AiKD's, such as mutations in IL36RN related with pustular psoriasis, acrodermatitis continua and hidradenitis suppurativa, in CARD14 in pityriasis rubra pilaris type V and some forms of pustular psoriasis, and in NLRP1 related with familial keratosis lichenoides chronica (KLC). It is suspected that AiKD pathophysiology would also be involved in non-monogenic disorders. The bidirectional relationship between inflammation and keratinization should be understood in order to outline optimal management, and new drug development should take both targets into account. We assume that new inflammatory keratinization diseases may be recognized as AiKDs in the coming years (AU)
Assuntos
Humanos , Dermatopatias/diagnóstico , Inflamação/diagnóstico , Queratinas , Pitiríase Liquenoide/diagnóstico , Hidradenite/diagnóstico , Psoríase/diagnóstico , Ceratose/diagnósticoRESUMO
Autoinflammatory keratinization disease (AiKD) is a novel clinical concept encompassing diseases with a genetic background and mixed pathogenic mechanisms of autoinflammation and autoimmunity, leading to an aberrant keratinization of the skin. Recent advances in medical genetics have revealed genetic causes and/or predisposing factors for a number of AiKD's, such as mutations in IL36RN related with pustular psoriasis, acrodermatitis continua and hidradenitis suppurativa, in CARD14 in pityriasis rubra pilaris type V and some forms of pustular psoriasis, and in NLRP1 related with familial keratosis lichenoides chronica (KLC). It is suspected that AiKD pathophysiology would also be involved in non-monogenic disorders. The bidirectional relationship between inflammation and keratinization should be understood in order to outline optimal management, and new drug development should take both targets into account. We assume that new inflammatory keratinization diseases may be recognized as AiKDs in the coming years.
RESUMO
The consumption of quinolones as first-line treatment has increased in recent years, leading to an increase in the incidence of hypersensitivity reactions (HSRs) to this antibiotic group. Both diagnosis and management of HSRs to quinolones are complex and controversial. These practical guidelines aim to provide recommendations for effective clinical practice. The recommendations were drafted by an expert panel that reviewed the literature regarding HSRs to quinolones and analyzed controversies in this area. Most HSRs to quinolones are immediate and severe. The risk for HSRs is higher in patients who report allergy to ß-lactams, moxifloxacininduced anaphylaxis, and immediate reactions than in patients who report reactions to quinolones inducing other symptoms. The usefulness of skin tests in diagnosing HSRs to quinolones is controversial, with sensitivity and specificity varying between studies. Most in vitro tests are produced in-house, with no validated commercial options. The basophil activation test has proven useful for diagnosing immediate reactions, albeit with diverse results regarding sensitivity. Drug provocation testing is currently the gold standard for confirming or excluding the diagnosis and for finding safe alternatives, although it is contraindicated in patients with severe reactions. Cross-reactivity between quinolones has proven controversial in several studies, with the lowest cross-reactivity reported for levofloxacin. Desensitization may be considered in allergy to quinolones when no other alternatives are available.
Assuntos
Alérgenos/efeitos adversos , Antialérgicos/efeitos adversos , Dessensibilização Imunológica/métodos , Hipersensibilidade a Drogas/diagnóstico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico , Quinolonas/efeitos adversos , Alérgenos/imunologia , Antialérgicos/uso terapêutico , Teste de Degranulação de Basófilos , Reações Cruzadas , Hipersensibilidade a Drogas/tratamento farmacológico , Hipersensibilidade a Drogas/etiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/tratamento farmacológico , Humanos , Guias de Prática Clínica como Assunto , Quinolonas/uso terapêutico , Testes CutâneosRESUMO
In this work we demonstrate the capability of two gain-switched optically injected semiconductor lasers to perform high-resolution dual-comb spectroscopy. The use of low duty cycle pulse trains to gain switch the lasers, combined with optical injection, allows us to obtain flat-topped optical frequency combs with 350 optical lines (within 10 dB) spaced by 100 MHz. These frequency combs significantly improve the spectral resolution reported so far on dual-comb spectroscopy with gain-switched laser diodes. We evaluate the performance of our system by measuring the transmission profile of an absorption line of H13CN at the C-band, analyzing the attainable signal-to-noise ratio for a range of averaging times.