Objectives: This study proposes to evaluate risk factors for kidney disease in HIV patients treated chronically and correlate with microalbuminuria measurements. Methods: Review charts and analyses of microalbuminuria in subgroup of HIV patients treated at Ceara/Brazil. Results: 149 patients, 69.1% male, mean 38.5 years old, infection mean 86.8 months. Mean Creatinine Clearance 110.2%, Creatinine 0.97, Urea 27.76 mg/dl, CD4+ 600.37 cels/mm 3 and detectable viral load 530.59 copies with 61.7% undetectable. Mean Dosages of microalbuminuria/24h 147, 46 ± 820, 45 (N = 48) and microalbuminuria (mg/dl) 32.05 ± 85.25 (N = 43). Kidney Diseases Classification analyses evidenced 6.4% patients in stages ≥3 and 6.2% presented altered Microalbuminuria/24h. Patients using Tenofovir (TDF) 27.27% had Stage 2 and protease inhibitors (PI) had 4.1% in Stage 3. Proteinuria was observed in 5% stage ≥3. Association PI/TDF had 4.1% in Stage 3. No statistical difference between CD4 > or < 350 cels/mm 3 and microalbuminuria/24h > 300 mg (p = 0.69); detectable/undetectable viral load and microalbuminuria/24h (p = 0.63) or stage ≥3 (p = 0.17); relation to Diabetes or arterial hypertension and microalbuminuria 24 h (p = 0.5 and p = 0.21); relation stage ≥3 and microalbuminuria/24h (p = 0.33); relation HIV diagnoses >/< 60 months and stage ≥3 (p = 0.51); or microalbuminuria/24h and TDF (p = 0.4), PI (p = 1), TDF/PI (p = 0.69), Atazanavir (p = 0.4) or Lopinavir/r (p = 1) regimens. There was statistical significance comparing age > or < 50 years and stage ≥3 (p = 0.001) without difference with age > or < 50 years and microalbuminuria/24h (p = 0.55) or microalbuminuria mg/d (p = 0.32). Relating comorbidities risk (Diabetes Mellitus plus Systemic Arterial Hypertension) to Kidney Diseases, it was found that 55.5% patients in Stage 3 or above with comorbidities compared with 15% with comorbidities in lower stages (P = 0.005). Nevertheless, comorbidities presence was not associated with microalbuminuria (p = 0.08). Conclusion: Kidney disease is a real risk for HIV patients and stages ≥3 have to be early detected. Microalbuminuria dosage did not demonstrate more sensibility than proteinuria to early diagnoses, even related to antiretroviral drugs. Major risk factor for kidney damage evidenced to be older than 50 years and there was no protective effect from CD4 or undetectable viral load.
Objetivos: Descrever mudanças adotadas pelo departamento de cirurgia geral e apresentar métodos alternativos, utilizando modelos de baixo custo e práticos, para treinamento de residentes de cirurgia geral, por simulação de cirúrgica por laparoscopia, durante a pandemia COVID-19. Metodologia: Estudo exploratório com modelos simuladores que buscou propor um modelo de treinamento simulado, durante a pandemia da COVID-19. Resultados: Os modelos são práticos e baratos, de fácil confecção e úteis para a realização de exercícios simulados, auxiliando as habilidades cirúrgicas vídeo laparoscópicas. Conclusões: A criação de um modelo de baixo custo de produção para o treinamento de anastomoses laparoscópicas mostra-se como uma opção viável para o treinamento de residentes de instituições públicas com recursos financeiros limitados, principalmente em tempos de pandemia, como a COVID-19.
The relationship between neurocysticercosis and the development of mesial temporal lobe sclerosis A relação entre neurocisticercose e o desenvolvimento de esclerose temporal mesialTo the editor: The work by Oliveira, et al. published in the journal last July addressed once again the interesting question regarding the relationship of chronic calcifications suggestive of neurocysticercosis (NC) and the development of mesial temporal lobe epilepsy with hippocampal sclerosis (MTE-HS)
Background: Anatomical variants of brain ventricles are a known marker for abnormal central nervous system development. They seem to be more prevalent in several neuropsychiatric disorders, e.g. schizophrenia, personality disorders, and psychosis. However, knowledge about the risk factors and their overall prevalence in the general population, especially in developing countries is still limited. Methods: We evaluated the prevalence of prevalence of anatomical ventricular variants [Cavum septum pellucidum (CSP), Cavum vergae (CV), and Cavum velum interpositi (CVI)] in 1467 multislice head CTs from two large private hospitals in the city of Fortaleza, Ceará – Brazil. Results: Hospital one had a higher percentage of patients with low-cost health insurance, strokes, and neurocysticercosis (P<0.05). 15.1% of participants in hospital one versus 7.1% in hospital two had at least one type of cerebral cavum, including vestigial CSP. The rarest types of cava (CV and CVI) were twice more common in hospital one (P<0.05). Logistic regression analysis confirmed that patients from hospital one, older patients, and men were more likely to have any type of cerebral cavum and CSP. Conclusions: Anatomical brain ventricular variants (including vestigial CSP) were present in about 12% of participants of this middle-class Brazilian sample while also being more prevalent in male elderly and participants from lower socioeconomic strata. Further studies are necessary to prospectively investigate the association between socioeconomic variables and how they relate to the prevalence of anatomical brain ventricular variants and other known risk factors for developmental disorders.Trial registration: This study was approved by the Institutional Review Board from both participants institutions- Research Ethics Committee (CEP) - Unichristus (Protocols 099/11 and CAAE: 58763716.3.0000.5049).
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