Objective: Due to the lack of studies assessing hypovitaminosis D and secondary hyperparathyroidism in Brazilian HIV-infected population, especially in the northeastern population, this study aimed to determine the profile of these conditions in patients infected with HIV and its correlation with immuno-virological, sociodemographic data and associated comorbidities. Methods: Comparison studies were obtained from routine clinical samples of HIV infected patients submitted for 25-OH Vitamin D, PTH and alkaline phosphatase determination. Results: A total of 78 patients were included, 42 (53.8%) males, mean age 45.7 years. Antiretroviral regimens most used in this study were Zidovudine/Lamivudine/Efavirenz 17.9%, Tenofovir/Lamivudine/Efavirenz 17.9%, Tenofovir/Lamivudine/Atazanavir-r 15.4%. The mean value CD4 count was 592.1 ± 247.2 cells/mm 3 , CD8 cell count was 1026.5 ± 467.3 cells/mm 3 , mean detectable viral load was 2220 ± 15703 copies and CD4/CD8 ratio was 0.63 ± 0.33. A total of 34 vitamin D dosages were collected with 41.2% representing sufficient amount and 58.8% insufficient. Alkaline Phosphatase (ALP) dosage was elevated in 49.3% (N=35) of the patients. Parathormone (PTH) was elevated in 18% (N = 11). Among patients with elevated PTH levels, 81.9% had elevated levels of ALP (p = 0.01). In the group of patients with high levels of ALP, 45.7% had a CD4 count < 500 cels/mm 3 (p = 0.02). There was no significant difference in vitamin D related to gender (p = 0.21), age (p = 0.23), CD4 count (p = 0.26), suppressed viral load (p = 0.44) or blood glucose (p = 0.45). Conclusions: This study evi-
This article reports an anatomic specimen specifically prepared to demonstrate a rare anomaly of the origin of the left coronary artery from the right sinus of Valsalva, with an incidence of 0.15% in patients undergoing coronary angiography. This is a subgroup of coronary artery anomalies with the greatest potential for clinical repercussions, especially sudden death in young patients. Based on current knowledge, pathophysiologic mechanisms, diagnosis and treatment options of anatomical variations of the anomalous origin of a coronary artery from the contralateral sinus are discussed. Case Report t he heart is perfused by the coronary arteries and their branches, which originate from the sinuses of Valsalva. Generally, the right coronary artery originates from the right anterior sinus of Valsalva, passing through the coronary groove, and emerging between the pulmonary artery trunk and right atrium. In turn, the left coronary artery originates in the left anterior sinus of Valsalva, behind the pulmonary artery, passing through the coronary groove, and emerging between the pulmonary trunk and left atrium. Coronary artery anomalies result from disturbances that occur in the third week of fetal development. DESCRIPtORS 2These changes cause anatomical variations related to the origin, trajectory, and termination of these arteries, or alterations in their intrinsic anatomy. Some coronary artery anomalies cause occasional or obligatory ischemia (anomalous origin of the left coronary artery from the pulmonary artery), whereas others predispose to complications (spasm or development of atheromatous plaques). 3This study aimed to discuss a rare case of anomalous origin of the coronary artery, detected in an anatomic specimen from the anatomy laboratory of a medical school.
Background Sexually transmitted infections (STIs) are a major public health problem in Europe and in Portugal, their incidence has been increasing since the 90s. Although STIs are among the most frequently reported infections globally, they still go often underdiagnosed. Their under notification is also a problem in Portugal. The aim of this study is to describe STIs' notifications in the area of the groups of primary healthcare centers of Loures-Odivelas (ACES LO), between 2015-2019. Methods An observational, descriptive, quantitative study was performed. Data was collected in January 2020, from the National System of Epidemiological Surveillance Database. Variables included for each STIs notification were age and sex. Univariate descriptive analysis and evolution trends were performed for each variable. Results A total of 638 cases of STIs were reported from 2015 to 2019. The number of reported cases increased from 87 to 197 cases (126.4%). The annual mean incidence of HBV and HCV notifications were 8 and 4, respectively. There was an increase in reported cases of syphilis (33 to 57), HIV (13 to 29), chlamydia (13 to 46) and gonorrhea (18 to 51). In 2019, 30.9% of the notified cases were syphilis infections, 23.5% gonorrhea infections, 22.1% chlamydia infections and 13.2% HIV infections.Males comprised 460 cases (72.1%), and, in patients aged between 15 and 44 years old, 484 cases (75.9%) were reported. From 2015 to 2019, the co-infections of gonorrhea and chlamydia increased from 2 to 10 cases (25.0%). In 2019, 17.5% of the notified cases of gonorrhea were co-infections. Conclusions The modification of risk behaviors and the appropriate treatment of infected people, including infected partners, are determinant to prevent recurrent infections and to interrupt the transmission cycle. Increasing notification should facilitate the monitoring of STIs' trends, contributing to the implementation of appropriate interventions and for better decision-making in public health. Key messages Campaigns about sexual health promotion are important to increase safer sexual health practices. More notifications contribute to better data quality and more robust decision-making.
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