No abstract

A high prevalence of a prior history of STDs in the studied population was found. It is essential to find better ways to access HIV infection prevention, so that effective interventions can be more widely implemented.

The development of pulmonary arteriovenous fistulas after bidirectional cavopulmonary operations, such as the bidirectional Glenn shunt and Kawashima's procedure, has raised concern. Development of these fistulas, which are more frequent than initially thought, can represent a limiting factor in the late outcome of these patients and may even limit the indication for these types of surgery. Whether the fistulas can be reversed by transforming the surgical procedures has yet to be established. In the hope of avoiding this kind of complication, thought to be caused by the lack of passage of a hypothetical hepatic factor through the pulmonary circulation, we have developed an inverted type of bidirectional cavopulmonary connection in which the blood coming from the liver perfuses immediately both lungs. This is made possible by shunting via an intra-atrial tunnel the blood from the superior caval vein directly to the left atrium, and the blood from the inferior caval vein to the right branch of the pulmonary trunk (keeping its bifurcation intact). We describe findings in two patients undergoing successful surgery with this technique. Serial follow-up with contrast echocardiography did not show evidence of arteriovenous pulmonary fistulas. Despite our numbers being small, and the time of follow-up being limited, we believe that it is important to document these and similar cases.

Objectives: To describe the epidemiological profile, risk behaviors, and the prior history of Sexually transmitted diseases (STDs) in women living with acquired immunodeficiency syndrome (AIDS). Methods: Cross-sectional study, performed at the Centro de Referência e Treinamento em DST/AIDSs of São Paulo. The social, demographic, behavioral, and clinical data such as age, schooling, marital status, age at first Sexual intercourse, number of Sexual partners, parity, use of drugs, time of HIV diagnosis, CD4 count, and viral load determination were abstracted from the medical records of women living with AIDS who had gynecological consultation scheduled in the period from June 2008 to May 2009. Results: Out of 710 women who were scheduled to a gynecological consultation during the period of the study, 598 were included. Previous STD was documented for 364 (60.9%; 95% CI: 56.9%−64.8%) women. The associated factors with previous STDs and their respective risks were: human development index (HDI) < 0.50 (ORaj = 5.5; 95% CI: 2.8–11.0); non-white race (ORaj = 5.2; 95% CI: 2.5–11.0); first Sexual intercourse at or before 15 years of age (ORaj = 4.4; 95% CI: 2.3–8.3); HIV infection follow-up time of nine years or more (ORaj = 4.2; 95% CI: 2.3–7.8)]; number of Sexual partners during the entire life between three and five partners (ORaj = 2.2; 95% CI: 1.1–4.6), and six or more Sexual partners (ORaj = 3.9; 95% CI: 1.9–8.0%); being a Sex worker (ORaj = 1.9; 95% CI: 1.1–3.1). Conclusions: A high prevalence of a prior history of STDs in the studied population was found. It is essential to find better ways to access HIV infection prevention, so that effective interventions can be more widely implemented.

No abstract

American tegumentary leishmaniasis (ATL) is an infectious disease transmitted by vectors and caused by several protozoa of the genus Leishmania. In Brazil, it is considered a serious public health problem due to its endemicity throughout the national territory. The aim of this study is to analyze the spatial distribution of cases of ATL infection in the municipalities from the State of Alagoas, Brazil, and to identify related social determinants during the period of 2007 to 2021. This is an ecological, retrospective, and quantitative study. We use descriptive and spatial statistics. Data about the disease and social conditions were obtained in the Department of Informatics of the Brazilian National Health System (DATASUS) and Atlas Brasil platform. During this period, 1,033 cases of leishmaniasis were recorded, of which 41% corresponded to the age group of 15-39 years old; men (67%) and black individuals (76%) were the most affected by the disease. The predominant clinical form was cutaneous (95%). The spatial correlations indicate a lack of dependence of the disease, both alone and when compared to the human development index. The findings highlight the need for further investigations to better understand the underlying factors contributing to the disproportionate distribution of the disease and its association with demographic characteristics. KEY WORDS: American tegumentary leishmaniasis; cutaneous leishmaniasis; environmental health; social conditions.

Introduction Testing campaigns (entitled "Get to know") during high-traffic public events have been conducted in Brazil since July 2008. On these occasions, people are offered information about health and prevention and rapid tests (RTs), as well as condoms and lubricating gels. Initially, only rapid HIV testing was conducted; RTs for syphilis screening was included in 2010 and hepatitis B and C screening in 2012. Twenty-two national mobilizations were organised between 2008 and 2012, with approximately 26,300 RTs performed. Methodology A large number of people attend the carnival celebrations in the cities of Recife and Salvador and are the focus of Ministry of Health campaigns. In 2013, for the first time, the "Get to Know" campaign in these cities offered RTs for HIV, syphilis, and hepatitis B and C. Testing was conducted in health centres near places where large numbers of people congregated and at temporary centres at the carnival venues. In cases with RT reactive results, patients received the test results and were referred to qualified services for follow-up and healthcare. Results More than 8,000 tests were performed during the four days of carnival in Recife and Salvador. In Salvador, 5,280 tests were conducted in three locations, and 1,458,984 condoms were distributed by eleven mobile teams. Of those tested, 16 were reactive for HIV, 84 for syphilis, 7 for hepatitis B, and 14 for hepatitis C. In Recife, 5,527 RTs were performed in 3 locations, and 800,000 condoms were distributed. Twenty people were reactive for HIV, 60 for syphilis, 2 for hepatitis B, and 4 for hepatitis C. Conclusion The "Get to Know" campaign has been proven efficient in scaling up access to early diagnosis and reaching large numbers of people with information about the importance of getting tested and with awareness-raising activities about prevention. OptiMizing Care eFFiCienCy at tHe Sti CliniC: uSing CHlaMydia HOMe COlleCtiOn KitS