Background Brazil has many people living with HIV (PLWH) who are unaware of their serostatus. The public health system has recently added HIV self-testing (HIVST) for key populations such as men who have sex with men (MSM). This study estimates HIVST acceptability among Brazilian MSM and explores factors associated with acceptability among MSM who have never tested for HIV or who had a previous negative result. Methods Respondent-driven sampling (RDS) was used to recruit 4176 MSM in 12 Brazilian cities in 2016 to this biological and behavioral surveillance study. We excluded from this analysis all MSM who were aware of their positive HIV serostatus. Descriptive, bivariate and multivariate analyses were conducted. Overall proportions were weighted with Gile’s estimator in RDS Analyst software and 95% confidence intervals were calculated. The analyses of HIVST acceptability were stratified by prior HIV testing (never or one or more times). Results For this analysis, 3605 MSM were included. The acceptability of HIVST was 49.1%, lower among those who had never tested for HIV (42.7%) compared to those who had a previous HIV negative test (50.1%). In the subgroup of MSM who had never tested for HIV, those who reported discrimination or who had a medical appointment in the last 12 months reported higher HIVST acceptability. Among MSM who had a previous negative HIV test, only those reporting condomless receptive anal sex reported higher HIVST acceptability. In addition, we observed that high levels of knowledge of HIV/AIDS, taking part in lesbian, gay, bisexual, and transgender nongovernmental organizations (LGBT-NGO), or complete secondary or incomplete higher undergraduate education reported higher acceptability. Conclusions The acceptability of HIVST was low among MSM, especially among those who never tested for HIV. Given access to HIVST in Brazil, we point to the need for programs that enhance promotion of testing addressed to MSM.

Objective: Assess clinical results using two different protocols, 10 years after ACL reconstruction surgery with the central third of quadriceps muscle tendon (QT). Method: Between November /1997 and April/1998, 25 patients were submitted to 25 ACL reconstructions with QT by transtibial technique. The bone portion of the graft was fixated on femoral tunnel with interference screw and the tendinous portion of tibial tunnel with screw with washer. Two patients injured the new when playing soccer. Six patients were not available for follow-up (24%). Seventeen patients were evaluated, 15 men and two women, with mean age at surgery time of 28.53 ± 6.64 years. All patients were examined at six months, one year, and ten years after surgery. Clinical evaluation was made by the Lysholm scale, and the knee evaluation, with the Hospital for Special Surgery scale. Results: The patients had their injuries operated after 9.87 ± 14.42 months of the accident. According to Lysholm scale, the results at the end of the first year were 98.71 ± 2.47 and, after 10 years, 97.35 ± 3.12. Using the Hospital for Special Surgery scale, the mean score was 95.07 ± 5.23 in one year, and 94.87 ± 4.16 in 10 years. All patients returned to their professional activities with the same previous status. Fifteen (88.24%) patients were able to return to their sports activities, one by modifying the practice, while another one switched to another sport. No patient complained of pain on the donor area in the medium and long term. The sports return rate was excellent, and no changes were found on the femoropatellar joint.

RESUMOObjetivo: Avaliar os resultados clínicos utilizando dois diferentes protocolos, 10 anos após a cirurgia de reconstrução do LCA (Ligamento Cruzado Anterior) com o terço central do tendão do múscu-lo quadríceps (TQ). Método: Entre novembro/1997 e abril/1998, 25 pacientes foram submetidos a 25 reconstruções do LCA com TQ pela técnica transtibial. A parte óssea do enxerto foi fixada no túnel femoral com parafuso de interferência e a parte tendinosa no túnel tibial, com parafuso em poste com arruela. Dois pacientes romperam o novo ligamento em entorses durante futebol. Seis não foram encontrados para reavaliação (24%). Foram avaliados 17 pacientes, sendo 15 homens e duas mulheres, com média de idade na cirurgia de 28,53 ± 6,64 anos. Todos foram examinados com seis meses, um ano e dez anos de cirurgia. A avaliação clí-nica foi realizada com a escala de Lysholm e a do o joelho, com a do Hospital for Special Surgery. Resultados: As lesões foram operadas após 9,87 ± 14,42 meses do acidente. Segundo a escala de Lysholm, os resultados ao fim do primeiro ano foram de 98,71 ± 2,47 e, ao fim de dez anos, de 97,35 ± 3,12. Usando a escala do Hospital for Special Surgery, a pontuação foi de 95,07 ± 5,23 com um ano e de 94,87 ± 4,16 após 10 anos. Todos os pacientes retornaram ao trabalho nas mesmas condições. Quinze (88,24%) retornaram ao mesmo esporte, um com modificação na prática e outro mudou de esporte. Nenhum paciente se queixou dor na área doadora do enxerto após quatro semanas da cirurgia até a última avaliação. Quatro pacientes sofreram ruptura do LCA contralateral em atividades esportivas, sendo três entorses no futebol e uma durante dança. Conclusão: O enxerto do TQ é boa opção para a reconstrução do LCA, mesmo quando decorridos 10 anos do procedimento cirúrgico. Não houve dor na área doadora do enxerto a médio e longo prazo. A taxa de retorno ao esporte foi excelente e não houve alteração da articulação femoropatelar. Descritores

Objective: The aim of this study was to evaluate the treatment using BMMCs and arthroscopy in PF OA through functional questionnaires and MRI evaluations in a two year follow up. The use of mononuclear cells derived from bone marrow (BMMCs) is under investigation, and in vitro and pre-clinic studies showed promisor results. In comparison to the mesenchymal stem cells (MSC), the effectiveness is lower, however the costs for manipulation and laboratory handling make it difficult to use in clinical practice. Design: This was a pilot, longitudinal and prospective trial and 8 patients with patellofemoral osteoarthritis who met the study criteria were included. All of the patients underwent arthroscopic debridement and received an injection of autologous BMMCs. Clinical outcomes were evaluated using SF-36 and the TLKSS questionnaire at baseline, one and two years after the procedure. Results: In this study, an improvement in all of the evaluated parameters of the questionnaire was verified even after two years following the applications. The functional score of TKLSS showed a significant improvement in one and two years in comparison to the baseline (p<0.001). A significant improvement in SF-36 for all of the domains (p<0.001) was also verified. In addition, an improvement in the MRI images of the patients was noticed, which indicates patellar cartilage recovery. Conclusion: The procedure of the arthroscopy and the application of BMMCs has proved promising results to reduce the signs of PF OA and ensure the patient satisfaction with a safe return to social life and sports practice. The completed questionnaire confirmed a clear improvement and a strong impact on the quality of life of the patients with the regeneration of their articular cartilage and restored subchondral bone. These results offer a wide perspective for future studies with the use of BMMC to treat articular diseases.

Resumo O objetivo deste artigo é avaliar as Instituições de Longa Permanência para Idosos (ILPI) brasileiras, segundo o Modelo Teórico Multidimensional Integrado de Qualidade e Atendimento (MIQA), e comparar o desempenho alcançado entre as regiões do país. Estudo ecológico descritivo realizado com dados secundários públicos das ILPI participantes do Censo do Sistema Único da Assistência Social de 2018. Uma Matriz de Avaliação foi construída a partir das variáveis do Censo e do Modelo Teórico MIQA. Parâmetros de qualidade foram empregados para classificar o desempenho das instituições para cada indicador em “incipiente”, “em desenvolvimento” ou “desejável. O índice de disparidade foi obtido para cada indicador. Foram analisadas 1.665 instituições. Observaram-se diferenças nos percentuais de ILPI com desempenho “desejável” entre as regiões brasileiras, e a necessidade de aprimoramento na maioria das ILPI em relação à proporção de cuidadores de pessoas idosas, a composição da equipe multiprofissional, a acessibilidade e a oferta de ações de promoção de saúde. Verificou-se a necessidade de apoio governamental para a supressão dos critérios de diferenciações excludentes e para a expansão dos serviços para superar as superlotações.

Background: Brazil has a substantial population living with HIV (PLWH) who are unaware of their serostatus. The public health system has recently added HIV self-testing (HIVST) for key populations such as men who have sex with men (MSM). This study estimates HIVST acceptability among Brazilian MSM and explores factors associated with acceptability among MSM who have never tested for HIV or who had a previous negative result. Methods: Respondent-driven sampling (RDS) was used to recruit 4,176 MSM in 12 Brazilian cities in 2016 to this biological and behavioral surveillance study. We excluded from this analysis all MSM who were aware of their positive HIV serostatus. Descriptive, bivariate and multivariate analyses were conducted. Overall proportions were weighted with Gile’s estimator in RDS Analyst software and 95% confidence intervals were calculated. The analyses of HIVST acceptability were stratified by prior HIV testing (never or one or more times). Results: For this analysis, 3,605 MSM were included . The acceptability of HIVST was 49.1%, lower among those had never tested for HIV (42.7%) compared to those who had a previous HIV negative test (50.1%). In the subgroup of MSM who had never tested for HIV, those who reported discrimination or who had a medical appointment in the last 12 months reported higher HIVST acceptability. Among MSM who had a previous negative HIV test, only those reporting condomless receptive anal sex reported higher HIVST acceptability. In addition, we observed that high levels of knowledge of HIV/AIDS, taking part in lesbian, gay, bisexual, and transgender nongovernmental organizations (LGBT-NGO), or complete secondary or incomplete higher undergraduate education reported higher acceptability. Conclusions: The acceptability of HIVST was low among MSM, especially among those who never tested for HIV. Given access to HIVST in Brazil, we point to the need for programs that enhance promotion of testing addressed to MSM.

Background: Brazil has a lot of people living with HIV (PLWH) that are still unaware of their own serostatus and has recently integrated HIV self-test (HIVST) into its public health system and offered to key populations such as men who have sex with men (MSM). This study estimates HIVST acceptability among Brazilian MSM and its associated factors. Methods: Respondent-driven sampling (RDS) was used in behavioral and biological surveillance to recruit 4,176 MSM in 12 Brazilian cities in 2016. Descriptive, bivariate and multivariate analyses were conducted. Overall proportions were weighted according to Gile’s estimator using RDS Analyst Software and 95% confidence intervals were calculated. The analyses of HIVST acceptability were stratified by prior HIV testing (never or at least once in a lifetime). Results: We included 3,605 MSM who did not previously know they were PLWH. The HIVST acceptability was 49.1%, lower among those had done HIV test during lifetime compared to those who have never done it (42.7% vs 50.1%), especially among who are in a less vulnerable social context. In the subgroups of MSM who had never had an HIV test, those with complete secondary or incomplete higher school, who reported discrimination, who with a medical appointment in the last 12 months, with high levels of knowledge of HIV/AIDS and who took part in LGBT nongovernmental organization (LGBT-NGO) had higher HIVST acceptability. Among MSM who had taken an HIV test, those who took part in LGBT NGOs had greater HIVST acceptability. We observed a dose-response effect of schooling and knowledge of HIV/AIDS on HIVST acceptability: an increase in both levels was associated with greater acceptability. Conclusions: The findings highlight that it is necessary to improve information about HIVST among MSM more vulnerable in Brazil. Given the acceptability of self-testing and its current adoption in Brazil, we can also point to the need for policies that build on this and enhance timely access to health services and prevention information.

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