IntroductionIn Brazil, more than 487,450 individuals are currently undergoing antiretroviral treatment. In order to monitor the transmission of drug‐resistant strains and HIV subtype distribution in the country, this work aimed to estimate its prevalence and to characterize the nationwide pretreatment drug resistance in individuals recently diagnosed with HIV between 2013 and 2015.MethodsThe HIV threshold survey methodology (HIV‐THS, WHO) targeting antiretroviral‐naive individuals with recent HIV diagnosis was utilized, and subjects were selected from 51 highly populated cities in all five Brazilian macroregions. The HIV
pol genotypic test was performed by genomic sequencing.ResultsWe analysed samples from 1568 antiretroviral‐naive individuals recently diagnosed with HIV, and the overall transmitted drug resistance (TDR) prevalence was 9.5% (150 sequences). The regional prevalence of resistance according to Brazilian geographical regions was 9.4% in the northeast, 11.2% in the southeast, 6.8% in the central region, 10.2% in the north and 8.8% in the south. The inhibitor‐specific TDR prevalence was 3.6% for nucleoside reverse transcriptase inhibitors (NRTIs), 5.8% for non‐nucleoside reverse transcriptase inhibitors (NNRTIs) and 1.6% for protease inhibitors (PIs); 1.0% of individuals presented resistance to more than one class of inhibitors. Overall, subtype B was more prevalent in every region except for the southern, where subtype C prevails.ConclusionsTo the best of our knowledge, this is the first TDR study conducted in Brazil with nationwide representative sampling. The TDR prevalence revealed a moderate rate in the five Brazilian geographical regions, although some cities presented higher TDR prevalence rates, reaching 14% in São Paulo, for example. These results further illustrate the importance of surveillance studies for designing future strategies in primary antiretroviral therapy, aiming to mitigate TDR, as well as for predicting future trends in other regions of the globe where mass antiretroviral (ARV) treatment was implemented.
We retrospectively studied 343 consecutive patients treated between 1979 and 1992. Ninety patients whose stool was not examined were excluded. Fifty-three patients with strongyloidiasis were compared with 200 controls with regard to outcomes and the following characteristics: age, sex, underlying disease, use of corticosteroids, abdominal pain, diarrhea, fever, pulmonary symptoms, and eosinophilia. Patients with strongyloidiasis more commonly had eosinophilia (P = .01) and fever (P = .03). There was a single but fatal case of the disseminated disease syndrome (1.9% of patients with strongyloidiasis). In multiple logistic regression analysis, the factors predictive for strongyloidiasis were schistosomiasis (odds ratio [OR], 6.58), ascariasis (OR, 2.78), and the use of steroids (OR, 2.29). Strongyloidiasis was highly prevalent among patients with hematologic malignancies in Brazil. Occurrence of the disseminated disease syndrome seems to be unusual.
A informação de qualidade é essencial para qualquer organização e, assim, as organizações necessitam de sistemas de informação fáceis de serem usados. Essa necessidade de informação qualificada e de boa usabilidade torna a interface com o usuário parte fundamental dos sistemas de informação. Por ser a parte visível do software, por meio da qual os usuários se comunicam com os sistemas para executarem suas tarefas, é preciso que ela seja amigável, ou seja, de fácil utilização e que atenda as expectativas e necessidades de seus usuários. Para obter tais interfaces, deve ser dada atenção especial aos requisitos relacionados às entradas de dados e à exibição de informação. Apesar da obviedade das afirmações, não é freqüente na definição de sistemas de informação uma preocupação com sua usabilidade. O nosso objetivo é demonstrar por meio de uma análise de um site de comércio eletrônico, uma série de requisitos não funcionais que deveriam estar sempre presentes no projeto de interfaces de software que dão apoio a sistemas de informação.
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