Human Papillomavirus Typing in HIV-Positive Women

Objective: Human papillomavirus (HPV) is the major cause of cervical carcinoma and cervical intraepithelial neoplasia worldwide. Certain HPV types have a strong association with and probably a causative role in the pathogenesis of premalignant cervical lesions. Epidemiologic studies in women infected by the human immunodeficiency virus (HIV) have shown an increased incidence of squamous intraepithelial lesions (SILs), whichwere predominantly high-grade. Six to 30 per cent of women diagnosed with atypical squamous cells of undetermined significance (ASCUS) on a Papanicolaou (Pap) smear harbor SIL in normal screening populations. This study was undertaken to determine the presence of low- and high-risk HPV types in women infected by HIV and to correlate the results to those of the Pap smear. Study design: HPV DNA typing (low- and high-risk) by Digene™ (Digene Corporation, Gathesburg, MD) hybrid capture methodology was performed on cervical swabs from 209 HIV-positive women. The results of HPV typing were correlated with those of the Pap smear in a retrospective analysis. Results: One hundred and one women (48%) tested positive for HPV subtypes by DNA typing by the hybrid capture method. Of these, 64 patients (63%) had Pap smears whichwere read as being normal, having benign cellular changes, or having ASCUS (favor reactive process). Of these, 19 patients tested positive for both high-risk and low-risk subtypes, 32 patients tested positive only for high-risk subtypes, and 13 patients tested positive only for low-risk subtypes. Conclusion: HPV subtyping identifies a significant group of HIV-positive women who are at risk for developing cervical intraepithelial neoplasia, although they may not show significant abnormalities on their Pap smears

Abundance and Spatial Distribution of Brown Crab (Cancer pagurus) from Fishery-Independent Dredge and Trawl surveys in the North Sea

Acknowledgements We would like to thank the MSS staff who participated in the east coast dredge surveys and IBTS quarter 3 surveys for the data sampling work that has been used in this study. Thanks to Andrzej Jaworski for providing advice on the use of geostatistical methods. Finally, would also like to thank the editor and two anonymous reviewers for their helpful comments. Funding This study was funded by the Marine Collaboration Research Forum (MarCRF), with Marine Scotland Science and the University of Aberdeen.Peer reviewedPostprin

Effectiveness of appropriately trained nurses in preoperative assessment: randomised controlled equivalence/non-inferiority trial

Objective To determine whether preoperative assessments carried out by appropriately trained nurses are inferior in quality to those carried out by preregistration house officers. Design Randomised controlled equivalence/non-inferiority trial. Setting Four NHS hospitals in three trusts. Three of the four were teaching hospitals. Participants All patients attending for assessment before general anaesthesia for general, vascular, urological, or breast surgery between April 1998 and March 1999. Intervention Assessment by one of three appropriately trained nurses or by one of several preregistration house officers. Main outcome measures History taken, physical examination, and investigations ordered. Measures evaluated by a specialist registrar in anaesthetics and placed in four categories: correct, overassessment, underassessment not affecting management, and underassessment possibly affecting management (primary outcome). Results 1907 patients were randomised, and 1874 completed the study; 926 were assessed by house officers and 948 by nurses. Overall 121/948 (13%) assessments carried out by nurses were judged to have possibly affected management compared with 138/926 (15%) of those performed by house officers. Nurses were judged to be non-inferior to house officers in assessment, although there was variation among them in terms of the quality of history taking. The house officers ordered considerably more unnecessary tests than the nurses (218/926 (24%) v 129/948 (14%). Conclusions There is no reason to inhibit the development of nurse led preoperative assessment provided that the nurses involved receive adequate training. However, house officers will continue to require experience in preoperative assessment

Pulmonary capacity of patients with total traumatic injury of the brachial plexus submitted to neurotization with the phrenic nerve: a case series.

Total traumatic injury often requires surgical intervention such as neurotization using the phrenic nerve with the aim to recover the elbow function. However, its repercussions on the respiratory kinematics are unknown. Objective: To  valuate the ribcage volume in tricompartments division, kinematics of Duty Cycle, and shortening velocity of the respiratory muscles after nerve phrenic transfer. Methods: Five participants (4 male), aged 18 to 40 years old (32±2), diagnosed with total brachial plexus injury and with nerve phrenic transfer. The optoelectronic plethysmography (OEP) was the instrument to evaluate volume in quiet breathing (QB), inspiratory capacity (IC) and vital capacity (VC) of the rib cage in its tricompartments division (pulmonary rib cage, abdominal rib cage and abdomen rib cage) and in each hemithorax, as well as the shortening velocity of the respiratory muscles, and respiratory rate. Assessments occurred 30 days prior and 30 days after surgery. Results: There was a decrease in the total compartmental distribution in QB with statistical difference only in the abdominal compartment (p 0.05). Four patients showed a reduction in the shortening speed of the left diaphragm muscle. It was not possible to perform a group analysis of respiratory kinematics and volumes in CV, IC due to the variation found in each patient analyzed. Conclusion: There was a reduction in volume in the rib cage as well as a change in the speed of shortening of the respiratory muscles after the transfer of the phrenic nerve one month after surgery

A bibliometric analysis of systematic reviews on vaccines and immunisation.

INTRODUCTION: SYSVAC is an online bibliographic database of systematic reviews and systematic review protocols on vaccines and immunisation compiled by the London School of Hygiene & Tropical Medicine and hosted by the World Health Organization (WHO) through their National Immunization Technical Advisory Groups (NITAG) resource centre (www.nitag-resource.org). Here the development of the database and a bibliometric review of its content is presented, describing trends in the publication of policy-relevant systematic reviews on vaccines and immunisation from 2008 to 2016. MATERIALS AND METHODS: Searches were conducted in seven scientific databases according to a standardized search protocol, initially in 2014 with the most recent update in January 2017. Abstracts and titles were screened according to specific inclusion criteria. All included publications were coded into relevant categories based on a standardized protocol and subsequently analysed to look at trends in time, topic, area of focus, population and geographic location. RESULTS: After screening for inclusion criteria, 1285 systematic reviews were included in the database. While in 2008 there were only 34 systematic reviews on a vaccine-related topic, this increased to 322 in 2016. The most frequent pathogens/diseases studied were influenza, human papillomavirus and pneumococcus. There were several areas of duplication and overlap. DISCUSSION: As more systematic reviews are published it becomes increasingly time-consuming for decision-makers to identify relevant information among the ever-increasing volume available. The risk of duplication also increases, particularly given the current lack of coordination of systematic reviews on vaccine-related questions, both in terms of their commissioning and their execution. The SYSVAC database offers an accessible catalogue of vaccine-relevant systematic reviews with, where possible access or a link to the full-text. CONCLUSIONS: SYSVAC provides a freely searchable platform to identify existing vaccine-policy-relevant systematic reviews. Systematic reviews will need to be assessed adequately for each specific question and quality

Targeting SLMAP-ALK—a novel gene fusion in lung adenocarcinoma

Assessment of ALK gene rearrangements is strongly recommended by the Molecular Testing Guideline for Selection of Lung Cancer Patients proposed by IASLC, AMP, and CAP at the time of diagnosis for patients with advanced stage disease. Non- small-cell lung cancer (NSCLC) with ALK gene rearrangements or the resulting fusion pro- teins have been, for the most part, successfully targeted with ALK tyrosine kinase inhibitors (TKIs). The most frequent rearrangement, the EML4-ALK oncogenic fusion, has more than 10 distinct variants, each with a discrete breakpoint in EML4. Recent studies have suggested that EML4-ALK variants may have differential responses to TKIs. Additionally, non-EML4- ALK fusions that result from ALK rearrangements with diverse 5′ partners could possibly have varied biologic and clinical implications in their therapeutic responses and outcomes of patients with NSCLC. Existing literature documents at least 20 non-EML4 fusion partners for ALK, and the clinical responsiveness to crizotinib ranges from increased sensitivity to re- sistance. This underscores the importance of identifying the precise 5′ fusion partner to ALK before initiation of therapy. Herein we report the identification of a novel SLMAP-ALK fusion in a patient with NSCLC

Interpersonal relationships in work of multiprofessional team of family health unit

Objective: To learn the interpersonal relationships established by the multidisciplinary team in a Family Health Unit. Method: It is a qualitative, descriptive and exploratory study in a basic health unit located in a large city in southern Rio Grande do Sul. Participants were seven professionals of the staff, whose data were collected through semi-structured interviews and then treated by thematic analysis. Results: Three themes emerged in which it was revealed the fragility of interpersonal relationships in the study unit. Thus, some strategic aspects were listed for the consolidation of healthy interpersonal relationships as the proposal of a dialogical work environment and availability of spaces for discussions and team meetings, reflecting the improvement of health care to the described population. Conclusion: This study evidences the relevance of giving emphasis on interpersonal relationships and subjectivities of professionals in the labor process

O DANO MORAL NAS RELAÇÕES CONJUGAIS E OS REFLEXOS DA LEI MARIA DA PENHA

O presente artigo teve como escopo analisar o dano moral existente no âmbito familiar. Com a edição da Lei nº 11.340/2006, o legislador resolveu dar tratamento especifico ao dano moral do qual a mulher pode ser vítima no âmbito doméstico. Utilizando-se do método dedutivo e estudos históricos e dogmáticos, a pesquisa foi desenvolvida com o propósito de demonstrar a ocorrência do assédio moral nas relações conjugais e o dever do cônjuge agressor em indenizar o cônjuge vítima por danos morais. A Lei n° 11.340/2006 veio com a missão de proporcionar instrumentos adequados para enfrentar o problema da violência doméstica sofrida pelas mulheres. Demonstra-se a relevância da lei, pois esta compreende entre as formas de violência doméstica aquela que afeta a integridade psicológica da vítima. Conclui a pesquisa pela necessidade de maior empenho do Estado, para buscar medidas que amparem efetivamente as vítimas desse fenômeno social

RUPTURAS E CONTINUIDADES NA INCLUSÃO EDUCACIONAL DA PESSOA SURDA

Resumo: Este artigo discute a educação de surdos no contexto neoliberal partindo da tese de que a política de Educação Especial na Perspectiva Inclusiva fundamenta-se em um discurso pseudo-inclusivo que invisibiliza as especificidades da pessoa surda, a apropriação do conhecimento historicamente construído, consequentemente, a integração do surdo à sua realidade objetiva. Apresenta aproximações do objeto “educação de surdos” ao versar acerca de sua historicidade. A pseudo-inclusão do surdo nas políticas educacionais materializa a inadequada apropriação do conhecimento historicamente construído pela criança surda, bem como a reprodução ideológica e material dos interesses da classe dominante. Conclui-se, então, ser necessária reforçar a resistência da comunidade surda em defesa de uma educação que os perceba como sujeitos não ouvintes em lugar de pessoas deficientes e que sua inclusão educacional se efetiva na interpretação e interação que a pessoa surda faz com o mundo de modo visual e não oralista, isto é, como o sistema educacional ainda insiste em formalizar como método de ensino para os não ouvintes.   Palavras-chave: Educação de Surdos. Historicidade. Inclusão/exclusão