Twin pregnancy in a liver transplant recipient with HIV infection

We are not aware of a report detailing the complex obstetrical and medical management of twin pregnancy in the context of HIV infection and early post-liver transplantation period. Here we describe the successful outcome of a twin pregnancy in a 28-year-old HIV-positive female receiving antiretroviral therapy and immunosuppressive therapy who was the recipient of a liver transplant for previous drug-induced liver failure

Physical activity levels as a quantifier in police officers and cadets

Objectives: The aim of the present study was to determine the physical activity levels of active duty police officers and police academy cadets in different life domains and intensities. These parameters were treated as potential quantifiers that could be used when assessing individuals preparing for work as future police officers. Material and Methods: The study recruited 153 active police officers and 176 cadets attending a police academy and administered a diagnostic survey, the long-form version of the International Physical Activity Questionnaire, while in the statistical analysis the Student's t-test for independent groups was applied. Results: It was determined that police officers present high physical activity levels within the work domain, which are developed from initial training at a police academy and then throughout their police career. Conclusions: Such data are important in the light of the role police officers play in public safety as well as the prominence of physical activity within a particular profession and how it can be targeted and tailored to their needs

Survival of adult AIDS patients in a reference hospital of a metropolitan area in Brazil Sobrevivência de pacientes adultos com Aids em hospital de referência no Nordeste brasileiro

OBJECTIVE: To evaluate the influence of sociodemographic, clinical, and epidemiological factors in AIDS patients survival in a reference hospital. METHODS: A sample of 502 adult AIDS patients out of 1,494 AIDS cases registered in a hospital in Fortaleza, Brazil, was investigated between 1986 and 1998. Sixteen cases were excluded due to death at the moment of the AIDS diagnosis and 486 were analyzed in the study. Socioeconomic and clinical epidemiological were the variables studied. Statistical analysis was conducted using the Kaplan-Meier survival analysis and the Cox proportional hazards model. RESULTS: Three hundred and sixty two out of the 486 patients studied took at least one antiretroviral drug and their survival was ten times longer than those who did not take any drug (746 and 79 days, respectively, p <0.001). Patients who took two nucleoside reverse transcriptase inhibitors (NRTI) plus protease inhibitor were found to have higher survival rates (p <0.001). The risk of dying in the first year was significantly lower for patients who took NRTI and a protease inhibitor compared to those who took only NRTI. In addition, this risk was much lower from the second year on (0.10; 95%CI: 0.42-0.23). The risk of dying in the first year was significantly higher for less educated patients (15.58; 95%CI: 6.64-36.58) and those who had two or more systemic diseases (3.03; 95%CI: 1.74-5.25). After the first year post-diagnosis, there was no risk difference for these factors. CONCLUSIONS: Higher education revealed to exert a significant influence in the first-year survival. Antiretroviral drugs had a greater impact in the survival from the second year on. A more aggressive antiretroviral therapy started earlier could benefit those patients.<br>OBJETIVO: Avaliar, em um hospital de referência, a influência de fatores sociodemográficos e clínico-epidemiológicos na sobrevivência de pacientes com Aids. MÉTODOS:Foi estudada uma amostra de 486 adultos com Aids atendidos em hospital de referência no Ceará, entre 1986 e 1998. Foram avaliadas as variáveis socioeconômicas e clínico-epidemiológicas. A análise foi realizada pelo método Kaplan-Meier e por regressão de Cox. RESULTADOS: Dos 486 pacientes estudados, 362 utilizaram pelo menos uma droga anti-retroviral e tiveram sobrevida dez vezes maior que os que não a utilizaram (746 e 79 dias, respectivamente; p<0,001). O risco de morrer, no primeiro ano, foi significativamente menor (0,25; IC95%: 0,12-0,50) para os que fizeram uso de dois inibidores de transcriptase reversa ou HAART e menor a partir do segundo ano (0,10; IC95%:0,42-0,23) em relação aos que não os usaram. Indivíduos sem nível universitário (15,58; IC95%:6,64-36,58) e que apresentaram duas ou mais doenças sistêmicas (3,03; IC95%:1,74-5,25) tiveram risco significativamente maior de morrer no primeiro ano. Após o primeiro ano, não se observou diferença. CONCLUSÃO: O melhor nível socioeconômico, medido indiretamente pela escolaridade, demonstrou grande influência na sobrevivência no primeiro ano. As drogas anti-retrovirais tiveram mais impacto na sobrevivência a partir do segundo ano, assim como igualaram o risco de morrer de pacientes com duas ou mais doenças sistêmicas àqueles que não tiveram nenhuma no mesmo período. Concluiu-se que uma introdução mais precoce e mais agressiva dos anti-retrovirais poderia beneficiar os pacientes