Latex allergy: an emerging

Objectives: The current review presents the pathogenic mechanisms, diagnostic and therapeutic and preventive measures to avoid the development of complications related to latex allergy. Method: Literature search electronically from articles already published on the basis of the NCBI / PUBMED / MEDLINE. Results: Manifestations of latex allergy are related to immediate hypersensitivity such as urticaria, angioedema, asthma or even anaphylaxis, or delayed hypersensitivity by a mechanism such as allergic contact dermatitis or primary irritation. Conclusion: Prevention of exposure, replacement and use of latex-free products such as synthetic gloves are essential for those affected. Adjustments in the workplace should be done with gloves without talc, low in allergens or synthetic gloves. These preventive measures significantly reduce the prevalence of allergic reactions

UNIVERSITY HOSPITAL CRISIS IN BRAZIL

RESUMO:Introdução: Indústria da saúde chegou aos Hospitais Universitários(HU) no Brasil, com o contencioso entre o que o paciente quer e o que o Sistema Único de Saúde pode oferecer; HUs são instituições de ensino com a missão de transformar estudantes em profissionais de saúde competentes, desenvolver programas de pesquisa, prática assistencial  na rotina hospitalar diária, além de garantir direitos formais à comunicação, decência, cortesia e respeito.Realidade e Modelo: Há tendência a transformação de instituições de ensino (HUs) em sistemas de assistência à saúde fornecedoras de atendimento médico à população utilizando a prática da medicina baseada em evidência.Política Atual:O Governo Brasileiro estabeleceu nos HU Fundações de Apoio, através das quais os recursos necessários aos HU são transferidos para cobrir suas demandas bem como facilita a possibilidade de receita de planos para seus serviços médicos.Conclusão: É necessária avaliação crítica da situação nos HUs, fortalecendo estas instituições de ensino/pesquisa como instituições completas sociais de atenção à saúde, mas que além de prover saúde, fornece serviços médicos de excelência, contribuem na formação de recursos humanos, em tecnologia e infraestrutura. Descritores:Hospital Universitário,Hospital de Ensino, Crise no Hospital Universitário

UNIVERSITY HOSPITAL CRISIS IN BRAZIL

RESUMO: Introdução: Indústria da saúde chegou aos Hospitais Universitários(HU) no Brasil, com o contencioso entre o que o paciente quer e o que o Sistema Único de Saúde pode oferecer; HUs são instituições de ensino com a missão de transformar estudantes em profissionais de saúde competentes, desenvolver programas de pesquisa, prática assistencial  na rotina hospitalar diária, além de garantir direitos formais à comunicação, decência, cortesia e respeito.Realidade e Modelo: Há tendência a transformação de instituições de ensino (HUs) em sistemas de assistência à saúde fornecedoras de atendimento médico à população utilizando a prática da medicina baseada em evidência.Política Atual:O Governo Brasileiro estabeleceu nos HU Fundações de Apoio, através das quais os recursos necessários aos HU são transferidos para cobrir suas demandas bem como facilita a possibilidade de receita de planos para seus serviços médicos.Conclusão: É necessária avaliação crítica da situação nos HUs, fortalecendo estas instituições de ensino/pesquisa como instituições completas sociais de atenção à saúde, mas que além de prover saúde, fornece serviços médicos de excelência, contribuem na formação de recursos humanos, em tecnologia e infraestrutura. Descritores:Hospital Universitário,Hospital de Ensino, Crise no Hospital Universitário

Oral bacteriome of HIV-1-infected children from Rio de Janeiro, Brazil: next-generation DNA sequencing analysis

Background and Aim: This study compared the oral bacteriome between HIV-1-infected and non-HIV-1-infected Brazilian children/teenagers. Methods Whole saliva, biofilm from the dorsal surface of the tongue and biofilm from supragingival and subgingival sites were collected from 27 HIV-1-infected and 30 non-HIV-1-infected individuals. Bacterial genomic DNA was extracted and 16S rRNA genes were sequenced using next-generation sequencing technology (Ion Torrent). Results: In the supragingival biofilm, the phylum Firmicutes and genus Streptococcus sp. were more frequent in HIV-1-infected (95% and 78%, respectively) than in non-HIV-1-infected individuals (40% and 24%, respectively). In the subgingival biofilm of HIV-infected participants, the relative abundance of the Veillonella sp. and Prevotella sp. genera were higher than in non-HIV-1-infected participants. On the tongue, the genera with greater relative abundance in HIV-1-infected individuals were Neisseria sp. (21%). In saliva, the difference of the genus Prevotella sp. between non-HIV-1-infected and HIV-1-infected individuals was 15% and 7%, respectively. The Chao index revealed an increase in the richness of both sub- and supragingival biofilms in the HIV-1-infected samples compared with non-HIV-1-infected samples. Conclusion: HIV-1-infected children/teenagers have a higher frequency of the phyla Firmicutes and genus Streptococcus, and their oral microbiome shows more complexity than that of non-HIV-1-infected children/teenagers

Incidence and Clinical Description of Lymphomas in Children and Adolescents with Vertical Transmission of HIV in Rio de Janeiro, Brazil, in Pre- and Post-Combined Antiretroviral Therapy Eras: A Multicentric Hospital-Based Survival Analysis Study

The incidence of cancer in children living with HIV (CLWH) is high and lymphomas are the most common type of cancer in this population. The combined antiretroviral therapy (cART) changed the natural history of HIV infection. To determine the incidence and profile of these CLWH malignancies in Rio de Janeiro (RJ), Brazil, we conducted a retrospective and observational study of vertically infected CLWH, ranging from 0–20 incomplete years, from 1995 to 2018, at five reference centers. The study period was divided into three eras in accordance with the widespread use of cART in Brazil. 1306 patients were included. Of the 25 lymphomas found, 19 were AIDS-defining malignancies (ADM); 6 were non-AIDS-defining malignancies (NADM). The incidence rate (IR) of lymphoma developing was 1.70 per 1000 children-year (95% CI 1.09–2.50). ADM development IR decreased from 2.09–1.75–0.19 per 1000 children-year (p p = 0.013). This study demonstrates the IR of lymphoma in CLWH in RJ, Brazil, as well as the benefit of cART in reducing ADM and death occurrence in the Post-cART era

Prognostic Factors in Children and Adolescents with Lymphomas and Vertical Transmission of HIV in Rio de Janeiro, Brazil: A Multicentric Hospital-Based Survival Analysis Study

Lymphomas related to HIV are generally aggressive and have a poor prognosis, despite the use of combined antiretroviral therapy (cART) and effective chemotherapy treatment. To determine survival and prognostic factors in children and adolescents living with HIV (CLWH) in Rio de Janeiro (RJ), Brazil, who developed lymphomas, we performed a retrospective and observational study of vertically infected CLWH aged from 0 to 20 incomplete years during1995 to 2018 at five reference centers for cancer and HIV/AIDS treatment. Of the 25 lymphomas, 19 were AIDS-defining malignancies (ADM) and 6 were non-AIDS-defining malignancies (NADM). The 5-year overall survival (OS) and 5-year event-free survival (EFS) probabilities were both 32.00% (95% CI = 13.72–50.23%), and the 5-year disease-free survival (DFS) probability was 53.30% (95% CI = 28.02–78.58%). In the multivariate Cox regression analysis, performance status 4 (PS 4) was considered a poor prognostic factor for OS (HR 4.85, 95% CI = 1.81–12.97, p = 0.002) and EFS (HR 4.95, 95% CI = 1.84–13.34, p = 0.002). For the DFS, higher CD4+ T-cell counts were considered a better prognostic factor (HR 0.86, 95% CI = 0.76–0.97, p = 0.017) in the multivariate Cox regression analysis. This study demonstrates, for the first time, survival and prognostic factors for CLWH who developed lymphomas in RJ, Brazil