Analysis of the Seroprevalence of HIV and HIV 2 infection in women living in an area of the city of Lisbon

Os autores apresentam os resultados de um estudo de seroprevalência da infecção pelo HIV1 (Vírus da Imunodeficiência Humana Tipo 1) e pelo HIV2 (tipo II) em mulheres em idade fértil frequentando uma consulta de Planeamento Familiar e uma consulta de Cuidados Pré-Natais que serve uma população urbana de duas freguesias da cidade de Lisboa em que cerca de 7% é de origem Africana. Foi adoptado um protocolo de trabalho com características de estudo anónimo mas em que se previa a possibilidade da colheita de segunda amostra para confirmação de resultados (modelo non linked). Foram registados através de inquérito os elementos de ordem social e epidemiológica sendo realizado exame clínico a todas as participantes no estudo (1390). Esta fase foi seguida de colheita de amostras de sangue para estudos seroepidemiológicos relacionados com várias infecções virais incluindo o HIV e o HIV2. Foi comparada a população que compareceu (75%) com a que não compareceu á realização de análises verificando-se não haver em geral diferenças significativas entre os dois grupos no que refere a um conjunto de características epidemiológicas, sociais e clínicas. Foram considerados seropositivos para o HIV, os casos com anticorpos anti-HIV detectados por ELISA e confirmados por Western Blot revelando anticorpos contra as três proteínas (env, core e gag) e com resultados igualmente positivos pelos dois métodos em segunda amostra de sangue recolhida subsequentemente. As prevalências de infecção foram quer para o HIV quer para o 111V2 de 0.29% (total 0.58%) na população estudada, sendo a prevalência de HIV 2 de 1 .45% na população de origem Africana. Os seis casos seropositivos detectados incluíam um caso de toxicodependência, um caso de prostituição, um caso de origem Africana, não havendo nos três restantes factores de risco para além da existência de parceiros sexuais múltiplos em duas mulheres. As características clínicas, epidemiológicas e imunológicas dos casos seropositivos são descritas e discute-se a importância da prevalência encontrada. Finalmente salienta-se a relevância da análise e discussão detalhadas, antes do início de qualquer programa de rastreio da infecção pelo HIV, das vantagens, inconvenientes e limitações dos protocolos a usar no contexto da situação concreta do Centro e Comunidade em questão.A seroprevalence study of HIV 1 and HIV 2 infection in women attending a Family Planning and an Antenatal Clinic was done in an area of the City of Lisbon where 7% of the population is of African origin. The protocol of study was of non linked type although with the possibility of colecting a second sample of blood for confirmation of results. Epidemiological, social and clinical data were collected from 1390 women and this was followed by the collection of a blood sample for the seroepidemiological study of HIV 1 and HIV 2 in the population that was submited to blood tests (75%) was compared to the one that missed the test and it was found that no important differences were present between the two. The criteria for HIV1 or HIV 2 positive results were the presence of a positive ELISA test confirmed by an Western Blot revealing antibodies against the three proteins env, core and gag. For a test to be considered positive results by both methods had to be found in a second sample collected later. The prevalences of infection were of 0.29% for HIV 1 and 0.29% for HIV 2 although the prevalence of HIV 2 in the population of African origin was higher (1.45%). The six seropositive cases detected included a drug addict, one prostitute, one case of African origin and two cases with multiple sexual partners. The clinical, epidemiological and immunological features of the seropositive cases are presented and the prevalence found is discussed in the context of other portuguese data. The importance of discussing in detail the advantages and disadvantages of the different protocols of seroprevalence studies in the context of a given Center and Community before starting the screening programmes is stressed.info:eu-repo/semantics/publishedVersio

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Neotropical freshwater fisheries : A dataset of occurrence and abundance of freshwater fishes in the Neotropics

The Neotropical region hosts 4225 freshwater fish species, ranking first among the world's most diverse regions for freshwater fishes. Our NEOTROPICAL FRESHWATER FISHES data set is the first to produce a large-scale Neotropical freshwater fish inventory, covering the entire Neotropical region from Mexico and the Caribbean in the north to the southern limits in Argentina, Paraguay, Chile, and Uruguay. We compiled 185,787 distribution records, with unique georeferenced coordinates, for the 4225 species, represented by occurrence and abundance data. The number of species for the most numerous orders are as follows: Characiformes (1289), Siluriformes (1384), Cichliformes (354), Cyprinodontiformes (245), and Gymnotiformes (135). The most recorded species was the characid Astyanax fasciatus (4696 records). We registered 116,802 distribution records for native species, compared to 1802 distribution records for nonnative species. The main aim of the NEOTROPICAL FRESHWATER FISHES data set was to make these occurrence and abundance data accessible for international researchers to develop ecological and macroecological studies, from local to regional scales, with focal fish species, families, or orders. We anticipate that the NEOTROPICAL FRESHWATER FISHES data set will be valuable for studies on a wide range of ecological processes, such as trophic cascades, fishery pressure, the effects of habitat loss and fragmentation, and the impacts of species invasion and climate change. There are no copyright restrictions on the data, and please cite this data paper when using the data in publications