Sweden, the first country to achieve the Joint United Nations Programme on HIV/AIDS (UNAIDS)/World Health Organization (WHO) 90-90-90 continuum of HIV care targets

Objectives: The Joint United Nations Programme on HIV/AIDS (UNAIDS)/World Health Organization (WHO) 90-90-90 goals propose that 90% of all people living with HIV should know their HIV status, 90% of those diagnosed should receive antiretroviral therapy (ART), and 90% of those should have durable viral suppression. We have estimated the continuum of HIV care for the entire HIV-1-infected population in Sweden. Methods: The Swedish InfCare HIV Cohort Study collects viral loads, CD4 counts, and viral sequences, along with demographic and clinical data, through an electronic clinical decision support system. Almost 100% of those diagnosed with HIV infection are included in the database, corresponding to 6946 diagnosed subjects living with HIV-1 in Sweden by 31 December 2015. Results: Using HIV surveillance data reported to the Public Health Agency of Sweden, it was estimated that 10% of all HIV-infected subjects in Sweden remain undiagnosed. Among all diagnosed patients, 99.8% were linked to care and 97.1% of those remained in care. On 31 December 2015, 6605 of 6946 patients (95.1%) were on ART. A total of 6395 had been on treatment for at least 6 months and 6053 of those (94.7%) had a viral load 73% of all patients living with HIV should be virologically suppressed by 2020. Sweden has already achieved this target, with 78% suppression, and is the first country reported to meet all the UNAIDS/WHO 90-90-90 goals

Análise acústica da voz captada na faringe próximo à fonte glótica através de microfone acoplado ao fibrolaringoscópio Acoustic analysis of voice captured in the pharynx above the glottic source through a microphone on a laryngo-fiberscope

Objetivo: O objetivo deste trabalho foi estudar a voz próximo à sua fonte produtora, as pregas vocais, através de um microfone miniaturizado de aparelho auditivo que foi adaptado para ser acoplado à extremidade de um fibrolaringoscópio, permitindo a captação da voz durante a laringoscopia direta. Forma de estudo: Experimental. Material e Método: A voz foi estudada em um grupo de 50 indivíduos, 25 homens e 25 mulheres sem doenças, através de um programa de análise acústica MDVP (Multi-Dimensional Voice Program) do laboratório de voz Computerized Speech Lab, Model 4300B, da Kay Elemetrics. Amostras de vogais sustentadas /a/, /i/ e /u/ foram captadas de três formas diferentes, primeiramente com um microfone comum externo a 15 cm da boca, em segundo lugar com o microfone especial na faringe a 1,5 cm acima das pregas vocais e por último com o microfone especial externamente a 2 cm da boca. Doze parâmetros acústicos relacionados a freqüência fundamental, amplitude e ruído de cada uma das vogais foram comparadas estatisticamente conforme à sua forma de captação. Resultados: Os resultados mostraram diferenças estatisticamente significativas entre a voz captada pelo microfone comum externo e o microfone especial, em relação à freqüência fundamental, aos parâmetros de variação de periodicidade de freqüência, amplitude e ruído. Conclusão: A diferença do som da fonte glótica do som da voz externa pode mostrar as modificações sofridas pela voz no decorrer da passagem pelo trato vocal.<br>Aim: The aim of the present study is to examine the voice to its acoustic source - the vocal folds - with a miniature hearing-aid microphone coupled to the extremity of a laryngo-fiberscope allowing the voice to be captured during direct laryngoscopy. Study design: Experimental. Material and Method: The voice of 50 individuals - 25 males and 25 females bearing no pathologies - was collected by the Multi-Dimensional Voice Program (MDVP) by Kay Elemetrics’ Computerized Speech Lab 4300B Model. Samples of the sustained vowels /a/, /i/ and /u/ were picked up in three distinct ways. Firstly, by a common external microphone placed at 15 cm from the mouth. Secondly, a special microphone was placed on the pharynx 1.5 cm above the vocal folds. Lastly, the same special microphone was placed externally at 2 cm from the mouth. Twelve acoustic parameters regarding fundamental frequency, amplitude and noise of each and every vowel were compared statistically as to the way the voice was picked up. Results: Results show statistically significant differences between the voice picked up by the common external microphone and by the special one as regards to the fundamental frequency, frequency and amplitude variability and noise. Conclusion: The difference between the sound coming from the glottic source and the sound from the external voice shows alterations experienced by the voice during its passage through the vocal tract