RESUMO
PURPOSE: In the last two decades transmission of hepatitis C virus (HCV) in HIV positive men who have sex with men (MSM) has been reported globally. Chemsex and specific sexual practices have been identified as risk factors. Our study aimed to identify risk factors for HCV transmission in MSM living with HIV attending in Mexico. METHODS: We conducted a case-control study from April to December 2019 at the Hospital de Infectología "La Raza" National Medical Center, in Mexico City. A case was defined as an HIV-infected MSM with positive HCV-antibody test. For each case, 3 controls were included, defined as HIV infected MSM with negative HCV-antibody test. A self-questionnaire covering sexual practices and other risk factors for HCV transmission was applied. Bivariate analysis was performed to obtain odds ratio (OR) using Chi-square test. Independent risk factors were identified in a subsequent analysis performing a logistic regression model. RESULTS: A total of 324 patients participated in the study, 81 cases and 243 controls. Median age was 30.5 years (IQR: 18-52) and 28.8 years (IQR: 21-45) in the case and control group, respectively. Most prevalent HCV genotype was 1a (79%). In the logistic regression model, sharing straw during cocaine inhalation (OR: 9.03; 95% CI; 1.35-13.52; P = 0.003), sharing sex toys (OR: 17.53, 95% CI; 6.85-44.86; P = 0.002), and ethyl chloride use for chemsex (OR: 2.26; 95% CI; 1.29-5.56; P = 0.037) were significant risk factors for HCV infection. CONCLUSION: This study identifies risk factors for HCV transmission in Mexico in HIV positive MSM in congruence with the findings of many studies performed worldwide. This is the first study that indicates a possible association between ethyl chloride use in chemsex and HCV infection. Assessment of local populations for risk factors for HCV transmission may help to develop specifically targeted behavioral interventions to reduce HCV transmission.
Assuntos
Cloreto de Etil , Infecções por HIV , Hepatite C , Minorias Sexuais e de Gênero , Adulto , Estudos de Casos e Controles , Infecções por HIV/complicações , Hepacivirus/genética , Hepatite C/complicações , Homossexualidade Masculina , Humanos , Masculino , México/epidemiologia , Fatores de RiscoRESUMO
UNLABELLED: University students aged 17 to 24 years of age are prone to many risk factors. OBJECTIVES: Identify risk factors related to exploring sexuality and characteristics of consumption of psychoactive substances in students attending medical school. METHODS: 465 Medical students from Santa Casa of São Paulo Faculty of Medical Sciences (FCMSCSP) were prospectively and transversely evaluated during 2005. An anonymous, semi-structured, self-filling questionnaire was used. The average age of the students was 21.5 years, 43% females. 76.2% preferred alcohol, and 11.1% tobacco consumption; chloroethane (lança-perfume) consumption occurred in 22.6% and 15.3% consumption of other types of illicit drugs, with marijuana as the most used one (94%). 70.3%, of the parents drink alcohol and 30.5% smoke tobacco. As for the students' sexuality, 85.3% have already had sexual intercourses, starting at average age of 17. 88.8% used condom during the first sexual intercourse, however, 35.6% did not use it regularly; 5.4% had already had some type of DST. 79.8% of the females preferred having used contraceptive methods; however, 28.1% had a suspicion of pregnancy, which was confirmed in 7.9% of the cases. 9.9% of the students had ideas of abortion, 12.5% have effectively attempted it. 85% found medical school stressing and to relieve tension, 33.8% practiced sports; 6.9% preferred either licit or illicit drug consumption, and 5% used tranquilizers. The results showed risk behaviors: unsafe sex and the use of licit and illicit drugs indicated the need to establish guidance programs on reproductive health, improving self-esteem, and prevention during medical education.
Assuntos
Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Brasil , Preservativos/estatística & dados numéricos , Cloreto de Etil/administração & dosagem , Características da Família , Feminino , Humanos , Masculino , Gravidez não Planejada , Estudos Prospectivos , Infecções Sexualmente Transmissíveis/epidemiologia , Fumar/epidemiologia , Adulto JovemRESUMO
La corriente más importante del pensamiento médico sobre el origen del dolor lumbar gira alrededor de los transtornos degenerativos (espondiloartrosis), las desviaciones posturales o estructurales de columna, la patología discal con o sin compresión radicular, las malformaciones congénitas vertebrales, etc. Sin embargo, la mayoría de personas aquejadas de lumbalgia, presentan un proceso benigno, localizado en partes blandas, con un componente psicosomático. Proceso particularmente reversible al que se conoce con Síndrome Miofascial, para el cual existe tratamiento en base a medidas conservadoras, como la Digitopresión, estiramiento muscular, electropuntura galvánica, además de la infiltración en `puntos gatillo'. En el presente trabajo realizado sobre 102 pacientes que consultan por dolor lumbar, se demuestra error en el diagnóstico de entrada en el 96 por ciento. Además comprobamos las bondades del tratamiento conservador mencionado, al conseguir la regresión de los síntomas en forma total o significativa, en el 86 por ciento de los pacientes tratados
Assuntos
Masculino , Feminino , Fibromialgia , Dor Lombar/etiologia , Síndromes da Dor Miofascial/diagnóstico , Cloreto de Etil/uso terapêutico , Lidocaína/uso terapêutico , Síndromes da Dor Miofascial/terapia , PeruRESUMO
Ethephon (I) is used commercially to prolong the flow of latex from the rubber tree after tapping (Yield stimulation). The compound is applied to the bark in the region of the tapping cut and the effect on latex flow is due to the ethylene released by chemical decomposition, since gaseous ethylene itself is also a very effective stimulant. When 14C-I is applied to the bark of a young Hevea seedling, it is absorbed into the plant by processes which appear to be largely non-metabolic. Ethylene formation commences immediately at the site of application, and the gas is quickly translocated throughout the plant. Translocation of I to all parts of the plant also occurs and the accumulation of 14C in the bark above the zone of application is greater than that below. Chromatographic analysis has shown that compounds other than I remain in the plant tissue. Experiments using 14C-I have shown that detached leaves are able to convert a considerable proportion of the compound to at least twelve non-volatile acid products. One of these is a conjugate of I with an unidentified material. A major component of the products is 2-hydroxyethylphosphonic acid (II), which is itself converted to a number of compounds in leaves. The application of I to bark from mature Hevea, results in the formation of a single substance which is also a conjugate of I. Neither I nor II is effective in inducing the formation of ethylene from endogenous precursors in vegetative Hevea tissue. Ethylene is poorly metabolized by Hevea leaves and the evidence available indicates that it is unlikely that any of the compounds produced from I are metabolites of ethylene.