RESUMO
OBJECTIVE: Being a Caribbean country, the Dominican Republic is considered endemic for HTLV-1. Viral screening in blood banks is recommended for this blood borne infection. The purpose of this work is to analyze the seroprevalence and trends of HTLV-1/2 in the Dominican Republic blood donors; it is focused on Santo Domingo, the capital of the country, which has the largest blood donation activity. We also aim at comparing our findings with published data from neighboring countries. METHODS: We performed a retrospective cross-sectional study of 10 blood centers of Santo Domingo, which reported HTLV and the other blood-transmitted infections in full. They represent more than 40% of the province's blood donations. Annual seroprevalence of HTLV-1/2, period prevalence (2012-2017), and time trend were determined. RESULTS: A total of 352,960 blood donations were evaluated. The HTLV-1/2 period prevalence was 0.26% (929/352,960)(95% CI: 0.24-0.28%). We also found a marked predominance of replacement donation (90.4%) in comparison to voluntary contributions (9.6%). Therefore, this blood donor study may provide clues on the general prevalence of the infection. CONCLUSIONS: Seroprevalence of HTLV-1/2 in blood donors of Santo Domingo, Dominican Republic, showed a relatively low and steady trend in the studied period.
Assuntos
Doadores de Sangue , Vírus Linfotrópico T Tipo 1 Humano , Estudos Transversais , República Dominicana/epidemiologia , Humanos , Estudos Retrospectivos , Estudos SoroepidemiológicosRESUMO
BACKGROUND: Chemotherapy-associated liver injury (CALI) is a matter of concern for hepatobiliary surgeons as it can entail postoperative liver failure after an extensive hepatectomy. Recent studies have taken special interest in liver function parameters which can correlate with CALI to decrease this adverse event. Therefore, the current study investigates the usefulness of splenic volume as a biomarker of CALI through a portal hypertension mechanism, in patients with colorectal liver metastases (CRLM). STUDY DESIGN: We carried out a study in patients with CRLM operated on between 2009 and 2014 in our center. All samples of healthy liver were graded for non-alcoholic fatty liver disease (NAFLD) and sinusoidal obstructive syndrome. Computarized tomography scans for spleen volumetry were analyzed for each patient at CRLM diagnosis, after neoadjuvant chemotherapy, 1 and 6 months after resection. RESULTS: A group of 65 consecutive patients with CRLM of large bowel adenocarcinoma submitted to liver resection were included. Patients receiving neoadjuvant chemotherapy had a greater spleen volume increase than those who did not receive treatment (p = 0.053), finding a statistically significant spleen growth in patients with NAFLD (p = 0.036). There was no correlation between spleen enlargement and postoperative complications or average stay. However, survival was decreased in patients with spleen growth and CALI. CONCLUSIONS: Patients who receive neoadjuvant chemotherapy for liver metastasis surgery have a greater splenic volume increase, which correlates with NAFLD and a lower survival.
Assuntos
Adenocarcinoma/terapia , Antineoplásicos/efeitos adversos , Doença Hepática Induzida por Substâncias e Drogas/patologia , Neoplasias Colorretais/patologia , Hepatectomia , Hepatopatia Veno-Oclusiva/patologia , Neoplasias Hepáticas/terapia , Hepatopatia Gordurosa não Alcoólica/patologia , Baço/diagnóstico por imagem , Adenocarcinoma/secundário , Antineoplásicos/uso terapêutico , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Fígado Gorduroso/induzido quimicamente , Fígado Gorduroso/patologia , Hepatopatia Veno-Oclusiva/induzido quimicamente , Humanos , Neoplasias Hepáticas/secundário , Metastasectomia , Terapia Neoadjuvante , Hepatopatia Gordurosa não Alcoólica/induzido quimicamente , Tamanho do Órgão , Oxaliplatina/efeitos adversos , Oxaliplatina/uso terapêutico , Complicações Pós-Operatórias , Baço/patologia , Taxa de Sobrevida , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: Explore the role male partners should play in interventions that emerge from an empowerment perspective for the prevention of HIV/AIDS in women. Explore the social and cultural context, rationale and format for interventions if male partners are incorporated. BACKGROUND: Heterosexual women have become the most at risk group for HIV infection. Most of the HIV/AIDS prevention efforts have excluded the participation of male partners. Interventions with women have not been as affective as desired since the negotiation of safer sex method, such as the male condom, is not under their control. METHODS: Thirteen focus groups were conducted in Puerto Rico, Dominican Republic and Mexico. Groups were conducted with HIV/AIDS prevention researchers, service providers, and heterosexual men and women who participated in HIV/AIDS prevention interventions. The taped conversations were transcribed and analyzed using content analysis according to a set of defined categories and subcategories. RESULTS: The majority of participants agreed that men must be incorporated in HIV prevention efforts with women. Many conditioned this participation, while some expressed their opposition. Regarding the ways of participation many favored working with men and women separately at the beginning and integrating at the end. They recommended considering working at a group level. CONCLUSIONS: The HIV/AIDS epidemic has put in the forefront the need to consider non-traditional approaches to promote behavior change. A group-base intervention with couples may be an effective way to prevent the HIV/AIDS epidemic.
Assuntos
Humanos , Masculino , Feminino , Infecções por HIV/prevenção & controle , Papel (figurativo) , Síndrome da Imunodeficiência Adquirida/prevenção & controle , Grupos Focais , Fatores SexuaisRESUMO
This article discusses the challenges faced by researchers and interventionists when attempting to promote change in social norms and normative beliefs that promote HIV/AIDS risk-related behaviors among Puerto Rican and Dominican women. The article focuses on the role of culture in HIV/AIDS prevention with women by analyzing the sociohistorical context of some cultural beliefs and by illustrating the tension between risk-related and protective cultural beliefs in research conducted by the authors with women in both New York and Puerto Rico. The authors propose that promoting changes in sex-related social norms and normative beliefs might be constructed as a subversive act and present the challenge this analysis poses for community psychology. They conclude that this conceptualization might be construed as subversive because rather than idealizing culture, it promotes changes that respect diversity within the culture and foster participation in the development of new cultural values, beliefs and norms.
Assuntos
Infecções por HIV/etnologia , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Hispânico ou Latino/psicologia , Psicologia Social , Saúde da Mulher , Síndrome da Imunodeficiência Adquirida/etnologia , Síndrome da Imunodeficiência Adquirida/prevenção & controle , Características Culturais , República Dominicana/etnologia , Feminino , Identidade de Gênero , Educação em Saúde , Humanos , New York , Porto Rico/etnologia , Assunção de Riscos , Sexo Seguro , Comportamento Sexual , Apoio SocialRESUMO
The development and validation process of the Video Rating Scale of Conflict Management and Sexual Negotiation (EAVI) is presented. This instrument was developed as a response to the growing incidence of HIV/AIDS infection among heterosexual women and recognizes the need to evaluate prevention efforts that focus on the development of sexual negotiation skills. EAVI was used to evaluate taped simulations of couples negotiating safer sex. Content validity and reliability analysis were performed. Overall, the scale has a content validity score of .90 and a reliability of 75%. The validity and reliability of specific subscales was low thus suggesting a need for revision. Suggestions are provided for improving the measure and examples of its actual usefulness in academic and community settings are presented.
Assuntos
Síndrome da Imunodeficiência Adquirida/prevenção & controle , Conflito Psicológico , Infecções por HIV/prevenção & controle , Negociação , Sexo , Adulto , Feminino , Humanos , Porto Rico , Reprodutibilidade dos Testes , Gravação em VídeoRESUMO
In this article we examine the role of the family in the provision of social support by studying the identity of persons which the participants consider available for providing support. We define social support as that human relationship in which socio-emotional (closeness, intimacy counseling), instrumental (goods and services) and recreational (companionship for recreation) resources are interchanged. Based on a probabilistic sample of the adult (17-68 yrs.) population, 912 persons were successfully interviewed (response rate = 90.4%) using a structured interview schedule. Results indicate that close relatives (parents, brothers/sisters, sons/daughters) are the main resource of all types of support, not only of the general population but also of specific demographic groups defined by their gender, age (17-39, 40-68) and schooling (0-11, 12 + yrs). The marital partner was also identified as an important support resource, especially emotional and recreational; more distant relatives were also important for providing instrumental support. Although the compared groups showed many similarities, they also differed in various aspects both when individually and jointly analyzed. It is concluded that the family is very important in the provision of social support in Puerto Rico (PR).