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Background: Rectal and genital sampling in HIV prevention trials permits assessments at the site of HIV entry. Yet the safety and acceptability of circumcision and sigmoidoscopy (and associated abstinence recommendations) are unknown in uncircumcised men who have sex with men (MSM) at high risk of HIV infection. Methods: Twenty-nine HIV-seronegative high-risk Peruvian MSM agreed to elective sigmoidoscopy biopsy collections (weeks 2 and 27) and circumcision (week 4) in a 28-week cohort study designed to mimic an HIV vaccine study mucosal collection protocol. We monitored adherence to abstinence recommendations, procedure-related complications, HIV infections, peripheral immune activation, and retention. Results: Twenty-three (79.3%) underwent a first sigmoidoscopy, 21 (72.4%) were circumcised, and 16 (55.2%) completed a second sigmoidoscopy during the study period. All who underwent procedures completed the associated follow-up safety visits. Those completing the procedures reported they were well tolerated, and complication rates were similar to those reported in the literature. Immune activation was detected during the healing period (1 week post-sigmoidoscopy, 6 weeks post-circumcision), including increases in CCR5+CD4+T cells and α4β7+CD4+T cells. Most participants adhered to post-circumcision abstinence recommendations whereas reduced adherence occurred post-sigmoidoscopy. Conclusion: Rectosigmoid mucosal and genital tissue collections were safe in high-risk MSM. Although the clinical implications of the post-procedure increase in peripheral immune activation markers are unknown, they reinforce the need to provide ongoing risk reduction counseling and support for post-procedure abstinence recommendations. Future HIV vaccine studies should also consider the effects of mucosal and tissue collections on peripheral blood endpoints in trial design and analysis. Trial Registration: ClinicalTrials.gov [ABSTRACT FROM AUTHOR]

Introduction: There is a paucity of data on the prehospital presentation of stroke patients. Our assumption was that there are gender differences in S.B.P. and D.B.P. when paramedics first arrive at the scene to evaluate patients with acute non-traumatic cerebral deficit. According to the 2010 A.H.A. guidelines blood pressure elevation should not be treated acutely in the pre-hospital setting.METHODS: A retrospective review of run sheets was conducted to determine age, race, sex, initial blood pressure, onset of symptoms and whether the patients were being treated for hypertension. Minitab 16 was used to analyze the data. 2 sample poison test was used to compare groups.Results: •214 total records were reviewed •There were 142 Caucasian, 63 Afro-American and 6 Hispanic patients •The initial presenting E.K.G. rhythm was a. Fib in 14 patients, N.S.R. in 186 patients and a paced rhythm in 11 patients •All 209 patients were transported to stroke receiving hospitals without untoward consequences •46 patients called 911 more than 3.5 hrs after the onset of symptoms51/117 (43%) of women were on antihypertensive agents. 45/92 (48%) of men were on antihypertensive agents.Conclusions: For patients who call 911 after the onset of a non-traumatic acute cerebral deficit: there is no difference between men’s and women’s systolic and diastolic blood pressures; despite a significant difference in age and significant variation in treatment regiments for high blood pressure prior to the onset of symptoms. [ABSTRACT FROM AUTHOR]