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Background: The growing trend of STIs in recent years was altered after the outbreak of the SARS-CoV-2 pandemic., Objectives: Describe the impact of the SARS-CoV-2 pandemic on STI declarations received during the pre-pandemic to pandemic period and estimate the number of STI cases expected for the pandemic period., Material and Methods: Descriptive analysis of STI declarations received during the pre-pandemic (2018-2019) and pandemic (2020-2021) periods. The influence of the number of positive cases of SARS-CoV-2 with the number of positive cases of STIs during the months of the pandemic was studied using a correlation model. Using the Holt-Wilson time series model, an estimate was made of the number of STI cases expected for the pandemic period., Results: The global incidence rate for all STIs in 2020 decreased by 18.3% compared to 2019. Chlamydia and syphilis presented a greater reduction in their incidence from 2019 to 2020 of 22.7% and 20.9%, respectively and 9.5% and 2.5% for gonorrhea and LGV. Estimates showed that in 2020 there would have been 44.6% more STIs than those declared. The proportions according to sex, country of birth and sexual orientation changed significantly in chlamydia and gonorrhea., Conclusions: The measures adopted for the prevention of SARS-CoV-2 infections were able to achieve an initial decrease in STI cases in 2020, however, this change was not maintained during 2021, which ended with higher incidences recorded to date., (Copyright © 2023 Elsevier España, S.L.U. All rights reserved.)

The biological mechanisms underlying emotional distress in HIV infection are likely to be complex but remain understudied. We investigated whether dysbiotic signatures in the gut microbiome of persons living with HIV (PLWH) are associated with their emotional status. We retrospectively examined the gut microbiome and clinical evaluation of 129 adults (94 PLWH and 35 HIV-) enrolled at UC San Diego's HIV Neurobehavioral Research Program. A subset of participants (32 PLWH vs. 13 HIV-) underwent an emotional assessment using the NIH Toolbox Emotion Battery summarized by three composite scores (negative affect, social satisfaction, and psychological well-being). We then sequenced the 16S rDNA V3-V4 regions from stool and performed taxonomic assignment using CLC Microbial Genomics Module. The gut microbiota profiles were evaluated in relation to participants' emotional assessment. All analyses were done in R statistical software. We found that the relative abundance of aerotolerant bacteria was significantly higher in PLWH (p < 0.01) and was associated with a lifetime major depression diagnosis independently of HIV status (p = 0.05). Moreover, PLWH experienced significantly worse psychological well-being (p = 0.02), less social satisfaction (p = 0.03), and more negative affect (p = 0.02). Higher levels of aerotolerant bacteria were associated with worse psychological well-being (rho = -0.35, p = 0.02), less social satisfaction (r = - 0.42, p < 0.01), and more negative affect (rho = 0.46, p < 0.01). The association of aerotolerant bacteria with social satisfaction and negative affect was independent of HIV status (p < 0.05, for both). The over-representation of aerotolerant bacteria in the gut may reflect worse oxidative stress and barrier defects and may contribute to emotional distress during HIV infection.

We present a case report of a patient with osteopetrosis and refractory bilateral knees osteoarthritis who underwent bilateral total knee arthroplasties (TKAs). After conservative management has failed, surgical treatment with arthroplasty is an excellent alternative with satisfactory outcomes. TKA in patients with osteopetrosis has only been described in 6 other case studies, none of which underwent bilateral TKA. To perform this procedure, additional attention should be directed toward the presurgical planning because of the amplified difficulty of the procedure and the altered bone biology that increases the risks of intraoperative fractures and markedly extends the time of surgery. This report describes a case of osteopetrosis with refractory osteoarthritis managed with bilateral TKA, the surgical technique and special considerations, complications, and future recommendations.

Objective: Objectively evaluate the incidence of sciatic nerve injury after a total hip arthroplasty (THA) performed through a posterolateral approach., Methods: Patients scheduled to undergo THA were evaluated preoperatively and postoperatively with electrophysiologic studies, the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) questionnaire and other methods described in the study. Patients older than 21 years with any of the following preoperative diagnoses: primary or secondary osteoarthritis, aseptic avascular necrosis, rheumatoid arthritis, and posttraumatic arthritis were included. Variables used for analysis were sex, age, and body mass index (BMI). The Mann-Whitney U and Wilcoxon tests and, Pearson and Spearman correlation statistics were used for analysis of categorical and continuous data respectively., Results: Electrodiagnostic data showed alterations in 17 patients (70.8%). No signs of sciatic nerve injury. The mean preoperative and postoperative WOMAC scores were 40 and 74, respectively (p = 0.0001). Statistical differences were noted in sural sensory amplitude (SSA) and distal amplitude of the tibialis motor nerve in the female group (p=0.007; p=0.036, respectively). The SSA also demonstrated differences in the obese group (p=0.008). In terms of age, both the SSA (Pearson p=0.010 and Spearman p=0.024) and the proximal latency of the peroneal motor nerve (Pearson p=0.026 and Spearman p=0.046) demonstrated a decrease in amplitude and an increase in latency that was inversely related with age., Conclusion: According to our subclinical electrophysiological findings, surgeons that use the posterolateral approach in THA procedures must be conscious of the sciatic nerve's vulnerability to reduce possible clinical complications.

The human genes for interleukin 13 (IL-13) and its receptor alpha 1 (IL-13Rα1) are in chromosomal regions associated with Parkinson's disease (PD). The interaction of IL-13 with its receptor increases the susceptibility of mouse dopaminergic neurons to oxidative stress. We identified two rare single SNPs in IL13 and IL13RA1 and measured their cytotoxic effects. rs148077750 is a missense leucine to proline substitution in IL13. It was found in individuals with early onset PD and no other known monogenic forms of the disease and is significantly linked with PD (Fisher's exact test: p-value = 0.01, odds ratio = 14.2). rs145868092 is a leucine to phenylalanine substitution in IL13RA1 affecting a residue critical for IL-13 binding. Both mutations increased the cytotoxic activity of IL-13 on human SH-SY5Y neurons exposed to sublethal doses of hydrogen peroxide, t-butyl hydroperoxide or RLS3, an inducer of ferroptosis. Our data show that both rs148077750 and rs145868092 conferred a gain-of-function that may increase the risk of developing PD., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background and Objective: In the last decade, the incidence of syphilis has increased in our health area. Our objective is to describe the epidemiological and clinical characteristics of patients diagnosed with syphilis at our centre and their relationship with HIV., Patients and Methods: The clinical and epidemiological variables of patients diagnosed with syphilis in a third-level hospital over a period of 4.5 years, as well as their HIV status, were analysed through a descriptive study., Results: There was a significant increase in the incidence of syphilis in the period 2011-2015. We included 220 patients, 98% men (94% MSM). 62% were HIV+ and 89% came in early/infectious stages of the disease. 7% were concomitantly diagnosed with HIV. There was a high number of sexual partners and frequent use of drugs associated with sexual activity (46%)., Conclusions: The incidence of syphilis has increased in our centre in the last 2 years. The most affected group is MSM, with high HIV prevalence and risk behaviours for STI acquisition., (Copyright © 2017 Elsevier España, S.L.U. All rights reserved.)

Background: Overactivity of the bladder detrusor muscle can result in urinary urgency, frequency, and incontinence. Antimuscarinic agents are the treatment of choice, as they reduce the contractility of this muscle. Solifenacin succinate (SOL) is a competitive muscarinic-receptor antagonist approved by the US Food and Drug Administration in late 2004 for the treatment of overactive bladder (OAB) with symptoms of urge urinary incontinence, urgency, and urinary frequency., Objective: This article reviews the current primary literature concerning the pharmacokinetics, efficacy, and tolerability of SOL in the treatment of OAB., Methods: Pertinent English-language articles were identified through a search of MEDLINE (1966-week 4, 2006), EMBASE (1991-first quarter of 2006), Current Contents/Clinical Medicine (week 10, 2005-week 9, 2006), the Cochrane Database of Systematic Reviews, MICROMEDEX Healthcare Series, and International Pharmaceutical Abstracts (1970-present). The search terms were overactive bladder, urinary incontinence, solifenacin, YM905, pharmacokinetics, and cost., Results: SOL is highly lipophilic (50:1 octanol:water distribution at pH 7.0), completely orally bioavailable, and 98% protein bound. It is metabolized by the cytochrome P450 3A isozyme, and approximately 50% of a dose is eliminated renally as parent compound, with 1 active and 3 inactive metabolites. In two 12-week Phase III studies, patients receiving SOL 5 or 10 mg had significant reductions compared with placebo in the numbers of voids (P < or = 0.01), incontinence episodes (P < or = 0.05), and urgency episodes (P < or = 0.01) per 24 hours; the volume voided per micturition was significantly increased (P < or = 0.01). In a study that compared SOL 5 and 10 mg with tolterodine extended release 4 mg, both agents were associated with significant reductions in the number of voids per 24 hours (-2.45 and -2.24 episodes, respectively; P = 0.004 for noninferiority). In a study of pooled data from two 12-week studies, patients who received SOL 5 or 10 mg reported significant improvements in a number of quality-of-life domains (P < or = 0.05). In a pooled analysis of 4 studies, the most common adverse effects (occurring in > or =3% of any group) in patients receiving SOL 5 mg (n = 266) and 10 mg (n = 612) were dry mouth (10.9% and 27.1%, respectively), constipation (5.3% and 12.9%), and blurred vision (4.5% and 4.7%)., Conclusions: In the studies reviewed, SOL was effective in the treatment of OAB with urge incontinence. Adverse effects included dry mouth, constipation, and blurred vision. Further studies are needed to determine the efficacy and tolerability of SOL in patients with hepatic or renal impairment.

Simian immunodeficiency virus (SIV) infection of infant macaques is a useful animal model of pediatric HIV infection to evaluate the potential of chemoprophylactic regimens to reduce mother-to-infant transmission of HIV. Previous studies have demonstrated that short-term subcutaneous administration of the reverse transcriptase inhibitor tenofovir was highly effective in protecting newborn macaques against infection after a single high-dose oral inoculation with virulent SIVmac251. In the current study, we mimicked HIV transmission through breast-feeding by repeatedly feeding infant macaques low doses of SIVmac251. Topical administration of a low dose of the second-generation tenofovir prodrug GS-7340 did not have detectable prophylactic efficacy. Oral administration of tenofovir disoproxil fumarate (DF; 10 mg/kg SID) lowered the infection rate at birth, but had lower efficacy against virus infection at 4 weeks of age, most likely because drug levels became suboptimal relative to those obtained with the current tenofovir DF regimen in humans. These prophylactic results further underscore the relevance of the current tenofovir DF prevention trials in pediatric and adult populations.

A vaccine to protect human immunodeficiency virus (HIV)-exposed infants is an important goal in the global fight against the HIV pandemic. Two major challenges in pediatric HIV vaccine design are the competence of the neonatal/infant immune system in comparison to the adult immune system and the frequent exposure to HIV via breast-feeding. Based on the hypothesis that an effective vaccine needs to elicit antiviral immune responses directly at the site of virus entry, the pattern of virus dissemination in relation to host immune responses was determined in mucosal and lymphoid tissues of infant macaques at 1 week after multiple oral exposures to simian immunodeficiency virus (SIV). The results show that SIV disseminates systemically by 1 week. Infant macaques can respond rapidly to virus challenge and mount strong innate immune responses. However, despite systemic infection, these responses are most pronounced in tissues close to the viral entry site, with the tonsil being the primary site of virus replication and induction of immune responses. Thus, distinct anatomic compartments are characterized by unique cytokine gene expression patterns. Importantly, the early response at mucosal entry sites is dominated by the induction of proinflammatory cytokines, while cytokines with direct antiviral activity, alpha/beta interferons, are only minimally induced. In contrast, both antiviral and proinflammatory cytokines are induced in lymphoid tissues. Thus, although infant macaques can respond quickly to oral viral challenge, the locally elicited immune responses at mucosal entry sites are likely to favor immune activation and thereby virus replication and are insufficient to limit virus replication and dissemination.

The present investigation explored the relationship between psychosocial factors and condom use by African-American adolescents. Two hundred twenty-nine males, aged 14 to 19 years, responded to a health behavior survey that gathered information on demographics, HIV knowledge, perceived certainty of future condom use, present and past use of condoms, and intention to use condoms in the next six months. Several psychological variables, including sexual self-efficacy and self-esteem, were also measured. It was found that the majority of participants were sexually active by age 13, had four or more lifetime sexual partners, and were using condoms regularly. Multiple linear regression analysis indicated that sexual self-efficacy predicted perceived certainty of condom use. In addition, self-esteem and sexual self-efficacy predicted intention to use condoms. These findings highlight the need to develop HIV prevention curricula for African-American male adolescents that not only emphasize the potential risks associated with having multiple sexual partners, but also include components to enhance self-worth and sexual self-efficacy.

Cardiac transplantation is the treatment of choice for patients suffering from end-stage cardiac disease unamenable to conventional medical or surgical treatment. More than 390 patients have undergone heart transplantation at the Texas Heart Institute in Houston, and nine were Puerto Rican. Overall survival of these patients is 88%. Our experience with patients from Puerto Rico is described.

To evaluate a method of mechanical replacement of the left ventricle in patients with left ventricular failure, we used a single mechanical ventricle in experimental animals. Identical mechanical ventricles were placed in six Hereford calves to obtain data for partial replacement. Four of the animals were weaned from cardiopulmonary bypass, and the other two died because of kinked grafts and poor function of the right ventricle. The main problems occurring with the mechanical ventricle were postoperative bleeding and kinking of the grafts, both of which can be solved with improvements in the design of the device.

A successful cardiac transplant starts with the selection of an appropriate donor. Once consent to organ donation has been obtained, the donor should be managed aggressively in order to maintain optimal organ function. In the case of multi-organ donation, the heart is the first organ to be prepared, as well as the first to be removed. By means of simple preservation methods, the heart can be maintained for up to 4 hours ex vivo. For optimal timing and minimal ischemia, however, excellent communication and coordination is necessary on the part of transplant team members.

Central vein catheterization is a common procedure performed in major hospitals. Numerous complications have been described with the use of this technique. We present three patients in whom the positioning of a catheter at the junction of the right and left brachiocephalic veins caused hydrothorax. Placing the catheter at the junction of the superior vena cava and the right atrium is recommended.

The effect of low dietary intake of zinc was studied in six normal infants with the use of 70Zn as an extrinsic tag. Of the two study formulas, one provided a zinc intake similar to that of customary infant formulas ("high" intake), whereas the other provided a "low" zinc intake. Two zinc absorption studies were performed with each formula (sequence: high-low-low-high). Extrinsically labeled formula was fed for 24 h and excreta were collected for 72 h. Zinc isotope ratios were determined by inductively coupled plasma mass spectrometry (ICP/MS). When zinc intake was high, net zinc absorption was 9.1 +/- 8.7% (mean +/- SD) of intake and net zinc retention was 74 +/- 91 micrograms/(kg.d). True zinc (70Zn) absorption was 16.8 +/- 5.8% of intake and fecal excretion of endogenous zinc was 78 +/- 56 micrograms/(kg.d). When zinc intake was low, net absorption of zinc increased significantly (P less than 0.001) to 26.0 +/- 13.0% of intake, but net retention was not significantly different at 42 +/- 33 micrograms/(kg.d). True absorption of zinc also increased significantly (P less than 0.001) to 41.1 +/- 7.8% of intake, whereas fecal endogenous zinc decreased (P less than 0.05) to 34 +/- 16 micrograms/(kg.d) during low zinc intake. Thus, infants maintain zinc balance in the face of low zinc intake through increased efficiency of absorption and decreased excretion of endogenous zinc.