Visual Field Defects in Patients With Optic Nerve Head Drusen.

Background Optic nerve head drusen (ONHD) are acellular deposits in the optic nerve head, whose pathophysiology remains not fully understood. Most patients with ONHD have visual field (VF) defects. This study aims to describe the VF defects observed in patients with ONHD and to compare the anatomical and functional impairment between visible and buried ONHD.

Overdiagnosis of vaccine allergy: Skin testing and challenge at a public specialized unit (CRIE) in Rio de Janeiro, Brazil.

Background: Vaccination is an extremely safe public health intervention, but rare IgE-mediated adverse events must be identified to avoid the risk of anaphylaxis in the event of reexposure. However, using only clinical history to diagnose previous allergic reactions may lead to overdiagnosis of vaccine allergy and even to the use of medical exemptions as a subterfuge to mandatory vaccination.

Methods: We conducted a retrospective study to describe the outcomes of patients with a history of vaccine or vaccine component allergy who were evaluated at our unit from 2011 to 2017.

Hepatitis A seroprevalence among special populations in the Rio de Janeiro Metropolitan Area, Brazil.

The objectives were to estimate hepatitis A virus seroprevalence in subjects attending to a travel medicine and immunization clinic in Rio de Janeiro, Brazil, and to develop a prediction model for hepatitis A virus seroprevalence. This retrospective research included individuals sequentially from April 2011 to June 2019 at a travel medicine and special population immunization clinic with an anti-hepatitis A virus IgG chemiluminescence result. Participants' data were verified via electronic medical records.

Telemedicine in the National Immunization Program (Brazil): A promising tool.

Unlabelled: The coronavirus disease 2019 pandemic abruptly changed the dynamics of basic health care, with the consequent need for adjustments in essential services. The objective of this study was to evaluate the acceptance and impact of telemedicine at a Reference Center for Special Immunobiologicals (CRIE).

Methods: Patients aged 18 years or older who had a medical referral to CRIE and agreed to have a telemedicine consultation were included.

Unilateral Myelinated Retinal Nerve Fiber Layer, High Myopia, and Amblyopia: A Case Report.

Straatsma syndrome corresponds to the presence of myelinated retinal nerve fibers with ipsilateral myopia and amblyopia. Strabismus is also a common finding in this entity, and patients with strabismus usually present a poor visual prognosis. We report the case of a two-year-old male diagnosed with Straatsma syndrome with a follow-up period of 2.

Lack of Impact of Acute Pyelonephritis on Kidney Graft Survival.

Background: Urinary tract infection is the most common bacterial infection after kidney transplant. Some studies suggested that urinary tract infection could impair graft survival, but this issue remains debated. The objective of this study was to analyze the association between acute pyelonephritis (APN) and the risk of kidney graft failure.

Iron intake is positively associated with viral load in antiretroviral naïve Brazilian men living with HIV.

Background: Iron homeostasis contribute for the human immunodeficiency virus (HIV) pathogenesis.

Objectives: We assessed the iron intake pattern in antiretroviral naïve Brazilian men living with HIV correlating with clinical and nutritional parameters.

Methods: The iron consumption mean was estimated according to a food frequency questionnaire (FFQ), and a 3-day food record (3dFR) submitted to the patients.

Seroprevalence of varicella antibodies in adults without clinical history of disease.

Varicella in adults and immunocompromised patients can be severe. The clinical diagnosis of varicella has high accuracy and the history of disease has a high positive predictive value for protection. A significant portion of adults, however, cannot remember if they have had varicella, especially older individuals.

Addressing travelers' perception of risk in pre-travel care: Reports from a travel clinic in Rio de Janeiro, Brazil.

Introduction: Travel medicine is aimed at promoting health risk reduction. However, travelers' perception of risk is subjective and may influence implementation of recommendations. This study reports on travelers' perception of risk, pre-travel characteristics, and recommended interventions.

Immunogenicity and sustainability of the immune response in Brazilian HIV-1-infected individuals vaccinated with inactivated triple influenza vaccine.

HIV-infected individuals have a higher risk of serious illnesses following infection by infection with influenza. Although anti-influenza vaccination is recommended, immunosuppression may limit their response to active immunization. We followed-up a cohort of HIV-infected individuals vaccinated against influenza to assess the immunogenicity and sustainability of the immune response to vaccination.

Changing mortality profile among HIV-infected patients in Rio de Janeiro, Brazil: shifting from AIDS to non-AIDS related conditions in the HAART era.

Introduction: We describe temporal trends in the mortality rates and factors associated with AIDS and non-AIDS related mortality at the Evandro Chagas Clinical Research Institute (IPEC), Oswaldo Cruz Foundation (FIOCRUZ).

Methods: Adult patients enrolling from 1986 through 2009 with a minimum follow up of 60 days were included. Vital status was exhaustively checked using patients' medical charts, through active contact with individuals and family members and by linkage with the Rio de Janeiro Mortality database using a previously validated algorithm.

High IL-10 production by aged AIDS patients is related to high frequency of Tr-1 phenotype and low in vitro viral replication.

This work aims to elucidate the effects of age and HIV-1 infection on the frequency and function of T cell subsets in response to HIV-specific and non-specific stimuli. As compared with the younger AIDS group, the frequencies of naive and central memory T cells were significantly lower in aged AIDS patients. Although there was also a dramatic loss of classical CD4(+)FoxP3(+)CD25(+)Treg cells in this patient group, high frequencies of IL-10-producing CD4(+)FoxP3(-) T cells were observed.

[New clinical aspects of cardiac myxomas: a clinical and pathological reappraisal].

Unlabelled: Easy access to echocardiography and its extensive and repeated use (as is the case in Portugal) now facilitates the early diagnosis of cardiac myxoma (CM).

Objective: To re-evaluate the clinical and pathological profile of CM under current diagnostic conditions.

Methods: We performed a retrospective study of 40 patients consecutively referred for surgery (between January 2003 and January 2010) with a histologically-confirmed diagnosis of CM - 26 female (F) and 14 male (M), with a mean age of 64±12 years (range 12-81; 53% over 65, 43% over 70); 39 patients were operated (one was not operable due to major neurological deficit).

H1N1pdm09 adjuvanted vaccination in HIV-infected adults: a randomized trial of two single versus two double doses.

Background: Since human immunodeficiency virus (HIV)-infected individuals are at increased risk of severe disease from pandemic influenza A (H1N1pdm09), vaccination was recommended as a prevention strategy. The aim of the present study was to evaluate the safety, immunogenicity and persistence of the immune response after vaccination against pandemic influenza A (H1N1pdm09) with an adjuvanted vaccine in human immunodeficiency virus (HIV)-infected adults using two single and two double doses.

Methodology/principal Findings: Open label, randomized trial to evaluate the immune response following H1N1pdm09 vaccination in HIV-infected participants compared to HIV-negative controls (NCT01155037).

Simultaneous cytomegalovirus and Mycobacterium tuberculosis infection presenting as hemorrhagic colitis 3 years after a kidney transplant.

Cytomegalovirus is an important cause of colonic disease in solid organ transplant recipients. Although several reports have shown that simultaneous infection with other pathogens may aggravate the course of cytomegalovirus colitis, to our knowledge, no case of colitis caused by simultaneous cytomegalovirus and Mycobacterium tuberculosis has been previously reported. We describe a case of hemorrhagic colitis associated with simultaneous cytomegalovirus/ Mycobacterium tuberculosis infection in a 26-year-old woman, 38 months after a kidney transplant.

[Perioperative myocardial infarction in coronary bypass surgery: characterization of risk factors, clinical pictures and prognosis].

Unlabelled: Perioperative myocardial infarction ( POMI ) in cardiac surgery is an issue that deserves to be revisited.

Objective: To evaluate the risk factors, clinical characteristics and prognosis of POMI in high-risk patients ( pts ) undergoing coronary bypass surgery ( CABG ).

Material And Methods: Retrospective study of 694 pts undergoing isolated CABG - 252 pts with conventional CABG and 442 pts with off-pump CABG - and operated on by 4 surgeons largely experienced in both CABG modalities.

Impact of intraoperative transesophageal echocardiography in cardiac surgery: retrospective analysis of a series of 850 examinations.

Objective: To evaluate the impact of intraoperative transesophageal echocardiography (TEE) on surgical decisions patients undergoing cardiac surger in a Portuguese hospital.

Methods: The authors retrospectively analyzed a series of 850 examinations performed between 2003 and 2009 in patients who underwent different cardiac surgical procedures. Medical records and TEE reports were reviewed to determine whether new information was found and whether this changed the surgical plan.

[Advantages of off-pump coronary bypass surgery over conventional coronary bypass surgery].

Unlabelled: Comparison between off-pump coronary bypass surgery ( OP-CABG )and conventional CABG ( C-CABG ) remains a controversial issue.

Objective: To compare short and long term OP-CABG and C-CABG results in high-risk patients ( pts ), in absence of usual bias.

Material And Methods: A prospective observational study of 752 pts ( 252 pts with C-CABG and 500 with OP-CABG ) consecutively operated throughout 23 months by 4 surgeons largely experienced in both CABG modalities.

[Titanium transverse plate fixation system after sternum dehiscence in cardiac surgery].

Steel wire sternum fixation in patients who underwent median sternotomy for cardiac surgery, is a routine procedure in our clinical practice. Sternal dehiscence either associated or not to surgical wound infection, though with low incidence, carries high morbidity, mortality and economic costs that make the research for alternative techniques a fundamental task. A new titanium transverse plate fixation system seems to be an excellent and safe alternative, that can be performed by cardiac surgeons to reconstruct the sternum in case of dehiscence.

Flattening of oxygen pulse during exercise may detect extensive myocardial ischemia.

Purpose: Flattening of oxygen pulse curve during incremental cardiopulmonary exercise testing has been proposed for the improvement of diagnostic accuracy of exercise-induced myocardial ischemia. In this study, we compare the oxygen pulse response to incremental treadmill exercise in patients with and without ischemia as detected by myocardial perfusion scintigraphy.

Methods: Eighty-seven patients referred to exercise myocardial perfusion scintigraphy were also evaluated with incremental treadmill cardiopulmonary exercise testing.