ASSOCIATION BETWEEN SMOKING,CRACK COCAINE ABUSE AND THE DISCONTINUATION OF COMBINATION ANTIRETROVIRAL THERAPY IN RECIFE,PERNAMBUCO, BRAZIL

Despite the effectiveness of combination antiretroviral therapy in the treatment of people living with HIV/AIDS (PLWHA), nonadherence to medication has become a major threat to its effectiveness. This study aimed to estimate the prevalence of self-reported irregular use of antiretroviral therapy and the factors associated with such an irregularity in PLWHA. A cross-sectional study of PLWHA who attended two referral centers in the city of Recife, in Northeastern Brazil, between June 2007 and October 2009 was carried out. The study analyzed socioeconomic factors, social service support and personal habits associated with nonadherence to antiretroviral therapy, adjusted by multivariable logistic regression analysis. The prevalence of PLWHA who reported irregular use of combination antiretroviral therapy (cART) was 25.7%. In the final multivariate model, the irregular use of cART was associated with the following variables: being aged less than 40 years (OR = 1.66, 95%-CI: 1.29-2.13), current smokers (OR = 1.76, 95%-CI: 1.31-2.37) or former smokers (OR = 1.43, 95%-CI: 1.05-1.95), and crack cocaine users (OR = 2.79, 95%-CI: 1.24-6.32). Special measures should be directed towards each of the following groups: individuals aged less than 40 years, smokers, former smokers and crack cocaine users. Measures for giving up smoking and crack cocaine should be incorporated into HIV-control programs in order to promote greater adherence to antiretroviral drugs and thus improve the quality of life and prolong life expectancy.     

Lice infestation in goats in western Santa Catarina,Brazil

Parasitic diseases affecting goats are able to cause major economic losses, standing out, among them, the lice infestation. According to the literature, lice can act as vectors of other diseases, including the ones caused by blood protozoan. In this sense, this survey study aimed to assess the ectoparasites of goats in the west region of Santa Catarina (SC). Two hundred seventeen goats from 24 different rural properties located in 17 towns in SC were examined. From them, ectoparasites were collected and evaluated in laboratory, where the parasitological classification was performed. In 13 properties, it was possible to identify ectoparasites. Damalinia caprae lice were observed in 126 animals (58 %), while Linognathus stenopsis were found in 10 animals (4.6 %). It is noteworthy that, in these properties, all the animals were under lice parasitism, independent of sex or age. The goats had peeling skin, particularly in the back region (lumbar). All of the 24 properties evaluated were reported having problems with lice in different seasons of the year, even under regular treatment with cypermethrin (spraying). Based on our findings, it was possible to conclude that D. caprae is the major ectoparasite of goats in the investigated area.     

National emission ceilings in Portugal—trends,compliance and projections

The national emission ceilings (NEC) Directive was implemented to contribute to the reduction of transboundary air pollutions impacts, limiting emissions of acidifying and eutrophication pollutants as well as ozone precursors. It was first adopted by the European Commission (EC) in 2001 (Directive 2001/81/EC) covering four pollutants (NO_x, SO₂, NH₃ and NMVOC). Under the scope of the clean air programme for Europe, which established the air policy objectives for 2020 and 2030, a new NEC was adopted (Directive 2016/2284/EU) establishing more strict ceilings for those pollutants and adding as well PM_2.5. The objective of this paper is to analyse the evolution of the Portuguese national emissions and the compliance of NEC Directive in 2010 and to foresee if the new ceilings for 2030 will be fulfilled. The emission inventories reported to the EC show that emissions in Portugal presented a consistent decreasing trend for all pollutants from 2000 to 2014, and a slight increase in 2015. The 2010 targets were achieved with measures implemented at the time (particularly on the energy, industrial combustion and transport sectors) which allowed Portugal to even surpass the defined goals. The emission projections for 2030, however, reveal that necessary emission reductions for all pollutants could be attained only if measures of the most demanding scenarios are implemented. Therefore, an integrated strategy should be designed and implemented aiming to not only fulfil the NEC in 2030 but also guarantee a better air quality with the highest cost-benefit for the environment and health.     

Use of rhBMP-2 to reconstruct a severely atrophic mandible: a modified approach

This study reports the case of a patient with a severely resorbed mandible who was treated without a bone graft, using short implants, internal rigid fixation, rhBMP-2 and β-tricalcium phosphate. A 76-year-old woman, with a severely resorbed mandible (less than 3 mm), reported a history of nearly 25 years of complete edentulism and consecutive treatment failures, with total bilateral exposed inferior alveolar nerves and complete bone resorption of the inferior border in some areas. The treatment of choice was the placement of a 2.0 mm thick unilock bone plate (MatrixMandible, Synthes Maxillofacial, Paoli, PA, USA), to reinforce the mandible. Eight short implants with a regular platform (Nobel Biocare, Goteborg, Sweden) were placed: three on the external oblique line on both sides and two on the symphysis. In order to augment mandible height and coat the exposed thread of the anterior implants, rhBMP-2 (Infuse Bone, Meditronic Sofamor Danek, Memphis, TN, USA) and β-tricalcium phosphate (Cerasorb; Curasan, Kleinostheim, Germany) were used. Four 1.3 mm L miniplates were placed to support the graft. 14 months after surgery, the patient was satisfied and had excellent function without complications.     

Erratum to: Guidance for the treatment of deep vein thrombosis and pulmonary embolism

Journal of Thrombosis and Thrombolysis -