Slam Practice: A Review of the Literature

<b><i>Background:</i></b> Slamming has been developing since 2011 as a new international phenomenon, mostly among men who have sex with men (MSM). It consists of intravenous drug injection before or during planned sexual activity to sustain, enhance, disinhibit, or facilitate the experience. We aimed to synthesize the available published evidence through a systematic literature review in order to precisely describe this phenomenon and to better characterize the population engaging in this practice and its specific motives. <b><i>Methods:</i></b> A systematic review of the available literature was conducted to identify all relevant publications using PubMed, Psyc­INFO, the Cochrane Library, and ScienceDirect. To complete the review, we followed the recommendations of the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” method. We limited the search to studies published between January 2008 and May 2020. <b><i>Results:</i></b> Our search identified 530 publications, of which 27 were included in the final data synthesis. One study focused on heterosexual and homosexual subpopulations, and all other studies focused on MSM-specific samples. Among MSM, slam prevalence was extremely variable, ranging from 2 to 91%; regarding other sexually active subjects, prevalence ranged from 7 to 14%. The prevalence of HIV-positive subjects varied widely across studies, ranging from 0.6 to 100%. We found less data about hepatitis C virus serostatus, ranging from 3 to 100%. Methamphetamine and mephedrone were the 2 most used drugs. <b><i>Discussion/Conclusion:</i></b> The data we found in international literature were very heterogeneous and from poorly reproducible studies. The definition of slamming in the international literature is not always clear, which limits the completeness of the collected data. This topic has been open to studies only recently; however, health professionals must be trained in the management of this practice, considering its risks in the short and medium terms and its addictive potential. We provided and discussed recommendations and potential future directions.

Epidemiological characteristics and clinical analysis of 97 AIDS patients

This study is to analyze clinical features of 97 AIDS patients received and treated in our hospital. Clinical data of 97 HIV-infected patients who were admitted between September 2004 and September 2018 were analyzed retrospectively. We found that all patients were in AIDS stage, CD4+ T lymphocytes counts were (210.56 ± 79.31)/µL. After the highly active antiretroviral therapy (HAART) regimens, CD4+ cell number is 315.21 ± 187.90, most patients before clinical symptoms are significantly improved. HIV infections were mainly through intravenous drug injection (51 cases, 52.58%) and sex contact (29 cases, 29.90%). In conclusion, the clinical manifestations of AIDS patients are various, and the main infection route is intravenous drug injection. Multiple measures should be taken to prevent and control HIV transmission, patients should undergo effective antiviral treatment, monitor and follow-up, so as to control opportunistic infection and virus replication.

Outcome of Pseudoaneurysm Repair: A Single Tertiary Center Experience in Pahang, Malaysia

Introduction: Symptomatic arterial pseudoaneurysm is not an uncommon emergent vascular case presenting to a tertiary hospital. These are mainly associated with infection, iatrogenic puncture or trauma. The resultant morbidity, limb loss and mortality present a challenge to the surgeons managing these cases. Materials and method: We retrospectively reviewed all case notes of all pseudoaneurysm repair done at our centre from Jan 2015 to May 2017. Results: A total of 20 cases were treated surgically, with majority 16(80%) had ligation of the affected arteries. The rest were managed with reconstruction of the arteries with synthetic graft. In 7 patients (35%), the aetiology was identified as iatrogenic intravenous drug injection. Staphylococcus aureus remained the main causative organism with Treponema Pallidum and Burkholderia pseudomallei as the other organisms identified in the cultures. Our 3 patients with graft reconstruction had long term oral antibiotics upon discharge. Conclusion: Majority of pseudoaneurysms presented to our center results in ligation of the artery. Repair of mycotic aneurysm needs careful consideration as graft infection remains a lethal complication and no consensus is available regarding the duration of post-operative antibiotic cover.

Immunocompromised Hosts and Microorganism-Specific Syndromes

Human immunodeficiency virus (HIV) is transmitted sexually, perinatally, through parenteral inoculation (eg, intravenous drug injection, occupational exposure), through blood products, and, less commonly, through donated organs or semen. Sexual transmission is the most common means of infection. Conditions that may increase the risk of sexually acquiring HIV infection include traumatic intercourse (ie, receptive anal), ulcerative genital infections (including syphilis, herpes simplex, and chancroid), and lack of male circumcision. The proper use of latex condoms substantially reduces the risk of HIV transmission.

Human Immunodeficiency Virus Infection

Human immunodeficiency virus (HIV) is a lentivirus, a member of the Retroviridae family (retroviruses). There are 2 genetically distinct types of HIV: HIV-1 and HIV-2 HIV-1 is further classified into subtypes, also known as clades. HIV-1 is the predominant HIV type globally. Donated blood has been screened for HIV-1 since 1985 in the United States. The following factors have been identified with transmission of HIV: sexual contact, perinatal infection, parenteral inoculation (eg, intravenous drug injection, occupational exposure), receipt of blood products, and receipt of donated organs or semen. The most common mode of transmission is sexual intercourse. Traumatic intercourse and ulcerative genital infections increase the risk of HIV transmission. The proper use of condoms greatly reduces the risk of HIV transmission. The diagnosis and treatment of HIV and AIDS are also reviewed.