O11.3 Clinical improvement after treatment for urethritis: the role of Mycoplasma genitalium

A non-syndromic approach to treatment of people with non-gonococcal urethritis (NGU) requires identification of pathogens and understanding of the role of those pathogens in causing disease. The most commonly detected and isolated micro-organisms in the male urethral tract are bacteria belonging to the family of Mycoplasmataceae, in particular Ureaplasma urealyticum and Ureaplasma parvum. To better understand the role of these Ureaplasma species in NGU, we have performed a prospective analysis of male patients voluntarily attending a drop in STI clinic in Oslo. Of 362 male patients who were tested for NGU using microscopy of urethral smears, we found the following sexually transmissible micro-organisms: 16% Chlamydia trachomatis, 5% Mycoplasma genitalium, 14% U. urealyticum, 14% U. parvum and 5% Mycoplasma hominis. We found a high concordance in detecting in turn U. urealyticum and U. parvum using 16s rRNA gene and ureD gene as targets for nucleic acid amplification testing (NAAT). Whilst there was a strong association between microscopic signs of NGU and C. trachomatis infection, association of M. genitalium and U. urealyticum infections in turn were found only in patients with severe NGU (>30 polymorphonuclear leucocytes, PMNL/high powered fields, HPF). U. parvum was found to colonise a high percentage of patients with no or mild signs of NGU (0–9 PMNL/HPF). We conclude that urethral inflammatory response to ureaplasmas is less severe than to C. trachomatis and M. genitalium in most patients and that testing and treatment of ureaplasma-positive patients should only be considered when other STIs have been ruled out.

Download Full-text

The role of lumboperitoneal shunts in the treatment of syringomyelia

Journal of Neurosurgery Spine ◽

10.3171/2010.3.spine0964 ◽

2010 ◽

Vol 13 (1) ◽

pp. 133-138 ◽

Cited By ~ 11

Author(s):

Chima O. Oluigbo ◽

Karen Thacker ◽

Graham Flint

Keyword(s):

Clinical Improvement ◽

Medical Records ◽

Neurological Deterioration ◽

Lumboperitoneal Shunt ◽

Radiological Evidence ◽

Spinal Arachnoiditis ◽

The Mean

Object The role of thecoperitoneal shunts in the management of syringomyelia is not well defined. In this study, the authors analyze the outcome of lumboperitoneal shunt procedures carried out to treat syringomyelia in their institution. Methods The authors retrospectively reviewed the medical records of 19 patients who underwent lumboperitoneal shunt procedures for syringomyelia. Results The mean follow-up duration was 25 months (range 3–51 months). Of 16 cases followed up, only 5 patients reported clinical improvement in their preoperative symptoms, but of these, 2 had clear radiological evidence of improvement. Three of 6 patients with syringomyelia due to spinal arachnoiditis improved. Conclusions Lumboperitoneal shunts may lead to useful improvement in the symptoms of a patient with syringomyelia while avoiding the risk of neurological deterioration inherent in myelotomies required for syrinx shunting procedures.

Download Full-text

Neuroleptic Malignant Syndrome Associated with Refractory Acute Disseminated Encephalomyelitis

Case Reports in Neurology ◽

10.1159/000446106 ◽

2016 ◽

Vol 8 (1) ◽

pp. 92-96

Author(s):

Silvia R. Delgado ◽

Leticia Tornes ◽

Janice Maldonado ◽

Jeffrey Hernandez ◽

Yesica Campos ◽

...

Keyword(s):

Basal Ganglia ◽

Neuroleptic Malignant Syndrome ◽

Clinical Improvement ◽

Acute Disseminated Encephalomyelitis ◽

Dopamine Depletion ◽

Intravenous Methylprednisolone ◽

Intravenous Cyclophosphamide ◽

Inflammatory Lesions ◽

Significant Clinical Improvement

We present the case of a young man who was transferred to our hospital with worsening acute disseminated encephalomyelitis (ADEM) despite treatment with intravenous methylprednisolone, intravenous immunoglobulin and plasma exchange. He developed neuroleptic malignant syndrome (NMS) without the use of dopamine-modulating drugs. His progressive clinical improvement started after treatment with intravenous cyclophosphamide and methylprednisolone. In our patient, acute demyelination with severe bilateral inflammation of the basal ganglia could have caused a state of central dopamine depletion, creating proper conditions for the development of NMS. Significant clinical improvement of our case after treatment with intravenous cyclophosphamide and steroids provides further evidence for a possible role of the inflammatory lesions in the pathogenesis of NMS in association with ADEM.

Download Full-text

The two-sided role of the vaginal microbiome in Chlamydia trachomatis and Mycoplasma genitalium pathogenesis

Journal of Reproductive Immunology ◽

10.1016/j.jri.2018.08.006 ◽

2018 ◽

Vol 130 ◽

pp. 11-17 ◽

Cited By ~ 11

Author(s):

M.C. Molenaar ◽

M. Singer ◽

S. Ouburg

Keyword(s):

Chlamydia Trachomatis ◽

Mycoplasma Genitalium ◽

Vaginal Microbiome

Download Full-text

Graphology and psychiatric diagnosis: Is the writing on the wall?

Irish Journal of Psychological Medicine ◽

10.1017/s0790966700017626 ◽

2012 ◽

Vol 29 (1) ◽

pp. 52-54

Author(s):

Mary Davoren ◽

Natalie Sherrard ◽

Eugene Breen ◽

Brendan D. Kelly

Keyword(s):

Case Report ◽

Clinical Improvement ◽

Clinical Features ◽

Psychiatric Diagnosis ◽

Auditory Hallucinations ◽

Handwriting Analysis ◽

Speech And Language ◽

Language Difficulties ◽

Straight Lines

AbstractObjective: To review the role of handwriting analysis in psychiatry.Method: Case-report and review of key papers.Results: M, a 27-year-old man, presented with incoherent speech, palilalia, logoclonia, incongruous affect, paranoid delusions and auditory hallucinations. M was diagnosed with schizophrenia and cannabis misuse, complicated by speech and language difficulties. M spent long periods writing on pieces of paper; towards the start of his admission, his writing was unintelligible but became more intelligible as his psychosis resolved. M's handwriting demonstrates clinical features of psychosis (e.g. clang associations) and graphological abnormalities associated with schizophrenia in the literature (rigidity in letter-formation, mechanical expressions, and tendency toward over-use of straight lines).Conclusion: Analysis of handwriting is likely to play a limited role in psychiatric diagnosis but may prove useful in monitoring clinical improvement in certain patients.

Download Full-text

Changes in Hepcidin Serum Levels Correlate with Clinical Improvement in Idiopathic Restless Legs Syndrome Patients

Journal of Clinical Medicine ◽

10.3390/jcm9124115 ◽

2020 ◽

Vol 9 (12) ◽

pp. 4115

Author(s):

Hee-Jin Im ◽

Jee Hyun Kim ◽

Chang-Ho Yun ◽

Dong Wook Kim ◽

Jeeyoung Oh

Keyword(s):

Dopamine Agonist ◽

Clinical Improvement ◽

Restless Legs Syndrome ◽

Serum Levels ◽

Dependent Manner ◽

Healthy Controls ◽

Restless Legs ◽

Serum Hepcidin ◽

Drug Naïve

Background: Restless legs syndrome (RLS) is a common sensory motor neurological disorder that is related to iron–dopamine dysregulation and immune system alteration. We aimed to assess the effects of serum hepcidin, an iron-regulating hormone, in drug-naive RLS patients compared to healthy controls and to evaluate its role in helping to predict clinical improvement after treatment with dopamine agonist. Methods: Nonanemic and drug-naive RLS patients (n = 18) and healthy controls (n = 15) were enrolled. The serum hepcidin and iron-related values in the serum were measured upon the first visit in both groups and 12 weeks later after dopaminergic treatment in 12 patients. Information about sociodemographic characteristics, sleep-related profiles, mood and anxiety was obtained upon the first visit in all participants as well as after treatment in RLS patients. Results: Serum hepcidin levels exhibited no significant differences between patients with drug-naïve RLS and healthy controls at diagnosis (7.1 ± 2.4 vs. 7.0 ± 3.2 ng/mL, p = 0.357). Decreased hepcidin levels were significantly associated with decreased RLS severity (β = 0.002, 95% CI = 0.00−0.00, p = 0.005) and improved quality of life (β = 0.002, 95% CI = 0.00−7.01, p = 0.044) in a dose-dependent manner after 12 weeks of treatment with a dopamine agonist. This association was independent of age, sex, inflammatory markers, sleep quality, insomnia, daytime sleepiness, depression and anxiety. Conclusions: This study demonstrates the role of hepcidin in evaluating the positive therapeutic response in RLS.

Download Full-text