scholarly journals Epidemiological and Clinical Observations of Gonococcal Infections in Women and Prevention Strategies

Vaccines ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 327
Author(s):  
Ana Paula R. Costa-Lourenço ◽  
Xiaohong Su ◽  
Wenjing Le ◽  
Zhaoyan Yang ◽  
Gregory J. Patts ◽  
...  
Keyword(s):  
Inflammatory Responses ◽  
Positive Culture ◽  
Target Population ◽  
Clinic Visit ◽  
General Belief ◽  
Essential Information ◽  
Sexually Transmitted ◽  
Clinical Observations ◽  
Infected Partner ◽  
Control Clinic

Neisseria gonorrhoeae is rapidly developing antimicrobial resistance. There is an urgent need for an effective gonococcal vaccine. In this study we examined epidemiological and clinical factors associated with gonorrhea in a cohort of women exposed to men with gonococcal urethritis attending the National Center for STD Control clinic in Nanjing, China, to understand the natural history and the risk factors for gonorrhea in this vulnerable population. This analysis will help identify the best target populations for vaccination, which is essential information for the development of vaccine strategies. We observed that 75% of the women in our cohort yielded a N. gonorrhoeae positive culture (infected women) and reported multiple sexual exposures to their infected partner. Infected women were younger than exposed but uninfected women. Contrary to the general belief that gonorrhea is asymptomatic in most women, 68% of the infected women acknowledged symptoms during their STD clinic visit, and overt inflammatory responses were detected upon medical examination in 88% of subjects. Other sexually transmitted infections were detected in 85% of subjects. This study confirmed that N. gonorrhoeae infections are underdiagnosed in women and, consequentially, untreated. Thus, our analysis reinforces the need to establish strategies for gonococcal prevention through the determination of the target population for a gonococcal vaccine.

Histologic Features of Zygomycosis

2001 ◽  
Vol 125 (3) ◽  
pp. 375-378 ◽  
Author(s):  
John L. Frater ◽  
Gerri S. Hall ◽  
Gary W. Procop
Keyword(s):  
Perineural Invasion ◽  
Inflammatory Responses ◽  
Fungal Growth ◽  
Positive Culture ◽  
Clinical History ◽  
Invasive Disease ◽  
Medical Intervention ◽  
Common Finding ◽  
Fungus Ball ◽  
Fungal Morphology

Abstract Objective.—Invasive zygomycosis is rapidly progressive and is associated with angioinvasion and infarction. Invasive disease requires emergent surgical and medical intervention. Because it is important for surgical pathologists to recognize these fungi and their preferential sites of growth, the objective of this article is to describe the fungal morphology and histopathologic findings in biopsies from patients with zygomycotic disease, with emphasis on preferential sites of fungal growth. Design.—Medical record and histologic review identified 20 patients with zygomycosis. Inclusion criteria included the presence of typical ribbonlike hyphae and positive culture, a clinical history of invasive zygomycosis, or both. The histologic features of disease and the fungal morphology were assessed. Results.—Fungus ball (15%), rhinocerebral (55%), and pulmonary (30%) disease were the types of disease represented. The inflammatory responses were predominantly neutrophilic (50%), predominantly granulomatous (5%), pyogranulomatous (25%), or absent (20%). Invasive disease was characterized by prominent infarcts (94%), angioinvasion (100%), and, surprisingly, prominent perineural invasion (90%) in biopsies that contained nerves for evaluation. At least rare hyphal septa were always seen (100%), and most branches (95%) varied from 45° to 90°. Conclusions.—As known to mycologists, zygomycetes are pauciseptate, rather than aseptate, molds. Therefore, the presence of an occasional septum is expected. Perineural invasion is a common finding in invasive zygomycosis, as are angioinvasion and infarcts. Therefore, prior to excluding the presence of these fungi in biopsies suspected to contain zygomycetes, the perineural space should be carefully examined.

scholarly journals Inconsistent Use of Condom in Italian HIV-Serodiscordant Heterosexual Couples as Revealed by the Detection of Y Chromosomal (Yc) DNA in Vaginal Swabs

2019 ◽  
Vol 13 (1) ◽  
pp. 31-35
Author(s):  
Jose Ramon Fiore ◽  
Fabio Zoboli ◽  
Mariantonietta Di Stefano ◽  
Massimo Fasano ◽  
Marwan Jabr Alwazzeh ◽  
...  
Keyword(s):  
Condom Use ◽  
The Self ◽  
Self Report ◽  
Heterosexual Couples ◽  
Sexually Transmitted ◽  
Heterosexual Women ◽  
Infected Partner ◽  
Vaginal Swabs ◽  
Improper Use ◽  
Italian Women

Introduction: The prevention of transmission of HIV infection is based on the regular and correct use of condom and studies on transmission rates are generally based on the self-report of condom use. However, consistent data on different population suggest that this often leads to overreporting possibly due to social desirability. In addition, self-report of condom use does not consider improper use or breakage. Methods: Vaginal biomarkers were proposed to detect exposure to semen and among these detection of chromosome Y DNA (Yc) appeared promising in different research settings. Here, we searched for Yc in vaginal swabs of 33 Italian women, engaged in a regular heterosexual relationship with a HIV serodiscordant partner and reporting a regular use of condom during sexual intercourses. Results & Discussion: In 10 (30.3%) women Yc was detected, especially if the infected partner was male and if the couple did not have sons. This is confirmed in Italian heterosexual women and is already demonstrated in other populations: behavioural counselling is not always a valid tool and the self-reported use of condom is not fully reliable. Conclusion: Further studies could help in the future to individuate more effective preventive strategies for both HIV and sexually transmitted infections.

Condom use in the year following a sexually transmitted disease clinic visit

2009 ◽  
Vol 20 (1) ◽  
pp. 9-13 ◽  
Author(s):  
T A Peterman ◽  
L H Tian ◽  
L Warner ◽  
C L Satterwhite ◽  
C A Metcalf ◽  
...  
Keyword(s):  
Condom Use ◽  
Sexually Transmitted Disease ◽  
Transmitted Disease ◽  
Clinic Visit ◽  
Sexually Transmitted ◽  
Disease Clinic ◽  
Sexually Transmitted Disease Clinic

Perceptions of barriers to discussing and testing for sexually transmitted infections in a convenience sample of general practice patients

2013 ◽  
Vol 19 (2) ◽  
pp. 98 ◽  
Author(s):  
Joanne R. Baker ◽  
Diane E. Arnold-Reed ◽  
Tom Brett ◽  
Dana A. Hince ◽  
Ilse O'Ferrall ◽  
...  
Keyword(s):  
Sexual Health ◽  
Sexually Transmitted Infections ◽  
Target Population ◽  
Comfort Level ◽  
Patient Comfort ◽  
Waiting Room ◽  
Convenience Sample ◽  
Sexually Transmitted ◽  
Gender And Age ◽  
General Practices

We aimed to identify patient perceptions of barriers to discussing sexually transmitted infections (STIs) at the primary care level. An anonymous questionnaire was available to patients (16–70 years) in the waiting room of four metropolitan Perth general practices. Results are based on 370 participant views (9.5% of the potential target population). Patients felt comfortable discussing STIs with their general practitioner (GP) and their level of comfort would be enhanced if they knew their GP had a special interest or qualification in sexual health. Willingness to discuss issues increased or remained unchanged if the GP took time to explain it to them or was a good listener. Patients were willing to discuss STIs if they were a new patient and irrespective of the GP’s gender and age. Fewer patients were willing to discuss STIs if they knew the GP socially. Patients who had sex with a new partner were willing to request a STI test from their GP. Patients were not embarrassed if discussion was initiated in a consultation unrelated to sexual health and did not mind discussing the topic in the presence of a partner or parent, though this depended on circumstances. Waiting room STI test advertising did not affect patient comfort level. Patients would involve their GP when seeking information about STIs. Patients have fewer barriers to discussing sexual health matters than perceived by GPs.

scholarly journals Acceptability of Couples’ Voluntary HIV Testing Among HIV-infected Patients in Care and Their HIV-negative Partners in the United States

2016 ◽  
Vol 10 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Kristin M. Wall ◽  
Lauren Canary ◽  
Kimberly Workowski ◽  
Annie Lockard ◽  
Jeb Jones ◽  
...  
Keyword(s):  
The United States ◽  
Consistent Condom ◽  
Willingness To Participate ◽  
Hiv Counseling ◽  
Sexually Transmitted ◽  
Counseling And Testing ◽  
Infected Partner ◽  
The Us ◽  
Exposure Prophylaxis ◽  
Hiv Negative

Introduction: Couples’ voluntary HIV counseling and testing (CHTC) is an HIV risk reduction strategy not widely available in the US. Methods: We assessed willingness to participate in CHTC among US HIV-infected clinic patients via tablet-based survey and among HIV-negative persons with HIV-infected partners in care via mixed-method phone interviews. Results: Most of the N=64 HIV-infected partners surveyed were men (89%), on antiretroviral treatment (ART) (92%), and many self-identified homosexual (62%). We observed high levels of willingness to participate in CHTC (64%) among HIV-infected partners. Reasons for not wanting to participate included perceived lack of need (26%), desire to self-disclose their status (26%), and fear of being asked sensitive questions with their partner present (17%). HIV-infected partners were interested in discussing ART (48%), other sexually transmitted infections (STIs) (44%), and relationship agreements like monogamy (31%) during CHTC sessions. All N=15 HIV-negative partners interviewed were men, most identified as homosexual (73%), and about half (54%) reported consistent condom use with HIV-infected partners. We observed high levels of willingness to participate in CHTC (87%) among HIV-negative partners, who were also interested in discussing ART (47%), other STIs (47%), mental health services (40%), and relationship agreements (33%). Most negative partners (93%) indicated that they believed their HIV-infected partner was virally suppressed, but in the event that they were not, many (73%) were willing to take pre-exposure prophylaxis (PrEP). Conclusion: These results indicate that CHTC for serodiscordant couples is acceptable and should emphasize aspects most pertinent to these couples, such as discussion of ART/PrEP, STIs, and relationship agreements.

scholarly journals Susceptibility Pattern of Neisseria gonorrhoeae towards Cefixime and Ceftriaxone using Kirby-Bauer Method in Dr. Saiful Anwar General Hospital Malang

2020 ◽  
Vol 32 (2) ◽  
pp. 103
Author(s):  
Lita Setyowatie ◽  
Tantari SHW ◽  
Inneke Yulian
Keyword(s):  
Neisseria Gonorrhoeae ◽  
General Hospital ◽  
Positive Culture ◽  
Test Results ◽  
Susceptibility Pattern ◽  
First Line ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Gram Staining ◽  
Antibiotic Susceptibility Test

Background: Gonorrhea remains the second most common sexually transmitted infection (STI) in the world with an increasing number of cases. Oral cefixime and IM ceftriaxone are still the mainstay therapy for gonorrhea in Indonesia. However, previous studies suggested possible resistance to ceftriaxone and cefixime, which are the first-line treatment of gonorrhea. To date, there are no data available regarding the susceptibility of these antibiotics for the treatment of gonorrhea in Dr. Saiful Anwar General Hospital (RSSA) Malang. Purpose: Determine susceptibility pattern of Neisseria gonorrhoeaetowards cefixime and ceftriaxone in RSSA Malang. Methods: The samples were patients of the Outpatient Clinic of Dermatology and Venereology Department with a symptom of discharge which contained Gram-negative diplococcus after Gram staining and had a positive culture of Neisseria gonorrhoeae. Susceptibility testing for cefixime and ceftriaxone antibiotics were performed using the Kirby-Bauer method. The data are presented in percentages. Result: Antibiotic susceptibility test results showed that 80.77% of Neisseria gonorrhoeaeisolates were still susceptible to cefixime, and 80.77% of isolates were still susceptible to ceftriaxone. Conclusion: Cefixime and ceftriaxone are still effective as gonorrhea therapy in RSSA Malang. 

scholarly journals Catheter-Related Bloodstream Infections and Catheter Colonization among Haemodialysis Patients: Prevalence, Risk Factors, and Outcomes

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Shamira Shahar ◽  
Ruslinda Mustafar ◽  
Lydia Kamaruzaman ◽  
Petrick Periyasamy ◽  
Kiew Bing Pau ◽  
...  
Keyword(s):  
Femoral Vein ◽  
Healthcare Providers ◽  
Clinical Manifestations ◽  
Positive Culture ◽  
Bloodstream Infections ◽  
Dialysis Catheter ◽  
Catheter Colonization ◽  
Essential Information ◽  
Poor Outcomes ◽  
Stage Renal Disease

Introduction. Catheter-related bloodstream infection (CRBSI) and catheter colonization (CC) are two complications among haemodialysis (HD) patients that lead to increased morbidity and mortality. This study aims to evaluate the prevalence of CRBSI and CC among HD patients registered at Universiti Kebangsaan Malaysia Medical Centre and to identify the factors involved by focusing on the demographic profile of the patients as well as their clinical characteristics and outcomes. Method. This is a retrospective study of end-stage renal disease patients with suspected CRBSI during the period from 1 January 2016 to 31 December 2018. Data on patients who fulfilled the blood culture criteria for CRBSI and CC diagnosis were further analysed for clinical manifestations, comorbidities, history of dialysis, catheter characteristics, and microbiological culture results. The outcomes of CRBSI and CC were also assessed. Findings. In the 3-year period under study, there were 496 suspected CRBSI cases with a total of 175 events in 119 patients who fulfilled the inclusion criteria. During that time, the percentage of patients who experienced CRBSI and CC was 4.2% and 4.8%, respectively. The majority of the cohort consisted of male (59.4%), Malay ethnicity (75%), and patients on a tunnelled dialysis catheter (83%). Patients who were fistula naïve and had an internal jugular catheter were more common in the CRBSI group than in the CC group. The predominant microorganisms that were isolated were Gram-positive organisms. In terms of clinical presentation and outcome, no differences were found between the CRBSI and CC groups. Patients with Gram-negative bacteraemia, high initial c-reactive protein, and catheter salvation were likely to have poor outcomes. Recurrence of CRBSI occurred in 31% of the cohort. Neither catheter salvation nor antibiotic-lock therapy were associated with the recurrence of CRBSI. On the other hand, the femoral vein catheter site was associated with risk of recurrence. The overall mortality rate was 1.1%. Discussion. From the analysis, it was concluded that clinical assessment and positive culture are crucial in diagnosing CRBSI with or without peripheral culture. This study provides essential information for the local setting which will enable healthcare providers to implement measures for the better management of CRBSI.

scholarly journals Pathophysiological and Clinical Aspects of Chronic Rhinosinusitis: Current Concepts

2021 ◽  
Vol 2 ◽  
Author(s):  
Stephan Vlaminck ◽  
Frederic Acke ◽  
Glenis K. Scadding ◽  
Bart N. Lambrecht ◽  
Philippe Gevaert
Keyword(s):  
Chronic Rhinosinusitis ◽  
Inflammatory Responses ◽  
Adaptive Immune System ◽  
Current Approach ◽  
Clinical Aspects ◽  
Adaptive Immune ◽  
Clinical Observations ◽  
Localized Disease ◽  
Primary Focus

Adult chronic rhinosinusitis (CRS) is a chronic inflammation of the mucosa of the nose and paranasal sinuses. According to the latest EPOS guidelines CRS should be regarded as primary or secondary with distinction between diffuse and localized disease. Further pathophysiologic research identified different inflammatory patterns leading to the term “endotyping of CRS.” The primary focus of endotyping is to define a dominant inflammatory type allowing for better orientation of therapy. The current approach proposes the differentiation between type 2 (eosinophilic) and non-type 2 inflammatory responses. In this review pathophysiological concepts of CRS will be discussed, focusing on the different inflammatory endotypes of T cells with special attention to the eosinophilic type 2 inflammatory response. The contribution of innate and adaptive immune system responses is presented. The possibility of endotyping based on sinonasal secretions sampling is brought to attention because it is indicative of corticosteroid responsiveness and available to most ENT surgeons. Furthermore, the clinical aspects of the three distinct phenotypes are analyzed in view of their characteristics, the related endoscopic findings, typical radiological imaging, histopathology findings, their relation toward allergy and obvious therapeutical implications. This overview will enable clinicians to relate pathophysiological patterns with clinical observations by explaining the different inflammatory mechanisms, hence providing a better understanding of therapy.

scholarly journals Sexually Transmitted Diseases Among Residents in Nursing Homes: The Nurses' Perspective

2021 ◽  
Vol 4 (1) ◽  
pp. 23-30
Author(s):  
Lauren N. Maziarz ◽  
Nikki Sorgi ◽  
Nicole Fischer
Keyword(s):  
Older Adults ◽  
Nursing Homes ◽  
Transmitted Disease ◽  
Strong Support ◽  
Health Belief ◽  
Target Population ◽  
Sexual Relationships ◽  
Perceived Barriers ◽  
Sexually Transmitted ◽  
Belief Model

Background: Examining registered nurses' perceptions of sexually transmitted disease (STD) education among residents in nursing homes allows for broader insight into why STDs continue to increase among older adults. Methods: A 4-page pilot survey was mailed to nursing home directors of nursing in Northwest Ohio (n=99) with a response rate of 32%. Directors of nursing were the target population as they are the most likely employee to hold registered nurse licensure. The health belief model formed the basis for the survey. Results: Most nurses did not see STDs or human immunodeficiency virus (HIV) as problems among their residents (100% and 96%, respectively) yet support for sex among residents was high. All (100%) agreed sex among married residents should be supported, while 77% agreed sex among nonmarried residents should be supported. Most nurses stated they were comfortable discussing HIV risk (84%), STD risk (84%), erectile dysfunction (75%), sexual desire and intimacy (72%), and correct condom use (66%). The most commonly reported perceived barriers to STD education were family opposition (63%), resident embarrassment (56%), and lack of education regarding the prevalence of STDs in older adults (53%). The most commonly reported perceived benefits to STD education were being seen as a leading facility for healthy initiatives (66%) and promotion of healthy sexual relationships among residents (56%). Conclusion: There was strong support for STD education among nurses though implementation remains rare. Addressing the most commonly perceived barriers and benefits may prove beneficial in increasing the number of LTCFs that provide STD education to residents.

scholarly journals Results of a vaccination campaign against human papillomavirus in the province of La Spezia, Liguria, Italy, March-December 2008

2009 ◽  
Vol 14 (39) ◽  
Author(s):  
J Lugarini ◽  
F Maddalo
Keyword(s):  
Human Papillomavirus ◽  
Sexually Transmitted Diseases ◽  
Cervical Carcinoma ◽  
Vaccination Campaign ◽  
Hpv Vaccination ◽  
Target Population ◽  
Hpv Infection ◽  
Sexually Transmitted ◽  
Oral Cancers ◽  
The Ideal

Sexually transmitted diseases caused by human papillomavirus (HPV) are being diagnosed more frequently than others. It is accepted that HPV infection is a necessary cause for all cases of cervical carcinoma and a large number of other anogenital and oral cancers. Two vaccines have been developed and were licensed in 2007, which can prevent infections and pre-cancerous lesions due to HPV. In Italy pre-adolescent age (12 years-old) was identified as the ideal age for vaccination against HPV. In Liguria, the first free HPV vaccination campaign was started on 8 March 2008 in 12 year-old girls. We assessed the adherence to the vaccination during the 2008 campaign as 80.6%, 79.0% and 64.1%, respectively, for the first, second and third dose of vaccine in the target population.

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