Sexually transmitted

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  • Harrison's Internal Medicine Chapter 124. Sexually Transmitted Infections: Overview and Clinical Approach Classification and Epidemiology Worldwide, most adults acquire at least one sexually transmitted infection (STI), and many remain at risk for complications. Each year, for example, an estimated 6.2 million persons in the United States acquire a new genital human papillomavirus (HPV) infection, and many of these individuals are at risk for genital neoplasias.

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  • Sexually transmitted infections (STIs) are defined as infections that spread primarily through person-to-person sexual contact. However, several of these infections, in particular HIV, syphilis and hepatitis B, can also be transmitted via mother-to-child-transmission during pregnancy and childbirth, blood products or tissue transfer.

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  • Bacterial Vaginosis This syndrome (formerly termed nonspecific vaginitis, Haemophilus vaginitis, anaerobic vaginitis, or Gardnerella-associated vaginal discharge) is characterized by symptoms of vaginal malodor and a slightly to moderately increased white discharge, which appears homogeneous, is low in viscosity, and evenly coats the vaginal mucosa. An interesting observation is that new genital HPV infection in young women is associated with increased subsequent risk of developing bacterial vaginosis.

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  • Pelvic Inflammatory Disease: Treatment The 2006 CDC guidelines recommend initiation of empirical treatment for PID in sexually active young women and other women at risk for PID if they are experiencing pelvic or lower abdominal pain, if no other cause for the pain can be identified, and if pelvic examination reveals one or more of the following criteria for PID: cervical motion tenderness, uterine tenderness, or adnexal tenderness. Women with suspected PID can be treated as either outpatients or inpatients.

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  • Treat urethritis promptly, while test results are pending. Table 124-4 summarizes the steps in management of sexually active men with urethral discharge and/or dysuria. Table 124-4 Management of Urethral Discharge in Men Usual causes Usual initial evaluation Chlamydia trachomatis pyuria Neisseria gonorrhoeae Demonstration of urethral discharge or Exclusion of local or systemic Mycoplasma genitalium complications Ureaplasma urealyticum Urethral Gram's stain to confirm urethritis, detect gram-negative diplococci Trichomonas vaginalis Test for N. gonorrhoeae, C.

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  • CÁC BỆNH LÂY TRUYỀN BẰNG ĐƯỜNG SINH DỤC THÔNG THƯỜNG NHẤT Tỷ lệ mắc bệnh thật sự của hầu hết các bệnh lây truyền bằng đường sinh dục (sexually transmitted diseases) không được biết rõ bởi vì không phải tất cả các trường hợp đều được báo cáo. Nhìn toàn bộ, người ta ước tính rằng các bệnh lây truyền bằng đường sinh dục ảnh hưởng lên khoảng 12 triệu người ở Hoa Kỳ mỗi năm.

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  • 1/ CÁC BỆNH LÂY TRUYỀN BẰNG ĐƯỜNG SINH DỤC THÔNG THƯỜNG NHẤT. Tỷ lệ mắc bệnh thật sự của hầu hết các bệnh lây truyền bằng đường sinh dục (sexually transmitted diseases) không được biết rõ bởi vì không phải tất cả các trường hợp đều được báo cáo. Nhìn toàn bộ, người ta ước tính rằng các bệnh lây truyền bằng đường sinh dục ảnh hưởng lên khoảng 12 triệu người ở Hoa Kỳ mỗi năm.

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  • Take molecular genetics and bioinformatics for example; these are perhaps two of the most exciting areas of biology and are beginning to have an impact on other areas of medical therapeutics such as cancer and diabetes, and provide a signpost to ‘personalised medicine’. Yet recent genome wide association (GWAS) studies of large samples, have demonstrated that in schizophrenia around 1000 or more genetic variants of low penetrance may be implicated in the heritability of schizophrenia.

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  • Chapter 124. Sexually Transmitted Infections: Overview and Clinical Approach (Part 18) Table 124-8 Initial Management of Genital or Perianal Ulcer Usual causes Herpes simplex virus (HSV) Treponema pallidum (primary syphilis) Haemophilus ducreyi (chancroid) Usual initial laboratory evaluation Dark-field exam, direct FA, or PCR for T. pallidum; RPR or VDRL test for syphilis (if negative but primary syphilis suspected, repeat in 1 week); culture, direct FA, ELISA, or PCR for HSV; consider HSV-2-specific serology. In chancroid-endemic area: PCR or culture for H.

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  • Chapter 124. Sexually Transmitted Infections: Overview and Clinical Approach (Part 19) Ulcerative Genital or Perianal Lesions: Treatment Immediate syndrome-based treatment for acute genital ulcerations (after collection of all necessary hdiagnostic specimens at the first visit) is often appropriate before all test results become available, because patients with typical initial or recurrent episodes of genital or anorectal herpes can benefit from prompt oral antiviral therapy (Chap.

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  • Chapter 124. Sexually Transmitted Infections: Overview and Clinical Approach (Part 20) Proctitis, Proctocolitis, Enterocolitis, and Enteritis: Treatment Acute proctitis in persons who have practiced receptive anorectal intercourse is usually sexually acquired. Such patients should undergo anoscopy to detect rectal ulcers or vesicles and petechiae after swabbing of the rectal mucosa; to examine rectal exudates for PMNs and gram-negative diplococci; and to obtain rectal swab specimens for testing for rectal gonorrhea, chlamydial infection, herpes, and syphilis.

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  • Chapter 124. Sexually Transmitted Infections: Overview and Clinical Approach (Part 17) Diagnosis Although most genital ulcerations cannot be diagnosed confidently on clinical grounds alone, clinical findings plus epidemiologic considerations (Table 124-7) can usually guide initial management (Table 124-8) pending results of further tests. Clinicians should order a rapid serologic test for syphilis in all cases of genital ulcer and a dark-field or direct immunofluorescence test (or PCR test, where available) for T.

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  • Chapter 124. Sexually Transmitted Infections: Overview and Clinical Approach (Part 21) Although gonorrhea is now substantially less common than chlamydial infection in industrialized countries, screening tests for N. gonorrhoeae are still appropriate for women and teenage girls attending STD clinics and for sexually active teens and young women from areas of high gonorrhea prevalence. Multiplex NAATs that combine screening for N. gonorrhoeae and C. trachomatis in a single low-cost assay now facilitate the prevention and control of both infections in populations at high risk.

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  • Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: HIV among pregnant women in Moshi Tanzania: the role of sexual behavior, male partner characteristics and sexually transmitted infections...

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: The impact of provider-initiated (opt-out) HIV testing and counseling of patients with sexually transmitted infection in Cape Town, South Africa: a controlled trial

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  • In Africa, as in many parts of the world, adolescent reproductive health is a controversial issue for policy makers and programme planners. Adolescents are particularly vulnerable to HIV and AIDS and to a host of other problems such as sexually transmitted infection, unwanted pregnancy, unsafe abortions, sexual abuse, female genital mutilation and unsafe circumcision. Yet many countries don’t have adolescent health policies and much remains to be done to ensure that adolescents can access appropriate sexual and reproductive health services....

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  • Epididymitis Acute epididymitis, almost always unilateral, produces pain, swelling, and tenderness of the epididymis, with or without symptoms or signs of urethritis. This condition must be differentiated from testicular torsion, tumor, and trauma. Torsion, a surgical emergency, usually occurs in the second or third decade of life and produces a sudden onset of pain, elevation of the testicle within the scrotal sac, rotation of the epididymis from a posterior to an anterior position, and absence of blood flow on Doppler examination or 99m Tc scan.

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  • Inspection of the vulva and perineum may reveal tender genital ulcerations (typically due to HSV infection, occasionally due to chancroid) or fissures (typically due to vulvovaginal candidiasis) or discharge visible at the introitus before insertion of a speculum (suggestive of bacterial vaginosis or trichomoniasis).

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  • Bacterial Vaginosis: Treatment The standard dosage of metronidazole for the treatment of bacterial vaginosis is 500 mg PO twice daily for 7 days. The single 2-g oral dose of metronidazole recommended for trichomoniasis produces somewhat lower shortterm cure rates. Intravaginal treatment with 2% clindamycin cream [one full applicator (5 g containing 100 mg of clindamycin phosphate) each night for 7 nights] or with 0.75% metronidazole gel [one full applicator (5 g containing 37.

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  • Chapter 124. Sexually Transmitted Infections: Overview and Clinical Approach (Part 12) Figure 124-5 Gram's stain of cervical mucus, showing a strand of cervical mucus containing many polymorphonuclear leukocytes. This picture is typical of mucopurulent cervicitis. Note that leukocytes are not seen in areas of the slide containing vaginal epithelial cells, adjacent to the mucus strands.

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