Background: Sexually Transmitted Infections (STIs) rank in the top 5 disease categories for which adults in developing countries seek healthcare services. Community pharmacies offer clients convenience, proximity, extended opening hours, privacy, and efficiency, which could make them desirable locations for HIV and STI screening and treatment. We examined the feasibility of using point-of-care (POC) STI tests for screening HIV and other STIs at community pharmacies.
View Article and Find Full Text PDFBackground: Infection with Chlamydia trachomatis (CT) can have distinct clinical presentations, such as trachoma, or lymphogranuloma venereum (LGV). Certain populations are at greater risk for LGV acquisition and transmission, which requires a longer duration of therapy than other urogenital CT sexually transmitted infections (STIs). Commercial assays are not available in the United States to distinguish LGV from non-LGV serovars.
View Article and Find Full Text PDFBackground: The NHS Jewish BRCA Testing Programme is offering germline and genetic testing to people with ≥1 Jewish grandparent. Who have an increased likelihood of having an Ashkenazi Jewish (AJ) founder germline pathogenic variant (gPV) compared with the general population.Testing is offered via a self-referral, home-based saliva sampling pathway, supported by a genetic counsellor telephone helpline.
View Article and Find Full Text PDFPurpose: To assess the contribution of germline pathogenic variants (PVs) in population-based series of breast cancers and the best strategy to improve detection rates.
Methods: Three cohort studies were utilized, including a hospital-based series identified from new UK mainstream testing criteria (group-1), offering testing to all women (group-2-BReast CAncer [BRCA]-DIRECT), and a Greater Manchester cohort study recruited from the mammography screening population (group-3-Predicting Risk of Cancer at Screening). DNA samples from women with breast cancer were sequenced for PVs in , , and Partner and Localiser of BRCA2 ().
Background: Sexually transmitted infections (STIs) are a global health challenge. Testing is not routinely performed in low- and middle-income countries (LMICs), which bear a disproportionate burden of STIs. Self-collected penile-meatal swabs (SCPMS) are an alternative to urine for STI testing, but data from LMICs are limited.
View Article and Find Full Text PDFBackground: Patients with suspected mpox presented to different venues for evaluation during the 2022 outbreak. We hypothesized that practice patterns may differ across venue of care.
Methods: We conducted an observational study of patients undergoing mpox testing between 1 June 2022 and 15 December 2022.
Background: Men reporting same-sex behaviors are disproportionately impacted by sexually transmitted infections (STIs). Differences in clinical characteristics and STIs in men who have sex with men only (MSMO), with men and women (MSMW), and with women only (MSW) are not well described.
Methods: First visits to 2 Baltimore City STI clinics 2011-2016 from MSMO and MSMW compared with an age-matched random sample of MSW were analyzed.
Background: Since July 23, 2022, global mpox cases reached 92,546, with over 31,000 in the United States. Asymptomatic carriage is a critical mechanism influencing the global dissemination of mpox. Seroprevalence studies are crucial for determining the epidemic's true burden, but uncertainties persist in serologic assay performance and how smallpox vaccination may influence assay interpretation.
View Article and Find Full Text PDFBackground: Syphilis epidemics among women and men who have sex with men (MSM) may be connected, but these connections are poorly understood. Using egocentric network data from a US urban MSM cohort, we examined sociodemographics, behaviors, and syphilis positivity among MSM with (1) direct (MSM who report sex with women, MSMW); (2) indirect (MSM who only report male partners, some of whom are MSMW, MSMO/W); and (3) no (MSM who only report male partners and whose partners only have sex with men, MSMO/O) connection to women.
Methods: Sexually active MSM aged 18 to 45 years were administered behavioral and network interviews (recall period: 3 months) and syphilis/HIV testing.
Retrospective surveillance leveraging male rectal swab sample remnants from I Want the Kit from July 2021 through October 2023 identified 1 symptomatic and 1 asymptomatic mpox case at the peak of transmission in 2022. Although sporadic cases continue to be reported in Maryland, additional asymptomatic cases were not identified in this leveraged surveillance.
View Article and Find Full Text PDFWe aimed to (1) describe telemedicine utilization and usability during the first 6 weeks of the pandemic and (2) determine if usability varied by individual- or visit-level characteristics. We conducted a retrospective cohort study of ambulatory pediatric telemedicine visits occurring between March 10, 2020, and April 18, 2020, across a large academic health system. We performed manual chart review to assess individual- and visit-level characteristics and invited caregivers to respond to an adapted Telehealth Usability Questionnaire (TUQ).
View Article and Find Full Text PDFMed Clin North Am
March 2024
Syphilis serology interpretation can be challenging even for experienced providers. This article reviews the staging of syphilis and the principles of syphilis serology testing, the algorithms used in diagnosis, and guidance for their use in monitoring the response to treatment. The authors illustrate these principles through a series of clinical scenarios and describe the rationale behind the management approaches.
View Article and Find Full Text PDFPurpose: The aim of this study was to compare the rates of rebubbling after Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping endothelial keratoplasty (DSEK) between patients who had anterior chamber (AC) graft tamponade with 20% sulfur hexafluoride gas (SF6) and 6% perfluoropropane gas (C3F8).
Methods: The charts of 431 patients undergoing EK from June 8, 2010, to April 16, 2023, were reviewed. Patients undergoing EK alone as well as combined procedures with cataract extraction and intraocular lens implantation were included.
Background: The Rural Trauma Team Development Course (RTTDC) is designed to help rural hospitals better organize and manage trauma patients with limited resources. Although RTTDC is well-established, limited literature exists regarding improvement in the overall objectives for which the course was designed. The aim of this study was to analyze the goals of RTTDC, hypothesizing improvements in course objectives after course completion.
View Article and Find Full Text PDFBackground: During the 2022 mpox outbreak most patients were managed as outpatients, but some required hospitalization. Uncontrolled human immunodeficiency virus (HIV) has been identified as a risk factor for severe mpox.
Methods: Patients with mpox diagnosed or treated within the Johns Hopkins Health System between 1 June and 15 December 2022 were included.
Importance: Reported coronavirus disease 2019 (COVID-19) pandemic effects on pediatric trauma have been variable.
Objective: We investigated the characteristics of pediatric trauma including alcohol use during the pandemic at our urban trauma center.
Methods: The trauma database of our adult level 1 trauma center was queried for all pediatric (age ≤ 18 years) patients presenting between March 1, 2020, and October 30, 2020.
Introduction: The Fundamental Critical Care Support Course (FCCS) is a standardized multidisciplinary program designed to educate participants on the basics of identification and management of patients with critical illness. Our objective was to evaluate the effect of FCCS participation on confidence in the assessment and management of critically ill patients and attitudes towards multidisciplinary education and interprofessional care in a multidisciplinary group of participants.
Methods: Participants enrolled in the FCCS course from May 2018 to November 2019 were solicited to participate in a series of surveys evaluating their course experience and confidence in critical care.
Background: Treatment for bladder cancer includes radical cystectomy (RC) and urinary diversion; RC is associated with long-term morbidity, kidney impairment and mortality.
Aim: To identify risk factors associated with postoperative long-term kidney function and mortality.
Methods: Retrospective study of patients with RC and urinary diversion in Beaumont Hospital from 1996 to 2016.
Background: The incidence of sexually transmitted infections (STIs) is increasing in the United States. The COVID-19 pandemic resulted in significant reductions in access to health care services, including STI testing and treatment, leading to underreporting of STI cases and a need for alternatives to clinic-based testing. Moreover, concerns around confidentiality, accessibility, and stigma continue to limit access to clinic-based STI testing, particularly for high-priority populations.
View Article and Find Full Text PDFBackground: Integration of a sensitive point-of-care (POC) HIV viral load (VL) test into screening algorithms may help detect acute HIV infection earlier, identify people with HIV (PWH) who are not virally suppressed, and facilitate earlier referral to antiretroviral therapy (ART), or evaluation for pre-exposure prophylaxis (PrEP). This report describes a randomized clinical trial sponsored by the Centers for Disease Control and Prevention (CDC): "Ending the HIV Epidemic Through Point-of-Care Technologies" (EHPOC). The study's primary aim is to evaluate the use of a POC HIV VL test as part of a testing approach and assess the impact on time to linkage to ART or PrEP.
View Article and Find Full Text PDFBRCA1-associated protein-1 (BAP1) is a recognised tumour suppressor gene. Germline BAP1 pathogenic/likely pathogenic variants are associated with predisposition to multiple tumours, including uveal melanoma, malignant pleural and peritoneal mesothelioma, renal cell carcinoma and specific non-malignant neoplasms of the skin, as part of the autosomal dominant BAP1-tumour predisposition syndrome. The overall lifetime risk for BAP1 carriers to develop at least one BAP1-associated tumour is up to 85%, although due to ascertainment bias, current estimates of risk are likely to be overestimated.
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