Posts filed under ‘Infecciones de transmision sexual’
N Engl J Med 2015;372:2039-2048
R.C. Brunham, S.L. Gottlieb, and J. Paavonen
From the Department of Medicine, University of British Columbia, Vancouver, Canada (R.C.B.); the Department of Reproductive Health and Research, World Health Organization, Geneva (S.L.G.); and the Department of Obstetrics and Gynecology, University of Helsinki, Helsinki (J.P.).
Address reprint requests to Dr. Brunham at the Department of Medicine, University of British Columbia, 655 West 12th Ave., Vancouver, BC V5Z 4R4, Canada, or at email@example.com
Pelvic inflammatory disease is an infection-induced inflammation of the female upper reproductive tract (the endometrium, fallopian tubes, ovaries, or pelvic peritoneum); it has a wide range of clinical manifestations.
Inflammation spreads from the vagina or cervix to the upper genital tract, with endometritis as an intermediate stage in the pathogenesis of disease.
The hallmark of the diagnosis is pelvic tenderness combined with inflammation of the lower genital tract; women with pelvic inflammatory disease often have very subtle symptoms and signs.
Many women have clinically silent spread of infection to the upper genital tract, which results in subclinical pelvic inflammatory disease….
Use of 9-Valent Human Papillomavirus (HPV) Vaccine: Updated HPV Vaccination Recommendations of the Advisory Committee on Immunization Practices
MMWR Weekly March 27, 2015 V.64 N.11 P.300-304
Emiko Petrosky, MD, Joseph A. Bocchini Jr, MD, Susan Hariri, PhD, et al.
1Epidemic Intelligence Service, CDC; 2National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, CDC; 3Louisiana State University Health Sciences Center, Shreveport, Louisiana; 4National Center for Immunization and Respiratory Diseases, CDC; 5National Center for Chronic Disease Prevention and Health Promotion, CDC; 6National Center for Emerging and Zoonotic Infectious Diseases, CDC (Corresponding author: Emiko Petrosky, firstname.lastname@example.org, 404-639-1817)
During its February 2015 meeting, the Advisory Committee on Immunization Practices (ACIP) recommended 9-valent human papillomavirus (HPV) vaccine (9vHPV) (Gardasil 9, Merck and Co., Inc.) as one of three HPV vaccines that can be used for routine vaccination (Table 1).
HPV vaccine is recommended for routine vaccination at age 11 or 12 years (1). ACIP also recommends vaccination for females aged 13 through 26 years and males aged 13 through 21 years not vaccinated previously.
Vaccination is also recommended through age 26 years for men who have sex with men and for immunocompromised persons (including those with HIV infection) if not vaccinated previously (1). 9vHPV is a noninfectious, virus-like particle (VLP) vaccine.
Similar to quadrivalent HPV vaccine (4vHPV), 9vHPV contains HPV 6, 11, 16, and 18 VLPs. In addition, 9vHPV contains HPV 31, 33, 45, 52, and 58 VLPs (2). 9vHPV was approved by the Food and Drug Administration (FDA) on December 10, 2014, for use in females aged 9 through 26 years and males aged 9 through 15 years (3).
For these recommendations, ACIP reviewed additional data on 9vHPV in males aged 16 through 26 years (4). 9vHPV and 4vHPV are licensed for use in females and males. Bivalent HPV vaccine (2vHPV), which contains HPV 16, 18 VLPs, is licensed for use in females (1).
This report summarizes evidence considered by ACIP in recommending 9vHPV as one of three HPV vaccines that can be used for vaccination and provides recommendations for vaccine use….
PDF See P.300-304
Behavioral Sexual Risk-Reduction Counseling in Primary Care to Prevent Sexually Transmitted Infections – An Updated Systematic Evidence Review for the U.S. Preventive Services Task Force
Annals of Internal Medicine Sept.23, 2014
Elizabeth A. O’Connor, PhD; Jennifer S. Lin, MD, MCR; Brittany U. Burda, MPH; Jillian T. Henderson, PhD; Emily S. Walsh, MPH; and Evelyn P. Whitlock, MD, MPH
From Kaiser Permanente Center for Health Research, Portland, Oregon.
Sexually transmitted infections (STIs) are common and preventable.
To update a previous systematic review about the benefits and harms of sexual risk-reduction counseling to prevent STIs for the U.S. Preventive Services Task Force.
Selected databases from January 2007 through October 2013, manual searches of references lists and grey literature, and studies from the previous review.
English-language fair- or good-quality trials conducted in adolescents or adults.
One investigator abstracted data and a second checked the abstraction. Study quality was dual reviewed.
31 trials were included: 16 were newly published (n = 56 110) and 15 (n = 14 214) were from the previous review. Most trials targeted persons at increased risk for STIs based on sociodemographic characteristics, risky sexual behavior, or history of an STI. High-intensity (>2 hours) interventions reduced STI incidence in adolescents (odds ratio, 0.38 [95% CI, 0.24 to 0.60]) and adults (odds ratio, 0.70 [CI, 0.56 to 0.87]). Lower-intensity interventions were generally not effective in adults but some approaches were promising. Although moderate-intensity interventions may be effective in adolescents, data were very sparse. Reported behavioral outcomes were heterogeneous and most likely to show a benefit with high-intensity interventions at 6 months or less. No consistent evidence was found that sexual risk-reduction counseling was harmful.
Low-risk populations and male adolescents were underrepresented. Reliability of self-reported behavioral outcomes was unknown.
High-intensity counseling on sexual risk reduction can reduce STIs in primary care and related settings, especially in sexually active adolescents and in adults at increased risk for STIs.
Primary Funding Source
Agency for Healthcare Research and Quality.
PDF (CLIC PDF)
Indian J Sex Transm Dis. 2014 Jan;35(1):70-1.
Archana BR1, Prasad SR1, Beena PM1, Okade R2.
1Department of Microbiology, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India.
2Department of Dermatology and Venereology, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India.