Posts filed under ‘Infecciones de transmision sexual’
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.
Current standards for diagnosis and treatment of syphilis: selection of some practical issues, based on the European (IUSTI) and U.S. (CDC) guidelines.
Postepy Dermatol Alergol. 2013 Aug;30(4):203-10.
Pastuszczak M1, Wojas-Pelc A.
1Department of Dermatology, Jagiellonian University Medical College, Krakow, Poland. Head: Prof. Anna Wojas-Pelc MD, PhD.
Syphilis continues to be an important epidemiologic problem. For a few years a steady increase in the incidence of this sexually transmitted disease has been observed. Advances in medical science obligate the doctor to use only such diagnostic and therapeutic approaches that are scientifically proven. Based on the European (IUSTI) and U.S. (CDC) guidelines, in this manuscript, we present some selected practical issues concerning diagnosis and treatment of syphilis. We truly hope that the present review will help all doctors taking care of syphilitic patients to systematize the current knowledge.
Current Opinion in Infectious Diseases Feb 2013 V.26 N.1 P.80–85
Poynten, I. Marya; Grulich, Andrew E.a; Templeton, David J.a,b
aKirby Institute, University of New South Wales, Sydney
bRPA Sexual Health, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
Correspondence to Dr Mary Poynten, Kirby Institute, The University of New South Wales, Sydney, NSW 2052, Australia. Tel: +61 2 93850937; fax: +61 2 93850920; e-mail: firstname.lastname@example.org
Purpose of review
People are living longer and healthier lives. In recent years, there has been a focus on recognition of ongoing sexual activity among older adults and leading from this, the potential for an increase in diagnoses of sexually transmitted infections (STIs). Data on STI rates, sexual behaviour and factors affecting susceptibility to STIs are discussed.
There is limited published literature in this field and few recent longitudinal studies of STI acquisition in people older than 50 years. Although there is evidence of an increase in incidence, STIs remain rare in older compared with younger populations. Compared with their heterosexual counterparts, older men who have sex with men are at higher risk of incident HIV and some other STIs. The HIV epidemic is ageing as a result of increasing life span and acquisition of HIV at older ages. Improved longevity, evolving societal norms and physiological changes may place older people at risk of HIV and other STIs.
Routine STI screening is not warranted in all older people. Education and prevention strategies for all people at greater risk of HIV, regardless of age are required. Age-appropriate interventions designed to impart knowledge and provide the requisite skills needed to reduce STI risk in older age would be beneficial.
PDF (CLIC PDF)
N Engl J of Medic Aug.14, 2014 V.371 P.667-667
IMAGES IN CLINICAL MEDICINE
- Cherniak and M. Silverman
A 45-year-old woman presented to an outreach clinic in rural Uganda with a 1-year history of a progressively enlarging ulcerated mass on the hard palate (Panel A). The mass had initially been painless but more recently had become painful and was causing difficulty in speaking and swallowing. She had received a diagnosis of cancer and was attempting to sell her home to pay for surgical resection. She had no history of syphilitic symptoms or treatment. The results on Treponema pallidum hemagglutination assay were positive for syphilis; nontreponemal testing was not locally available. Serologic analysis for human immunodeficiency virus was negative. Tertiary syphilis with an oral gumma was diagnosed. The patient was treated with three intramuscular injections of 2.4 million units of penicillin G benzathine at 1-week intervals. At follow-up 2 months after the end of treatment, there was resolution of the mass and symptoms (Panel B). In the oral cavity, gummas may occur as masses on the hard palate or tongue that frequently ulcerate….