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Open Forum Infectious Diseases Jul 2021This study aimed to identify enteric and sexually acquired rectal pathogens, other than chlamydia and gonorrhea, associated with symptomatic proctitis in men who have...
BACKGROUND
This study aimed to identify enteric and sexually acquired rectal pathogens, other than chlamydia and gonorrhea, associated with symptomatic proctitis in men who have sex with men (MSM).
METHODS
Anorectal swab samples were obtained from MSM presenting with rectal symptoms and a clinical diagnosis of proctitis at the Melbourne Sexual Health Centre between January 2017 and March 2019. Samples that tested positive for and were excluded. As a comparison group, anorectal samples were also obtained from MSM not reporting symptoms of proctitis between November 2018 and February 2019. Samples from both groups were tested for 15 viral, bacterial, and protozoal enteric pathogens using polymerase chain reaction.
RESULTS
Anorectal samples from 499 men with symptomatic proctitis and 506 asymptomatic men were analyzed. Age, HIV status, and pre-exposure prophylaxis (PrEP) use did not differ between men with proctitis and asymptomatic men. was more common in men with proctitis (risk difference [RD], 3.6%; 95% CI, 2.0%-5.2%). Most men with anorectal presented with painful anal primary infections. spp. was more common among men with proctitis compared with asymptomatic men (RD, 1.8%; 95% CI, 0.1%-3.5%). Most men with did not report diarrhea. was more common in men with proctitis (RD, 4.3%; 95% CI, 1.1%-7.5%). Herpes simplex virus (HSV)-1 (RD, 10.1%; 95% CI, 6.8%-13.3%) and HSV-2 (RD, 7.2%; 95% CI, 4.5%-10.0%) were more common with proctitis.
CONCLUSIONS
Testing for , , and HSV should be considered in MSM presenting with symptomatic proctitis. These data provide support for as a significant cause of proctitis. A comprehensive diagnostic evaluation is required for MSM with proctitis.
PubMed: 34671693
DOI: 10.1093/ofid/ofab137 -
Pathogens (Basel, Switzerland) Oct 2021(CT) is the agent of the most common bacterial sexually transmitted infection worldwide, with a significant impact on women's health. Despite the increasing number of...
(CT) is the agent of the most common bacterial sexually transmitted infection worldwide, with a significant impact on women's health. Despite the increasing number of studies about the vaginal microbiome in women with CT infections, information about the composition of the anal microbiome is still lacking. Here, we assessed the bacterial community profiles of vaginal and anal ecosystems associated or not with CT infection in a cohort of Caucasian young women. A total of 26 women, including 10 with a contemporary vaginal and ano-rectal CT infection, were enrolled. Composition of vaginal and anal microbiome was studied by 16S rRNA gene profiling. Co-occurrence networks of bacterial communities and metagenome metabolic functions were determined. In case of CT infection, both vaginal and anal environments were characterized by a degree of dysbiosis. Indeed, the vaginal microbiome of CT-positive women were depleted in lactobacilli, with a significant increase in dysbiosis-associated bacteria (e.g., ), whereas the anal microbiota of CT-infected women was characterized by higher levels of and and lower levels of . Interestingly, the microbiome of anus and vagina had numerous bacterial taxa in common, reflecting a significant microbial 'sharing' between the two sites. In the vaginal environment, CT positively correlated with spp. while co-occurred with several dysbiosis-related microbes, regardless of CT vaginal infection. The vaginal microbiome of CT-positive females exhibited a higher involvement of chorismate and aromatic amino acid biosynthesis, as well as an increase in mixed acid fermentation. These data could be useful to set up new diagnostic/prognostic tools, offering new perspectives for the control of chlamydial infections.
PubMed: 34684295
DOI: 10.3390/pathogens10101347 -
Lasers in Medical Science Mar 2023The treatment of sacrococcygeal pilonidal disease (SPD) is still challenging. Although many non-surgical and surgical methods exist, no consensus has been reached on the...
The treatment of sacrococcygeal pilonidal disease (SPD) is still challenging. Although many non-surgical and surgical methods exist, no consensus has been reached on the best treatment. This study aimed to evaluate the efficacy of laser ablation using 1470-nm radial diode laser fiber in treating SPD. We retrospectively studied the data of our 48 patients who operated on this technique between March 2019 and July 2022. All patients were treated with laser ablation using 1470-nm radial diode laser fiber. The healing rate and recurrence rate, demographic and surgical data, postoperative pain, complications (wound infection, wound bleeding), the time of returning to regular work and life, and the time of wound healing were recorded. Postoperative pain was measured based on the visual analog scale (VAS) score. Postoperative follow-up was performed in the outpatient clinic every 1 week for 1 month. Among the 48 patients, 41 males and 7 females, with a mean age of 27.7 years (range 14-42), the healing rate was 100%, and the average healing time was 28.3 ± 5.5 days. Mean operative time was 15.5 ± 3.3 min. The recurrence rate was 2.1%. One patient relapsed 3 months after the operation. The patient underwent laser ablation again, and the sinus tract was closed. The median visual analog scale (VAS) score on the day of operation was 0(0,2). The median VAS score on the first, third, seventh, and fourteenth day after operation was 0(0,2), 0(0,1), 0(0,1), and 0(0,0), respectively. There was no wound infection or bleeding after the operation. The mean time to normal work/life was 7.1 ± 3.2 days. Almost all the patients felt very satisfied with the operation. Laser ablation using 1470-nm radial diode laser fiber is effective in SPD treatment. It is associated with minor wounds and mild postoperative pain. It is a simple, safe, and minimally invasive technique and its clinical application for acute and chronic SPD in the absence of abscess is promising.
Topics: Female; Male; Humans; Adolescent; Young Adult; Adult; Pilonidal Sinus; Retrospective Studies; Laser Therapy; Skin Diseases; Pain, Postoperative
PubMed: 36856904
DOI: 10.1007/s10103-023-03741-1 -
Frontiers in Pharmacology 2022Therapies based on orally administrated nucleic acids have significant potential for the treatment of infectious diseases, including chronic inflammatory diseases such... (Review)
Review
Therapies based on orally administrated nucleic acids have significant potential for the treatment of infectious diseases, including chronic inflammatory diseases such as inflammatory bowel disease (IBD)-associated with the gastrointestinal (GI) tract, and infectious and acute contagious diseases like coronavirus disease 2019 (COVID-19). This is because nucleic acids could precisely regulate susceptibility genes in regulating the pro- and anti-inflammatory cytokines expression related to the infections. Unfortunately, gene delivery remains a major hurdle due to multiple intracellular and extracellular barriers. This review thoroughly discusses the challenges of nanoparticle-based nucleic acid gene deliveries and strategies for overcoming delivery barriers to the inflammatory sites. Oral nucleic acid delivery case studies were also present as vital examples of applications in infectious diseases such as IBD and COVID-19.
PubMed: 36105233
DOI: 10.3389/fphar.2022.984981 -
Journal of Pediatric Surgery Aug 2023The goal of this study was to evaluate outcomes in patients treated with sacral nerve stimulation (SNS) for medically refractory fecal incontinence or severe...
INTRODUCTION
The goal of this study was to evaluate outcomes in patients treated with sacral nerve stimulation (SNS) for medically refractory fecal incontinence or severe constipation.
METHODS
We performed a retrospective cohort study of all patients treated with SNS after failed medical management at a single center between 9/1/2015 and 6/30/2022. Demographic and clinical data was extracted from the electronic medical record. Rates of involuntary bowel movements were evaluated using a bowel severity score questionnaire and compared pre- and post-SNS using McNemar and McNemar-Bowker tests.
RESULTS
70 patients underwent SNS placement. The median age was 12.8 years (IQR 8.6-16.0) and 61.4% were male. The most common diagnosis was idiopathic constipation (67.1%), followed by anorectal malformation (15.7%), and others. 43 patients had severity scores recorded both pre- and at least 90 days post-SNS insertion. The rates of daytime and nighttime involuntary bowel movements were significantly different pre-compared to post-SNS placement (p = 0.038 and p = 0.049, respectively). The rate of daytime and nighttime fecal continence increased from 44% to 58.1% and 53.5%-83.7%, respectively. The rate of at least weekly daytime and nighttime fecal incontinence decreased from 48.8% to 18.7% and 34.9%-7.0%, respectively. Minor pain/neurological symptoms occurred in 40% of patients, while 5.7% developed a wound infection. Further surgery for the SNS was required in 40% of patients.
CONCLUSIONS
SNS placement can be an effective treatment for medically refractory fecal incontinence. Minor complications and the need for further procedures are common, while more serious complications like wound infections are rare.
TYPE OF STUDY
Retrospective Cohort Study.
LEVEL OF EVIDENCE
Level 3.
Topics: Humans; Male; Child; Female; Fecal Incontinence; Retrospective Studies; Electric Stimulation Therapy; Spinal Nerves; Treatment Outcome; Constipation; Pain; Lumbosacral Plexus; Quality of Life
PubMed: 37221127
DOI: 10.1016/j.jpedsurg.2023.04.007 -
International Journal of Gynaecology... Apr 2023Considering the exponentially growing concerns about the increase of anal cancer rates in women with human papillomavirus (HPV) infection and cervical intraepithelial...
OBJECTIVE
Considering the exponentially growing concerns about the increase of anal cancer rates in women with human papillomavirus (HPV) infection and cervical intraepithelial neoplasia, the authors evaluated concurrent anorectal and cervical cytology in women with positive and negative cervical smear tests.
METHOD
The current investigation was designed as a cross-sectional study conducted in Arash Women's Hospital, Tehran, Iran, between November 2020 and November 2021. Cervical cytology, HPV test, and anal cytology samples were prepared. Then women with abnormal cervical cytology and/or positive high-risk HPV were referred to a colposcopy clinic for further evaluation.
RESULTS
Five hundred and forty-three women were recruited during the study period. These women were divided into two groups of positive cervical cytology (n = 161) and negative cervical cytology (n = 382). There were no cases of anal intraepithelial neoplasia in either group. Negative anal cytology was reported in 99 (61.5%) of participants with a positive cervical cytology and 254 (66.7%) of participants with a negative cervical cytology. A total of 62 (38.5%) anal samples in the positive group and 127 (33.3%) in the negative group were unsatisfactory for further evaluation.
CONCLUSION
We were unable to show any correlation between abnormal cervical cytology, dysplasia, or cervical high-risk HPV with anal abnormal cytology.
Topics: Female; Humans; Pregnancy; Vaginal Smears; Cross-Sectional Studies; Papillomavirus Infections; Iran; Uterine Cervical Dysplasia; Anus Neoplasms; Uterine Cervical Neoplasms; Papillomaviridae; Colposcopy
PubMed: 36183298
DOI: 10.1002/ijgo.14490 -
Journal of Ethnopharmacology Jan 2024Sanhuang ointment (SHO) has been widely used in the traditional Chinese medical system for 1500 years and has efficacy in clearing away heat and dampness, reducing...
ETHNOPHARMACOLOGICAL RELEVANCE
Sanhuang ointment (SHO) has been widely used in the traditional Chinese medical system for 1500 years and has efficacy in clearing away heat and dampness, reducing swelling, and alleviating pain. Hemorrhoids will damage the normal physiological function of the body, resulting in obstructed defecation, accompanied by massive hemorrhage and necrosis of tissues and cells, which is easy to breed bacteria and cause infection. SHO can promote lesion healing in hemorrhoid rats, but the pharmacological mechanism underlying this effect remains unknown.
AIM
To evaluate the effect of SHO on experimental hemorrhoids in rats induced by croton oil and glacial acetic acid.
MATERIALS AND METHODS
In this research, the effective components of SHO were analyzed in detail by High performance liquid chromatography (HPLC) and Liquid chromatography/mass spectrometry (LC/MS). Hemorrhoids were induced by 6% balsam and glacial acetic acid respectively in the anorectal region of rats. SHO was administered externally to the anorectal region of rats at doses of 185 mg/g (crude drug/ointment), 370 mg/g (crude drug/ointment) and 740 mg/g (crude drug/ointment) for 11 days. Mayinglong musk hemorrhoids ointment (1 g/kg) and Taining cream (1 g/kg) were used as reference anti hemorrhoids drugs. On the 11th day, hemorrhoids were evaluated by measuring the biochemical parameters of hemorrhoids in rats and the histology of anorectal tissues.
RESULTS
Using high performance liquid chromatography liquid chromatography mass spectrometry, 41 compounds, including phenylpropionic acids and alkaloids, were identified. the fingerprints of 18 common peaks were identified. In Hemorrhoids like rats, acetic acid induced inflammation was inhibited in a dose-dependent manner during SHO treatment. In addition, the detailed experimental results show that SHO can effectively improve hemorrhoids by inhibiting the production of inflammatory cytokines in serum, reversing the down-regulation of vanillin subtype 1 (TRPV1), calcitonin gene related peptide (CGRP) and substance P (SP) levels of pain related genes in anal tissues, and the up regulation of Vascular endothelial growth factor (VEGF) levels of vascular growth related genes.
CONCLUSION
The results showed that SHO could alleviate the edema caused by the exudation of anorectal tissue fluid in rats by anti-inflammatory effect and reducing the Vascular permeability of rats. The study validates the traditional use of SHO in the treatment of hemorrhoids and demonstrates its anti-hemorrhoidal potential.
Topics: Rats; Animals; Hemorrhoids; Ointments; Acetic Acid; Vascular Endothelial Growth Factor A; Pain
PubMed: 37741471
DOI: 10.1016/j.jep.2023.117173 -
Revista Espanola de Enfermedades... Apr 2023Condyloma acuminatum (CA) is a common sexually transmitted disease caused by human papilloma virus infection. Although it is generally seen in the genital and perianal...
Condyloma acuminatum (CA) is a common sexually transmitted disease caused by human papilloma virus infection. Although it is generally seen in the genital and perianal regions, anal canal and rectum sometimes could be involved. It has been reported to be associated with higher risk of intraepithelial neoplasia and cancer. Surgery excision and fulguration are the primary treatment, while high local recurrence rate of CA remains bothering. We presented a case of CA that detected via colonoscopy and successfully treated with endoscopic submucosal dissection.
PubMed: 37073690
DOI: 10.17235/reed.2023.9622/2023 -
Annals of Translational Medicine Sep 2020Good hand hygiene is the most effective basic measure for preventing hospital-acquired infections. This research project, which originated from a project report on...
BACKGROUND
Good hand hygiene is the most effective basic measure for preventing hospital-acquired infections. This research project, which originated from a project report on improving hand hygiene at a general hospital in Hangzhou, Zhejiang, China, aimed to investigate the effectiveness of hand hygiene improvement among the hospital staff.
METHODS
Since 2017, a hand hygiene improvement project involving the staff of a 2,500-bed general teaching hospital in Zhejiang, China, has been carried out. This study summarized the implementation and effectiveness of the project, which is based on the five factors of systematic evaluation. The research summary was divided into three phases: phase I (December 2017 to August 2018), phase 2 (September 2018 to April 2019), and phase 3 (May 2019 to December 2019). The data of hand hygiene compliance rates of different groups of professionals in the different research periods were statistically analyzed.
RESULTS
The results showed that continuous intervention led to a gradual increasing trend (Ptrend<0.001) in the hand hygiene implementation rate with as the intervention time and phases progressed. The hand hygiene compliance rates differed significantly during different phases (76.61%, 79.95%, and 83.34% in phases 1, 2, and 3, respectively, P<0.001). At the same time, the compliance rates of hand hygiene at each phase differed significantly between different professions (P<0.001, the compliance rate of hand hygiene among nurses was the highest and lowest among workers). The compliance rate of hand hygiene for different professions during the three phases were: nurses, 84.73%; doctors, 78.35%; interns, 77.62%; and other hospital workers, 72.79%.
CONCLUSIONS
The hand hygiene compliance rate was effectively improved among the hospital staff after the implementation of the hand hygiene improvement project. In this hospital, the project yielded remarkable results. Hand hygiene must be continuously practiced and improved to develop good habits. Effective and detailed planning as well as key factors, such as hand hygiene facilities, information monitoring, the active participation and response of employees, training and education, and supervision and feedback, could help to guarantee the effectiveness of the project.
PubMed: 33240998
DOI: 10.21037/atm-20-5480 -
Diseases of the Colon and Rectum Mar 2021
Topics: Abscess; Anal Canal; Bacterial Infections; Humans; Intestinal Fistula; Rectal Diseases
PubMed: 33399409
DOI: 10.1097/DCR.0000000000001911