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Journal of Medical Economics 2022Human papillomavirus (HPV) is one of the most common sexually transmitted infection in the United States and can lead to cervical, vulvovaginal, anal, penile, and...
BACKGROUND
Human papillomavirus (HPV) is one of the most common sexually transmitted infection in the United States and can lead to cervical, vulvovaginal, anal, penile, and oropharyngeal cancers. Compared with the general population, US military members are at a higher risk of HPV-related conditions, yet vaccination rates are relatively low in this population. As many service members may not be diagnosed with HPV-related cancers until after they leave active service, the objective of this study was to determine the incidence, prevalence, and economic burden of HPV-related cancers among US veterans.
METHODS
The study used the 2014-2018 Veterans Health Administration (VHA) database to identify newly diagnosed adult patients (cases) with HPV-related cancers, including cervical, vulvovaginal, anal, penile, and oropharyngeal cancers. Cases were matched by age, race, and sex to patients without HPV related cancer (controls). Outcome measures included annual incidence, prevalence, health care resource utilization (HCRU), and costs. These outcomes were calculated from the index date (first cancer diagnosis) through the earliest of 24 months, death, or end of study period. Adjusted results were examined using generalized linear models.
RESULTS
The annual prevalence and incidence rates of HPV-related cancers ranged from 43 (anal) to 790 (oropharyngeal) cases per million (CPM), and four (anal) to 131 (cervical) CPM, respectively. Compared with controls, cases had significantly higher annual HCRU. Mean numbers of annual inpatient hospitalizations were several times higher compared to controls (cervical: 6.7-times (×); vulvovaginal: 2.7×; penile: 6.6×; oropharyngeal: 10.2×; and anal: 14.9×; all < 0.01). Similarly, cases had significantly higher all-cause healthcare costs vs. matched controls across all cancer types: cervical ($24,252 vs. $10,402), vulvovaginal ($34,801 vs. $10,913), penile ($42,772 vs. $9,139), oropharyngeal ($82,763 vs. $10,017), and anal ($98,146 vs. $8,339); (all < 0.01).
CONCLUSIONS
HPV-related cancers may cause significant clinical and economic burden within the VHA system. Given the consequences of HPV-related cancers among veterans who did not have access to the vaccine, HPV vaccination of active military and eligible veterans should be considered a healthcare priority.
Topics: Adult; Alphapapillomavirus; Anus Neoplasms; Financial Stress; Health Care Costs; Humans; Oropharyngeal Neoplasms; Papillomaviridae; Papillomavirus Infections; United States; Veterans
PubMed: 35156867
DOI: 10.1080/13696998.2022.2041855 -
Asian Journal of Andrology 2021Hyaluronic acid injection is becoming a popular way for penile augmentation. However, only few studies and follow-ups have investigated the various complications of...
Hyaluronic acid injection is becoming a popular way for penile augmentation. However, only few studies and follow-ups have investigated the various complications of hyaluronic acid injection and their corresponding management. In this study, a total of 230 patients who had penile augmentation with hyaluronic acid injection from January 2018 to December 2019 were examined on follow-up for penile girth, complications, and their corresponding management. At 1-month, 3-month, and 6-month postoperative follow-ups, the penile circumference had increased by 2.66 ± 1.24 cm, 2.28 ± 1.02 cm, and 1.80 ± 0.83 cm, respectively. During the entire 6-month follow-up, 4.3% had complications such as subcutaneous bleeding, subcutaneous nodules, and infection. There were no systemic or local allergic reactions among all the patients. All complications were treated accordingly, and no further deterioration or severe sequelae were observed. Although complications of hyaluronic acid injections are mild and rare, these may affect the patient's satisfaction postoperatively. Preoperative redundant prepuce may increase the incidence of penile edema or postoperative gel migration. Standardization of the surgery protocol and elucidation of the effects of other injection parameters are still lacking. Nevertheless, it still highlights the importance of preoperative preparation and surgical technique.
Topics: Adult; Aftercare; China; Humans; Hyaluronic Acid; Injections; Male; Middle Aged; Patient Satisfaction; Penis; Postoperative Complications
PubMed: 33533738
DOI: 10.4103/aja.aja_78_20 -
The Journal of Infectious Diseases Sep 2022We determined how the vaginal and penile microbiomes contribute to herpes simplex virus type 2 (HSV-2) serostatus within sexual partnerships.
BACKGROUND
We determined how the vaginal and penile microbiomes contribute to herpes simplex virus type 2 (HSV-2) serostatus within sexual partnerships.
METHODS
Microbiomes were characterized in cervicovaginal lavage and penile meatal swab specimens through high-throughput 16s ribosomal RNA gene amplicon sequencing. HSV-2 antibody was detected in serum specimens. We modeled vaginal and penile taxa and covariates contributing to HSV-2 status in women and men using bivariate probit analysis.
RESULTS
Among 231 couples, HSV-2 was detected in both partners in 78 couples (33.8%), in the woman only in 52 (22.5%),in the man only in 27 (11.7%), and in neither in 74 (32.0%). Among the women (median age, 22 years) 10.9% had human immunodeficiency virus (HIV), and 21.4% had Bacterial vaginosis. Among men (median age, 26 years), 11.8% had HIV, and 55.0% circumcised. In an analysis with adjustment for sociodemographics and Bacterial vaginosis, enrichment of vaginal Gardnerella vaginalis and Lactobacillus iners was associated with increased likelihood of HSV-2 in both partners. Penile taxa (including Ureaplasma and Aerococcus) were associated with HSV-2 in women.
CONCLUSIONS
We demonstrate that penile taxa are associated with HSV-2 in female partners, and vaginal taxa are associated with HSV-2 in male partners. Our findings suggest that couples-level joint consideration of genital microbiome and sexually transmitted infection or related outcomes could lead to new avenues for prevention.
Topics: Humans; Female; Male; Young Adult; Adult; Herpesvirus 2, Human; Herpes Genitalis; Vaginosis, Bacterial; Sexual Partners; HIV Infections; Microbiota
PubMed: 32822500
DOI: 10.1093/infdis/jiaa529 -
The Journal of Infectious Diseases Mar 2024International data on anogenital HPV infection incidence among men are limited.
BACKGROUND
International data on anogenital HPV infection incidence among men are limited.
METHODS
Incidence of incident-persistent (IP) anogenital HPV infections was evaluated among 295 men who have sex with men (MSM) and 1576 heterosexual men (HM) aged 16-27 years in the placebo arm of a global, multicenter 4-valent (4v) HPV vaccine trial. We estimated IP incidence (penile/scrotal, perineal/perianal, anal) for 4vHPV and 9-valent (9v) HPV vaccine types and cumulative IP incidence over 36 months.
RESULTS
IP infection incidence per 100 person-years (95% CI) among HM for 4vHPV and 9vHPV types was 4.1 (3.5-4.9) and 6.8 (5.9-7.6) at penile/scrotal, and 1.2 (.8-1.6) and 1.9 (1.5-2.4) at perineal/perianal sites, respectively; and among MSM, IP infection incidence was 2.3 (1.3-3.8) and 3.2 (2.0-4.9) at penile/scrotal, 6.8 (4.9-9.2) and 9.0 (6.9-11.6) at perineal/perianal, and 12.0 (9.4-15.1) and 16.8 (13.7-20.2) at anal sites, respectively. Cumulative IP incidence over 36 months (excluding anal canal; any 9vHPV type) was higher among MSM versus HM (24.1% vs 18.4%).
CONCLUSIONS
A substantial proportion of unvaccinated men of catch-up vaccination age developed IP 9vHPV-related infections. Gender-neutral vaccination could decrease male HPV infection, contribute to herd protection, and reduce disease burden. Clinical Trials Registration. NCT00090285.
Topics: Humans; Male; Homosexuality, Male; Papillomaviridae; Papillomavirus Infections; Papillomavirus Vaccines; Sexual and Gender Minorities; Adolescent; Young Adult; Adult
PubMed: 38012959
DOI: 10.1093/infdis/jiad485 -
Current Opinion in HIV and AIDS Jul 2022We review macaque models for preexposure prophylaxis (PrEP) for HIV prevention and highlight their role in advancing currently approved and novel PrEP agents. (Review)
Review
PURPOSE OF REVIEW
We review macaque models for preexposure prophylaxis (PrEP) for HIV prevention and highlight their role in advancing currently approved and novel PrEP agents.
RECENT FINDINGS
The development of the repeat low dose simian HIV (SHIV) challenge models represented a significant advancement in preclinical PrEP modeling that has allowed the investigation of PrEP under conditions that better mimic HIV exposures in humans. These models incorporate relevant drug pharmacology to inform drug correlates of PrEP protection. Models of rectal, vaginal, and penile infection are now available and have been found to predict clinical efficacy of all the currently approved PrEP strategies including daily oral PrEP with the combination of emtricitabine and tenofovir disoproxil fumarate or tenofovir alafenamide, and a long-acting formulation of the integrase inhibitor cabotegravir. These models are being used to test new PrEP modalities including the nucleoside reverse transcriptase-translocation inhibitor islatravir and long-acting capsid inhibitors. The SHIV models have also been supplemented by sexually transmitted infection co-infections with Chlamydia trachomatis, Treponema pallidum or Trichomonas vaginalis to assess the impact of inflammation on PrEP efficacy.
SUMMARY
Clinical efficacy validated current PrEP macaque models supporting their continued use to advance novel PrEP agents to improve global PrEP coverage.
Topics: Animals; Anti-HIV Agents; Emtricitabine; Female; HIV Infections; Humans; Macaca; Pre-Exposure Prophylaxis
PubMed: 35762371
DOI: 10.1097/COH.0000000000000738 -
Urology Dec 2020The implantation of penile protheses for the surgical treatment of erectile dysfunction has risen in popularity over the past several decades. Considerable advances have... (Review)
Review
The implantation of penile protheses for the surgical treatment of erectile dysfunction has risen in popularity over the past several decades. Considerable advances have been made in surgical protocol and device design, specifically targeting infection prevention. Despite these efforts, device infection remains a critical problem, which causes significant physical and emotional burden to the patient. The aim of this review is to broaden the discussion of best practices by not only examining practices in urology, but additionally delving into the field of orthopedic surgery to identify techniques and approaches that may be applied to penile prothesis surgery.
Topics: Anti-Bacterial Agents; Anti-Infective Agents; Antibiotic Prophylaxis; Biofilms; Cost-Benefit Analysis; Erectile Dysfunction; Humans; Male; Operating Rooms; Orthopedic Procedures; Penile Implantation; Penile Prosthesis; Penis; Prosthesis-Related Infections; Staphylococcus aureus; Surgical Wound Infection; Urology
PubMed: 32991908
DOI: 10.1016/j.urology.2020.08.060 -
Viruses Nov 2021Only a handful of cell types, including fibroblasts, epithelial, and endothelial cells, can support human cytomegalovirus (CMV) replication in vitro, in striking...
Only a handful of cell types, including fibroblasts, epithelial, and endothelial cells, can support human cytomegalovirus (CMV) replication in vitro, in striking contrast to the situation in vivo. While the susceptibility of epithelial and endothelial cells to CMV infection is strongly modulated by their anatomical site of origin, multiple CMV strains have been successfully isolated and propagated on fibroblasts derived from different organs. As oral mucosal cells are likely involved in CMV acquisition, we sought to evaluate the ability of infant labial fibroblasts to support CMV replication, compared to that of commonly used foreskin and fetal lung fibroblasts. No differences were found in the proportion of cells initiating infection, or in the amounts of viral progeny produced after exposure to the fibroblast-adapted CMV strain AD169 or to the endothelial cell-adapted strain TB40/E. Syncytia formation was, however, significantly enhanced in infected labial and lung fibroblasts compared to foreskin-derived cells, and did not occur after infection with AD169. Together, these data indicate that fibroblast populations derived from different tissues are uniformly permissive to CMV infection but retain phenotypic differences of potential importance for infection-induced cell-cell fusion, and ensuing viral spread and pathogenesis in different organs.
Topics: Cytomegalovirus; Cytomegalovirus Infections; Endothelial Cells; Fibroblasts; Foreskin; Genomics; Giant Cells; Humans; Lung; Male; Viral Tropism; Virus Replication
PubMed: 34960624
DOI: 10.3390/v13122355 -
Nutrients Sep 2023Persistent high-risk human papillomavirus (HPV) infection is responsible for most genital, anal, and oropharyngeal cancers, in which men contribute significantly to...
Association between Dietary Vitamin E Intake and Human Papillomavirus Infection among US Adults: A Cross-Sectional Study from National Health and Nutrition Examination Survey.
Persistent high-risk human papillomavirus (HPV) infection is responsible for most genital, anal, and oropharyngeal cancers, in which men contribute significantly to infection and subsequent tumorigenesis in women. Vitamin E has been shown to be associated with vaginal HPV infection and cervical cancer. However, the association of vitamin E consumption with HPV infection among the overall population remains unclear. We investigate the association between vitamin E consumption and genital and oral HPV infection in both men and women. We used cross-sectional data from the National Health and Nutrition Examination Survey between 2013 and 2016 to collect details on their dietary vitamin E intake, genital and oral HPV infection status, and other essential variables. In total, 5809 participants aged 18-59 years were identified, with overall prevalence of high-risk and low-risk HPV infection of 23.7% and 21.1%, respectively. Compared with the lowest vitamin E group Q1 (<5.18 mg/day), the adjusted OR for vitamin E consumption and overall high-risk HPV infection in Q2 (5.18-7.54 mg/day), Q3 (7.55-10.82 mg/day), and Q4 (>10.82 mg/day) were 0.91 (95% CI: 0.81-1.03, = 0.134), 0.77 (95% CI: 0.69-0.87, < 0.001), and 0.72 (95% CI: 0.65-0.80, < 0.001), respectively. Restricted cubic spline regression showed a linear relationship between vitamin E consumption and overall high-risk HPV infection. This linear relationship also existed for vitamin E consumption and overall low-risk HPV infection. After being stratified by gender and site, vitamin E consumption was inversely related to vaginal low- and high-risk HPV infection, penile high-risk HPV infection, and male oral low-risk HPV infection. In conclusion, we identified inverse linear relationships between dietary vitamin E intake and overall high- and low-risk HPV infection. Future well-designed longitudinal studies are still required to validate the impact of vitamin E on HPV carcinogenesis.
Topics: Humans; Adult; Female; Male; Cross-Sectional Studies; Papillomavirus Infections; Human Papillomavirus Viruses; Nutrition Surveys; Diet; Carcinogenesis
PubMed: 37686857
DOI: 10.3390/nu15173825 -
Abdominal Radiology (New York) Jul 2020To discuss the imaging appearances of various pathologies affecting adult male urethra and to review the role of imaging in the assessment of artificial urinary... (Review)
Review
To discuss the imaging appearances of various pathologies affecting adult male urethra and to review the role of imaging in the assessment of artificial urinary sphincters and penile prostheses. Diagnosis of common male urethral diseases heavily depends on two conventional fluoroscopic techniques namely retrograde urethrography and voiding cystourethrography. These are useful in evaluating common urethral diseases like traumatic injury, infections, and strictures. Cross-sectional imaging can be useful in evaluating periurethral pathologies. Artificial urinary sphincters, slings, and periurethral bulking agents are used in the management of urinary incontinence and imaging can be utilized to detect complications in these devices. Cross-sectional imaging especially MRI plays a significant role in evaluating the different types of penile prostheses and their malfunctioning.
Topics: Adult; Humans; Magnetic Resonance Imaging; Male; Penile Prosthesis; Urethra; Urethral Diseases; Urinary Sphincter, Artificial
PubMed: 31834460
DOI: 10.1007/s00261-019-02356-x -
Annals of Medicine and Surgery (2012) Aug 2023In children, one of the most common surgical procedures worldwide is circumcision, which has strong religious implications and is frequently performed for nontherapeutic...
UNLABELLED
In children, one of the most common surgical procedures worldwide is circumcision, which has strong religious implications and is frequently performed for nontherapeutic reasons. Circumcision is typically associated with old customs. Complete penile amputation is extremely uncommon, and the prognosis is little understood.
CASE PRESENTATION
A 7-day-old male term baby was circumcised with a cauter by an unexperienced practitioner, and the patient was admitted to the department of pediatric surgery. Both the glans and the body had become discolored and necrotic. The patient was taken into the theater and given general anesthesia. The authors removed the debridement and inserted a catheter into the urethra to prevent urethral stenosis.
DISCUSSION
The procedure of circumcision has several medical benefits and is widely performed for religious, cultural, and medical reasons. It is generally agreed that circumcision prevents against sexually transmitted diseases, penile and cervical cancer in adults, as well as urinary tract infections in children.Partial or complete penile amputation injuries are rare and frequently the result of psychotic self-harm. Operators must correctly conduct the circumcision in order to prevent the potential complications that can happen when the procedure is performed out by untrained hands.The most common cause of penile amputation injuries, whether partial or total, is psychotic self-harm. Operators must carry out the procedure carefully to prevent the potential complications that can happen when circumcision is performed by untrained hands.
CONCLUSION
The authors present here a case of a 7-day-old boy who had ritual circumcision with a cauter complicated by an entire penile amputation, which was treated with the insertion of a catheter to prevent the closure of the urethra. The patient reported his penis was circumcised with cautery one day later the glans and the entire penis became discolored and necrosis, unfortunately, the entire penis was lost with the overlying skin.
PubMed: 37554901
DOI: 10.1097/MS9.0000000000000996