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MMWR. Recommendations and Reports :... Jun 2015These guidelines for the treatment of persons who have or are at risk for sexually transmitted diseases (STDs) were updated by CDC after consultation with a group of...
These guidelines for the treatment of persons who have or are at risk for sexually transmitted diseases (STDs) were updated by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on April 30-May 2, 2013. The information in this report updates the Sexually Transmitted Diseases Treatment Guidelines, 2010 (MMWR Recomm Rep 2010;59 [No. RR-12]). These updated guidelines discuss 1) alternative treatment regimens for Neisseria gonorrhoeae; 2) the use of nucleic acid amplification tests for the diagnosis of trichomoniasis; 3) alternative treatment options for genital warts; 4) the role of Mycoplasma genitalium in urethritis/cervicitis and treatment-related implications; 5) updated HPV vaccine recommendations and counseling messages; 6) the management of persons who are transgender; 7) annual testing for hepatitis C in persons with HIV infection; 8) updated recommendations for diagnostic evaluation of urethritis; and 9) retesting to detect repeat infection. Physicians and other health-care providers can use these guidelines to assist in the prevention and treatment of STDs.
Topics: Complementary Therapies; Condylomata Acuminata; Counseling; Female; Gonorrhea; HIV Infections; Hepatitis C; Humans; Male; Mass Screening; Mycoplasma genitalium; Nucleic Acid Amplification Techniques; Papillomavirus Infections; Papillomavirus Vaccines; Recurrence; Sexually Transmitted Diseases; Transgender Persons; Trichomonas Infections; Urethritis; Uterine Cervicitis
PubMed: 26042815
DOI: No ID Found -
CMAJ : Canadian Medical Association... Jan 1998
Topics: Bacteriological Techniques; Chlamydia Infections; Chlamydia trachomatis; Female; Humans; Neutrophils; Practice Guidelines as Topic; Uterine Cervicitis; Vaginal Smears
PubMed: 9475913
DOI: No ID Found -
PloS One 2019Cervicitis is one of the major health problems amongst women caused by infection of various pathogens including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG),...
BACKGROUND
Cervicitis is one of the major health problems amongst women caused by infection of various pathogens including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV) as well as human papillomavirus (HPV), and persistent cervical inflammation is one of the etiologic agents of cervical cancer. Toll-like receptors (TLRs) play an important role in the recognition and subsequent elimination of these pathogens. Variations in the Toll-like receptor genes influence susceptibility to pathogens as well as disease progression independently.
METHODS
Ten single nucleotide polymorphisms, five each of TLR4 and TLR9 genes were analyzed among 130 cervicitis patients and 150 controls either using polymerase chain reaction-restriction fragment length polymorphism or allele specific-PCR.
RESULTS
T. vaginalis infection was found at the highest frequency (30.7%) as compared to C. trachomatis (1.5%), N. gonorrhoeae (2.3%) and HPV (4.6%) infections in cervicitis patients. TLR4 rs11536889 CC (age-adjusted OR, 2.469 [95% CI, 1.499 to 4.065]; p < 0.001) and TLR9 rs187084 TC (age-adjusted OR, 2.165 [95% CI, 1.267-3.699]; p = 0.005) genotypes showed the higher distribution in cervicitis patients compared to controls. In addition, TLR4 rs11536889 C allele was shown to increase the risk of cervicitis (age-adjusted OR, 1.632 [95% CI, 1.132 to 2.352]; p = 0.009) compared to controls. The TLR4 haplotype GCA (OR, 0.6 [95% CI, 0.38-0.95]; p = 0.0272) and TLR9 haplotype GTA (OR, 1.99 [95% CI, 1.14-3.48]; p = 0.014) were found to be associated with decreased and increased risk of cervicitis respectively.
CONCLUSIONS
TLR4 and TLR9 polymorphisms, as well as haplotypes were shown to modulate the cervicitis risk.
Topics: Alleles; Case-Control Studies; Chlamydia trachomatis; Female; Genetic Predisposition to Disease; Genotype; Haplotypes; Humans; Linkage Disequilibrium; Neisseria gonorrhoeae; Odds Ratio; Papillomaviridae; Polymorphism, Single Nucleotide; Risk Factors; Toll-Like Receptor 4; Toll-Like Receptor 9; Trichomonas vaginalis; Uterine Cervicitis
PubMed: 31365550
DOI: 10.1371/journal.pone.0220330 -
The Journal of Infectious Diseases Jul 2017Mycoplasma genitalium is increasingly appreciated as a common cause of sexually transmitted disease syndromes, including urethritis in men and cervicitis, endometritis,... (Review)
Review
Mycoplasma genitalium is increasingly appreciated as a common cause of sexually transmitted disease syndromes, including urethritis in men and cervicitis, endometritis, pelvic inflammatory disease, and possibly preterm birth, tubal factor infertility, and ectopic pregnancy in women. Despite these disease associations, which parallel those of Chlamydia trachomatis and Neisseria gonorrhoeae, the mechanisms by which this pathogen elicits inflammation, causes cellular damage, and persists in its only natural host (humans) are unique and are not fully understood. The purpose of this review is to briefly provide a historical background on the discovery, microbiology, and recognition of M. genitalium as a pathogen, and then summarize the recent advances in our understanding of the molecular biology and pathogenesis of this unique urogenital organism. Collectively, the basic scientific discussions herein should provide a framework for understanding the clinical and epidemiological outcomes described in the accompanying articles in this supplemental issue.
Topics: Female; Genome, Bacterial; Humans; Immune Evasion; Immunity; Male; Mycoplasma Infections; Mycoplasma genitalium; Risk Factors; Sexually Transmitted Diseases, Bacterial; Urethritis; Uterine Cervicitis
PubMed: 28838077
DOI: 10.1093/infdis/jix172 -
European Annals of Otorhinolaryngology,... Nov 2022The advent of free flaps has made it possible to undertake increasingly complex reconstructive surgeries. Many of the patients have already undergone extensive prior...
The advent of free flaps has made it possible to undertake increasingly complex reconstructive surgeries. Many of the patients have already undergone extensive prior surgery, primary free flap reconstruction and/or cervical irradiation. These treatments strongly impact anatomy and tissue quality. The reconstructive surgeon may be faced with a situation where the choice of recipient vessels is limited; in 7% of cases, no cervical vessels are available at all. For venous anastomosis, branches of the internal and external jugular vein are preferentially used, but may have been ligated or be unusable. Venous congestion is one of the most common causes of failure in these situations. The cephalic vein has been described as an alternative for second anastomosis in first line, but is rarely used for early free-flap salvage. Based on a case study, the technique of cephalic vein transposition is illustrated for early salvage of a double free flap for head-and-neck reconstruction. This technique is simple, reliable and rapid. It should be part of the armamentarium of the head and neck reconstructive surgeon.
Topics: Humans; Neck; Free Tissue Flaps; Plastic Surgery Procedures; Anastomosis, Surgical; Head and Neck Neoplasms; Retrospective Studies
PubMed: 35131200
DOI: 10.1016/j.anorl.2022.01.001 -
Sexually Transmitted Infections Feb 2005To study the prevalence, symptoms, and signs of Mycoplasma genitalium and Chlamydia trachomatis infections in women attending a Swedish STD clinic, accessible for both... (Comparative Study)
Comparative Study
OBJECTIVES
To study the prevalence, symptoms, and signs of Mycoplasma genitalium and Chlamydia trachomatis infections in women attending a Swedish STD clinic, accessible for both sexes, and in a group of young women called in the cervical cancer screening programme.
METHODS
A cross sectional study among female STD clinic attendees in Orebro and a study among women called for Papanicolaou smear screening. Attendees were examined for urethritis and cervicitis. First void urine and endocervical samples were tested for M genitalium and C trachomatis.
RESULTS
The prevalence of C trachomatis and M genitalium in the STD clinic population was 10% (45/465) and 6% (26/461), respectively. Dual infection was diagnosed in four women. In the cancer screening group of women the corresponding prevalence was 2% (1/59) and 0%, respectively. Among the STD clinic attendees there were no significant differences in symptoms (32% v 23%, RR 1.4, 95% CI 0.6 to 3.4) or signs (71% v 50%, RR 1.4, 95% CI 0.9 to 2.3) between C trachomatis and M genitalium infections. Microscopic signs of cervicitis were significantly more common among M genitalium and C trachomatis infected women than in the cancer screening group of women. 56% (15/27) of male partners of M genitalium infected women were infected with M genitalium compared to 59% of male partners of C trachomatis infected women who were infected with C trachomatis (p = 0.80).
CONCLUSIONS
M genitalium is a common infection associated with cervicitis and with a high prevalence of infected sexual partners supporting its role as a cause of sexually transmitted infection.
Topics: Adolescent; Adult; Cervix Uteri; Chlamydia Infections; Chlamydia trachomatis; Cross-Sectional Studies; Female; Follow-Up Studies; Humans; Male; Middle Aged; Mycoplasma Infections; Mycoplasma genitalium; Papanicolaou Test; Sexual Partners; Sweden; Urethra; Urethritis; Uterine Cervicitis; Vaginal Smears; Vaginosis, Bacterial
PubMed: 15681728
DOI: 10.1136/sti.2004.010439 -
The Journal of Infectious Diseases Jul 2017Mycoplasma genitalium is very difficult to grow in culture but has been more able to be studied for disease associations since the advent of research molecular... (Review)
Review
BACKGROUND
Mycoplasma genitalium is very difficult to grow in culture but has been more able to be studied for disease associations since the advent of research molecular amplification assays. Polymerase chain reaction (PCR) and other molecular assays have demonstrated an association with adverse disease outcomes, such as urethritis or nongonococcal urethritis in men and adverse reproductive sequelae in women-for example, cervicitis, endometritis, and pelvic inflammatory disease (PID), including an association with risk for human immunodeficiency virus. The lack of commercially available diagnostic assays has limited widespread routine testing. Increasing reports of high rates of resistance to azithromycin detected in research studies have heightened the need available commercial diagnostic assays as well as standardized methods for detecting resistance markers. This review covers available molecular methods for the diagnosis of M. genitalium and assays to predict the antibiotic susceptibility to azithromycin.
METHODS
A PubMed (US National Library of Medicine and National Institutes of Health) search was conducted for literature published between 2000 and 2016, using the search terms Mycoplasma genitalium, M. genitalium, diagnosis, and detection.
RESULTS
Early PCR diagnostic tests focused on the MPa adhesion gene and the 16S ribosomal RNA gene. Subsequently, a transcription-mediated amplification assay targeting ribosomes was developed and widely used to study the epidemiology of M. genitalium. Newer methods have proliferated and include quantitative PCR for organism load, AmpliSens PCR, PCR for the pdhD gene, a PCR-based microarray for multiple sexually transmitted infections, and multiplex PCRs. None yet are cleared by the Food and Drug Administration in the United States, although several assays are CE marked in Europe. As well, many research assays, including PCR, gene sequencing, and melt curve analysis, have been developed to detect the 23S ribosomal RNA gene mutations that confer resistance to azithromycin. One recently developed assay can test for both M. genitalium and azithromycin resistance mutations at the same time.
CONCLUSIONS
It is recommended that more commercial assays to both diagnose this organism and guide treatment choices should be developed and made available through regulatory approval. Research is needed to establish the cost-effectiveness of routine M. genitalium testing in symptomatic patients and screening in all individuals at high risk of acquiring and transmitting sexually transmitted infections.
Topics: Anti-Bacterial Agents; Azithromycin; Drug Resistance, Bacterial; Female; Humans; Macrolides; Male; Multiplex Polymerase Chain Reaction; Mutation; Mycoplasma Infections; Mycoplasma genitalium; Pelvic Inflammatory Disease; RNA, Ribosomal, 16S; Urethritis; Uterine Cervicitis
PubMed: 28838072
DOI: 10.1093/infdis/jix104 -
Microbiology Spectrum Dec 2022Many diverse pathogens have been discovered from reproductive-tract infections, but the relationship between the presence and abundance of particular pathogen species...
Many diverse pathogens have been discovered from reproductive-tract infections, but the relationship between the presence and abundance of particular pathogen species and disease manifestations is poorly defined. The present work examined the association of multiple common pathogens causing sexually transmitted infections (STIs) with cervicitis and vaginitis. The presence and abundance of 15 STI pathogens and the genotypes of human papillomavirus were determined in a cohort of 944 women that included 159 cervicitis patients, 207 vaginitis patients, and 578 healthy controls. Logistic regression and random forest models were constructed and validated in a separate cohort of 420 women comprising 52 cervicitis patients, 109 vaginitis patients, and 259 healthy controls. The frequency of individual STI pathogen species varied among the symptomatic patients and healthy controls. Abundance determination was necessary for most pathogens that were associated with the studied diseases. STI pathogens were more commonly associated with cervicitis than with vaginitis. Pathogen identification- and quantification-based diagnosis was observed for cervicitis with high sensitivity and specificity, but for vaginitis, the assay results would need to be combined with results of other diagnostic tests to firmly establish the pathogen-disease correlation. Integrated qualitative and quantitative detection of a selected panel of common STI pathogens can reveal their association with cervicitis and vaginitis. STI pathogen identification and quantification can be used to diagnose cervicitis and also help improve correct diagnosis of vaginitis. Scarce information exists with regard to whether STI pathogens can be defined as valid microbiological predictive markers for the diagnosis of cervicitis and vaginitis. We therefore conducted this study to assess the presence and abundance of a wide range of STI pathogens among patients having these two diseases and healthy controls as well. High sensitivity and specificity were observed for cervicitis by pathogen identification- and quantification-based diagnosis. In contrast, the assay results obtained for vaginitis would need to be combined with test results obtained by other diagnostic methods to decisively establish the pathogen-disease correlation. Simultaneous qualitative and quantitative detection of a selected panel of common STI pathogens and further coupling with machine learning models is worthwhile for establishing pathogen-based diagnosis of gynecological inflammations, which could be of great value in guiding the rational use of antimicrobials to control the spread of STIs.
Topics: Humans; Female; Uterine Cervicitis; Sexually Transmitted Diseases; Vaginitis; Inflammation
PubMed: 36314938
DOI: 10.1128/spectrum.01966-22 -
Cell Jan 2017Superior predatory skills led to the evolutionary triumph of jawed vertebrates. However, the mechanisms by which the vertebrate brain controls predation remain largely...
Superior predatory skills led to the evolutionary triumph of jawed vertebrates. However, the mechanisms by which the vertebrate brain controls predation remain largely unknown. Here, we reveal a critical role for the central nucleus of the amygdala in predatory hunting. Both optogenetic and chemogenetic stimulation of central amygdala of mice elicited predatory-like attacks upon both insect and artificial prey. Coordinated control of cervical and mandibular musculatures, which is necessary for accurately positioning lethal bites on prey, was mediated by a central amygdala projection to the reticular formation in the brainstem. In contrast, prey pursuit was mediated by projections to the midbrain periaqueductal gray matter. Targeted lesions to these two pathways separately disrupted biting attacks upon prey versus the initiation of prey pursuit. Our findings delineate a neural network that integrates distinct behavioral modules and suggest that central amygdala neurons instruct predatory hunting across jawed vertebrates.
Topics: Animals; Anxiety; Central Amygdaloid Nucleus; Electromyography; Interneurons; Mandible; Mice; Neck; Neurons; Periaqueductal Gray; Predatory Behavior
PubMed: 28086095
DOI: 10.1016/j.cell.2016.12.027 -
Taiwanese Journal of Obstetrics &... May 2019This study aims to identify the prevalence of bacterial vaginosis (BV) and cervicitis among 511 female workers attending gynecological examination and determine the risk...
OBJECTIVE
This study aims to identify the prevalence of bacterial vaginosis (BV) and cervicitis among 511 female workers attending gynecological examination and determine the risk factors for bacterial vaginosis and cervicitis.
MATERIALS AND METHODS
This study enrolled 511 female workers attending gynecological examination in Changchun Obstetrics-Gynaecology Hospital in Changchun city from January 1,2015 to December 31, 2015. A structured questionnaire was designed to survey the general demographic characteristics, living habits and health status of the participants. Gynecological examinations were performed to assess the presence of bacterial vaginosis and cervicitis. Univariate and multivariate logistic regression analysis were used to identify risk factors associated with bacterial vaginosis and cervicitis.
RESULTS
Of 511 female workers (median age, 40 years) were enrolled in our study, the prevalence of BV was 5.3%, and the prevalence of cervicitis was 22.1%. In multivariable analysis, women of specific ethnic groups had a higher odds ratio of BV (OR = 3.332, 95%CI 1.014-10.955) and premenopausal women had a reduced odds ratio of BV(OR = 0.162, 95%CI 0.061-0.425). Higher levels of education were associated with a reduced odds ratio of cervicitis (OR = 0.248, 95%CI 0.080-0.772).
CONCLUSIONS
BV and cervicitis were both common among female workers. Improving women's educational level should be concerned so as to reduce the prevalence of cervicitis.
Topics: Adult; Case-Control Studies; China; Cross-Sectional Studies; Female; Humans; Middle Aged; Occupational Health Services; Pregnancy; Risk Factors; Surveys and Questionnaires; Uterine Cervicitis; Vaginosis, Bacterial; Young Adult
PubMed: 31122530
DOI: 10.1016/j.tjog.2018.11.036