RESUMEN
This cohort study describes and identifies patient characteristics associated with use of in-office narrowband UV-B (NBUVB) or systemic therapy following home NBUVB machine receipt.
Asunto(s)
Psoriasis , Terapia Ultravioleta , Humanos , Estudios de Cohortes , Psoriasis/radioterapia , Resultado del TratamientoAsunto(s)
Dermatología , Bibliometría , Estudios Transversales , Femenino , Humanos , Masculino , Factores SexualesRESUMEN
Clinical Question: Who should receive human papillomavirus (HPV) vaccination? Bottom Line: Catch-up vaccination is now recommended for all persons through age 26 years. For persons aged 27 through 45 years, clinicians and patients should now jointly decide whether HPV vaccination is appropriate. Routine HPV vaccination at age 11 or 12 years (or as early as age 9 years) continues to be recommended.
Asunto(s)
Medicina Basada en la Evidencia/normas , Vacunación Masiva/normas , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/administración & dosificación , Guías de Práctica Clínica como Asunto , Adolescente , Adulto , Comités Consultivos/normas , Centers for Disease Control and Prevention, U.S./normas , Niño , Femenino , Humanos , Esquemas de Inmunización , Masculino , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/virología , Estados Unidos/epidemiología , Adulto JovenRESUMEN
HIV remains an important public health concern in the United States, particularly for men who have sex with men (MSM) and transgender persons. With HIV preexposure prophylaxis (PrEP), persons who are HIV-uninfected take antiretroviral medications to prevent HIV infection. The most common PrEP regimen involves taking a single pill daily and is very effective in reducing risk of HIV infection, with few adverse effects. Barriers to PrEP access exist for MSM and transgender persons. Dermatologists can help combat the ongoing HIV epidemic among MSM, transgender persons, and others by understanding why, when, and how PrEP should be considered as an HIV prevention approach.
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Antirretrovirales/uso terapéutico , Infecciones por VIH/prevención & control , Profilaxis Pre-Exposición/métodos , Minorías Sexuales y de Género , Dermatólogos , Humanos , Profilaxis Pre-Exposición/estadística & datos numéricos , Derivación y Consulta , Personas TransgéneroRESUMEN
Syphilis is caused by infection with the spirochetal bacterium Treponema pallidum subsp. pallidum. It was first recognized in the late 15th century. Since 2000, the incidence of sexually acquired syphilis has increased substantially in the developed world, with men who have sex with men and persons living with HIV infection disproportionately affected. Clinical manifestations of syphilis are protean and often include mucocutaneous manifestations. The first article in this continuing medical education series reviews historical aspects, microbiology, epidemiology, and clinical manifestations of sexually acquired syphilis.
Asunto(s)
Homosexualidad Masculina/estadística & datos numéricos , Sífilis/diagnóstico , Sífilis/epidemiología , Treponema pallidum/aislamiento & purificación , Educación Médica Continua , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Humanos , Masculino , Prevalencia , Medición de Riesgo , Conducta Sexual , Enfermedades Bacterianas de Transmisión Sexual/diagnóstico , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Sífilis Cutánea/diagnóstico , Sífilis Cutánea/epidemiología , Estados Unidos/epidemiologíaRESUMEN
The methods used for the laboratory diagnosis of syphilis include direct detection of Treponema pallidum subspecies pallidum and serologic testing. Serologic testing relies on both nontreponemal and treponemal tests. In newly developed reverse-sequence screening algorithms, treponemal tests are performed before nontreponemal tests. The management of syphilis requires appropriate staging, treatment, and follow-up of patients along with the prompt reporting of infections to public health authorities to assist with prevention and control efforts. Benzathine penicillin G remains the treatment of choice for all stages of syphilis. Screening of populations at higher risk for syphilis is recommended by the US Centers for Disease Control and Prevention, the US Preventive Services Task Force, and the World Health Organization. The second article in this continuing medical education series reviews the testing for and the management of sexually acquired syphilis.
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Penicilina G/administración & dosificación , Enfermedades de Transmisión Sexual/diagnóstico , Serodiagnóstico de la Sífilis/métodos , Sífilis/diagnóstico , Sífilis/epidemiología , Treponema pallidum/patogenicidad , Técnicas de Laboratorio Clínico , Diagnóstico Precoz , Educación Médica Continua , Humanos , Incidencia , Masculino , Prevención Primaria/organización & administración , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/epidemiología , Sífilis/tratamiento farmacológico , Estados Unidos/epidemiologíaAsunto(s)
Conocimientos, Actitudes y Práctica en Salud , Minorías Sexuales y de Género/estadística & datos numéricos , Baño de Sol/psicología , Adulto , Anciano , Estudios Transversales , Humanos , Masculino , Persona de Mediana Edad , Motivación , San Francisco , Minorías Sexuales y de Género/psicología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
More than 10 million lesbian, gay, bisexual, and transgender (LGBT) persons live in the United States. Improving their health is a public health priority. LGBT persons have specific health concerns and face health care disparities. Awareness of those issues and disparities can enable dermatologists to provide medically appropriate and culturally competent care to LGBT patients. This review highlights terminology important in caring for LGBT persons, LGBT demographics in the United States, health care disparities faced by LGBT persons, and approaches to caring for LGBT patients.
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Dermatología/métodos , Disparidades en Atención de Salud , Atención al Paciente , Minorías Sexuales y de Género , Demografía , Identidad de Género , Disparidades en el Estado de Salud , Humanos , Conducta Sexual , Terminología como Asunto , Estados UnidosRESUMEN
Lesbian, gay, bisexual, and transgender (LGBT) persons face important health issues relevant to dermatologists. Men who have sex with men (MSM) are at higher risk of certain infectious diseases, including HIV, syphilis and other sexually transmitted diseases (STDs), methicillin-resistant Staphylococcus aureus infections, and invasive meningococcal disease, and might be at higher risk of non-infectious conditions, including skin cancer. Recommendations for preventive health care, including screening for HIV and other STDs, sexual health-related vaccinations, and HIV pre-exposure prophylaxis, differ for MSM compared with non-MSM. Women who have sex with women experience disparities in STDs, including chlamydia and HPV. Transgender patients have unique, and often unmet, dermatologic needs during gender transition (also called gender affirmation), related to hormonal therapy and gender-affirming surgery. Familiarity with LGBT health issues and disease-prevention guidelines can enable dermatologists to provide medically appropriate and culturally competent care to LGBT persons.
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Dermatología/métodos , Homosexualidad Femenina , Homosexualidad Masculina , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de la Piel/diagnóstico , Enfermedades de la Piel/epidemiología , Personas Transgénero , Femenino , Humanos , Masculino , Guías de Práctica Clínica como Asunto , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades de la Piel/prevención & controlAsunto(s)
Fármacos Anti-VIH/uso terapéutico , Condones , Infecciones por VIH/prevención & control , Profilaxis Pre-Exposición , Sexo Seguro , Toma de Decisiones Clínicas , Condones/tendencias , Femenino , Humanos , Masculino , Aceptación de la Atención de Salud , Conducta Sexual , Enfermedades de Transmisión Sexual/prevención & control , Estados UnidosAsunto(s)
Dermatología/organización & administración , Identidad de Género , Conducta Sexual , Minorías Sexuales y de Género/estadística & datos numéricos , Enfermedades de la Piel/terapia , Recolección de Datos/métodos , Femenino , Humanos , Masculino , Evaluación de Necesidades , Enfermedades de la Piel/diagnóstico , Enfermedades de la Piel/epidemiología , Estados Unidos , Poblaciones VulnerablesRESUMEN
OBJECTIVES: To describe collection and reporting of gender data, including for transgender individuals and other gender minorities, in HIV and sexually transmitted infection (STI) surveillance in the United States. METHODS: We performed a cross-sectional study of the top 50 US jurisdictions in 2015 for incident infections of HIV, gonorrhea, chlamydia, or primary and secondary syphilis. For each jurisdiction, we described gender-reporting options on HIV and STI data collection forms (also called confidential morbidity report forms) and data surveillance reports, which present aggregate data at either the county or the state level. RESULTS: Seventy-one jurisdictions were among the top 50 for at least 1 infection, and we included them. Gender minority categories appeared on 60 of 71 (85%) HIV confidential morbidity report forms and 33 of 70 (47%) STI confidential morbidity report forms, and in 22 of 71 (31%) HIV surveillance reports and 8 of 71 (11%) STI surveillance reports. CONCLUSIONS: Collection and reporting of gender data were suboptimal and inconsistent. Gender minority data were collected more often than reported, suggesting barriers to reporting. Health departments should standardize collection and reporting of gender data in HIV and STI surveillance to better inform prevention and control efforts.