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1.
Emerg Med Clin North Am ; 39(4): 689-702, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34600631

RESUMO

The physical examination of the patient is the cornerstone of the practice of medicine, and the skills to complete a thorough abdominal examination are critical in the care of patients. When performed correctly, the abdominal examination can be revealing when it comes to the overall health of the patient as well as acute pathology. The examination of the abdomen has the potential to minimize further testing or radiation and serves as a key diagnostic tool. In this article, we will discuss each portion of the abdominal examination in detail as well as pathologic findings, abdomen-specific signs, special patient populations, and clinical pearls.


Assuntos
Abdome , Exame Físico/métodos , Auscultação , Exame Retal Digital , Medicina de Emergência , Genitália/anatomia & histologia , Humanos , Palpação , Percussão
2.
BMC Infect Dis ; 21(1): 947, 2021 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-34521367

RESUMO

BACKGROUND: Chlamydia trachomatis (chlamydia) is the most diagnosed sexually transmitted infection in Belgium. Screening programs focus on young women, due to the implications of chronic asymptomatic infections for reproductive health. Thereby, the frequency of infections in men and older adults is underestimated. This study aimed to estimate the point-prevalence of chlamydia in the broader Belgian population, to inform evidence-based prevention and control strategies. METHODS: We conducted two cross-sectional prevalence studies of chlamydia infection in the population of Belgium aged 16-59 years, 2018-2020. In the CT1 study 12,000 representative individuals were randomly selected from the national register and invited by letter to collect a urine sample at home. The CT2 study used urine samples collected through the Belgian Health Examination Survey. Molecular detection of chlamydia DNA was performed using Xpert® or Abbott Real-Time CT/NG assays. Weighted estimated prevalence and 95% confidence interval (CI) was calculated per gender and age groups of 16/18-29, 30-44 and 45-59 years, relative to the general Belgian population. Data collected on sociodemographic variables and sexual behavior were used to identify potential risk factors for chlamydia infection through calculation of the odds ratio (OR). RESULTS: The population-wide weighted estimated prevalence was 1.54% (95% CI 0.78-3) in CT1 and 1.76% (95% CI 0.63-4) in CT2. We observed no statistically significant difference between men and women or age groups. Civil relationship status (OR = 14.1 (95% CI 1.78-112), p < 0.01), sexual intercourse with a casual partner (OR = 6.31 (95% CI 1.66-24.1), p < 0.01) and > 3 sexual partners in the last 12 months (OR = 4.53 (95% CI 1.10-18.6), p = 0.02) were associated with higher relative risk for chlamydia infection. CONCLUSION: Nationwide prevalence studies are relevant to assess the distribution of chlamydia and inform public health actions. The overall low prevalence and heterogeneous distribution of chlamydia in the general Belgian population needs to be considered for future strategies and potential harm of testing and treating asymptomatic individuals need to be taken into account. Effective case management should include appropriate treatment of symptomatic patients and partner notification, and prevention strategies should encourage behaviors such as condom use.


Assuntos
Infecções por Chlamydia , Chlamydia trachomatis , Adolescente , Adulto , Bélgica/epidemiologia , Infecções por Chlamydia/epidemiologia , Estudos Transversais , Feminino , Genitália , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Comportamento Sexual , Adulto Jovem
3.
Front Cell Infect Microbiol ; 11: 704037, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34497776

RESUMO

Background: Sexually transmitted infections (STIs) are some of the most common communicable conditions and exert impact on the health and lives of many hundreds of millions of people across the world every year. Screening high-risk populations and conducting comprehensive detection tests would lead to a significant improvement in preventing the transmission of STIs and help us to provide rapid treatment to those affected. Here, we successfully established and validated a novel high-throughput multiplex gene detection system (HMGS) for the simultaneous and semiquantitative detection of six important curable sexually transmitted pathogens in a single reaction from secretions samples. Method: Fluorescently labeled primers were designed to target specific conserved and single-copy gene fragments of Ureaplasma urealyticum (U. urealyticum), Mycoplasma hominis (M. hominis), Chlamydia trachomatis (C. trachomatis), Neisseria gonorrhoeae (N. gonorrhoeae), Trichomonas vaginalis (T. vaginalis), and Treponema pallidum (T. pallidum). The specificity and sensitivity of the STI-HMGS was validated and optimized using plasmids and quantitative genomic DNA. Next, we validated the performances of the STI-HMGS for clinical application by testing samples of clinical secretions collected from patients who visited the gynecology and urology outpatient clinics of our reproductive medicine center. Results derived from the STI-HMGS were then compared with three approved commercialized kits that used to detect U. urealyticum, C. trachomatis and N. gonorrhoeae, respectively, followed by further validation with Sanger sequencing for all pathogens. Finally, a comprehensive analysis of epidemiology was performed among different subgroups to investigate the association between infection rates and clinically-relevant information. Results: The sensitivity of STI-HMGS for six target genes was 10 copies/µL. Data derived from the detection of 381 clinical secretions demonstrated that the STI-HMGS exhibited high concordance rate compared with approved commercialized kits and almost 100% sensitivity and specificity for the detection of six sexually transmitted pathogens when validated by Sanger sequencing. Semi-quantitative analysis found that STIs caused by N. gonorrhoeae had a significantly higher (P<0.05) pathogen load than the other pathogens. Infections caused by C. trachomatis were significantly more common in younger individuals (P<0.05). We also found that U. urealyticum infections were more likely to happen in females; while the males were more affected by N. gonorrhoeae (P<0.05). Conclusions: STI-HMGS proved to be an efficient method for the semi-quantitative detection of six important curable sexually transmitted pathogens and therefore represents an alternative method for the clinical detection and monitoring of STIs.


Assuntos
Chlamydia trachomatis , Trichomonas vaginalis , Chlamydia trachomatis/genética , Feminino , Genitália , Humanos , Masculino , Neisseria gonorrhoeae/genética , Trichomonas vaginalis/genética , Ureaplasma urealyticum/genética
5.
Rheumatol Int ; 41(11): 1885-1894, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34455463

RESUMO

The SARS-CoV-2 virus is known to mediate attack via ACE-2 Receptor, thus having adverse effects on cardiovascular, respiratory, digestive and reproductive systems, the latter being an area of emerging concern, due to the associated impact on fertility, with potential for an outsized effect on population distribution and socioeconomic road map in subsequent years. This narrative review aims to put forth the current evidence of effect of SARS-CoV-2 on human fertility from a multipronged immunologic, haematologic, and gynaecologic perspective; highlighting the areas of contradiction and potential future measures. A literature search was conducted through the MEDLINE and SCOPUS databases to identify articles on the subject in English. Relevant information was extracted from around 300 articles for this review. The existing data give non-conclusive evidence about the impact of SARS-CoV-2 infection on fertility; however, a greater impact on male fertility as compared to females merits further exploration. However, reproduction and fertility is a key concern and considering the pandemic is prolonged, natural conception or ART require extra precautions.


Assuntos
Autoimunidade , COVID-19/complicações , Fertilidade , Genitália/virologia , Enzima de Conversão de Angiotensina 2 , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Pandemias , Gravidez , SARS-CoV-2
6.
Molecules ; 26(15)2021 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-34361685

RESUMO

Nitric Oxide (NO) is a potent signaling molecule involved in the regulation of various cellular mechanisms and pathways under normal and pathological conditions. NO production, its effects, and its efficacy, are extremely sensitive to aging-related changes in the cells. Herein, we review the mechanisms of NO signaling in the cardiovascular system, central nervous system (CNS), reproduction system, as well as its effects on skin, kidneys, thyroid, muscles, and on the immune system during aging. The aging-related decline in NO levels and bioavailability is also discussed in this review. The decreased NO production by endothelial nitric oxide synthase (eNOS) was revealed in the aged cardiovascular system. In the CNS, the decline of the neuronal (n)NOS production of NO was related to the impairment of memory, sleep, and cognition. NO played an important role in the aging of oocytes and aged-induced erectile dysfunction. Aging downregulated NO signaling pathways in endothelial cells resulting in skin, kidney, thyroid, and muscle disorders. Putative therapeutic agents (natural/synthetic) affecting NO signaling mechanisms in the aging process are discussed in the present study. In summary, all of the studies reviewed demonstrate that NO plays a crucial role in the cellular aging processes.


Assuntos
Envelhecimento/metabolismo , Senescência Celular , Regulação para Baixo , Óxido Nítrico/metabolismo , Transdução de Sinais , Animais , Sistema Cardiovascular/metabolismo , Sistema Nervoso Central/metabolismo , Feminino , Genitália/metabolismo , Humanos , Masculino , Óxido Nítrico Sintase Tipo I/metabolismo , Óxido Nítrico Sintase Tipo III/metabolismo
7.
Adv Clin Exp Med ; 30(9): 879-883, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34435475

RESUMO

The receptor activator of nuclear factor-κB (RANK) and its ligand RANKL are members of the tumor necrosis factor (TNF) super-family of cytokines with a role in progestogen-associated malignancies in breast. Basic and clinical data support the participation of the cytokine pathway in metastatic disease and as poor prognosis markers. The value of RANK/RANKL as prognostic indicators in endometrial and ovarian tumors, as well as the data suggesting a potential role of RANK/RANKL in hormone dependent tumorigenesis in the endometrium, have been described. The D-CARE study could not confirm benefit in the modulation of RANKL in breast cancer.


Assuntos
Neoplasias Ovarianas , Ligante RANK/metabolismo , Receptor Ativador de Fator Nuclear kappa-B/metabolismo , Carcinogênese , Transformação Celular Neoplásica , Feminino , Genitália , Humanos
8.
BMJ Open ; 11(8): e046308, 2021 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-34385236

RESUMO

INTRODUCTION: Left untreated, sexually transmitted and genital infections (henceforth STIs) in pregnancy can lead to serious adverse outcomes for mother and child. Papua New Guinea (PNG) has among the highest prevalence of curable STIs including syphilis, chlamydia, gonorrhoea, trichomoniasis and bacterial vaginosis, and high neonatal mortality rates. Diagnosis and treatment of these STIs in PNG rely on syndromic management. Advances in STI diagnostics through point-of-care (PoC) testing using GeneXpert technology hold promise for resource-constrained countries such as PNG. This paper describes the planned economic evaluation of a cluster-randomised cross-over trial comparing antenatal PoC testing and immediate treatment of curable STIs with standard antenatal care in two provinces in PNG. METHODS AND ANALYSIS: Cost-effectiveness of the PoC intervention compared with standard antenatal care will be assessed prospectively over the trial period (2017-2021) from societal and provider perspectives. Incremental cost-effectiveness ratios will be calculated for the primary health outcome, a composite measure of the proportion of either preterm birth and/or low birth weight; for life years saved; for disability-adjusted life years averted; and for non-health benefits (financial risk protection and improved health equity). Scenario analyses will be conducted to identify scale-up options, and budget impact analysis will be undertaken to understand short-term financial impacts of intervention adoption on the national budget. Deterministic and probabilistic sensitivity analysis will be conducted to account for uncertainty in key model inputs. ETHICS AND DISSEMINATION: This study has ethical approval from the Institutional Review Board of the PNG Institute of Medical Research; the Medical Research Advisory Committee of the PNG National Department of Health; the Human Research Ethics Committee of the University of New South Wales; and the Research Ethics Committee of the London School of Hygiene and Tropical Medicine. Findings will be disseminated through national stakeholder meetings, conferences, peer-reviewed publications and policy briefs. TRIAL REGISTRATION NUMBER: ISRCTN37134032.


Assuntos
Nascimento Prematuro , Doenças Sexualmente Transmissíveis , Criança , Análise Custo-Benefício , Feminino , Genitália , Humanos , Recém-Nascido , Papua Nova Guiné/epidemiologia , Testes Imediatos , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/tratamento farmacológico
9.
Int J Cancer ; 149(7): 1483-1494, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34224588

RESUMO

Oral human papillomavirus (HPV) is associated with increasing rates of HPV-associated oropharyngeal cancer (OPC) in men. Sequential infection from one site to another has been demonstrated at the cervix and anus. Thus, risk of an oral HPV infection after a genital infection of the same type in the HPV infection in men study was investigated. Samples from 3140 men enrolled in a longitudinal cohort were assessed for sequential genital to oral infection with one of nine HPV types (HPV 6, 11, 16, 18, 31, 33, 45, 52 and 58); and then also sequential, same-type oral to genital infection. Incidence rate ratios (IRRs) compared rates of oral HPV among men with and without prior genital infection of the same type. Risk of sequential HPV infections were assessed using Cox proportional hazards model. Incidence of an oral HPV infection was significantly higher among men with a prior genital infection of the same type for any of the 9 HPV types (IRR: 2.3; 95% CI: 1.7-3.0). Hazard ratio of a sequential genital to oral HPV infection was 2.3 (95% CI: 1.7-3.1) and 3.5 (95% CI: 1.9-6.4) for oral to genital infection. Both changed minimally after adjustment for age, country, circumcision, alcohol use, lifetime sexual partners and recent oral sex partners. HPV infections at one site could elevate risk of a subsequent genital or oral HPV infection of the same type in men, emphasizing the importance of vaccination to prevent all HPV infections.


Assuntos
Doenças dos Genitais Masculinos/epidemiologia , Genitália/patologia , Doenças da Boca/epidemiologia , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/epidemiologia , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Estudos de Coortes , Seguimentos , Doenças dos Genitais Masculinos/virologia , Humanos , Incidência , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Doenças da Boca/virologia , Infecções por Papillomavirus/virologia , Prognóstico , Comportamento Sexual , Estados Unidos/epidemiologia , Adulto Jovem
10.
Med Sci Monit ; 27: e930168, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34193809

RESUMO

Coronavirus Disease-2019 (COVID-19) is a rapidly spreading pandemic that began at the end of 2019. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Reproductive health has always been one of the most important healthcare problems, and the impacts of COVID-19 on the reproductive systems have become an emerging topic. The effects of infection with SARS-CoV-2 on males are more harmful than on females. The outcomes of pregnancy also can show the condition of male and female reproductive system health. The vertical transmission of SARS-CoV-2 significantly affects pregnancy healthy. SARS-CoV-2, antibody, and other factors, such as the decline of lymphocyte counts, and increased erythrocyte sedimentation rate, C-reactive protein, and D-dimer levels, are evidence of SARS-CoV-2 vertical transmission. Angiotensin-converting enzyme 2 (ACE2) is regarded as a virus receptor in the reproductive system. The expression and activity of ACE2 are influenced by sex hormones, especially the male sex hormones. The strength of immunity is crucial to fighting off viral infection. Antibodies against SARS-CoV-2 show different expression in male and female patients, and the antibodies have been regarded as having potential applications in COVID-19 prevention and treatment. This review aims to present the current status of what is known about the involvement of the male and female reproductive systems, as well as the effects on pregnancy health, during infection with SARS-CoV-2, and discusses the implications for future fertility.


Assuntos
COVID-19/epidemiologia , Genitália/imunologia , Complicações Infecciosas na Gravidez/epidemiologia , Saúde Reprodutiva , SARS-CoV-2/imunologia , Enzima de Conversão de Angiotensina 2/metabolismo , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , COVID-19/complicações , COVID-19/imunologia , COVID-19/transmissão , Feminino , Fertilidade/imunologia , Hormônios Esteroides Gonadais/metabolismo , Humanos , Transmissão Vertical de Doenças Infecciosas , Masculino , Gravidez , Complicações Infecciosas na Gravidez/imunologia , Complicações Infecciosas na Gravidez/virologia , Fatores de Risco , SARS-CoV-2/patogenicidade , Fatores Sexuais , Internalização do Vírus
11.
J Med Case Rep ; 15(1): 362, 2021 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-34253226

RESUMO

BACKGROUND: Disorders of sex development are anomalies in which the development of urogenital ridge is undifferentiated for the male and female child. Imaging plays a vital role in investigating the gross anatomy and associated anomalies. Ultrasonography, such as genitography and magnetic resonance, is the primary modality for demonstrating internal gonads and genitalia. Early multidisciplinary approach in the management of ambiguous genitalia including early surgical intervention is the predominant practice, with few current considerations on deferral of genital reconstruction until adolescent age. CASE PRESENTATION: We report the rare case of a 24-year-old adult female from a majority ethnic group of the Volta region, Ghana who was diagnosed and raised as male, now requiring surgical restoration to the female gender. The surgical team decided to assign external genitalia to correspond with the already intact internal organs, thus constructing the vulva. Consent was given by the client and her family members for management and surgical intervention. The surgery was scheduled and duly performed with a successful outcome. Understanding and consent was sought from the patient for the purpose of using her images for teaching, scientific publication, and demonstrations. CONCLUSION: The advantages of deferring surgical reconstruction with psychological counseling after early assessment need to be considered to prevent inappropriate gender assignment.


Assuntos
Transtornos do Desenvolvimento Sexual , Transtornos do Desenvolvimento Sexual/cirurgia , Família , Feminino , Genitália/diagnóstico por imagem , Genitália Masculina , Gana , Humanos , Masculino , Ultrassonografia , Adulto Jovem
12.
Proc Biol Sci ; 288(1954): 20211068, 2021 07 14.
Artigo em Inglês | MEDLINE | ID: mdl-34229496

RESUMO

Our understanding of coevolution between male genitalia and female traits remains incomplete. This is perhaps especially true for genital traits that cause internal injuries in females, such as the spiny genitalia of seed beetles where males with relatively long spines enjoy a high relative fertilization success. We report on a new set of experiments, based on extant selection lines, aimed at assessing the effects of long male spines on females in Callosobruchus maculatus. We first draw on an earlier study using microscale laser surgery, and demonstrate that genital spines have a direct negative (sexually antagonistic) effect on female fecundity. We then ask whether artificial selection for long versus short spines resulted in direct or indirect effects on female lifetime offspring production. Reference females mating with males from long-spine lines had higher offspring production, presumably due to an elevated allocation in males to those ejaculate components that are beneficial to females. Remarkably, selection for long male genital spines also resulted in an evolutionary increase in female offspring production as a correlated response. Our findings thus suggest that female traits that affect their response to male spines are both under direct selection to minimize harm but are also under indirect selection (a good genes effect), consistent with the evolution of mating and fertilization biases being affected by several simultaneous processes.


Assuntos
Besouros , Animais , Evolução Biológica , Besouros/genética , Feminino , Genitália , Genitália Masculina , Masculino , Reprodução , Seleção Genética , Comportamento Sexual Animal
13.
Artigo em Russo | MEDLINE | ID: mdl-34223752

RESUMO

Pelvic floor surgery is currently recognized as the only effective method for treating genital prolapse but it is not able to restore fully the qualitative characteristics of perineal tissues. The risk of recurrence of the pathological process in the long-term period remains a serious negative aspect. Optimization of pelvic floor rehabilitation after surgical correction of perineal ptosis remains an urgent problem in the female population. The validated method of questioning is a priority in assessing the dynamics of clinical manifestations of failure of the anatomical and functional structures of the pelvic floor, their impact on the life quality of patients before and after the biofeedback method (BFB therapy) and electrical impulse stimulation (EIS) of muscles. Multi-parametric ultrasound diagnostics of perineal tissues can confirm the improvement of the echo-structure of the anatomical and functional elements of the pelvic floor after the complex application of physiotherapeutic effects using modern high-tech hardware systems through an external feedback channel by means of acoustic, visual and tactile perception. OBJECTIVE: To evaluate the effectiveness of biofeedback therapy and EIS of the neuromuscular apparatus of the pelvic floor in patients operated on for stage III, IV of genital prolapse using mesh implants by means of validated questionnaire survey and measuring the parameters of perineal tissues by the method of multi-parametric ultrasound. MATERIAL AND METHODS: The study included 187 women after surgical correction of stage III and IV genital prolapse according to POP-Q using mesh technologies. The 149 women underwent the observation program; 36 patients of the control group were recommended to modify their lifestyle; 113 patients of the main group - biofeedback therapy and EIS. The indicators of validated questionnaires (determination of the of perineal structures failure influence index on the life quality, ILQ) and ultrasound multi-parametric examination were assessed at baseline, 6 months and 1 year after the program of observation and rehabilitation. RESULTS: The clinical effectiveness of biofeedback therapy and EIS was confirmed by validated questionnaire: after 1 year, the ILQ in the control group decreased by 7.7%, in the main group - by 43.3% (p<0.05). Multi-parametric ultrasound assessment of perineal tissues after surgical correction of stages III and IV of genital prolapse showed a positive effect of conservative rehabilitation on the anatomical and functional structures of the pelvic floor. The diagnostic advantage of endo-anal sonography in the analysis of the echo-structure of the pelvic floor elements, detection of pathologies that cannot be scanned endo-vaginally and trans-perineally has been established. There were 2 (5.5%) cases of recurrence of genital prolapse in the control group; there were no relapsesamong the patients of the main group. CONCLUSION: The validated questioning for the ILQ and ultrasound multi-parametric study by measuring the parameters of perineal tissues confirmed the effectiveness of biofeedback therapy and EIS after surgical correction of stage III and IV genital prolapse using mesh technologies. Endo-anal sonography is essential in the examination of gynecological patients. The adherence to the monitoring and rehabilitation program was 79.6%.


Assuntos
Diafragma da Pelve , Prolapso de Órgão Pélvico , Biorretroalimentação Psicológica , Feminino , Genitália , Humanos , Diafragma da Pelve/diagnóstico por imagem , Diafragma da Pelve/cirurgia , Prolapso de Órgão Pélvico/diagnóstico por imagem , Prolapso de Órgão Pélvico/cirurgia , Qualidade de Vida , Inquéritos e Questionários , Resultado do Tratamento
14.
Trials ; 22(1): 469, 2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34284808

RESUMO

BACKGROUND: Genital erosive lichen planus (GELP) is a genital subtype of lichen planus, a chronic autoimmune inflammatory disease of unknown aetiology. In women, GELP is characterised by painful vulvo-vaginal mucosal erosions and scarring, often resulting in poor sexual health and reduced quality of life. Treatment options are limited and often with little effect. Apremilast, a phosphodiesterase 4-inhibitor, has been shown to have a positive effect on psoriasis and other inflammatory skin diseases. We aim to investigate the effect and safety of peroral apremilast in women with GELP in a randomised placebo-controlled double-blinded clinical trial. METHODS: We will recruit 42 adult women with characteristic clinical and/or histological features of moderate-to-severe GELP from a specialised vulva clinic in Oslo, Norway. The patients will be randomised 1:1 to either apremilast 30 mg BID (with an initial dose titration on days 1-6) or a placebo for 24 weeks. The concomitant use of topical corticosteroids will be allowed. The primary end point will be the mean GELP score, a clinical scoring system, at week 24 in the apremilast-treated patients versus the placebo-treated patients. The secondary end points will include the mean GELP score improvement from weeks 0 to 24, patient-reported use of topical steroids, the pain score on a visual analogue scale and the number of patients with GELP score improvements at weeks 16 and 24. The Physician Global Assessment , Patient Global Assessment and selected quality of life and sexual function assessments will be recorded at weeks 0, 16 and 24. The exploratory endpoints include description of immunohistochemical changes before and after apremilast therapy, assessed in vulvar or vaginal biopsies at weeks 0 and 24. Regular follow-ups for possible adverse events will be conducted. DISCUSSION: The study design is based on experience from studies on apremilast in other inflammatory skin diseases using equivalent apremilast doses for approved indications. The trial may provide evidence for the use of apremilast in women with this burdensome genital dermatosis. TRIAL REGISTRATION: ClinicalTrials.gov NCT0365666 . Registered on 4 September 2018.


Assuntos
Líquen Plano , Qualidade de Vida , Adulto , Feminino , Genitália , Humanos , Noruega , Ensaios Clínicos Controlados Aleatórios como Assunto , Talidomida/análogos & derivados
17.
Ann Emerg Med ; 78(3): 409-415, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34148664

RESUMO

Patients who undergo gender-affirming genital surgeries may present to the emergency department for their postsurgical complications. In this paper, we briefly describe the transfeminine and transmasculine genital procedures, review the diagnosis and management of both common and potentially life-threatening complications, and discuss the criteria for hospitalization and time frame for surgical consultation and referral.


Assuntos
Genitália/cirurgia , Complicações Pós-Operatórias/terapia , Cirurgia de Readequação Sexual/efeitos adversos , Medicina de Emergência/educação , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Cirurgia de Readequação Sexual/métodos
18.
Ann Saudi Med ; 41(3): 186-189, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34085543

RESUMO

At least 27 million men present with urogenital manifestations of genital filariasis (GF). Although there is a large burden of GF in residents in endemic regions, infection in short-term travellers and in non-endemic areas is rare. We report the case of a 75-year-old Italian man referred to our institution for a testicular discomfort. Clinical examination and ultrasound detected a mass of 40×18 mm in the scrotum without signs of varicocele, hydrocele and testicular or epididymal abnormalities. After ineffective medical treatment, the patient underwent surgical excision. Histology demonstrated filarial granuloma with thick cuticles pathognomonic of an adult worm in the testicular tunics. Surgery has a fundamental role in localized cases of GF to remove nematodes from the fibrotic nodules. The present manuscript describes a singular case of GF observed in Italy in a non-immigrant patient with evidence of remnants of an adult worm in the testicular tunics. SIMILAR CASES PUBLISHED: 11.


Assuntos
Filariose , Escroto , Idoso , Filariose/diagnóstico , Genitália , Humanos , Itália , Masculino , Escroto/diagnóstico por imagem , Ultrassonografia
20.
Biomolecules ; 11(5)2021 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-34064759

RESUMO

Gammaherpesvirus reactivation can promote diseases or impair reproduction. Understanding reactivation patterns and associated risks of different stressors is therefore important. Nevertheless, outside the laboratory or captive environment, studies on the effects of stress on gammaherpesvirus reactivation in wild mammals are lacking. Here we used Mustelid gammaherpesvirus 1 (MusGHV-1) infection in European badgers (Meles meles) as a host-pathogen wildlife model to study the effects of a variety of demographic, physiological and environmental stressors on virus shedding in the genital tract. We collected 251 genital swabs from 150 free-ranging individuals across three seasons and screened them for the presence of MusGHV-1 DNA using PCR targeting the DNA polymerase gene. We explored possible links between MusGHV-1 DNA presence and seven variables reflecting stressors, using logistic regression analysis. The results reveal different sets of risk factors between juveniles and adults, likely reflecting primary infection and reactivation. In adults, virus shedding was more likely in badgers in poorer body condition and younger than 5 years or older than 7; while in juveniles, virus shedding is more likely in females and individuals in better body condition. However, living in social groups with more cubs was a risk factor for all badgers. We discuss possible explanations for these risk factors and their links to stress in badgers.


Assuntos
Gammaherpesvirinae/isolamento & purificação , Infecções por Herpesviridae/veterinária , Mustelidae/virologia , Animais , Feminino , Genitália/virologia , Infecções por Herpesviridae/genética , Infecções por Herpesviridae/virologia , Masculino , Reprodução/fisiologia , Fatores de Risco , Estações do Ano , Estresse Fisiológico/fisiologia , Ativação Viral
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