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Ruiz Del Pino M, Rosales-Castillo A, Hidalgo-Tenorio C, Expósito-Ruiz M, Navarro-Marí JM, Gutiérrez-Fernández J. [Isolation of Haemophilus no ducreyi in samples from the genital tract of men: Its clinical relationship]. Rev Int Androl 2023; 21:100374. [PMID: 37413940 DOI: 10.1016/j.androl.2023.100374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/01/2023] [Accepted: 03/27/2023] [Indexed: 07/08/2023]
Abstract
INTRODUCTION With the advancement of microbiological methods, the isolation of less typical pathogens in cases of urethral and rectal infection is more frequent, apart from the classic etiological agents. One of them is formed by species of Haemophilus no ducreyi (HND). The objective of this work is to describe frequency, susceptibility to antibiotics, and clinical features of HDN urethritis and proctitis in adult males. PATIENTS AND METHODS This is an observational retrospective descriptive study of the results obtained by the Microbiology laboratory of the Virgen de las Nieves University Hospital on the isolates of HND in genital and rectal samples from males between 2016 and 2019. RESULTS HND was isolated in 135 (7%) of the genital infection episodes diagnosed in men. H. parainfluenzae was the most commonly isolated (34/45; 75.6%). The most frequent symptoms in men with proctitis were rectal tenesmus (31.6%) and lymphadenopathy (10.5%); in those with urethritis, dysuria (71.6%), urethral suppuration (46.7%) and gland lesions (27%), so differentiating it from infections caused by other genitopathogens is difficult. 43% of patients were HIV positive. Antibiotic resistance rates for H. parainfluenzae were high to quinolons, ampicillin, tetracycline and macrolides. CONCLUSION HND species should be considered as possible etiologic agents in episodes of urethral and rectal infection in men, especially in cases with negative screening tests for agents that cause sexually transmitted infections (STIs). Its microbiological identification is essential for the establishment of an effective targeted treatment.
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Affiliation(s)
- Marta Ruiz Del Pino
- Departamento de Microbiología, Hospital Universitario Virgen de las Nieves-IBS, Granada, España
| | - Antonio Rosales-Castillo
- Servicio de Medicina Interna, Hospital Universitario Virgen de las Nieves-IBS, Granada, España; Departamento de Microbiología, Facultad de Medicina, Programa de Doctorado en Medicina Clínica y Salud Pública, Universidad de Granada-IBS, Granada, España.
| | - Carmen Hidalgo-Tenorio
- Unidad de Enfermedades Infecciosas, Hospital Universitario Virgen de las Nieves-IBS, Granada, España
| | - Manuela Expósito-Ruiz
- Departamento de Bioestadística de FIBAO, Hospital Universitario Virgen de las Nieves-IBS, Granada, España
| | - José María Navarro-Marí
- Departamento de Microbiología, Facultad de Medicina, Programa de Doctorado en Medicina Clínica y Salud Pública, Universidad de Granada-IBS, Granada, España
| | - José Gutiérrez-Fernández
- Departamento de Microbiología, Hospital Universitario Virgen de las Nieves-IBS, Granada, España; Departamento de Microbiología, Facultad de Medicina, Programa de Doctorado en Medicina Clínica y Salud Pública, Universidad de Granada-IBS, Granada, España
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Eleutério J, Campaner AB, de Carvalho NS. Diagnosis and treatment of infectious vaginitis: Proposal for a new algorithm. Front Med (Lausanne) 2023; 10:1040072. [PMID: 36844222 PMCID: PMC9947655 DOI: 10.3389/fmed.2023.1040072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
Background Vaginitis is the most common gynecologic diagnosis in primary care, and most women have at least one episode during their lives. The need for standardized strategies to diagnose and treat vaginitis, both in primary care and among gynecologists, is emphasized. The Brazilian Group for Vaginal Infections (GBIV, acronym in Portuguese) aimed to update the practical approach to affected women by reviewing and discussing recent literature, and developing algorithms for diagnosis and treatment of vaginitis. Methods A literature search within biomedical databases PubMed and SCieLo was conducted in January 2022. The available literature was evaluated by three experienced researchers, members of the GBIV, to summarize the main data and develop practical algorithms. Results and conclusion Detailed algorithms were developed with the main goal to improve gynecological practice considering different scenarios and access to diagnostic tools, from the simplest to the most complex tests. Different age groups and specific contexts were also considered. The combination of anamnesis, gynecological examination, and complementary tests remains the basis of a proper diagnostic and therapeutic approach. Periodic updates of these algorithms are warranted as new evidence becomes available.
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Affiliation(s)
- José Eleutério
- Department of Health for Women, Children, and Adolescents, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil,*Correspondence: José Eleutério Jr.,
| | - Adriana Bittencourt Campaner
- Department of Gynecology and Obstetrics, Faculty of Medical Sciences of Santa Casa de São Paulo, São Paulo, Brazil
| | - Newton Sergio de Carvalho
- Department of Gynecology and Obstetrics, Infectious Diseases in Gynecology and Obstetrics Sector, Federal University of Paraná, Curitiba, Paraná, Brazil
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Desai S, Pandey N, Singh RJ, Bhasin S. Gender inequities in treatment-seeking for sexual and reproductive health amongst adolescents: Findings from a cross-sectional survey in India. SSM Popul Health 2021; 14:100777. [PMID: 33997240 PMCID: PMC8095180 DOI: 10.1016/j.ssmph.2021.100777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/10/2021] [Accepted: 03/12/2021] [Indexed: 11/22/2022] Open
Abstract
CONTEXT India's adolescent health policy aims to improve sexual and reproductive health, especially amongst the most vulnerable. There is limited evidence on how gender influences treatment-seeking patterns amongst unmarried adolescents. METHODS We analyzed data from 11,651 unmarried adolescent boys and girls aged 15-19 from a cross-sectional survey conducted in two large states of India. We conducted sex-disaggregated analyses to estimate the prevalence of symptoms of genital infections and compare treatment-seeking patterns. We identified correlates through multivariable regression and used a conceptual framework to explore structural, household, social and individual factors that influence gender inequities in adolescent sexual and reproductive health. RESULTS One in five unmarried adolescents reported symptoms of genital infections, such as burning or discharge, in the past three months. Factors associated with reporting symptoms varied between boys and girls, except for a common correlation with symptoms of depression. At least two-thirds of boys sought treatment, compared to approximately one in four girls (rural: 66.2% boys, 23.1% girls; urban: 69.4% boys, 30.7% girls). Boys primarily sought care from medical shops or private facilities, while girls used both private and government services. Amongst boys, having friends and being in school was associated with seeking treatment (aOR: 11.47; 95% CI: 2.75, 47.87; aOR: 1.95; 95% CI: 1.24, 3.07, respectively). Odds of seeking treatment were higher amongst girls with exposure to any mass media (aOR: 1.93; 95% CI: 1.25, 2.99) and who had discussed puberty with a parent (aOR: 1.98; 95% CI: 1.32, 2.98). CONCLUSION Stark sex differentials in factors associated with symptoms and in treatment-seeking illustrate how structural gender inequities, such as access to economic resources and education, influence sexual and reproductive health amongst adolescents. Along with health system interventions, addressing gender inequities calls for strategies to strengthen parental engagement, social support and girls' access to resources.
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Wang M, Zhang X, Ni T, Wang Y, Wang X, Wu Y, Zhu Z, Li Q. Comparison of New Oral Hypoglycemic Agents on Risk of Urinary Tract and Genital Infections in Type 2 Diabetes: A Network Meta-analysis. Adv Ther 2021; 38:2840-53. [PMID: 33999339 DOI: 10.1007/s12325-021-01759-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 04/22/2021] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Dipeptidyl peptidase 4 (DPP4) inhibitors and sodium-glucose co-transporter 2 (SGLT2) inhibitors have often been used for patients with T2DM because of the reduced risk of hypoglycemia. However, DPP4 inhibitors and SGLT2 inhibitors may increase the risk of infectious diseases. This network meta-analysis (NMA) was performed to investigate the risk of urinary tract and genital infections associated with the use of two new glucose-lowering drug classes in patients with type 2 diabetes. METHODS PubMed, Web of Science, Embase, and the Cochrane Library were comprehensively searched for articles from the date of database inception until September 8, 2020. Placebo-controlled or head-to-head trials of the two new drug classes used for treatment of adults with type 2 diabetes were included. The primary outcome was the incidence of any confirmed urinary tract infection; genital infection was also used as an important outcome indicator. RESULTS Fifty-five studies were identified, covering 29,574 participants. Regarding urinary tract infections, SGLT2 inhibitors were not associated with increased risk, and among all drugs, sitagliptin, ipragliflozin, and linagliptin were the safest according to probability ranking. Regarding genital infections, saxagliptin was associated with significantly reduced risk in pairwise comparisons with placebo (RR 0.12, 95% CI 0.00-0.78), linagliptin (RR 0.09, 95% CI 0.00-0.78), canagliflozin (RR 0.04, 95% CI 0.00-0.31), dapagliflozin (RR 0.04, 95% CI 0.00-0.26), empagliflozin (RR 0.03, 95% CI 0.00-0.25), and ertugliflozin (RR 0.03, 95% CI 0.00-0.24). Among all drugs, saxagliptin, sitagliptin, and ipragliflozin were the safest according to probability ranking. Considering both urinary tract and genital infection risks, DPP4 inhibitors showed greater reductions than SGLT2 inhibitors and placebo. Saxagliptin was the safest drug according to probability ranking for both infection risks. CONCLUSIONS This NMA showed that, to reduce genital infection risk, current evidence favors DPP4 inhibitors over SGLT2 inhibitors. Most SGLT2 inhibitors may not be associated with the risk of urinary tract infections. Considering both infection risks, saxagliptin may be the safest drug. Finally, mechanistic studies are needed to better understand the physiological basis for these effects.
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Rosales-Castillo A, Hidalgo-Tenorio C, Navarro-Marí JM, Gutiérrez-Fernández J. Emerging presence of urethritis and balanitis by Pasteurella bettyae. Infect Dis Now 2021; 51:492-4. [PMID: 34366085 DOI: 10.1016/j.idnow.2020.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/12/2020] [Accepted: 10/29/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Humans can also be infrequent infected by Pasteurella bettyae. We report the first association of P. bettyae with urethritis and balanitis in men who have sex with men practicing unprotected intercourse. PATIENTS AND METHODS The standard culture for bacteria and fungi in genital samples, and a PCR study for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma spp. and Ureaplasma spp, were performed. Cultured microorganisms were identified by Maldi-Tof mass spectrometry and the susceptibility of the isolates were evaluated with the gradient test. RESULTS P. bettyae were isolated and were found to be susceptible to penicillin, amoxicillin-clavulanic acid, trimethoprim-sulfamethoxazole, ciprofloxacin, and doxycycline. CONCLUSION This novel finding highlights the need for complete microbiological screening in adequate samples to detect possible infectious agents in these cases, not limited to conventional agents. These rare microorganisms can be detected by the application of Maldi-Tof in colonies grown in culture media.
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Sohrabi A, Bassam-Tolami F, Imani M. The Impact of MTHFR 1298 A > C and 677 C > T Gene Polymorphisms as Susceptibility Risk Factors in Cervical Intraepithelial Neoplasia Related to HPV and Sexually Transmitted Infections. J Obstet Gynaecol India 2020; 70:503-509. [PMID: 33406167 PMCID: PMC7758384 DOI: 10.1007/s13224-020-01363-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/25/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND HPV genotypes are the most common etiological factor for genital neoplasia. It would appear that sexually transmitted infections accompanied with HPV genotypes might have synergistic interactions in cancer progression. The genetic polymorphisms are involved in metabolizing carcinogens which may contribute to the susceptibility of developing genital cancers by less efficient or overly down metabolic pathways and cell signaling. MTHFR polymorphisms are related to several metabolic disorders and human cancers. We investigated the contribution of MTHFR 1298 and MTHFR 677 polymorphisms as potential risk factors for outcomes with HPV genotypes and STIs in Iranian population. MATERIALS AND METHODS As a case-control study, MTHFR A1298C and C677T were assessed for SNPs analysis using a PCR-RFLP assay in 50 cervical intraepithelial neoplasia (CIN) cases, 98 HPV-positive subjects and 47 non-cancerous/non-HPV patients as healthy controls. RESULTS Finding suggested a significant association between the MTHFR 1298 CC polymorphisms (OR = 3.5, 95% CI = 1.13-10.82, P ≤ 0.05) in women with CIN as compared to non-cancerous/non-HPV subjects. There was not a significant difference of MTHFR 677 between outcomes. DISCUSSION It would seem MTHFR 1298 CC is more likely to be a potential risk factor for HPV-cervical cancer progression. Consequences support further attempts to understand the clinical manifestations of neoplasia related to genital infections and gene mutations.
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Affiliation(s)
- Amir Sohrabi
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, Solna Campus, PO Box 171 77, Stockholm, Sweden
| | | | - Mohsen Imani
- Department of Molecular Biology, Research Center of Health Reference Laboratory, Ministry of Health and Medical Education, Tehran, Iran
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Mangiardi-Veltin M, Aicardi S, Vermeille M, Amblard J, Savary D. Pasteurella multocida: First case report of uterine abscess and septic metastasis. J Gynecol Obstet Hum Reprod 2020; 50:102003. [PMID: 33249256 DOI: 10.1016/j.jogoh.2020.102003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/14/2020] [Accepted: 11/18/2020] [Indexed: 10/22/2022]
Abstract
Human pasteurellosis with a gynecologic tropism is rare. A 54 year-old woman presented with sepsis due to a uterine abscess from pasteurella multocida (PM) secondarily complicated by gluteal abscess. She had a history of adenomyosis and had previously undergone hysteroscopic sterilization with micro-inserts. Treatment consisted in antibiotherapy, laparoscopic hysterectomy with salpingectomy and abscess drainage, which resulted in complete recovery. This is the first case of uterine abscess from PM with a second septic location.
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Affiliation(s)
| | - Stéphanie Aicardi
- Gynecology and Obstetrics, Pôle Santé d'Arcachon, Avenue Jean Hameau, 33260, La Teste-de-Buch, France
| | - Marjorie Vermeille
- Gynecology and Obstetrics, Pôle Santé d'Arcachon, Avenue Jean Hameau, 33260, La Teste-de-Buch, France
| | - Joël Amblard
- Gynecology and Obstetrics, Pôle Santé d'Arcachon, Avenue Jean Hameau, 33260, La Teste-de-Buch, France
| | - Denis Savary
- Gynecology and Obstetrics, Pôle Santé d'Arcachon, Avenue Jean Hameau, 33260, La Teste-de-Buch, France
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Liu D, Chen H, Song F, Ahmed MA, Wu H. Adverse Drug Events Observed with the Novel Sodium/Glucose Co-Transporter 2 Inhibitor Ipragliflozin for the Treatment of Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis of Randomized Studies. Adv Ther 2020; 37:4356-4369. [PMID: 32845473 DOI: 10.1007/s12325-020-01471-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Type 2 diabetes mellitus (T2DM) is becoming a major issue worldwide. To effectively control the blood sugar of patients with T2DM, several novel oral hypoglycemic agents (OHAs) are being developed. Sodium/glucose co-transporter 2 (SGLT 2) inhibitors have recently shown beneficial outcomes in patients with T2DM. In this analysis, we aimed to systematically compare the adverse drug events observed with ipragliflozin versus placebo for the treatment of patients with T2DM. METHODS http://www.ClinicalTrials.gov , the bibliographic database of life science and biomedical information MEDLINE, EMBASE and the Cochrane Central were searched for English publications satisfying the inclusion and exclusion criteria of this study. Adverse drug events were the end points in this analysis. The latest version (5.4) of the RevMan software was used to analyze the data, and risk ratios (RR) with 95% confidence intervals (CI) were used to represent the data post analysis. RESULTS Eight randomized studies with a total of 1519 participants with T2DM were included in this analysis whereby total treatment-emergent adverse events (RR: 1.06, 95% CI: 0.96-1.16; P = 0.26), including mild (RR: 0.95, 95% CI: 0.79-1.13; P = 0.54), moderate (RR: 1.04, 95% CI: 0.72-1.51; P = 0.83) and severe treatment-emergent adverse events (RR: 0.72, 95% CI: 0.26-1.96; P = 0.52), were not significantly different in those patients who were assigned to ipragliflozin versus placebo for the treatment of T2DM. Moreover, drug-related adverse events (RR: 1.04, 95% CI: 0.69-1.58; P = 0.85), adverse events leading to drug discontinuation (RR: 1.09, 95% CI: 0.57-2.10; P = 0.79), urinary tract infection (RR: 1.03, 95% CI: 0.60-1.77; P = 0.91), naso-pharyngitis (RR: 0.54, 95% CI: 0.19-1.52; P = 0.25), constipation (RR: 1.94, 95% CI: 0.90-4.20; P = 0.09), dizziness (RR: 0.81, 95% CI: 0.20-3.23; P = 0.76), gastrointestinal disorders (RR: 0.96, 95% CI: 0.68-1.36; P = 0.82) and dehydration (RR: 2.26, 95% CI: 0.38-13.43; P = 0.37) were also not significantly different. However, genital infection (RR: 4.53, 95% CI: 1.48-13.85; P = 0.008) and hypoglycemia (RR: 1.68, 95% CI: 1.03-2.74; P = 0.04) rates were significantly higher in the ipragliflozin group. CONCLUSIONS The current analysis showed ipragliflozin to be associated with significantly higher genital infection rates compared to placebo, whereas no significant difference was observed compared to the other adverse drug events in these patients with T2DM. In addition, hypoglycemia was also not significantly different following sensitivity analysis.
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Affiliation(s)
- Dan Liu
- Department of Endocrinology, The First Affiliated Hospital of Yangtze University, Jingzhou First People's Hospital, Jingzhou, Hubei, People's Republic of China
| | - Hao Chen
- Department of Endocrinology, The First Affiliated Hospital of Yangtze University, Jingzhou First People's Hospital, Jingzhou, Hubei, People's Republic of China
| | - Fang Song
- Department of Endocrinology, The First Affiliated Hospital of Yangtze University, Jingzhou First People's Hospital, Jingzhou, Hubei, People's Republic of China
| | - Mohamad Anis Ahmed
- Department of Cardiology, Peking University People's Hospital, Beijing, People's Republic of China
| | - Hongyan Wu
- Department of Endocrinology, The First Affiliated Hospital of Yangtze University, Jingzhou First People's Hospital, Jingzhou, Hubei, People's Republic of China.
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Mora-Palma JC, Guillot-Suay V, Sánchez Gila MM, Gutiérrez-Fernández J. [Pelvic inflammatory disease by Streptococcus constellatus. Clinical experience and a review]. Rev Esp Quimioter 2020; 33:285-288. [PMID: 32515179 PMCID: PMC7374034 DOI: 10.37201/req/020.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/03/2020] [Accepted: 04/14/2020] [Indexed: 06/11/2023]
Affiliation(s)
| | | | | | - J Gutiérrez-Fernández
- José Gutiérrez-Fernández. Servicio de Microbiología. Hospital Universitario Virgen de las Nieves. Avenida de las Fuerzas Armadas, 2. E-18012 Granada, Spain.
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Nakhleh A, Zloczower M, Gabay L, Shehadeh N. Effects of sodium glucose co-transporter 2 inhibitors on genital infections in female patients with type 2 diabetes mellitus- Real world data analysis. J Diabetes Complications 2020; 34:107587. [PMID: 32354622 DOI: 10.1016/j.jdiacomp.2020.107587] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/09/2020] [Accepted: 04/09/2020] [Indexed: 02/06/2023]
Abstract
AIMS Sodium glucose co-transporter 2 (SGLT2) inhibitors are associated with increased risk of genital infections. We aimed to assess incidence and risk factors associated with genital infections among female patients with type 2 diabetes mellitus (T2DM) treated with SGLT2 inhibitors. METHODS We retrieved data on adult female patients with T2DM who initiated treatment with empagliflozin or dapagliflozin during March 2015-March 2018, in a large Israeli health maintenance organization (HMO). Genital infections were identified by diagnosis codes or relevant dispensed prescriptions. The proportion of days covered with SGLT2 inhibitors (SGLT2i-PDC) was measured. Univariate and multivariate analyses were performed to identify risk factors. RESULTS Of 1542/6153 patients, 25.1% had events of genital infections during a mean of 2.3 years. The adjusted hazard ratio (HR) was 4.25 for the highest versus lowest SGLT2i-PDC group. Younger age, history of genital infection, and estrogen therapy were associated with increased risk of genital infections. Chronic Kidney Disease and DPP4 inhibitor therapy at baseline were associated with lower risk of genital infections. CONCLUSIONS Potential risk factors for genital infections were identified in women initiating SGLT2 inhibitors.
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Affiliation(s)
- Afif Nakhleh
- Diabetes and Endocrinology Clinic, Maccabi Healthcare Services, 54 Simcha Golan St, Haifa, Israel; Institute of Endocrinology, Diabetes and Metabolism, Rambam Health Care Campus, 8 HaAliya HaShniya St, Haifa, Israel.
| | - Moshe Zloczower
- Institute of Endocrinology, Diabetes and Metabolism, Rambam Health Care Campus, 8 HaAliya HaShniya St, Haifa, Israel
| | - Linoy Gabay
- Maccabi-Kahn Institute of Research, 4 Koifman St, Tel Aviv, Israel
| | - Naim Shehadeh
- Diabetes and Endocrinology Clinic, Maccabi Healthcare Services, 54 Simcha Golan St, Haifa, Israel; Institute of Endocrinology, Diabetes and Metabolism, Rambam Health Care Campus, 8 HaAliya HaShniya St, Haifa, Israel
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Siles-Guerrero V, Cardona-Benavides I, Liébana-Martos C, Vázquez-Alonso F, Expósito-Ruiz M, Navarro-Marí JM, Gutiérrez-Fernández J. Recent clinical relevance of mono-genital colonization/infection by Ureaplasma parvum. Eur J Clin Microbiol Infect Dis 2020; 39:1899-1905. [PMID: 32436116 DOI: 10.1007/s10096-020-03928-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/12/2020] [Indexed: 12/14/2022]
Abstract
Ureaplasma parvum is the most prevalent genital mycoplasma in women of childbearing age. There is debate around the relevance of its presence in male or female genitals for disease development and as a cofactor. The objective of this study was to determine the prevalence of colonization/infection by U. parvum and its possible relationship with reproductive tract infections. We retrospectively analyzed the presence of U. parvum in patients referred by specialist clinicians for suspicion of genitourinary tract infection. U. parvum was detected in 23.8% of samples, significantly more frequently in females (39.9%) than in males (6%). Among the males, U. parvum was found alone in 68.4% of episodes, with Ct < 30. Among the females, U. parvum was detected in 88.6% of cases, with Ct < 30, including 22 cases with premature rupture of membranes and 6 cases with threat of preterm labor. Co-infection was significantly more frequent in females (62.6%) than in males (31.6%). Given the high prevalence of U. parvum as sole isolate in males and females with genitourinary symptoms, it should be considered in the diagnosis and treatment of genital infections, although its pathogenic role in some diseases has not been fully elucidated.
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Affiliation(s)
- Víctor Siles-Guerrero
- Department of Microbiology, School of Medicine, University of Granada-Instituto de Investigación Biosanitaria de Granada.ibs, Granada, Spain
| | - Inmaculada Cardona-Benavides
- Department of Obstetrics and Gynecology, University Hospital Virgen de las Nieves- Instituto de Investigación Biosanitaria de Granada, ibs Granada, Granada, Spain
| | - Carmen Liébana-Martos
- Department of Microbiology, University Hospital Ciudad de Jaén -Instituto de Investigación Biosanitaria de Granada, ibs Granada, Jaén, Spain
| | - Fernando Vázquez-Alonso
- Department of Urology, University Hospital Virgen de las Nieves-Instituto de Investigación Biosanitaria de Granada, ibs Granada, Granada, Spain
| | - Manuela Expósito-Ruiz
- Research and Biostatistics Methodology Unit, University Hospital Virgen de las Nieves- Instituto de Investigación Biosanitaria de Granada, ibs Granada, Granada, Spain
| | - José María Navarro-Marí
- Department of Microbiology, University Hospital Virgen de las Nieves-Instituto de Investigación Biosanitaria de Granada, ibs Granada, Granada, Spain
| | - José Gutiérrez-Fernández
- Department of Microbiology, School of Medicine, University of Granada-Instituto de Investigación Biosanitaria de Granada.ibs, Granada, Spain.
- Department of Microbiology, University Hospital Virgen de las Nieves-Instituto de Investigación Biosanitaria de Granada, ibs Granada, Granada, Spain.
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Kherabi Y, Chevrel G, Roux D, Federici L. [Gynecological Lemierre's syndrome: A case report and literature review]. Rev Med Interne 2020; 41:493-495. [PMID: 32371121 DOI: 10.1016/j.revmed.2020.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 02/10/2020] [Accepted: 02/13/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Lemierre's syndrome is defined as an oropharyngeal infection due to Fusobacterium necrophorum, associated with septic thrombophlebitis of the internal jugular vein. The uncommon pelvic variant of the syndrome is a rare condition, poorly described in literature. CASE REPORT We report a case of gynecological Lemierre's syndrome in a 19-year-old woman after a first sexual intercourse, who presented acute respiratory failure, left internal iliac vein thrombosis with pulmonary embolism, in the setting of salpingitis and F. necrophorum bacteriemia. CONCLUSION Gynecological Lemierre's syndrome is a rare and unrecognized condition, which could be lethal. Early recognition of the disorder enables initiation of appropriate antibiotic therapy for 4 to 6 weeks, and discussion of anticoagulant therapy which indications are not yet well defined.
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Affiliation(s)
- Y Kherabi
- AP-HP, hôpital Louis-Mourier, service de réanimation médico-chirurgicale, 92700 Colombes, France.
| | - G Chevrel
- Centre hospitalier Sud Francilien, service de réanimation médico-chirurgicale, 91100 Corbeil-Essonnes, France
| | - D Roux
- AP-HP, hôpital Louis-Mourier, service de réanimation médico-chirurgicale, 92700 Colombes, France; Université de Paris, Inserm, IAME, UMR-1137, 75018 Paris, France
| | - L Federici
- AP-HP, hôpital Louis-Mourier, service de réanimation médico-chirurgicale, 92700 Colombes, France; Centre hospitalier Sud Francilien, service de réanimation médico-chirurgicale, 91100 Corbeil-Essonnes, France
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13
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Gopinath H, Karthikeyan K. Genital scabies: Haven of an unwelcome guest. Indian J Sex Transm Dis AIDS 2020; 41:10-16. [PMID: 33062975 PMCID: PMC7529175 DOI: 10.4103/ijstd.ijstd_69_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 04/10/2018] [Accepted: 12/30/2019] [Indexed: 11/04/2022] Open
Abstract
The itch mite Sarcoptes scabiei var. hominis has been a menace to humanity for ages. Diagnosing scabies can be a challenge in view of the varied presentations of the disease. The male genitalia are an important area of predilection of the mite. Examination of this often overlooked area is essential as it may reveal both characteristic and atypical manifestations of scabies. Genital involvement also attains special relevance in view of the possible sexual transmission of the mite. In addition to the morbidity caused by itching, patients may have to deal with myths, stigma, and embarrassment.
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Affiliation(s)
- Hima Gopinath
- Department of Dermatology, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India
| | - Kaliaperumal Karthikeyan
- Department of Dermatology, Venereology and Leprosy, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
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14
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Yabe D, Yasui A, Ji L, Lee M, Ma RCW, Chang T, Okamura T, Zeller C, Kaspers S, Lee J, Kohler S, Seino Y. Safety and tolerability of empagliflozin in East Asian patients with type 2 diabetes: Pooled analysis of phase I-III clinical trials. J Diabetes Investig 2019; 10:418-428. [PMID: 30099847 PMCID: PMC6400242 DOI: 10.1111/jdi.12910] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 07/25/2018] [Accepted: 08/07/2018] [Indexed: 12/13/2022] Open
Abstract
AIMS/INTRODUCTION We investigated the safety and tolerability of empagliflozin (EMPA) in East Asian patients with type 2 diabetes. MATERIALS AND METHODS Data were pooled from participants with type 2 diabetes evenly randomized to a placebo, EMPA 10 mg or EMPA 25 mg in 15 phase I-III trials. Adverse events (AEs) were analyzed in the subgroup of trial participants from East Asian countries/regions. RESULTS In total, 709, 724 and 708 East Asian trial participants with type 2 diabetes received a placebo, EMPA 10 mg and EMPA 25 mg, respectively; total exposure was 953, 1,072, and 1,033 patient-years in these groups, respectively. The EMPA and placebo groups had similar incidences of severe AEs, serious AEs and AEs leading to discontinuation. Incidences of hypoglycemia differed according to anti-diabetes medication used at baseline. Higher rates of events consistent with genital infection were observed with EMPA (EMPA 1.5-1.7/100, placebo 0.2/100 patient-years). Rates of AEs consistent with volume depletion were comparable among treatment groups (0.8-1.4/100 patient-years), but in trial participants aged ≥65 years, the rate was greater with EMPA 25 mg (EMPA 25 mg 3.5/100, placebo 2.0/100 patient-years). Incidences of events consistent with urinary tract infection, thromboembolic events, renal events, hepatic AEs, diabetic ketoacidosis, fractures and lower limb amputation were similar between EMPA and the placebo. CONCLUSIONS In the present pooled analysis, EMPA was well tolerated in East Asian type 2 diabetes patients based on >2,100 patient-years' exposure, consistent with results from the overall analysis population.
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Affiliation(s)
- Daisuke Yabe
- Kansai Electric Power Medical Research InstituteKobeJapan
- Kyoto UniversityKyotoJapan
| | | | - Linong Ji
- Peking University People's HospitalBeijingChina
| | - Moon‐Kyu Lee
- Sungkyunkwan University School of MedicineSeoulKorea
| | | | | | | | - Cordula Zeller
- Boehringer Ingelheim Pharma GmbH & Co. KGBiberach an der RissGermany
| | | | - Jisoo Lee
- Boehringer Ingelheim International GmbHIngelheimGermany
| | - Sven Kohler
- Boehringer Ingelheim International GmbHIngelheimGermany
| | - Yutaka Seino
- Kansai Electric Power Medical Research InstituteKobeJapan
- Kansai Electric Power HospitalOsakaJapan
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Carrillo-Ávila JA, Bonilla-García L, Navarro-Marí JM, Gutiérrez-Fernández J. The first reported case of pelvic inflammatory disease caused by Actinobaculum massiliense. Anaerobe 2018; 55:93-95. [PMID: 30439470 DOI: 10.1016/j.anaerobe.2018.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 11/06/2018] [Accepted: 11/10/2018] [Indexed: 10/27/2022]
Abstract
We report the first case of pelvic inflammatory disease (PID) caused by Actinobaculum massiliense. A 53-year-old woman attended the emergency department with symptoms compatible with a PID episode, finally resolved by intramuscular antibiotic treatment. Actinobaculum sp. was isolated by culture, and A. massiliense was confirmed by matrix assisted laser desorption time-of-flight mass spectrometry and 16S rRNA gene sequencing. Only a few cases of A. massiliense infections have been reported, and the pathogenesis of infections by these bacteria is poorly understood. The introduction of new diagnostic methods into hospital routines will improve the detection of new and little-studied pathogens.
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Affiliation(s)
| | - Laura Bonilla-García
- Department of Obstetrics and Gynecology, University Hospital Virgen de las Nieves -ibs Granada, Granada, Spain
| | - José María Navarro-Marí
- Microbiology Laboratory, University Hospital Virgen de las Nieves -ibs Granada, Granada, Spain
| | - José Gutiérrez-Fernández
- Microbiology Laboratory, University Hospital Virgen de las Nieves -ibs Granada, Granada, Spain; Department of Microbiology, University of Granada-ibs Granada, Granada, Spain.
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16
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Mora-Palma JC, Rodríguez-Oliver AJ, Navarro-Marí JM, Gutiérrez-Fernández J. Emergent genital infection by Leptotrichia trevisanii. Infection 2019; 47:111-4. [PMID: 29980937 DOI: 10.1007/s15010-018-1175-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 07/05/2018] [Indexed: 10/28/2022]
Abstract
We report the first case of an association between Leptotrichia trevisanii and an episode of pelvic inflammatory disease (PID) and the second case of the isolation of this infection in the cervical canal. A 45-yr-old woman was admitted to our emergency department with clinical and radiological signs and symptoms compatible with an episode of PID. She was hospitalized for intravenous antibiotic control and treatment and the subsequent surgical drainage of abscesses. Cultures were taken throughout the process, but only cultures from cervical canal exudate were positive, with the growth of L. trevisanii species. It appears important to carry out a complete microbiological screening, not limited to conventional agents, on adequate clinical samples to detect possible infectious agents that may be missed in these cases.
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Stanfield BA, Rider PJF, Caskey J, Del Piero F, Kousoulas KG. Intramuscular vaccination of guinea pigs with the live-attenuated human herpes simplex vaccine VC2 stimulates a transcriptional profile of vaginal Th17 and regulatory Tr1 responses. Vaccine 2018; 36:2842-2849. [PMID: 29655629 DOI: 10.1016/j.vaccine.2018.03.075] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 03/23/2018] [Accepted: 03/27/2018] [Indexed: 12/31/2022]
Abstract
Herpes simplex virus is a common causative agent of oral and genital diseases. Novel vaccines and therapeutics are needed to combat herpes infections especially after the failure of subunit vaccines in human clinical trials. We have shown that the live-attenuated HSV-1 VC2 vaccine strain is unable to establish latency in vaccinated animals and produces a robust immune response capable of completely protecting mice against lethal vaginal HSV-1 or HSV-2 infections. The guinea pig represents the best small animal model of genital HSV-2 disease. Reported here, twenty-one female Hartley guinea pigs received intramuscular injection with either the VC2 vaccine, or equal volume of conditioned tissue culture media. Animals received 2 booster vaccinations at 21 day intervals following the initial vaccination. After vaccination, animals were challenged with the highly virulent HSV-2 (G) strain. Histologically, VC2 vaccinated animals had little to no apparent inflammation/disease following challenge. Unvaccinated animals developed moderate to severe erosive and ulcerative vaginitis. Quantitative reverse-transcriptase PCR analysis in VC2 vaccinated and challenged animals identified transcriptional signatures of Th17 and regulatory Tr1 cells associated with the inflammatory response primed by VC2 vaccination. Treatment of cultured human vaginal epithelial cells (VK2 cells) with a combination of IL-17A and IL-22 resulted in the significant induction of beta-defensin 3 expression. Further, treatment of VK2 cells with IL-17A, IL-22, IL-36 or beta-defensin 3 resulted in diminished HSV-2 replication. Overall, these results suggest that intramuscular vaccination with the live-attenuated vaccine VC2 primes a mucosal immune response predisposing the adaptive expression of transcripts associated with a Th17 response to challenge and these responses contribute to antiviral immunity.
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Affiliation(s)
- Brent A Stanfield
- Department of Pathobiological Sciences and Division of Biotechnology and Molecular Medicine, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Paul J F Rider
- Department of Pathobiological Sciences and Division of Biotechnology and Molecular Medicine, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA
| | - John Caskey
- Department of Pathobiological Sciences and Division of Biotechnology and Molecular Medicine, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Fabio Del Piero
- Department of Pathobiological Sciences and Division of Biotechnology and Molecular Medicine, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Konstantin G Kousoulas
- Department of Pathobiological Sciences and Division of Biotechnology and Molecular Medicine, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA.
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Rizzi M, Trevisan R. Genitourinary infections in diabetic patients in the new era of diabetes therapy with sodium-glucose cotransporter-2 inhibitors. Nutr Metab Cardiovasc Dis 2016; 26:963-970. [PMID: 27514605 DOI: 10.1016/j.numecd.2016.07.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 07/06/2016] [Accepted: 07/07/2016] [Indexed: 12/11/2022]
Abstract
AIMS To review prevalence and significance of urinary tract (UTI) and genital infections (GI) in diabetes and the effects of sodium glucose cotransporter 2 (SGLT-2) inhibitors on these complications. DATA SYNTHESIS The prevalence of asymptomatic bacteriuria (ASB) is 2-3 times higher in diabetic than in non-diabetic women. The treatment of ASB has no impact on the development of UTIs and/or a decline in renal function. Therefore, there is no indication for screening for and/or treatment of ASB. The incidence of UTI is higher and frequently complicated in diabetic patients, particularly in those with longer duration of disease and of older age. There is no consistent evidence of an association between A1c levels, glycosuria and the risk of ASB and/or UTIs. Diabetes is a known risk factor for Candida colonization and GI, and a poor glycemic control is associated with a higher risk. While patients treated with SGLT-2 inhibitors may have a non-significant increased risk of UTI, they have a clearly increased risk of GI; most of these infections are mild, easy to treat, and the rate of recurrence is low. CONCLUSION Diabetic patients are at high risk of UTIs and of GI. Only GI are associated with poor glycemic control. Although patients treated with SGLT-2 inhibitors have an increased 3-5 fold risk of GI, proper medical education can reduce this risk.
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Affiliation(s)
- M Rizzi
- Infectious Diseases Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - R Trevisan
- Endocrinology and Diabetes Unit, ASST Papa Giovanni XXIII, Bergamo, Italy.
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19
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Ahmadi A, Khodabandehloo M, Ramazanzadeh R, Farhadifar F, Roshani D, Ghaderi E, Farhangi N. The Relationship between Chlamydia trachomatis Genital Infection and Spontaneous Abortion. J Reprod Infertil 2016; 17:110-6. [PMID: 27141466 PMCID: PMC4842232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Chlamydia trachomatis is the etiology of most of sexually transmitted diseases. Colonization of C. trachomatis in the genital tract during early gestation has been associated with preterm birth, and preterm premature rupture of the membranes. The role of C. trachomatis on spontaneous abortion has not yet been proved completely. The aim of this study was to evaluate the frequency of C. trachomatis infection among pregnant women and its association with spontaneous abortion. METHODS This case-control study was conducted from August 2012 until January 2013. Totally, 218 women were included; 109 women with spontaneous abortion with gestation age between 10-20 weeks (cases), and 109 women with normal pregnancy with gestation age between 20-30 weeks (controls) in Sanandaj, Iran. DNA was extracted from endocervical swabs and a PCR test was conducted for detection of C. trachomatis infection in women using specific primers. Independent T-test and Chi-square were used for comparison of quantitative and qualitative variables, respectively, and p<0.05 was considered significant. RESULTS The total prevalence of C. trachomatis infection was 38(17.43%) in endocervical swabs of women. However, the number of cases with C. trachomatis infections was 25 out of 109(22.9%) in the case group and 13 out of 109(11.9%) in control group, respectively. Association between chlamydia infection and spontaneous abortion was statistically significant (OR=2.198, CI 95%: 1.058-4.56). CONCLUSION Our study showed that C. trachomatis infection was associated with spontaneous abortion. Thus, screening and treatment of pregnant women may prevent this adverse pregnancy outcome.
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Affiliation(s)
- Amjad Ahmadi
- Department of Microbiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran,Cellular and Molecular Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mazaher Khodabandehloo
- Department of Microbiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran,Cellular and Molecular Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran,Corresponding Author: Mazaher Khodabandehloo, Department of Microbiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Pasdaran Boulevard, Sanandaj, Iran, Postal Box: 66177-13446, E-mail:
| | - Rashid Ramazanzadeh
- Department of Microbiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran,Cellular and Molecular Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Fariba Farhadifar
- Department of Obstetrics and Gynecology, Social Determinant of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Daem Roshani
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ebrahim Ghaderi
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Niloofar Farhangi
- Be’sat Hospital, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Abstract
In type 2 diabetes (T2DM), glycaemic control delays the development and slows the progression of complications. Although there are numerous glucose-lowering agents in clinical use, only approximately half of T2DM patients achieve glycaemic control, while undesirable side-effects, such as hypoglycaemia and body weight gain, often impede treatment in those taking these medications. Thus, there is a need for novel agents and treatment options. Sodium-glucose cotransporter-2 inhibitors (SGLT-2-i) have recently been developed for the treatment of T2DM. The available data suggest a good tolerability profile for the three available drugs - canagliflozin, dapagliflozin and empagliflozin - approved by the US Food and Drug Administration (FDA) for the American market as well as in other countries. The most frequently reported adverse events with SGLT-2-i are female genital mycotic infections, urinary tract infections and increased urination. The pharmacodynamic response to SGLT-2-i declines with increasing severity of renal impairment, requiring dosage adjustments or restrictions with moderate-to-severe renal dysfunction. Most patients treated with SGLT-2-i also have a modest reduction in blood pressure and modest effects on serum lipid profiles, some of which are beneficial (increased high-density lipoprotein cholesterol and decreased triglycerides) and others which are not (increased low-density lipoprotein cholesterol, LDL-C). A number of large-scale and longer-term cardiovascular trials are now ongoing. In patients treated with dapagliflozin, a non-significant excess number of breast and bladder cancers has been reported; considered as due to a bias, this is nevertheless being followed in the ongoing trials. No other significant safety issues have been reported so far. Although there is some benefit for several cardiovascular risk factors such as HbA1c, high blood pressure, obesity and increases in LDL-C, adequately powered trials are still required to determine the effects of SGLT-2-i on macrovascular outcomes.
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Affiliation(s)
- S Halimi
- Scientific University Joseph-Fourier, and Diabetology Department Pavillon les Écrins, BP 217X, University Hospital Grenoble, 38043 Grenoble Cedex, France
| | - B Vergès
- Department of Endocrinology and Diabetology, University Hospital Dijon, and INSERM CRI 866, Dijon, France
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Wagner M, Bennetts L, Patel H, Welner S, de Sanjose S, Weiss TW. Global availability of data on HPV genotype-distribution in cervical, vulvar and vaginal disease and genotype-specific prevalence and incidence of HPV infection in females. Infect Agent Cancer 2015; 10:13. [PMID: 25987893 PMCID: PMC4435914 DOI: 10.1186/s13027-015-0008-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 04/15/2015] [Indexed: 02/08/2023] Open
Abstract
Background Country-level HPV genotyping data may be sought by decision-makers to gauge the genotype-specific burden of HPV-related diseases in their jurisdiction and assess the potential impact of HPV vaccines. We investigated, by country, the availability of published literature on HPV genotypes in cervical, vaginal and vulvar cancers and intraepithelial neoplasms (CINs, VaINs and VINs) and on prevalence and incidence of genital HPV infections among women without clinically manifest disease. Findings Primary sources of publications were the PubMed/Medline and EMBASE databases. Original studies or meta-analyses published from 2000, covering genotypes 16 and 18 and at least one of genotypes 31/33/45/52/58, were included. Key exclusion criteria were language not English, cervical lesions not histologically confirmed (cytology only), special populations (e.g., immunocompromised) and, for cervical studies, small population (<50). A total of 727 studies reporting HPV genotype-specific data were identified: 366 for cervical cancers and CINs, 43 for vulvar or vaginal cancers and VINs/VaINs, and 395 and 21 for infection prevalence and incidence, respectively, in general female population samples. A large proportion of studies originated from a small set of countries. Cervical cancer/CIN typing data was scarce for several regions with the highest cervical cancer burden, including Eastern, Middle and Western Africa, Central America, South-East Asia, South Asia, and Eastern Europe. Data for vulvar/vaginal disease was limited outside of Europe and North America. Conclusions Although a large body of published HPV genotype-specific data is currently available, data gaps exist for genotype-specific infection incidence and several world regions with the highest cervical cancer burden. Electronic supplementary material The online version of this article (doi:10.1186/s13027-015-0008-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | - Silvia de Sanjose
- Cancer Epidemiology Research Program, Institut Català d'Oncologia-Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain ; CIBER en Epidemiología y Salud Pública, Barcelona, Spain
| | - Thomas W Weiss
- Merck Center for Observational and Real-World Evidence, West Point, PA USA
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Uyangaa E, Choi JY, Ryu HW, Oh SR, Eo SK. Anti-herpes Activity of Vinegar-processed Daphne genkwa Flos Via Enhancement of Natural Killer Cell Activity. Immune Netw 2015; 15:91-9. [PMID: 25922598 PMCID: PMC4411514 DOI: 10.4110/in.2015.15.2.91] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 03/17/2015] [Accepted: 03/25/2015] [Indexed: 01/06/2023] Open
Abstract
Herpes simplex virus (HSV) is a common causative agent of genital ulceration and can lead to subsequent neurological disease in some cases. Here, using a genital infection model, we tested the efficacy of vinegar-processed flos of Daphne genkwa (vp-genkwa) to modulate vaginal inflammation caused by HSV-1 infection. Our data revealed that treatment with optimal doses of vp-genkwa after, but not before, HSV-1 infection provided enhanced resistance against HSV-1 infection, as corroborated by reduced mortality and clinical signs. Consistent with these results, treatment with vp-genkwa after HSV-1 infection reduced viral replication in the vaginal tract. Furthermore, somewhat intriguingly, treatment of vp-genkwa after HSV-1 infection increased the frequency and absolute number of CD3-NK1.1+NKp46+ natural killer (NK) cells producing interferon (IFN)-γ and granyzme B, which indicates that vp-genkwa treatment induces the activation of NK cells. Supportively, secreted IFN-γ was detected at an increased level in vaginal lavages of mice treated with vp-genkwa after HSV-1 infection. These results indicate that enhanced resistance to HSV-1 infection by treatment with vp-genkwa is associated with NK cell activation. Therefore, our data provide a valuable insight into the use of vp-genkwa to control clinical severity in HSV infection through NK cell activation.
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Affiliation(s)
- Erdenebileg Uyangaa
- College of Veterinary Medicine and Bio-Safety Research Institute, Specialized Campus, Chonbuk National University, Iksan 570-752, Korea
| | - Jin Young Choi
- College of Veterinary Medicine and Bio-Safety Research Institute, Specialized Campus, Chonbuk National University, Iksan 570-752, Korea
| | - Hyung Won Ryu
- Natural Medicine Research Center, KRIBB, Chungbuk 363-883, Korea
| | - Sei-Ryang Oh
- Natural Medicine Research Center, KRIBB, Chungbuk 363-883, Korea
| | - Seong Kug Eo
- College of Veterinary Medicine and Bio-Safety Research Institute, Specialized Campus, Chonbuk National University, Iksan 570-752, Korea. ; Department of Bioactive Materials Sciences, Graduate School, Chonbuk National University, Jeonju 561-756, Korea
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Mikhail N. Place of sodium-glucose co-transporter type 2 inhibitors for treatment of type 2 diabetes. World J Diabetes 2014; 5:854-859. [PMID: 25512787 PMCID: PMC4265871 DOI: 10.4239/wjd.v5.i6.854] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 07/19/2014] [Accepted: 08/29/2014] [Indexed: 02/05/2023] Open
Abstract
Inhibitors of sodium-glucose co-transporter type 2 (SGLT2), such as canagliflozin and dapagliflozin, are recently approved for treatment of type 2 diabetes. These agents lower blood glucose mainly by increasing urinary glucose excretion. Compared with placebo, SGLT2 inhibitors reduce hemoglobin A1c (HbA1c) levels by an average of 0.5%-0.8% when used as monotherapy or add-on therapy. Advantages of this drug class include modest weight loss of approximately 2 kg, low risk of hypoglycemia, and decrease blood pressure of approximately 4 mmHg systolic and 2 mmHg diastolic. These characteristics make these agents potential add-on therapy in patients with HbA1c levels close to 7%-8.0%, particularly if these patients are obese, hypertensive, and/or prone for hypoglycemia. Meanwhile, these drugs are limited by high frequency of genital mycotic infections. Less common adverse effects include urinary tract infections, hypotension, dizziness, and worsening renal function. SGLT2 inhibitors should be used with caution in the elderly because of increased adverse effects, and should not be used in chronic kidney disease due to decreased or lack of efficacy and nephrotoxicity. Overall, SGLT2 inhibitors are useful addition for treatment of select groups of patients with type 2 diabetes, but their efficacy and safety need to be established in long-term clinical trials.
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Bhat FA, Bhattacharyya HK, Hussain SA. White side test: A simple and rapid test for evaluation of nonspecific bacterial genital infections of repeat breeding cattle. Vet Res Forum 2014; 5:177-80. [PMID: 25568715 PMCID: PMC4279644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 01/26/2014] [Accepted: 09/15/2014] [Indexed: 11/29/2022]
Abstract
The objective of the present study was to determine the grades of nonspecific bacterial infection of genitalia of repeat breeding cattle by a simple and rapid test under field condition. For this purpose, a total of 100 crossbred Jersey cows comprising of 80 repeat breeding animals presented for treatment and 20 normal cyclic (control group) animals presented for artificial insemination at their first service were selected. Estrual cervical mucus from all the animals was collected at 8 to 12 hr after the onset of behavioral estrus and subjected to white side test (WST) and bacteriological examination. The results of WST showed only 15% of control group had infection but the remaining 85% were free of it. In contrast, the majority of repeat breeding animals (57/80) showed infection (71.25%) and only 28.75% animals were free of infection. In bacterial culture, 60 (75.00%) from the 80 repeat breeding animals were found positive, and 20 (25.00%) were free of bacteria. All the three samples of control group that showed no color reaction in WST had also no growth in bacterial culture. The WST results showed a positive (p < 0.01) correlation of 0.48 with bacterial culture. It is thus concluded that under field condition WST can be used as a prime modality for ascertaining nonspecific bacterial infection of repeat breeding cattle before subjecting them to any antibiotic therapy thereby reducing the cost of diagnosis and treatment.
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Affiliation(s)
- Fayaz Ahmad Bhat
- Department of Animal Reproduction, Gynecology and Obstetrics, Faculty of Veterinary Sciences and Animal Husbandry, Sher-e-Kashmir University of Agricultural Sciences and Technology of Kashmir, Shuhama-Alusteng, Srinagar, Jammu and Kashmir, India;
| | - Hiranya Kumar Bhattacharyya
- Farm Science Centre, Assam Agricultural University, Dibrugarh, Assam, India; ,Correspondence: Hiranya Kumar Bhattacharyya. MVSc, PhD, Farm Science Centre, Assam Agricultural University, Dibrugarh, Assam, India. E-mail:
| | - Syed Akram Hussain
- Department of Veterinary Public Health, Faculty of Veterinary Sciences and Animal Husbandry, Sher-e-Kashmir University of Agricultural Sciences and Technology of Kashmir, Shuhama-Alusteng, Srinagar, Jammu and Kashmir, India.
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Church DL, Zentner A, Semeniuk H, Henderson E, Read R. Reasons for testing women for genital Chlamydia trachomatis infection in the Calgary region. Can J Infect Dis 2003; 14:35-40. [PMID: 18159423 DOI: 10.1155/2003/682345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2001] [Accepted: 02/19/2002] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To determine the clinical reason(s) for screening women with varying degrees of risk for genital Chlamydia trachomatis (CT) in the Calgary region. DESIGN Women aged 15 to 75 years were enrolled at various patient care locations. Pertinent risk factors for genital CT infection were recorded and a gynecological examination was performed. Two endocervical swabs and a first-void urine sample were collected for CT detection using two different nucleic acid amplification test methods. SETTING Calgary is an urban region that provides healthcare services to a population of almost one million people. Microbiology services are provided by Calgary Laboratory Services through a centralized regional laboratory service. MAIN RESULTS 504 women with a mean age of 28.1 +/-SD 8.22 years were enrolled. Two hundred ninety-one women (57.8%) were at high risk for acquiring genital CT infection. Twenty-eight (5.6%) tested positive for CT infection and almost all of these women (26 of 28, 93%) had risk factors for acquiring infection. Of the high-risk women, 9.8% were CT positive versus only 1.3% of women at low risk (P=0.0001). Only two of 152 (1.3%) women older than 30 years had genital CT infections. Although most women were asymptomatic, those with laboratory-confirmed CT infection were more likely to have genitourinary symptoms. Three hundred forty-three of 476 (72%) women who did not have genital CT infection had no risk factors, and screening was done as part of a routine gynecological examination for other purposes (prenatal visit, Pap smear). CONCLUSION Women without risk factors are being screened routinely for genital CT infection as part of a routine gynecological examination done for other reasons. Elimination of the routine screening of low-risk women older than 30 years of age would decrease the current regional utilization of CT tests by as much as one-third.
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