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- Increasing HIV and Decreasing Syphilis Prevalence in a Context of Persistently High Unprotected Anal Intercourse, Six Consecutive Annual Surveys among Men Who Have Sex with Men in Guangzhou, China, 2008 to 2013. [JOURNAL ARTICLE]
- PLoS One 2014; 9(7):e103136.
Previous studies have reported a possibly increasing HIV prevalence among men who have sex with men (MSM) in China. However there have been limited systematic analyses of existing surveillance data to learn the trend of HIV prevalence and factors driving the trend. The aims of this study were to examine the trend of HIV prevalence among MSM in Guangzhou and to explore the role of unprotected anal intercourse (UAI) in the trend.Snow-ball sampling was applied in the subject recruitment for the annual serological and behavioral surveys among MSM from 2008 to 2013. Data collected in the behavioral survey include demographic information, HIV related sexual behavior with men and women, access to HIV prevention services, and symptoms of sexually transmitted infections. Chi-square test was used to analyze the trend of HIV prevalence. Multivariate logistic regression was conducted to test the factors associated with HIV infection.HIV prevalence increased significantly from 5.0% in 2008 to 11.4% in 2013 while syphilis prevalence decreased from 17.4% to 3.3% in the same period. UAI rates were high and stable in every single year, ranging from 54.5% to 62.0%. Those who were having UAI (OR = 1.80, 95% confidence interval (CI): 1.26-2.58), being migrants, having more than 10 partners, and infected with syphilis had higher risk for HIV infection.HIV epidemic is expanding in Guangzhou. The persistently high UAI may have played a major role in the increasing trend of HIV prevalence. Targeted prevention program should be conducted among MSM who are migrants, low educational level, syphilis infected, or having multiple partners to encourage HIV test and change UAI behavior. The general high UAI calls for tailored intervention program to promote healthy culture and form a safe sex social norm in the MSM community.
- [Trend on HIV prevalence and risk behaviors among men who have sex with men in China from 2010 to 2013]. [English Abstract, Journal Article]
- Zhonghua Liu Xing Bing Xue Za Zhi 2014 May; 35(5):542-6.
To understand the trends on HIV and syphilis infections, as well as on risk behaviors and intervention among MSM in China from 2010 to 2013 so as to provide information for the development of intervention strategies for MSM.Study population involved MSM who were recruited for the national HIV sentinel surveillance between 2010 and 2013. Demographic information, HIV related risk behaviors, and results on HIV and syphilis infections were described and trend analysis was performed.Between 2010 and 2013, the total number of MSM under survey was 149 848. As for sources of the studied population, 12.3% of them were from public bathrooms (Group A), 30.1% from internet (Group B), and 57.5% were others (Group C). Proportions of three groups were similar between 2010 and 2013. The proportion of always using condom in the last six months increased from 30.2% to 37.8%, from 34.7% to 42.9% and from 35.3% to 43.1% in group A, B or C (trend:P < 0.01), from 2010 to 2013. The proportion of using condom in group A was the lowest among the three groups. The prevalence rate of HIV increased from 7.8% in 2010 to 9.2% in 2013 among group A, from 5.0% in 2010 to 6.8% in 2013 among group B, from 5.6% in 2010 to 6.5% in 2013 among group C(trend:P < 0.01). The prevalence rate of syphilis decreased from 13.2% in 2010 to 9.5% in 2013 among group A, from 6.1% in 2010 to 5.7% in 2013 among group B, from 8.7% in 2010 to 6.2% in 2013 among group C (trend:P < 0.01). In this MSM population, 77.1% of them were at age 21-40, 9.4% were at age 41-50 and 2.8% were older than 50 years of age. Both the prevalence rates of HIV and syphilis were the highest-10.1% and 13.6%, among age group of over 50s, respectively.HIV prevalence among MSM increased rapidly in the last four years, especially in older age groups and from public bathrooms. More intervention efforts should be targeting on MSM with the above mentioned characters.
- [Prevalence of HIV and sexually transmitted diseases as well as related associated risk factors among middle/low level female sex workers in a city in Guangdong province]. [English Abstract, Journal Article]
- Zhonghua Liu Xing Bing Xue Za Zhi 2014 May; 35(5):510-3.
To explore the prevalence of HIV, sexually transmitted diseases (STDs) and associated factors among medium/low level female sex workers (FSWs) in an under-developed city in Guangdong province.FSWs were reached by probability proportionate to size sampling through mapping. A cross-sectional survey was conducted to investigate data on demographic characteristics, sexual behaviors, condom use and drug use. 5 ml blood samples were collected to test for human immunodeficiency virus(HIV), syphilis and HSV-2.The prevalence rates of HIV, syphilis and HSV-2 were 0.3% (2/575), 4.9% (28/575) and 30.6% (176/575) respectively, and 32.2% (185/575)for STDs. Results from multivariate unconditional logistic regression model indicated that drug use (OR = 3.91, 95% CI:1.17-13.03) was the independent risk factor for STDs infection. Risks as ever accepted intervention program (OR = 0.14, 95% CI:0.04-0.52), with higher education level (OR = 0.40, 95% CI:0.19-0.83)and medium-fee charged FSWs(OR = 0.27, 95% CI:0.09-0.79) were protective factors for STDs.Sources of STDs and related risk factors were comprehensive among medium/low FSWs, especially for the latter, whith all calling for multi-sector cooperation to explore the effective intervention program in this population.
- The pre-Anschluss Vienna School of Medicine - the physicians: Sigmund Freud (1856-1939), Julius Wagner-Jauregg (1857-1940) and Karel Wenckebach (1864-1940). [JOURNAL ARTICLE]
- J Med Biogr 2014 Jul 22.
Three physicians are discussed. Sigmund Freud, probably the best-known member of the Vienna School of Medicine, was the path-breaking pioneer in psychoanalysis and psychotherapy. Julius Wagner-Jauregg was a psychiatrist who discovered the link between iodine deficiency and goitre and also developed malaria therapy to treat progressive paralysis caused by syphilis for which he was awarded the Nobel Prize. Karel Wenckebach, the pioneering Dutch cardiologist, is best known for the Wenckebach block. After the Anschluss, fate dealt very different hands to these three physicians. Freud fled to London where he soon died. Wagner-Jauregg, who had some pan-Germanic sympathies as well as views on eugenics, left a controversial legacy. The Dutch cardiologist Wenckebach died in Vienna shortly after his homeland had been invaded in 1940 by that of his hosts.
- The Pre-Anschluss Vienna School of Medicine - The medical scientists: Karl Landsteiner (1868-1943) and Otto Loewi (1873-1961). [JOURNAL ARTICLE]
- J Med Biogr 2014 Jul 22.
Two famous medical scientists are described whose major advances were made largely from laboratory-based research. Karl Landsteiner, who received the Nobel Prize in 1930, was the discoverer or co-discoverer of the blood groups and the Rhesus factor. He contributed to the understanding of poliomyelitis, syphilis and typhus. He made major contributions to immunology, inter alia by isolating haptens. After World War I, he left Austria and continued his work initially in the Netherlands and then at the Rockefeller Institute in the USA. Otto Loewi, a pharmacologist, received his Nobel Prize (jointly with his life-long friend, Sir Henry Dale) in 1936 for his discovery that acetylcholine was the chemical agent for the stimulation of autonomic nerves to transmit to the organs they govern. He also made numerous other contributions including the demonstration that amino acids could be converted by animals to proteins. He left Austria after the Anschluss and settled in the USA.
- [Leukocyte elastase, alpha 1-proteinase inhibitor and C-reactive protein in patients with delayed negativation of serological reactions after treatment of early syphilis]. [English Abstract, Journal Article]
- Patol Fiziol Eksp Ter 2014 Jan-Mar; (1):8-12.
It was investigated the activity of leukocyte elastase, alpha 1-proteinase inhibitor and C-reactive protein in patients with delayed negativation of serological reactions after a treatment of syphilis. The patients were divided into three subgroups. The first subgroup consisted of patients who did not have the signs of non-specific immune system response. Second subgroup consisted of patients with clear signs of infection process. The patients this subgroup had elevated values of the contents of inflammatory mediators. The remaining patients with questionable results were attributed in the third subgroup. The obtained results can be of great value to determine further treatment strategy in patients with delayed negativation of serological reactions.
- Current trends in donor testing to detect syphilis infection. [Journal Article]
- Curr Infect Dis Rep 2014 Sep; 16(9):423.
Potential organ and tissue donors are tested to detect infection with T. pallidum, the etiologic agent of syphilis. Important considerations for testing potential donors include available specimen type and volume, turnaround time, and ability to distinguish between past and current infection. Aspects of syphilis infection that inform organ and tissue donor assay selection and interpretation and the principles underlying available assays are described. Serologic assays for syphilis are the methods most commonly used in donor testing. The two categories of serologic assays, treponemal and nontreponemal, have advantages and limitations for testing potential donors. Knowledge of the common syphilis-testing algorithms used in clinical diagnostic testing is useful for assay selection in the organ and tissue donor setting.
- Seroprevalence of syphilis and biologically false positive cases in a tertiary care center. [Letter]
- Indian J Dermatol Venereol Leprol 2014 Jul-Aug; 80(4):340-1.
- The Social Justice Agenda. [JOURNAL ARTICLE]
- Am J Public Health 2014 Jul 17.:e1-e3.
I do not pretend to understand the moral universe. The arc is a long one. My eye reaches but little ways. I cannot calculate the curve and complete the figure by experience of sight. I can divine it by conscience. And from what I see I am sure it bends toward justice. -Theodore Parker, 19th century abolitionist and Unitarian minister Four years ago, I wrote a chapter for a volume since published titled, "The Search for the Legacy of the USPHS Syphilis Study at Tuskegee: Reflective Essays Based Upon Findings From the Tuskegee Legacy Project."(1) (Am J Public Health. Published online ahead of print July 17, 2014: e1-e3. doi:10.2105/AJPH.2014.302127).
- Delayed Onset of the Jarisch-Herxheimer Reaction in Doxycycline-Treated Disease: A Case Report and Review of its Histopathology and Implications for Pathogenesis. [JOURNAL ARTICLE]
- Am J Dermatopathol 2014 Jul 15.
: The Jarisch-Herxheimer reaction (JHR) is a transient inflammatory syndrome triggered hours after the start of antibiotic treatment of spirochete infections, namely syphilis. Clinically, JHR manifests as an abrupt onset of constitutional symptoms and exacerbation of cutaneous lesions that resolve without intervention. JHR's pathogenesis is unclear and it is histopathologically rarely reported. Herein, the authors report a 47-year-old woman, with solitary erythema migrans and positive Lyme disease serology, who presented for medical care 14 days after commencement of doxycycline therapy. She complained of malaise, facial flushing, gingival erythema, and acquisition of additional plaques characterized by swelling, increased erythema, pruritus, and exfoliative scale. Punch biopsies demonstrated subacute to chronic spongiotic psoriasiform reaction patterns with a superficial lymphocytic infiltrate. By Borrelia-specific immunohistochemistry, spirochetes were found in the deep dermis, unassociated with inflammation, and focally in the upper spinous layer, associated with spongiosis. Borrelia burgdorferi DNA was detected by nested polymerase chain reaction. Doxycycline was discontinued, and symptoms and signs resolved within a few days. Liberation of endotoxin-like materials (eg, lipoproteins) from degenerating spirochetes and concomitant cytokine production is the suspected cause of JHR and supported by the finding of lesional spirochetes. Alternatively, a reversal reaction with a delayed-type hypersensitivity reaction is also a plausible cause based on spirochetes found in the lymphocytic spongiotic dermatitis.