DOCSLIB.ORG

Sexually Transmitted Diseases Treatment Guidelines, 2010

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Sexually Transmitted Diseases Treatment Guidelines, 2010 Morbidity and Mortality Weekly Report www.cdc.gov/mmwr Recommendations and Reports December 17, 2010 / Vol. 59 / No. RR-12 Sexually Transmitted Diseases Treatment Guidelines, 2010 department of health and human services Centers for Disease Control and Prevention MMWR CONTENTS The MMWR series of publications is published by the Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Introduction .............................................................................. 1 Disease Control and Prevention (CDC), U.S. Department of Health Methods ................................................................................... 1 and Human Services, Atlanta, GA 30333. Clinical Prevention Guidance ..................................................... 2 STD/HIV Prevention Counseling ............................................... 2 Suggested Citation: Centers for Disease Control and Prevention. [Title]. MMWR 2010;59(No. RR-#):[inclusive page numbers]. Prevention Methods ................................................................ 4 Partner Management .............................................................. 7 Centers for Disease Control and Prevention Reporting and Confidentiality .................................................. 8 Thomas R. Frieden, MD, MPH Special Populations ................................................................... 8 Director Pregnant Women ................................................................... 8 Harold W. Jaffe, MD, MA Adolescents .......................................................................... 10 Associate Director for Science Children .............................................................................. 11 James W. Stephens, PhD Persons in Correctional Facilities ............................................ 11 Office of the Associate Director for Science Men Who Have Sex with Men ............................................... 12 Stephen B. Thacker, MD, MSc Women Who Have Sex with Women .................................... 13 Deputy Director for HIV Infection: Detection, Counseling, and Referral ..................... 14 Surveillance, Epidemiology, and Laboratory Services Diseases Characterized by Genital, Anal, or Perianal Ulcers ...... 18 Stephanie Zaza, MD, MPH Chancroid............................................................................ 19 Director, Epidemiology and Analysis Program Office Genital HSV Infections .......................................................... 20 Granuloma Inguinale (Donovanosis) ...................................... 25 Editorial and Production Staff Lymphogranuloma Venereum ................................................ 26 Ronald L. Moolenaar, MD, MPH Syphilis ................................................................................ 26 Editor, MMWR Series Congenital Syphilis ............................................................ 36 Christine G. Casey, MD Management of Persons Who Have a History of Penicillin Allergy . 39 Deputy Editor, MMWR Series Diseases Characterized by Urethritis and Cervicitis .................... 40 Teresa F. Rutledge Urethritis ............................................................................. 40 Managing Editor, MMWR Series Nongonococcal Urethritis ..................................................... 41 David C. Johnson Cervicitis .............................................................................. 43 Lead Technical Writer-Editor Chlamydial Infections .............................................................. 44 Rachel J. Wilson Gonococcal Infections .............................................................. 49 Project Editor Diseases Characterized by Vaginal Discharge ........................... 56 Martha F. Boyd Bacterial Vaginosis ............................................................... 56 Lead Visual Information Specialist Trichomoniasis ..................................................................... 58 Malbea A. LaPete Vulvovaginal Candidiasis ...................................................... 61 Stephen R. Spriggs Pelvic Inflammatory Disease .................................................... 63 Terraye M. Starr Epididymitis ............................................................................ 67 Visual Information Specialists Human Papillomavirus (HPV) Infection ...................................... 69 Quang M. Doan, MBA Genital Warts ......................................................................... 70 Phyllis H. King Cervical Cancer Screening for Women Who Attend STD Clinics Information Technology Specialists or Have a History of STDs ....................................................... 74 Vaccine-Preventable STDs ........................................................ 78 Editorial Board Hepatitis A ........................................................................... 78 William L. Roper, MD, MPH, Chapel Hill, NC, Chairman Hepatitis B ........................................................................... 80 Hepatitis C .............................................................................. 85 Virginia A. Caine, MD, Indianapolis, IN Proctitis, Proctocolitis, and Enteritis ........................................... 87 Jonathan E. Fielding, MD, MPH, MBA, Los Angeles, CA Ectoparasitic Infections ............................................................. 88 David W. Fleming, MD, Seattle, WA Pediculosis Pubis .................................................................. 88 William E. Halperin, MD, DrPH, MPH, Newark, NJ Scabies ................................................................................ 89 King K. Holmes, MD, PhD, Seattle, WA Sexual Assault and STDs .......................................................... 90 Deborah Holtzman, PhD, Atlanta, GA References .............................................................................. 96 John K. Iglehart, Bethesda, MD Terms and Abbreviations Used in This Report .......................... 109 Dennis G. Maki, MD, Madison, WI Patricia Quinlisk, MD, MPH, Des Moines, IA Patrick L. Remington, MD, MPH, Madison, WI Barbara K. Rimer, DrPH, Chapel Hill, NC John V. Rullan, MD, MPH, San Juan, PR William Schaffner, MD, Nashville, TN Anne Schuchat, MD, Atlanta, GA Dixie E. Snider, MD, MPH, Atlanta, GA John W. Ward, MD, Atlanta, GA Vol. 59 / RR-12 Recommendations and Reports 1 Sexually Transmitted Diseases Treatment Guidelines, 2010 Prepared by Kimberly A. Workowski, MD1,2 Stuart Berman, MD1 1Division of STD Prevention National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention 2Emory University, Atlanta, Georgia Summary These guidelines for the treatment of persons who have or are at risk for sexually transmitted diseases (STDs) were updated by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on April 18–30, 2009. The information in this report updates the 2006 Guidelines for Treatment of Sexually Transmitted Diseases (MMWR 2006;55[No. RR–11]). Included in these updated guidelines is new information regarding 1) the expanded diagnostic evaluation for cervicitis and trichomoniasis; 2) new treatment recommendations for bacterial vaginosis and genital warts; 3) the clinical efficacy of azithromycin for chlamydial infections in pregnancy; 4) the role of Mycoplasma genitalium and trichomoniasis in urethritis/cervicitis and treatment-related implications; 5) lymphogranuloma venereum proctocolitis among men who have sex with men; 6) the criteria for spinal fluid examination to evaluate for neurosyphilis; 7) the emergence of azithromycin-resistant Treponema pallidum; 8) the increasing prevalence of antimicrobial-resistant Neisseria gonorrhoeae; 9) the sexual transmission of hepatitis C; 10) diagnostic evaluation after sexual assault; and 11) STD prevention approaches. Introduction Methods The term sexually transmitted diseases (STDs) is used to These guidelines were developed using a multistage refer to a variety of clinical syndromes caused by pathogens process. Beginning in 2008, CDC staff members and public that can be acquired and transmitted through sexual activity. and private sector experts knowledgeable in the field of STDs Physicians and other health-care providers play a critical role in systematically reviewed literature using an evidence-based preventing and treating STDs. These guidelines for the treat- approach (e.g., published abstracts and peer-reviewed journal ment of STDs are intended to assist with that effort. Although articles), focusing on the common STDs and information that these guidelines emphasize treatment, prevention strategies and had become available since publication of the 2006 Guidelines diagnostic recommendations also are discussed. for Treatment of Sexually Transmitted Diseases (1). CDC staff These recommendations should be regarded as a source of members and STD experts developed background papers and clinical guidance and not prescriptive standards; health-care tables of evidence that summarized the type of study (e.g., providers should always consider the clinical circumstances of randomized controlled trial or case series), study population each person in the context of local disease prevalence. They are and setting, treatments or other interventions, outcome applicable to various patient-care settings, including family- measures assessed, reported findings, and weaknesses and biases planning clinics, private physicians’ offices, managed care orga- in study design and analysis. CDC staff then developed
Load more

Recommended publications
  • The Male Reproductive System
    Management of Men’s Reproductive 3 Health Problems Men’s Reproductive Health Curriculum Management of Men’s Reproductive 3 Health Problems © 2003 EngenderHealth. All rights reserved. 440 Ninth Avenue New York, NY 10001 U.S.A. Telephone: 212-561-8000 Fax: 212-561-8067 e-mail: [email protected] www.engenderhealth.org This publication was made possible, in part, through support provided by the Office of Population, U.S. Agency for International Development (USAID), under the terms of cooperative agreement HRN-A-00-98-00042-00. The opinions expressed herein are those of the publisher and do not necessarily reflect the views of USAID. Cover design: Virginia Taddoni ISBN 1-885063-45-8 Printed in the United States of America. Printed on recycled paper. Library of Congress Cataloging-in-Publication Data Men’s reproductive health curriculum : management of men’s reproductive health problems. p. ; cm. Companion v. to: Introduction to men’s reproductive health services, and: Counseling and communicating with men. Includes bibliographical references. ISBN 1-885063-45-8 1. Andrology. 2. Human reproduction. 3. Generative organs, Male--Diseases--Treatment. I. EngenderHealth (Firm) II. Counseling and communicating with men. III. Title: Introduction to men’s reproductive health services. [DNLM: 1. Genital Diseases, Male. 2. Physical Examination--methods. 3. Reproductive Health Services. WJ 700 M5483 2003] QP253.M465 2003 616.6’5--dc22 2003063056 Contents Acknowledgments v Introduction vii 1 Disorders of the Male Reproductive System 1.1 The Male
    [Show full text]
  • Genital Ulcers and Swelling in an Adolescent Girl
    PHOTO CHALLENGE Genital Ulcers and Swelling in an Adolescent Girl Meghan E. Ryan, DO; Pui-Ying Iroh Tam, MD A 14-year-old previously healthy, postmenarcheal adolescent girl with a family history of thyroid dis- ease and rheumatoid arthritis presented with vulvar pain and swelling. Vulvar pruritus was noted 6 days prior, which worsened and became associated with vulvar swelling, yellow vaginal discharge, dif- ficulty walking, and a fever (temperature, 39.3°C). Her condition did not improve after a course of cephalexin andcopy trimethoprim-sulfamethoxazole. She denied being sexually active or exposing for- eign objects or chemicals to the vaginal area. not WHAT’S THE DIAGNOSIS? a. Behçet disease Dob. candida c. chlamydia d. Epstein-Barr virus e. herpes simplex virus PLEASE TURN TO PAGE E5 FOR THE DIAGNOSIS CUTIS Dr. Ryan was from Des Moines University College of Osteopathic Medicine, Iowa. Dr. Ryan currently is from and Dr. Iroh Tam is from the University of Minnesota Masonic Children’s Hospital, Minneapolis. Dr. Iroh Tam is from the Department of Pediatric Infectious Diseases and Immunology. The authors report no conflict of interest. Correspondence: Pui-Ying Iroh Tam, MD, 3-210 MTRF, 2001 6th St SE, Minneapolis, MN 55455 ([email protected]). E4 I CUTIS® WWW.CUTIS.COM Copyright Cutis 2017. No part of this publication may be reproduced, stored, or transmitted without the prior written permission of the Publisher. PHOTO CHALLENGE DISCUSSION THE DIAGNOSIS: Epstein-Barr Virus hysical examination revealed bilateral 1-cm ulcer- is the assumed etiology of genital ulcers, especially in ated lesions on the labia minora with vulvar edema sexually active patients, and misdiagnosis in the setting of P(Figure).
    [Show full text]
  • COVID-19) Pandemic on National Antimicrobial Consumption in Jordan
    antibiotics Article An Assessment of the Impact of Coronavirus Disease (COVID-19) Pandemic on National Antimicrobial Consumption in Jordan Sayer Al-Azzam 1, Nizar Mahmoud Mhaidat 1, Hayaa A. Banat 2, Mohammad Alfaour 2, Dana Samih Ahmad 2, Arno Muller 3, Adi Al-Nuseirat 4 , Elizabeth A. Lattyak 5, Barbara R. Conway 6,7 and Mamoon A. Aldeyab 6,* 1 Clinical Pharmacy Department, Jordan University of Science and Technology, Irbid 22110, Jordan; [email protected] (S.A.-A.); [email protected] (N.M.M.) 2 Jordan Food and Drug Administration (JFDA), Amman 11181, Jordan; [email protected] (H.A.B.); [email protected] (M.A.); [email protected] (D.S.A.) 3 Antimicrobial Resistance Division, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland; [email protected] 4 World Health Organization Regional Office for the Eastern Mediterranean, Cairo 11371, Egypt; [email protected] 5 Scientific Computing Associates Corp., River Forest, IL 60305, USA; [email protected] 6 Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK; [email protected] 7 Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield HD1 3DH, UK * Correspondence: [email protected] Citation: Al-Azzam, S.; Mhaidat, N.M.; Banat, H.A.; Alfaour, M.; Abstract: Coronavirus disease 2019 (COVID-19) has overlapping clinical characteristics with bacterial Ahmad, D.S.; Muller, A.; Al-Nuseirat, respiratory tract infection, leading to the prescription of potentially unnecessary antibiotics. This A.; Lattyak, E.A.; Conway, B.R.; study aimed at measuring changes and patterns of national antimicrobial use for one year preceding Aldeyab, M.A.
    [Show full text]
  • In Silico Methods for Drug Repositioning and Drug-Drug Interaction Prediction
    In silico Methods for Drug Repositioning and Drug-Drug Interaction Prediction Pathima Nusrath Hameed ORCID: 0000-0002-8118-9823 Submitted in total fulfilment of the requirements for the degree of Doctor of Philosophy Department of Mechanical Engineering THE UNIVERSITY OF MELBOURNE May 2018 Copyright © 2018 Pathima Nusrath Hameed All rights reserved. No part of the publication may be reproduced in any form by print, photoprint, microfilm or any other means without written permission from the author. Abstract Drug repositioning and drug-drug interaction (DDI) prediction are two fundamental ap- plications having a large impact on drug development and clinical care. Drug reposi- tioning aims to identify new uses for existing drugs. Moreover, understanding harmful DDIs is essential to enhance the effects of clinical care. Exploring both therapeutic uses and adverse effects of drugs or a pair of drugs have significant benefits in pharmacology. The use of computational methods to support drug repositioning and DDI prediction en- able improvements in the speed of drug development compared to in vivo and in vitro methods. This thesis investigates the consequences of employing a representative training sam- ple in achieving better performance for DDI classification. The Positive-Unlabeled Learn- ing method introduced in this thesis aims to employ representative positives as well as reliable negatives to train the binary classifier for inferring potential DDIs. Moreover, it explores the importance of a finer-grained similarity metric to represent the pairwise drug similarities. Drug repositioning can be approached by new indication detection. In this study, Anatomical Therapeutic Chemical (ATC) classification is used as the primary source to determine the indications/therapeutic uses of drugs for drug repositioning.
    [Show full text]
  • Treating Opportunistic Infections Among HIV-Infected Adults and Adolescents
    Morbidity and Mortality Weekly Report Recommendations and Reports December 17, 2004 / Vol. 53 / No. RR-15 Treating Opportunistic Infections Among HIV-Infected Adults and Adolescents Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association/ Infectious Diseases Society of America INSIDE: Continuing Education Examination department of health and human services Centers for Disease Control and Prevention MMWR CONTENTS The MMWR series of publications is published by the Epidemiology Program Office, Centers for Disease Introduction......................................................................... 1 Control and Prevention (CDC), U.S. Department of How To Use the Information in This Report .......................... 2 Health and Human Services, Atlanta, GA 30333. Effect of Antiretroviral Therapy on the Incidence and Management of OIs .................................................... 2 SUGGESTED CITATION Initiation of ART in the Setting of an Acute OI Centers for Disease Control and Prevention. Treating (Treatment-Naïve Patients) ................................................. 3 Management of Acute OIs in the Setting of ART .................. 4 opportunistic infections among HIV-infected adults and When To Initiate ART in the Setting of an OI ........................ 4 adolescents: recommendations from CDC, the National Special Considerations During Pregnancy ........................... 4 Institutes of Health, and the HIV Medicine Association/ Disease Specific Recommendations ....................................
    [Show full text]
  • Use of Antibiotics for Cholera Chemoprevention
    Use of antibiotics for cholera chemoprevention Iza Ciglenecki, Médecins Sans Frontières GTFCC Case management meeting, 2018 Outline of presentation • Key questions: ₋ Rationale for household prophylaxis – household contacts at higher risk? ₋ Rationale for antibiotic use? ₋ What is the effectiveness? ₋ What is the impact on the epidemic? ₋ Risk of antimicrobial resistance ₋ Feasibility during outbreak control interventions • Example: Single-dose oral ciprofloxacin prophylaxis in response to a meningococcal meningitis epidemic in the African meningitis belt: a three-arm cluster-randomized trial • Prevention of cholera infection among contacts of case: a cluster-randomized trial of Azithromycine Rationale: risk for household contacts Forest plot of studies included in meta-analysis: association of presence of household contact with cholera with symptomatic cholera Richterman et al. Individual and Household Risk Factors for Symptomatic Cholera Infection: A Systematic Review and Meta-analysis. JID 2018 Rationale: clustering of cholera cases in time and space Relative risk for cholera among case cohorts compared with control cohorts at different spatio-temporal scales Living within 50 m of the index case: RR 36 (95% CI: 23–56) within 3 days of the index case presenting to the hospital Debes et al. Cholera cases cluster in time and space in Matlab, Bangladesh: implications for targeted preventive interventions. Int J Epid 2016 Rationale: clustering of cholera cases in time and space Relative risk of next cholera case occuring at different distances from primary case Relative risk of next cholera case being within specific distance to another case within days 0-4 Within 40 m: Ndjamena: RR 32.4 (95% 25-41) Kalemie: RR 121 (95% CI 90-165) Azman et al.
    [Show full text]
  • Final Decisions & Reasons for Decisions by Delegates of the Secretary to the Department of Health
    Final decisions & reasons for decisions by delegates of the Secretary to the Department of Health 29 June 2017 (ACMS and ACCS meetings – March 2017) Notice under subsections 42ZCZS/42ZCZX of the Therapeutic Goods Regulations 1990 (the Regulations) The delegates of the Secretary to the Department of Health hereby give notice of delegates’ final decisions for amending the Poisons Standard (commonly referred to as the Standard for the Uniform Scheduling of Medicines and Poisons - SUSMP) under subsections 42ZCZS/42ZCZX of the Therapeutic Goods Regulations 1990 (the Regulations). This notice also provides the reasons for each decision and the date of effect (implementation date) of the decision. The delegates’ final decisions and reasons relate to: · scheduling proposals initially referred to the March 2017 meeting of the Advisory Committee on Medicines Scheduling (ACMS#20); · scheduling proposals initially referred to the March 2017 Joint meeting of the Advisory Committees on Chemicals and Medicines Scheduling (ACCS-ACMS#15); · scheduling proposals initially referred to the March 2017 meeting of the Advisory Committee on Chemicals Scheduling (ACCS#19); and · scheduling proposals considered as delegate-only matters, i.e. not referred to an expert advisory committee. Scheduling proposals referred to the expert advisory committees. Pre-meeting public notices On 22 December 2016 and 3 February 2017, under subsection 42ZCZK of the Therapeutic Goods Regulations 1990 (the Regulations), the delegate published pre-meeting public notices on the TGA website which specified the proposed amendments to the current Poisons Standard. The notices also invited public comment on the scheduling proposals referred to the expert advisory committees. The pre-meeting consultation periods were open for public comment for 20 business days and closed on 10 February 2017 and 3 March 2017, respectively.
    [Show full text]
  • Prediction of Premature Termination Codon Suppressing Compounds for Treatment of Duchenne Muscular Dystrophy Using Machine Learning
    Prediction of Premature Termination Codon Suppressing Compounds for Treatment of Duchenne Muscular Dystrophy using Machine Learning Kate Wang et al. Supplemental Table S1. Drugs selected by Pharmacophore-based, ML-based and DL- based search in the FDA-approved drugs database Pharmacophore WEKA TF 1-Palmitoyl-2-oleoyl-sn-glycero-3- 5-O-phosphono-alpha-D- (phospho-rac-(1-glycerol)) ribofuranosyl diphosphate Acarbose Amikacin Acetylcarnitine Acetarsol Arbutamine Acetylcholine Adenosine Aldehydo-N-Acetyl-D- Benserazide Acyclovir Glucosamine Bisoprolol Adefovir dipivoxil Alendronic acid Brivudine Alfentanil Alginic acid Cefamandole Alitretinoin alpha-Arbutin Cefdinir Azithromycin Amikacin Cefixime Balsalazide Amiloride Cefonicid Bethanechol Arbutin Ceforanide Bicalutamide Ascorbic acid calcium salt Cefotetan Calcium glubionate Auranofin Ceftibuten Cangrelor Azacitidine Ceftolozane Capecitabine Benserazide Cerivastatin Carbamoylcholine Besifloxacin Chlortetracycline Carisoprodol beta-L-fructofuranose Cilastatin Chlorobutanol Bictegravir Citicoline Cidofovir Bismuth subgallate Cladribine Clodronic acid Bleomycin Clarithromycin Colistimethate Bortezomib Clindamycin Cyclandelate Bromotheophylline Clofarabine Dexpanthenol Calcium threonate Cromoglicic acid Edoxudine Capecitabine Demeclocycline Elbasvir Capreomycin Diaminopropanol tetraacetic acid Erdosteine Carbidopa Diazolidinylurea Ethchlorvynol Carbocisteine Dibekacin Ethinamate Carboplatin Dinoprostone Famotidine Cefotetan Dipyridamole Fidaxomicin Chlormerodrin Doripenem Flavin adenine dinucleotide
    [Show full text]
  • Clindamycin with Primaquine Vs. Trimethoprim-Sulfamethoxazole
    524 Clindamycin with Primaquine vs. Trimethoprim-Sulfamethoxazole Therapy for Mild and Moderately Severe Pneumocystis carinii Pneumonia in Patients with AIDS: A Multicenter, Double-Blind, Randomized Trial (CTN 004) Emil Toma, Anona Thorne, Joel Singer, Janet Raboud, From the Department of Microbiology and Infectious Diseases, Centre Claude Lemieux, Sylvie Trottier, Michel G. Bergeron, Hospitalier de l'Universite de MontreÂal, the Immunode®ciency Chris Tsoukas, Julian Falutz, Richard Lalonde, Treatment Centre (IDTC), Montreal General Hospital, and the Royal Victoria Hospital, Montreal, and Centre Hospitalier de l'Universite du Christiane Gaudreau, Rachel Therrien, and the QueÂbec, Quebec, Quebec; and the Canadian HIV Trials Network, CTN-PCP Study Group* Vancouver, British Columbia, Canada This double-blind, randomized, multicenter trial compared clindamycin/primaquine (Cm/Prq) Downloaded from https://academic.oup.com/cid/article/27/3/524/280761 by guest on 25 September 2021 with trimethoprim-sulfamethoxazole (TMP-SMZ) as therapy for AIDS-related Pneumocystis carinii pneumonia (PCP). Forty-®ve patients received clindamycin (450 mg four times daily [q.i.d.]) and primaquine (15 mg of base/d); 42 received TMP-SMZ (320 mg/1,600 mg q.i.d. if weight of §60 kg or 240 mg/1,200 mg q.i.d. if weight of õ60 kg) plus placebo primaquine. Overall, the ef®cacy of Cm/Prq was similar to that of TMP-SMZ (success rate, 76% vs. 79%, respectively); Cm/Prq was associated with fewer adverse events (P Å .04), less steroid use (P Å .18), and more rashes (P Å .07). These differences were even greater for patients with PaO2 of ú70 mm Hg (P Å .02, P Å .04, and P Å .02, respectively).
    [Show full text]
  • Multipurpose Tenofovir Disoproxil Fumarate Electrospun Fibers for the Prevention of HIV-1 and HSV-2 Infections
    University of Louisville ThinkIR: The University of Louisville's Institutional Repository Electronic Theses and Dissertations 8-2016 Multipurpose tenofovir disoproxil fumarate electrospun fibers for the prevention of HIV-1 and HSV-2 infections. Kevin Tyo Follow this and additional works at: https://ir.library.louisville.edu/etd Part of the Other Chemicals and Drugs Commons, Polymer Chemistry Commons, Preventive Medicine Commons, and the Virus Diseases Commons Recommended Citation Tyo, Kevin, "Multipurpose tenofovir disoproxil fumarate electrospun fibers for the prevention of HIV-1 and HSV-2 infections." (2016). Electronic Theses and Dissertations. Paper 2486. https://doi.org/10.18297/etd/2486 This Master's Thesis is brought to you for free and open access by ThinkIR: The University of Louisville's Institutional Repository. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of ThinkIR: The University of Louisville's Institutional Repository. This title appears here courtesy of the author, who has retained all other copyrights. For more information, please contact [email protected]. MULTIPURPOSE TENOFOVIR DISOPROXIL FUMARATE ELECTROSPUN FIBERS FOR THE PREVENTION OF HIV-1 AND HSV-2 INFECTIONS By Kevin Tyo B.S. Virginia Tech, 2010 A Thesis Submitted to the Faculty of the School of Medicine of the University of Louisville In Partial Fulfillment of the Requirement for the Degree of Master of Science In Pharmacology and Toxicology Department of Pharmacology and Toxicology School of Medicine University of Louisville Louisville, KY August, 2016 MULTIPURPOSE TENOFOVIR DISOPROXIL FUMARATE ELECTROSPUN FIBERS FOR THE PREVENTION OF HIV-1 AND HSV-2 INFECTIONS By Kevin Tyo B.S.
    [Show full text]
  • | Tidsskrift for Den Norske Legeforening a Previously Healthy Man in His Late Forties Consulted His Doctor About a Lump in His Anus
    A man in his forties with anal tumour and inguinal lymphadenopathy NOE Å LÆRE AV SVETLANA SHARAPOVA E-mail: [email protected] Department of Gastrointestinal and Paediatric Surgery Oslo University Hospital Svetlana Sharapova, specialty registrar in general surgery and gastrointestinal surgery, and acting consultant. The author has completed the ICMJE form and declares no conflicts of interest. USHA HARTGILL Olafia Clinic Department of Venereology Oslo University Hospital Usha Hartgill, specialist in dermatological and venereal diseases, head of department and senior consultant. The author has completed the ICMJE form and declares no conflicts of interest. PREMNAATH TORAYRAJU Olafia Clinic Department of Venereology Oslo University Hospital Premnaath Torayraju, specialty registrar in the Department of Medicine at Diakonhjemmet Hospital, specialising in dermatological and venereal diseases. The author has completed the ICMJE form and declares no conflicts of interest. BETTINA ANDREA HANEKAMP Department of Radiology Oslo University Hospital Bettina Andrea Hanekamp, specialist in radiology, and senior consultant in the Section for Oncological and Abdominal Imaging. The author has completed the ICMJE form and declares no conflicts of interest. SIGURD FOLKVORD Department of Gastrointestinal and Paediatric Surgery Oslo University Hospital Sigurd Folkvord, PhD, senior consultant and specialist in gastrointestinal surgery. The author has completed the ICMJE form and declares no conflicts of interest. A man in his late forties was examined for suspected cancer of the anal canal with spreading to inguinal lymph nodes. When biopsies failed to confirm malignant disease, other differential diagnoses had to be considered. A man in his forties with anal tumour and inguinal lymphadenopathy | Tidsskrift for Den norske legeforening A previously healthy man in his late forties consulted his doctor about a lump in his anus.
    [Show full text]
  • Evidence That Coronavirus Superspreading Is Fat-Tailed BRIEF REPORT Felix Wonga,B,C and James J
    Evidence that coronavirus superspreading is fat-tailed BRIEF REPORT Felix Wonga,b,c and James J. Collinsa,b,c,d,1 aInstitute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139; bDepartment of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139; cInfectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Cambridge, MA 02142; and dWyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115 Edited by Simon A. Levin, Princeton University, Princeton, NJ, and approved September 28, 2020 (received for review September 1, 2020) Superspreaders, infected individuals who result in an outsized CoV and SARS-CoV-2 exhibited an exponential tail. We number of secondary cases, are believed to underlie a significant searched the scientific literature for global accounts of SSEs, in fraction of total SARS-CoV-2 transmission. Here, we combine em- which single cases resulted in numbers of secondary cases pirical observations of SARS-CoV and SARS-CoV-2 transmission and greater than R0, estimated to be ∼3 to 6 for both coronaviruses extreme value statistics to show that the distribution of secondary (1, 7). To broadly sample the right tail, we focused on SSEs cases is consistent with being fat-tailed, implying that large super- resulting in >6 secondary cases, and as data on SSEs are sparse, spreading events are extremal, yet probable, occurrences. We inte- perhaps due in part to a lack of data sharing, we pooled data for grate these results with interaction-based network models of disease SARS-CoV and SARS-CoV-2. Moreover, to avoid higher- transmission and show that superspreading, when it is fat-tailed, order transmission obfuscating the cases generated directly by leads to pronounced transmission by increasing dispersion.
    [Show full text]