Impact of Vaginal-Rectal Ultrasound Examinations with Covered and Low-Level Disinfected Transducers on Infectious Transmissions in France

2014 ◽  
Vol 35 (12) ◽  
pp. 1497-1504 ◽  
Author(s):  
Sandrine Leroy ◽  
Fatima M’Zali ◽  
Michael Kann ◽  
David J. Weber ◽  
David D. Smith
Keyword(s):  
Viral Infections ◽  
De Novo ◽  
Meta Analysis ◽  
Virus Hepatitis ◽  
Sexually Transmitted ◽  
Low Level ◽  
Number Of Patients ◽  
Simplex Virus ◽  
High Level ◽  
Vaginal Ultrasonography

Background.The risk of cross-infection from shared ultrasound probes in endorectal and vaginal ultrasonography due to low-level disinfection (LLD) is difficult to estimate because potential infections are also sexually transmitted diseases, and route of contamination is often difficult to establish. In France, the widely used standard for prevention of infections is through the use of probe covers and LLD of the ultrasound transducer by disinfectant wipes. We performed an in silico simulation based on a systematic review to estimate the number of patients infected after endorectal or vaginal ultrasonography examination using LLD for probes.Study design.We performed a stochastic Monte Carlo computer simulation to produce hypothetical cohorts for a population of 4 million annual ultrasound examinations performed in France, and we estimated the number of infected patients for human immunodeficiency virus (HIV), herpes simplex virus, hepatitis B virus, hepatitis C virus, human papilloma virus, cytomegalovirus, and Chlamydia trachomatis. Modeling parameters were estimated by meta-analysis when possible.Results.The probability of infection from a contaminated probe ranged from 1% to 6%, depending on the pathogen. For cases of HIV infection, this would result in approximately 60 infected patients per year. For other common viral infections, the number of new cases ranged from 1,600 to 15,000 per year that could be attributable directly to ultrasound and LLD procedures.Conclusions.Our simulation results showed that, despite cumulative use of probe cover and LLD, there were still some cases of de novo infection that may be attributable to ultrasound procedures. These cases are preventable by reviewing the currently used LLD and/or upgrading LLD to high-level disinfection, as recommended by the US Centers for Disease Control and Prevention.

scholarly journals Sexually Transmitted Infections and Male Circumcision: A Systematic Review and Meta-Analysis

ISRN Urology ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-42 ◽  
Author(s):  
Robert S. Van Howe
Keyword(s):  
Systematic Review ◽  
Human Papillomavirus ◽  
Sexually Transmitted Infections ◽  
Sexually Transmitted Infection ◽  
Positive Impact ◽  
Meta Analysis ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
General Populations ◽  
Simplex Virus

The claim that circumcision reduces the risk of sexually transmitted infections has been repeated so frequently that many believe it is true. A systematic review and meta-analyses were performed on studies of genital discharge syndrome versus genital ulcerative disease, genital discharge syndrome, nonspecific urethritis, gonorrhea, chlamydia, genital ulcerative disease, chancroid, syphilis, herpes simplex virus, human papillomavirus, and contracting a sexually transmitted infection of any type. Chlamydia, gonorrhea, genital herpes, and human papillomavirus are not significantly impacted by circumcision. Syphilis showed mixed results with studies of prevalence suggesting intact men were at great risk and studies of incidence suggesting the opposite. Intact men appear to be of greater risk for genital ulcerative disease while at lower risk for genital discharge syndrome, nonspecific urethritis, genital warts, and the overall risk of any sexually transmitted infection. In studies of general populations, there is no clear or consistent positive impact of circumcision on the risk of individual sexually transmitted infections. Consequently, the prevention of sexually transmitted infections cannot rationally be interpreted as a benefit of circumcision, and any policy of circumcision for the general population to prevent sexually transmitted infections is not supported by the evidence in the medical literature.

scholarly journals P1639DEVELOPMENT OF SELF-LIMITED LOW-LEVEL BK VIREMIA/VIRURIA SUGGESTS IDEAL IMMUNOSUPPRESSION TO SUPPRESS T-CELL AND ANTIBODY-MEDIATED REJECTION AND PRESERVE KIDNEY ALLOGRAFT FUNCTION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Bettina Näf ◽  
Thomas Müller ◽  
Rudolf Peter Wuthrich ◽  
Thomas Schachtner
Keyword(s):  
Lower Incidence ◽  
De Novo ◽  
Allograft Survival ◽  
Kidney Allograft ◽  
Low Level ◽  
Antibody Mediated Rejection ◽  
Maintenance Immunosuppression ◽  
Allograft Function ◽  
High Level ◽  
Egfr Slope

Abstract Background and Aims Polyomavirus BK (BKV) viremia has been suggested as a surrogate marker of overimmunosuppression. Due to recent advances in monitoring strategies and pre-emptive therapy, progression to BKV-associated nephropathy (BKVN) has been reduced. Reduction of maintenance immunosuppression during BKVN, however, has been associated with both T-cell mediated rejection (TCMR), antibody-mediated rejection (ABMR), and inferior kidney allograft outcomes. Although the administration of intravenous immunoglobulins (IVIG) failed to treat BKVN, IVIG may have properties to reduce allosensitization. Method We studied 860 kidney transplant recipients (KTRs) predominantly under tacrolimus-based triple-drug maintenance immunosuppression from 2009 to 2018. We identified 130 KTRs (15.1%) with high-level BK viremia >10,000 copies/mL (presumptive BKVN), 180 KTRs (20.9%) with low-level BK viremia <10,000 copies/mL, 85 KTRs (9.9%) with isolated BK viruria, and 465 KTRs (54.1%) with no BK viruria/viremia. Kidney allograft outcomes with respect to TCMR, ABMR, development of de novo donor-specific antibodies (DSA), kidney allograft survival, and estimated glomerular filtration rate (eGFR) slope were analysed. Due to the increased incidence of TCMR and ABMR among KTRs with presumptive BKVN, 48 of 130 KTRs (36.9%) with high-level BK viremia starting from 2015 received IVIG (0.5 g/kg of body weight) on a biweekly basis during BKV replication. Results Very interestingly, KTRs with low-level BK viremia/viruria showed a significantly lower incidence of TCMR compared to KTRs with no BK viremia/viruria and KTRs with high-level BK viremia (p<0.05). In addition, KTRs with low-level BK viremia/viruria showed a significantly lower incidence of ABMR compared to KTRs with high-level BK viremia (p<0.05). No differences were observed with respect to the development of de novo DSA (MFI>5000) between KTRs with low-level BK viremia/viruria, KTRs with no BK viremia/viruria, and KTRs with high-level BK viremia (p>0.05). KTRs with low-level BK viremia/viruria showed superior kidney allograft survival and lower eGFR slope compared to KTRs with no BK viremia/viruria and KTRs with high-level BK viremia (p<0.05). The administration of IVIG during high-level BK viremia didn’t impact the development of TCMR, ABMR, development of de novo DSA, eGFR slope, and kidney allograft survival (p<0.05). Conclusion Our results show that low-level BK viremia/viruria is associated with suppression of TCMR and ABMR in the early period posttransplantation, and preservation of kidney allograft function in the long-term. The administration of IVIG didn’t prove beneficial to reduce allosensitization among KTRs with high-level BK viremia.

scholarly journals Non-HPV Perianal and Anorectal Sexually Transmitted Viral Infections

2019 ◽  
Vol 32 (05) ◽  
pp. 340-346
Author(s):  
Margarita Murphy ◽  
Gabriel Ryan Chedister ◽  
Virgilio George
Keyword(s):  
Immune Deficiency ◽  
Viral Infections ◽  
Human Papilloma Virus Infection ◽  
Molluscum Contagiosum ◽  
Perianal Skin ◽  
Human Immune Deficiency Virus ◽  
Papilloma Virus ◽  
Sexually Transmitted ◽  
Human Immune ◽  
Simplex Virus

AbstractThis article reviews the epidemiology, diagnosis, and management of common viral infections of the perianal skin and anorectum including herpes simplex virus, human immune deficiency virus, and molluscum contagiosum. Human papilloma virus infection is reviewed in the subsequent article.

scholarly journals Antiviral Agents for the Prevention and Treatment of Herpes Simplex Virus Type-1 Infection in Clinical Oncology: A Network Meta-Analysis

2020 ◽  
Vol 17 (23) ◽  
pp. 8891
Author(s):  
Farah Wasim Aribi Al-Zoobaee ◽  
Loo Yee Shen ◽  
Sajesh K. Veettil ◽  
Divya Gopinath ◽  
Mari Kannan Maharajan ◽  
...  
Keyword(s):  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Viral Infections ◽  
Meta Analysis ◽  
Antiviral Agents ◽  
Antiviral Agent ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Assessment Development ◽  
Simplex Virus

Cancer therapy may be complicated and compromised by viral infections, including oral herpes simplex virus (HSV) infection. This network meta-analysis aimed to identify the best antiviral agent to prevent or treat oral HSV infection in patients being treated for cancer. A search was conducted for trials published since inception until the 10th of May 2020 in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials. A network meta-analysis was performed on the data from randomized controlled trials that assessed antiviral agents for preventive or therapeutic activity vs. placebo, no treatment or any other active intervention in patients being treated for cancer. The agents were ranked according to their effectiveness in the prevention of oral HSV using surface under the cumulative ranking (SUCRA). Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to assess the certainty of the evidence. In total, 16 articles were included. The pooled relative risk (RR) to develop oral HSV infection in the acyclovir group was 0.17 (95% CI: 0.10, 0.30), compared to 0.22 (95% CI: 0.06, 0.77) in the valacyclovir group. Acyclovir ranked highest for the prevention of oral HSV followed by valacyclovir. Subgroup analysis with different acyclovir regimens revealed that the best regimens in terms of HSV-1 prevention were 750 mg/m2 acyclovir administered intravenously followed by 1600 mg per day orally. Acyclovir (250 mg/m2 per day) administered intravenously was the least effective against the prevention of oral HSV.

scholarly journals Interplay among Vaginal Microbiome, Immune Response and Sexually Transmitted Viral Infections

2019 ◽  
Vol 20 (2) ◽  
pp. 266 ◽  
Author(s):  
Maria Torcia
Keyword(s):  
Immune Cells ◽  
Viral Infections ◽  
Bacterial Species ◽  
Disease Status ◽  
Lactobacillus Species ◽  
Sexually Transmitted ◽  
Immunodeficiency Virus ◽  
Reproductive Life ◽  
Simplex Virus ◽  
Herpes Simplex Virus 2

The vaginal ecosystem is important for women’s health and for a successful reproductive life, and an optimal host-microbial interaction is required for the maintenance of eubiosis. The vaginal microbiota is dominated by Lactobacillus species in the majority of women. Loss of Lactobacillus dominance promotes the colonization by anaerobic bacterial species with an increase in microbial diversity. Vaginal dysbiosis is a very frequent condition which affects the immune homeostasis, inducing a rupture in the epithelial barrier and favoring infection by sexually transmitted pathogens. In this review, we describe the known interactions among immune cells and microbial commensals which govern health or disease status. Particular attention is given to microbiota compositions which, through interplay with immune cells, facilitate the establishment of viral infections, such as Human Immunodeficiency Virus (HIV), Human Papilloma Virus (HPV), Herpes Simplex Virus 2 (HSV2).

scholarly journals Do highly physically active workers die early? A systematic review with meta-analysis of data from 193 696 participants

2018 ◽  
Vol 52 (20) ◽  
pp. 1320-1326 ◽  
Author(s):  
Pieter Coenen ◽  
Maaike A Huysmans ◽  
Andreas Holtermann ◽  
Niklas Krause ◽  
Willem van Mechelen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Health Outcomes ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Meta Analysis ◽  
Occupational Physical Activity ◽  
Low Level ◽  
All Cause Mortality ◽  
High Level

ObjectiveRecent evidence suggests the existence of a physical activity paradox, with beneficial health outcomes associated with leisure time physical activity, but detrimental health outcomes for those engaging in high level occupational physical activity. This is the first quantitative systematic review of evidence regarding the association between occupational physical activity and all-cause mortality.DesignSystematic review with meta-analysis.Data sourceA literature search was performed in electronic databases PubMed, Embase, CINAHL, PsycINFO and Cochrane.Eligibility criteria for selecting studiesWe screened for peer reviewed articles from prospective studies assessing the association of occupational physical activity with all-cause mortality. A meta-analysis assessed the association of high (compared with low) level occupational physical activity with all-cause mortality, estimating pooled hazard ratios (HR) (with 95% CI).Results2490 unique articles were screened and 33 (from 26 studies) were included. Data from 17 studies (with 193 696 participants) were used in a meta-analysis, showing that men with high level occupational physical activity had an 18% increased risk of early mortality compared with those engaging in low level occupational physical activity (HR 1.18, 95% CI 1.05 to 1.34). No such association was observed among women, for whom instead a tendency for an inverse association was found (HR 0.90, 95% CI 0.80 to 1.01).ConclusionsThe results of this review indicate detrimental health consequences associated with high level occupational physical activity in men, even when adjusting for relevant factors (such as leisure time physical activity). These findings suggest that research and physical activity guidelines may differentiate between occupational and leisure time physical activity.

scholarly journals Systematic review and meta-analysis assessing the knowledge and use of the female condom among Nigerians

2021 ◽  
Vol 21 (3) ◽  
pp. 1362-1374
Author(s):  
Philemon Dauda Shallie ◽  
Firoza Haffejee
Keyword(s):  
Undergraduate Students ◽  
Meta Analysis ◽  
Female Condom ◽  
Critical Component ◽  
Sources Of Information ◽  
Sexually Transmitted ◽  
Unintended Pregnancies ◽  
Comprehensive Information ◽  
Significant Difference ◽  
High Level

Background: The female condom (FC) is a critical component in a comprehensive and sustainable approach to prevent HIV, other sexually transmitted infections and unintended pregnancies. Objectives: This review provides comprehensive information about Nigerian’s knowledge and use of FC. Methods: We screened search output, evaluated study eligibility, and extracted data in duplicate. Data from similar studies were combined in a meta-analysis. Results: There was a significantly (p < 0.0001) high-level of awareness amongst the respondents. However, the use of the FC was very low at 5.5% among female respondents. There was a significant (p < 0.0001) difference between FC awareness and use. The main reasons for FC use were prevention of unintended pregnancy (55%) and STIs/HIV (31%). We observed a significant difference between reasons of non-use of the FC [F (5, 13) = 5.195, P = 0.0077]. Furthermore, there were significant differences between the sources of information on FC [F (3, 8) = 32.89, P < 0.0001]. Conclusion: Despite the high levels of awareness, especially among the female respondents, the use of the FC has remained extremely low even among the young, educated undergraduate students. There is aneed for robust and consistent advocacy to make the FC available and affordable. Keywords: Female condom; women; men; awareness; use; Nigeria.

Design of A Multi-Epitope Protein Vaccine Against Herpes Simplex Virus, Human Papillomavirus and Chlamydia Trachomatis as the Main Causes of Sexually Transmitted Diseases

2020 ◽  
Author(s):  
Hesam Dorosti ◽  
Sedigheh Eskandari ◽  
Mahboubeh Zarei ◽  
Navid Nezafat ◽  
Younes Ghasemi
Keyword(s):  
Human Papillomavirus ◽  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Chlamydia Trachomatis ◽  
T Lymphocytes ◽  
Sexually Transmitted Diseases ◽  
Viral Infections ◽  
Protein Vaccine ◽  
Sexually Transmitted ◽  
Simplex Virus

Abstract Background: Sexually transmitted diseases (STDs) have a profound effect on reproductivity and sexual health worldwide. According to world health organization (WHO) 375 million new case of STD, including chlamydia trachomatis (chlamydia), Neisseria gonorrhoeae, HSV, HPV has been reported in 2016. More than 30 diverse pathogenesis have identified to be transmitted through sexual intercourse. Of these, viral infections (hepatitis B, herpes simplex virus (HSV or herpes), HIV, and human papillomavirus (HPV) are incurable. However, symptoms caused by the incurable viral infections can be alleviated through treatment. Antimicrobial resistance (AMR) of sexually transmitted infections (STIs) to antibiotics has increased recent years, in this regard, vaccination is proposed as an important strategy for prevention or treatment of STDs. Vaccine against HPV 16 and 18 suggests a new approach for controlling STDs but until now, there is no prophylactic or therapeutic vaccine have been approved for HSV-2 and Chlamydia trachomatis(CT); in this reason, developing an efficient vaccine is inevitable. Recently, different combinatorial forms of subunit vaccines against two or three type of bacteria have been designed. Results: In this study, to design a combinatorial vaccine against HSV, CT, and HPV, the E7 and L2 from HPV, glycoprotein D from HSV-2 and ompA from CT were selected as final antigens. Afterward, the immunodominant helper T lymphocytes (HTLs) and cytolytic T lymphocytes (CTLs) epitopes were chosen from aforesaid antigens. P30 (tetanus toxoid epitope) as universal T-helper were also added to the vaccine. Moreover, flagellin D1/D0 as TLR5 agonist and the RS09 as a TLR4 ligand were incorporated to N and C-terminals of peptide vaccine, respectively. Finally, all selected parts were fused together by appropriate linkers to enhance vaccine efficiency. The physicochemical, structural, and immunological properties of the designed vaccine protein were assessed. To achieve the best 3D model of the protein vaccine, modeling, refinement, and validation of modeled structures were also done. Docking evaluation demonstrated suitable interaction between the vaccine and TLR5. Moreover, molecular dynamics (MD) studies showed an appropriate and stable structure of protein and TLR5. Conclusion: Based on immunoinformatic analysis, our vaccine candidate could potentially incite humoral and cellular immunities, which are critical for protection against HPV, HSV-2, and chlamydia trachomatis. It should be noted that, experimental studies are needed to confirm the efficacy of the designed vaccine.

scholarly journals High Level of Interaction between Phages and Bacteria in an Artisanal Raw Milk Cheese Microbial Community

2021 ◽  
Author(s):  
Luciano Lopes Queiroz ◽  
Gustavo Augusto Lacorte ◽  
William Ricardo Isidorio ◽  
Mariza Landgraf ◽  
Bernadette Dora Gombossy de Melo Franco ◽  
...  
Keyword(s):  
Viral Infections ◽  
Production Systems ◽  
Meta Analysis ◽  
Starter Culture ◽  
Growth Dynamics ◽  
Raw Milk ◽  
Starter Cultures ◽  
Bacteria Growth ◽  
The World ◽  
High Level

Endogenous starter cultures are used in the production of several cheeses around the world, such as Parmigiano Reggiano, in Italy, Epoisses, in France, and Canastra, in Brazil. These microbial communities are responsible for many of the intrinsic characteristics of each of these cheeses. Bacteriophages are ubiquitous around the world, well known to be involved in the modulation of complex microbiological processes. However, little is known about phage bacteria growth dynamics in cheese production systems, where phages are normally treated as problems, as the viral infections can negatively affect or even eliminate the starter culture during production. Furthermore, a recent metagenomic based meta-analysis has reported that cheeses contain a high abundance of phage-associated sequences. Here, we analyse the viral and bacterial metagenomes of Canastra cheese, a tradition artisanal cheese produced using an endogenous starter culture. We observe a very high phage diversity level, mostly composed of novel sequences. We detect several metagenomic assembled bacterial genomes at strain level resolution, and several putative phage-bacteria interactions, evidenced by the recovered viral and bacterial genomic signatures. We postulate that at least one bacterial strain detected could be endogenous to the Canastra region, in Brazil, and that its growth seems to be modulated by native phages present in this artisanal production system. This relationship is likely to influence the fermentation dynamics and ultimately the sensorial profile of these cheeses, with implications for all cheeses that employ similar production processes around the world.

scholarly journals The Inability of Wild-Type Rabies Virus To Activate Dendritic Cells Is Dependent on the Glycoprotein and Correlates with Its Low Level of theDe Novo-Synthesized Leader RNA

2014 ◽  
Vol 89 (4) ◽  
pp. 2157-2169 ◽  
Author(s):  
Yang Yang ◽  
Ying Huang ◽  
Clement W. Gnanadurai ◽  
Shengbo Cao ◽  
Xueqin Liu ◽  
...  
Keyword(s):  
Dendritic Cells ◽  
Immune Responses ◽  
Rabies Virus ◽  
Adoptive Transfer ◽  
Viral Infections ◽  
De Novo ◽  
Wild Type ◽  
Adaptive Immune Responses ◽  
Low Level ◽  
Adaptive Immune

ABSTRACTDendritic cells (DCs) are the most efficient antigen-presenting cells, playing a key role in the adaptive immune responses to viral infections. Our studies demonstrate that wild-type (wt) rabies virus (RABV) does not activate DCs. Adoptive transfer of DCs primed with wt RABV did not activate DCs, stimulate virus neutralizing antibodies (VNA), or protect recipients against challenge. However, adoptive transfer of DCs primed with laboratory-attenuated RABV resulted in DC activation, production of VNA, and protection against challenge.In vitrostudies with recombinant RABV (laboratory-attenuated RABV expressing the glycoprotein or the phosphoprotein from wt RABV) demonstrate that DC activation is dependent on the glycoprotein and involves the IPS-1 pathway. Furthermore, binding to and entry into DCs by wt RABV is severely blocked, and the copy number ofde novo-synthesized leader RNA was two logs lower in DCs infected with the wt than in DCs treated with laboratory-attenuated RABV. However, transient transfection of DCs with synthesized leader RNA from either wt or attenuated RABV is capable of activating DCs in a dose-dependent manner. Thus, the inability of wt RABV to activate DCs correlates with its low level of thede novo-synthesized leader RNA.IMPORTANCERabies remains a public health threat, with more than 55,000 fatalities each year around the world. Since DCs play a key role in the adaptive immune responses to viral infections, we investigated the ability of rabies virus (RABV) to activate DCs. It was found that the adoptive transfer of DCs primed with wt RABV did not activate DCs, stimulate VNA, or protect mice against lethal challenge. However, laboratory-attenuated RABV mediates the activation of DCs via the IPS-1 pathway and is glycoprotein dependent. We further show that wt RABV evades DC-mediated immune activation by inefficient binding/entry into DCs and as a result of a reduced level ofde novo-synthesized leader RNA. These findings may have important implications in the development of efficient rabies vaccines.

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