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Sample records for asymptomatic anorectal sexually

  1. Anorectal emergencies.

    PubMed

    Lohsiriwat, Varut

    2016-07-14

    Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrhoid, thrombosed or strangulated internal hemorrhoid, bleeding hemorrhoid, bleeding anorectal varices, anal fissure, irreducible or strangulated rectal prolapse, anorectal abscess, perineal necrotizing fasciitis (Fournier gangrene), retained anorectal foreign bodies and obstructing rectal cancer. Sexually transmitted diseases as anorectal non-surgical emergencies and some anorectal emergencies in neonates are also discussed. The last part of this review dedicates to the management of early complications following common anorectal procedures that may present as an emergency including acute urinary retention, bleeding, fecal impaction and anorectal sepsis. Although many of anorectal disorders presenting in an emergency setting are not life-threatening and may be successfully treated in an outpatient clinic, an accurate diagnosis and proper management remains a challenging problem for clinicians. A detailed history taking and a careful physical examination, including digital rectal examination and anoscopy, is essential for correct diagnosis and plan of treatment. In some cases, some imaging examinations, such as endoanal ultrasonography and computerized tomography scan of whole abdomen, are required. If in doubt, the attending physicians should not hesitate to consult an expert e.g., colorectal surgeon about the diagnosis, proper management and appropriate follow-up. PMID:27468181

  2. Anorectal emergencies.

    PubMed

    Lohsiriwat, Varut

    2016-07-14

    Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrhoid, thrombosed or strangulated internal hemorrhoid, bleeding hemorrhoid, bleeding anorectal varices, anal fissure, irreducible or strangulated rectal prolapse, anorectal abscess, perineal necrotizing fasciitis (Fournier gangrene), retained anorectal foreign bodies and obstructing rectal cancer. Sexually transmitted diseases as anorectal non-surgical emergencies and some anorectal emergencies in neonates are also discussed. The last part of this review dedicates to the management of early complications following common anorectal procedures that may present as an emergency including acute urinary retention, bleeding, fecal impaction and anorectal sepsis. Although many of anorectal disorders presenting in an emergency setting are not life-threatening and may be successfully treated in an outpatient clinic, an accurate diagnosis and proper management remains a challenging problem for clinicians. A detailed history taking and a careful physical examination, including digital rectal examination and anoscopy, is essential for correct diagnosis and plan of treatment. In some cases, some imaging examinations, such as endoanal ultrasonography and computerized tomography scan of whole abdomen, are required. If in doubt, the attending physicians should not hesitate to consult an expert e.g., colorectal surgeon about the diagnosis, proper management and appropriate follow-up.

  3. Anorectal emergencies

    PubMed Central

    Lohsiriwat, Varut

    2016-01-01

    Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrhoid, thrombosed or strangulated internal hemorrhoid, bleeding hemorrhoid, bleeding anorectal varices, anal fissure, irreducible or strangulated rectal prolapse, anorectal abscess, perineal necrotizing fasciitis (Fournier gangrene), retained anorectal foreign bodies and obstructing rectal cancer. Sexually transmitted diseases as anorectal non-surgical emergencies and some anorectal emergencies in neonates are also discussed. The last part of this review dedicates to the management of early complications following common anorectal procedures that may present as an emergency including acute urinary retention, bleeding, fecal impaction and anorectal sepsis. Although many of anorectal disorders presenting in an emergency setting are not life-threatening and may be successfully treated in an outpatient clinic, an accurate diagnosis and proper management remains a challenging problem for clinicians. A detailed history taking and a careful physical examination, including digital rectal examination and anoscopy, is essential for correct diagnosis and plan of treatment. In some cases, some imaging examinations, such as endoanal ultrasonography and computerized tomography scan of whole abdomen, are required. If in doubt, the attending physicians should not hesitate to consult an expert e.g., colorectal surgeon about the diagnosis, proper management and appropriate follow-up. PMID:27468181

  4. Characteristic Male Urine Microbiomes Associate with Asymptomatic Sexually Transmitted Infection

    PubMed Central

    Nelson, David E.; Van Der Pol, Barbara; Dong, Qunfeng; Revanna, Kashi V.; Fan, Baochang; Easwaran, Shraddha; Sodergren, Erica; Weinstock, George M.; Diao, Lixia; Fortenberry, J. Dennis

    2010-01-01

    Background The microbiome of the male urogenital tract is poorly described but it has been suggested that bacterial colonization of the male urethra might impact risk of sexually transmitted infection (STI). Previous cultivation-dependent studies showed that a variety of non-pathogenic bacteria colonize the urethra but did not thoroughly characterize these microbiomes or establish links between the compositions of urethral microbiomes and STI. Methodology/Findings Here, we used 16S rRNA PCR and sequencing to identify bacteria in urine specimens collected from men who lacked symptoms of urethral inflammation but who differed in status for STI. All of the urine samples contained multiple bacterial genera and many contained taxa that colonize the human vagina. Uncultivated bacteria associated with female genital tract pathology were abundant in specimens from men who had STI. Conclusions Urine microbiomes from men with STI were dominated by fastidious, anaerobic and uncultivated bacteria. The same taxa were rare in STI negative individuals. Our findings suggest that the composition of male urine microbiomes is related to STI. PMID:21124791

  5. Sexual transmission of Zika virus in an entirely asymptomatic couple returning from a Zika epidemic area, France, April 2016.

    PubMed

    Fréour, Thomas; Mirallié, Sophie; Hubert, Bruno; Splingart, Carole; Barrière, Paul; Maquart, Marianne; Leparc-Goffart, Isabelle

    2016-06-01

    The current Zika virus outbreak and its potential severe health consequences, especially congenital fetal syndrome, have led to increased concern about sexual transmission, especially in pregnant women and women of reproductive age. Here we report a case of Zika virus sexual transmission, likely male-to-female, in a totally asymptomatic couple. PMID:27311680

  6. Sexual transmission of Zika virus in an entirely asymptomatic couple returning from a Zika epidemic area, France, April 2016.

    PubMed

    Fréour, Thomas; Mirallié, Sophie; Hubert, Bruno; Splingart, Carole; Barrière, Paul; Maquart, Marianne; Leparc-Goffart, Isabelle

    2016-06-01

    The current Zika virus outbreak and its potential severe health consequences, especially congenital fetal syndrome, have led to increased concern about sexual transmission, especially in pregnant women and women of reproductive age. Here we report a case of Zika virus sexual transmission, likely male-to-female, in a totally asymptomatic couple.

  7. Anorectal human papillomavirus: current concepts.

    PubMed

    Assi, Roland; Reddy, Vikram; Einarsdottir, Hulda; Longo, Walter E

    2014-12-01

    Increased anorectal human papillomavirus (HPV) infection is related to the recent trends in sexual behavior in both homosexual and heterosexual groups and prevalence of infection with human immunodeficiency virus (HIV). Clinical presentation and natural history depend on the serotype involved. HPV 6 and 11 are found in the benign wart. Local control can be achieved with a wide selection of surgical and topical techniques. HPV 16, 18, and 31 are found in dysplastic lesions and have the potential to progress to invasive anal squamous cell carcinoma. Recognition and early management of dysplastic lesions is crucial to prevent the morbidity and mortality associated with anal cancer. While low-grade lesions can be closely observed, high-grade lesions should be eradicated. Different strategies can be used to eradicate the disease while preserving anorectal function. Studies on the efficacy of vaccination on anorectal HPV showed promising results in select population groups and led to the recent expansion of current vaccination recommendations.

  8. Prevalence of sexually transmissible pathogens in semen from asymptomatic male infertility patients with and without leukocytospermia

    PubMed Central

    Bezold, Guntram; Politch, Joseph A.; Kiviat, Nancy B.; Kuypers, Jane M.; Wolff, Hans; Anderson, Deborah J.

    2009-01-01

    Objective To determine the prevalence of pathogens that cause sexually transmitted infections (STIs) in semen from asymptomatic male infertility patients with and without leukocytospermia (LCS), and associations between STIs, inflammatory markers and other semen variables. Design Retrospective, controlled study. Setting Center for Reproductive Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Patient(s) 241 male infertility patients undergoing routine semen analysis; 132 with LCS, and 109 without LCS. Intervention(s) None Main Outcome Measure(s) DNA from STI pathogens [human papillomavirus (HPV), cytomegalovirus (CMV), herpes simplex virus (HSV), human herpes virus type 6 (HHV-6), Epstein-Barr virus (EBV), hepatitis B virus (HBV) and Chlamydia trachomatis (CT)], routine semen parameters and markers of accessory gland and epididymal function and inflammation. Results STI DNA was detected in 45/241 (18.7%) of the samples (CMV 8.7%, HPV 4.5%, HHV-6 3.7%, HSV 3.7%, CT 2.5%, EBV 0.4%, and HBV 0%), with no difference in prevalence between LCS and non-LCS groups. STI DNA in semen was associated with a decrease in sperm concentration, motile sperm concentration, total sperm count and neutral α-glucosidase concentration, whereas LCS was associated with a decrease in total sperm count, % normal forms and fructose concentration. Conclusion(s) STI pathogen DNA was detected in semen from a high percentage of asymptomatic male infertility patients and was associated with poor semen quality. Efforts to diagnose and treat subclinical genital tract infections should be intensified. PMID:17433312

  9. Anorectal abscess during pregnancy.

    PubMed

    Koyama, Shinsuke; Hirota, Masaki; Kobayashi, Masaki; Tanaka, Yusuke; Kubota, Satoshi; Nakamura, Ryo; Isobe, Masanori; Shiki, Yasuhiko

    2014-02-01

    Anorectal symptoms and complaints caused by hemorrhoids or anal fissures are common during pregnancy. It is known that one-third of pregnant women complain of anal pain in the third trimester. Anal pain may be caused by a wide spectrum of conditions, but if it begins gradually and becomes excruciating within a few days it may indicate anorectal abscess. We experienced a case of anorectal abscess during pregnancy which was diagnosed by magnetic resonance imaging and treated by incision and seton drainage at 36 weeks of gestation, followed by a normal spontaneous delivery at 38 weeks of gestation. To our knowledge, this is the first case report of anorectal abscess during pregnancy in the English-language published work. The clinical course of our case and clinical considerations of anorectal abscesses are discussed.

  10. Anorectal melanoma. An update.

    PubMed

    Reina, Angel; Errasti, José; Espín, Eloy

    2014-10-01

    Anorectal melanoma is an uncommon and aggressive disease. Because the patients often present with non specific complaints, a high clinical suspicion is important to avoid a delayed diagnosis. Patients undergoing radical surgery have no significant survival difference compared to those undergoing wide local excision. Abdominoperineal resection should be reserved for selected patients in whom local excision is not technically possible or cannot obtain a clear margin. The indiscriminate use of groin dissection is not advisable in anorectal melanoma and should be use in selected cases. Systemic chemotherapy is generally a non effective treatment and continues be studied. Radiation therapy can be used as hypofractionated radiation therapy combined with local excision or in a palliative setting. The oncological outcomes in anorectal melanoma are very poor. The aim of the present study is to review clinicopathology features and management of anorectal melanoma.

  11. Common Anorectal Disorders

    PubMed Central

    Foxx-Orenstein, Amy E.; Umar, Sarah B.; Crowell, Michael D.

    2014-01-01

    Anorectal disorders result in many visits to healthcare specialists. These disorders include benign conditions such as hemorrhoids to more serious conditions such as malignancy; thus, it is important for the clinician to be familiar with these disorders as well as know how to conduct an appropriate history and physical examination. This article reviews the most common anorectal disorders, including hemorrhoids, anal fissures, fecal incontinence, proctalgia fugax, excessive perineal descent, and pruritus ani, and provides guidelines on comprehensive evaluation and management. PMID:24987313

  12. Asymptomatic rectal mucosal lesions and hepatitis B surface antigen at sites of sexual contact in homosexual men with persistent hepatitis B virus infection.

    PubMed

    Reiner, N E; Judson, F N; Bond, W W; Francis, D P; Petersen, N J

    1982-02-01

    To ascertain why active and passive oral-anal and genital anal intercourse correlate strongly with hepatitis B virus (HBV) infection in homosexual men, we studied 22 men with HBV infection for the presence of hepatitis B surface antigen (HBsAg) in gingival and anorectal mucosa, feces, and semen. Thirteen of 22 (59%) patients had asymptomatic rectal mucosal lesions consisting of punctate bleeding points. Seventy-seven percent of swabbed specimens from lesions, 62% from feces, 59% from rectal mucosa, and 50% from anal canal mucosa contained HBsAg. Sera diluted serially and tested for HBsAg by radioimmunoassay showed that men with serum titers of 105 or greater were more likely to have HBsAg in specimens from lesions (p = 0.034), feces (p = 0.032), and normal mucosa (p = 0.001) than men with titers under 10 5. Asymptomatic rectal bleeding is frequent in homosexual men with persistent HBV infection. Rectal mucosa, feces, and anal canal mucosa become contaminated with HBsAg, creating a setting for de facto parenteral transmission when there is contact with oral or urethral mucosa. PMID:7059064

  13. Anorectal Physiology: Test and Clinical Application

    PubMed Central

    2010-01-01

    The physiology of the anorectal region is very complex, and it is only recently that detailed investigations have given us a better understanding of its function. The methods that are used for the evaluation of anorectal physiology include anorectal manometry, defecography, continence tests, electromyography of the anal sphincter and the pelvic floor, and nerve stimulation tests. These techniques furnish a clearer picture of the mechanisms of anorectal disease and demonstrate pathophysiologic abnormalities in patients with disorders of the anorectal region. Therefore, therapeutic recommendations for anorectal disease can be made best when the anatomy and the physiology of the anorectal region are understood. PMID:21152132

  14. 2013 European Guideline on the management of proctitis, proctocolitis and enteritis caused by sexually transmissible pathogens.

    PubMed

    de Vries, Henry J C; Zingoni, Adele; White, John A; Ross, Jonathan D C; Kreuter, Alexander

    2014-06-01

    Proctitis is defined as an inflammatory syndrome of the distal 10-12 cm of the anal canal, also called the rectum. Infectious proctitis can be sexually transmitted via genital-anal mucosal contact, but some also via mutual masturbation.N. gonorrhoeae,C. trachomatis(including lymphogranuloma venereum), Herpes Simplex Virus andT. pallidumare the most common sexually transmitted anorectal pathogens. Shigellosis can be transferred via oral-anal contact and may lead to proctocolitis or enteritis. Although most studies on these infections have concentrated on men who have sex with men (MSM), a significant proportion of women have anal intercourse and therefore may also be at risk. A presumptive clinical diagnosis of proctitis can be made when there are symptoms and signs, and a definitive diagnosis when the results of laboratory tests are available. The symptoms of proctitis include anorectal itching, pain, cramps (tenesmus) and discharge in and around the anal canal. Asymptomatic proctitis occurs frequently and can only be detected by laboratory tests. The majority of rectal chlamydia and gonococcal infections are asymptomatic. Therefore when there is a history of receptive anal contact, exclusion of anorectal infections is generally indicated as part of standard screening for sexually transmitted infections (STIs). Condom use does not guarantee protection from bacterial and protozoan STIs, which are often spread without penile penetration. PMID:24352129

  15. 2013 European Guideline on the management of proctitis, proctocolitis and enteritis caused by sexually transmissible pathogens.

    PubMed

    de Vries, Henry J C; Zingoni, Adele; White, John A; Ross, Jonathan D C; Kreuter, Alexander

    2014-06-01

    Proctitis is defined as an inflammatory syndrome of the distal 10-12 cm of the anal canal, also called the rectum. Infectious proctitis can be sexually transmitted via genital-anal mucosal contact, but some also via mutual masturbation.N. gonorrhoeae,C. trachomatis(including lymphogranuloma venereum), Herpes Simplex Virus andT. pallidumare the most common sexually transmitted anorectal pathogens. Shigellosis can be transferred via oral-anal contact and may lead to proctocolitis or enteritis. Although most studies on these infections have concentrated on men who have sex with men (MSM), a significant proportion of women have anal intercourse and therefore may also be at risk. A presumptive clinical diagnosis of proctitis can be made when there are symptoms and signs, and a definitive diagnosis when the results of laboratory tests are available. The symptoms of proctitis include anorectal itching, pain, cramps (tenesmus) and discharge in and around the anal canal. Asymptomatic proctitis occurs frequently and can only be detected by laboratory tests. The majority of rectal chlamydia and gonococcal infections are asymptomatic. Therefore when there is a history of receptive anal contact, exclusion of anorectal infections is generally indicated as part of standard screening for sexually transmitted infections (STIs). Condom use does not guarantee protection from bacterial and protozoan STIs, which are often spread without penile penetration.

  16. High prevalence of asymptomatic sexually transmitted infections in HIV-infected men who have sex with men: a stimulus to improve screening.

    PubMed

    Keaveney, S; Sadlier, C; O'Dea, S; Delamere, S; Bergin, C

    2014-09-01

    In Ireland the incidence of sexually transmitted infections (STIs) is steadily increasing while the number of new HIV-diagnoses in men who have sex with men has more than doubled in the past decade. This study investigated the prevalence of STIs in asymptomatic HIV-infected men who have sex with men (MSM) attending a clinic for routine HIV care in the largest HIV-centre in Ireland. Fifty HIV-infected MSM were included in the study (mean age [SD] 38years [9], 66% Irish). Sixteen per cent of HIV-infected MSM screened were diagnosed with a STI. Thirty-eight per cent reported always using condoms while 4% reported never using condoms, 46% used condoms inconsistently and 10% reported no sexual contacts in the preceding 12 months. Recognising the need to optimise STI screening, a pilot self-screening programme was subsequently introduced to our HIV clinic as a quality improvement initiative. Asymptomatic MSM attending for routine HIV care were invited to have an opportunistic STI screen either provider performed or by self-screening. Seventy-one patients were included in the pilot. Sixty-five (92%) opted for self-collected rectal swabs. Ten STIs were detected in eight patients. This study supports guidelines recommending routine screening for STIs in the care of HIV-infected patients and highlights opportunities to provide relevant screening and education interventions targeting unsafe sexual behaviours.

  17. Anorectal Transplantation in Human Cadavers: Mock Anorectal Allotransplantation

    PubMed Central

    Araki, Jun; Nishizawa, Yuji; Sato, Tomoyuki; Naito, Munekazu; Akita, Keiichi; Tashiro, Kensuke; Iida, Takuya; Koshima, Isao

    2013-01-01

    Background Anorectal transplantation is a method for patients who have lost their anorectal function or suffer from congenital anorectal dysfunction to recover this function, and this has been investigated in experimental animal models using pigs, dogs, and rats. In this study, we performed an examination of anorectal transplantation in human cadavers to investigate whether this procedure could be performed in patients. Methods A 77-year-old woman cadaver 1 was used as the donor and a 98-year-old woman cadaver 2 was used as the recipient. Initially, abdominoperineal excision of the anus and rectum (the Miles’ operation) was performed on the recipient. Next, an anorectal graft containing the pudendal nerve (PN), pudendal artery (PA), pudendal vein (PV), inferior mesenteric artery (IMA), and inferior mesenteric vein (IMV) was harvested from the donor. The donor graft was transplanted into the recipient by intestinal anastomosis and microneurovascular anastomoses orthotopically. Results The diameters of the PN (right/left), IMA, and IMV were 2.5 mm/2.5 mm, 2.0 mm, and 1.5 mm, respectively, in cadaver 1, and 2.0 mm/2.0 mm, 2.0 mm, and 2.0 mm, respectively, in cadaver 2. The length of the PN, PA, PV, IMA, and IMV in the graft was sufficient to allow proper anastomosis. Conclusion This preliminary study indicated that human anorectal transplantation was possible anatomically and technically. We anticipate our study will aid in the potential future application of this procedure to human patients. PMID:23874833

  18. Asymptomatic bacteriuria

    MedlinePlus

    ... Older age Pregnancy -- up to 40% of pregnant women with untreated asymptomatic bacteriuria will develop a kidney infection Vesicoureteral reflux (backward movement of urine from the bladder into ureters or ...

  19. Spontaneous ileal perforation complicating low anorectal malformation.

    PubMed

    Olatunji, TiJesuni; Igoche, Matthias; Anyanwu, Pascal; Ameh, Emmanuel A

    2015-01-01

    Anorectal malformation is a common anomaly in neonates. Although colorectal perforations have been reported as a complication, ileal perforation is rarely encountered. This is a report of a 2-day-old boy presenting with a low anorectal malformation, complicated with ileal perforation, necessitating laparotomy and ileal repair. Anoplasty was done for the low anomaly. Early presentation and prompt treatment of anorectal malformations is important to prevent such potential life threatening complication. PMID:26168757

  20. Primary anorectal malignant melanoma: an uncommon anorectal pathology.

    PubMed

    Juanmartiñena Fernández, José Francisco; Fernández-Urien, Ignacio; Córdoba, Alicia

    2016-09-01

    Anorectal malignant melanoma (AMM) is most common primary melanoma of gastrointestinal tract, accounting for 0.05% and 1% of all colorectal and anal cancers. We reported an 85 year-old woman with no significant past medical history who presented two-month period of rectal bleeding, abdominal pain, tenesmus and 2kg weight-loss. Laboratory markers were unremarkable, although rectal examination revealed two small haemorrhoids and a firm, non-obstructing mass in the lower rectum. Colonoscopy confirmed presence of an ulcerated pigmented neoplasm arising at dental line [A,B]. No distant metastases were found on computed tomography [C] although presented metastatic regional lymph nodes on pelvic MRI [D]. Therefore, abdominoperineal resection was performed, confirming loco-regional disease. Histopathology showed malignant melanoma with positive stains in immunohistochemistry for protein S100, HMB-45 and Melan-A [E,F,G,H] and stained negative for c-Kit.

  1. Evidence That Anorectal Transplantation Is the Logical Treatment for Serious Anorectal Dysfunction and Permanent Colostomy.

    PubMed

    Ferreira Galvao, F H; Araki, J; Seid, V E; Waisberg, D R; Traldi, M C; Naito, M; Araujo, B C; Lanchotte, C; Chaib, E; D'Albuquerque, L A C

    2016-03-01

    Anorectal dysfunction resulting in fecal incontinence or permanent colostomy is a current public health concern that strongly impairs patient quality of life. Present treatment options for this complex disease are expensive and usually ineffective. Anorectal transplantation is the logical treatment for fecal incontinence and permanent colostomy. This procedure has been clinically effective in a few cases reported in the medical literature. Furthermore, experiments in rats, pigs, and dogs have shown promising results, with functional recovery of the graft. In this article we describe the scientific evidence that anorectal transplantation may be an important option for treating anorectal dysfunction.

  2. [Urinary complications after anorectal surgery].

    PubMed

    Iusuf, T; Sârbu, V; Cristache, C; Popescu, R; Botea, F; Panait, L

    2000-01-01

    The prevalence of urinary complications after various anorectal operations was studied in a group of 273 patients. The overall prevalence of urinary complications was 26.7%; most of these complications affected men between 41 and 50, mainly after hemorrhoidectomy. In 10.6% of patients, bladder catheterization was needed. These urinary complications result from nervous reflexes originating from the anus and determined by the operative trauma and/or rectal distinction. In the treatment of these urinary complications, the role of the muses is essential for reassuring the patients. Parasympathomimetic drugs are often efficient. Urinary catheterization must be delayed until the 18th hour. Fluid restriction may be useful to prevent urinary retention. PMID:14870531

  3. Asymptomatic dystrophinopathy

    SciTech Connect

    Morrone, A. |; Hoffman, E.P.; Hoop, R.C.

    1997-03-31

    A 4-year-old girl was referred for evaluation for a mild but persistent serum aspartate aminotransferase (AST) elevation detected incidentally during routine blood screening for a skin infection. Serum creatine kinase activity was found to be increased. Immuno-histochemical study for dystrophin in her muscle biopsy showed results consistent with a carrier state for muscular dystrophy. Molecular work-up showed the proposita to be a carrier of a deletion mutation of exon 48 of the dystrophin gene. Four male relatives also had the deletion mutation, yet showed no clinical symptoms of muscular dystrophy (age range 8-58 yrs). Linkage analysis of the dystrophin gene in the family showed a spontaneous change of an STR45 allele, which could be due to either an intragenic double recombination event, or CA repeat length mutation leading to identical size alleles. To our knowledge, this is the first documentation of an asymptomatic dystrophinopathy in multiple males of advanced age. Based on molecular findings, this family would be given a diagnosis of Becker muscular dystrophy. This diagnosis implies the development of clinical symptoms, even though this family is clearly asymptomatic. This report underscores the caution which must be exercised when giving presymptomatic diagnoses based on molecular studies. 28 refs., 4 figs., 1 tab.

  4. Ectopic anus with barrel gun perineum rare type of anorectal anomaly.

    PubMed

    Chamaria, Komal; Shetty, Roshan

    2013-06-01

    Perineal ectopic anus in female infants is not a very uncommon congenital anorectal anomaly with opening into the low vaginal or vulvar region. However, ectopic anus with barrel gun perineum is a less common variety. Patients generally present with frequent history of constipation, but may seek medical help for just aesthetic reasons. We present here one such case of an asymptomatic seven years old female with the rare form of anterior ectopic anus with barrel gun perineum without any fistulous communications with an innovative method of demonstration of the anomaly by using ultrasound gel as rectal contrast in MRI pelvis.

  5. Hyperammonemia in anorectic tumor-bearing rats

    SciTech Connect

    Chance, W.T.; Cao, L.; Nelson, J.L.; Foley-Nelson, T.; Fischer, J.E.

    1988-01-01

    Plasma ammonia concentrations were significantly elevated by 150% in anorectic rats bearing methylcholanthrene sarcomas. Assessment of ammonia levels in blood draining these sarcomas indicated nearly a 20-fold increase as compared with venous blood in control rats, suggesting the tumor mass as the source of this increase in ammonia. Infusing increasing concentrations of ammonium salts produced anorexia and alterations in brain amino acids in normal rats that were similar to those observed in anorectic tumor-bearing rats. Therefore, these results suggest that ammonia released by tumor tissue may be an important factor in the etiology of cancer anorexia.

  6. What every gastroenterologist needs to know about common anorectal disorders

    PubMed Central

    Schubert, Moonkyung Cho; Sridhar, Subbaramiah; Schade, Robert R; Wexner, Steven D

    2009-01-01

    Anorectal complaints are very common and are caused by a variety of mostly benign anorectal disorders. Many anorectal conditions may be successfully treated by primary care physicians in the outpatient setting, but patients tend not to seek medical attention due to embarrassment or fear of cancer. As a result, patients frequently present with advanced disease after experiencing significant decreases in quality of life. A number of patients with anorectal complaints are referred to gastroenterologists. However, gastroenterologists’ knowledge and experience in approaching these conditions may not be sufficient. This article can serve as a guide to gastroenterologists to recognize, evaluate, and manage medically or non-surgically common benign anorectal disorders, and to identify when surgical referrals are most prudent. A review of the current literature is performed to evaluate comprehensive clinical pearls and management guidelines for each topic. Topics reviewed include hemorrhoids, anal fissures, anorectal fistulas and abscesses, and pruritus ani. PMID:19598294

  7. Californium-252 brachytherapy for anal and ano-rectal carcinoma

    SciTech Connect

    Cross, B.; Maruyama, Y.; Proudfoot, W.; Malcolm, A.

    1986-01-01

    Surgery has historically been the standard treatment for anal, ano-rectal and rectal carcinoma but is prone to local or regional failure. Over the past 15 years there has been increasing interest in and success with radiation therapy and combined chemoradiotherapy for treatment of anal and ano-rectal cancers. Cf-252 brachytherapy combined with external beam teletherapy has been investigated for anal and ano-rectal lesions at the Univ. of Kentucky with encouraging results.

  8. Complications in the Development of a Female Sexual Identity

    ERIC Educational Resources Information Center

    Magagna, Jeanne; Pepper Goldsmith, Tara

    2009-01-01

    This paper describes the struggle to develop a female sexual identity and the importance of the roles of the father and mother in this struggle. The clinical illustration is taken from the psychotherapy of an anorectic adolescent.

  9. Magnetic resonance imaging of anorectal malformations.

    PubMed

    Podberesky, Daniel J; Towbin, Alexander J; Eltomey, Mohamed A; Levitt, Marc A

    2013-11-01

    Anorectal malformation (ARM) occurs in approximately 1 in 5000 newborns and is frequently accompanied by anomalies of the genitalia, gynecologic system, urinary tract, spine, and skeletal system. Diagnostic imaging plays a central role in ARM evaluation. Because of the lack of ionizing radiation, excellent intrinsic contrast resolution, multiplanar imaging capabilities, technical advances in hardware, and innovative imaging protocols, magnetic resonance (MR) imaging is increasingly important in assessment of ARM patients in utero, postnatally before definitive surgical correction, and in the postoperative period. This article discusses the role of MR imaging in evaluating ARM patients. PMID:24183526

  10. Spontaneous asymptomatic gallbladder perforation

    PubMed Central

    Seçil, Mustafa

    2014-01-01

    Gallstone disease is common. However, a proportion of patients are asymptomatic and remain undiagnosed until the occurrence of complications. Common complications include acute cholecystitis, biliary obstruction, acute pancreatitis and cholangitis. Severe complications include gallbladder perforation, Mirizzi syndrome and fistula formation are usually associated with significant morbidity and mortality. We report a case of asymptomatic spotaneous gallbladder perforation due to acute cholecystitis. PMID:24914424

  11. [Currarino's triad: anorectal malformation, sacral anomaly and presacral mass].

    PubMed

    Arifi, Mohamed; Kaddouri, Nourredine; Abdelhak, M'Barek; Benhmamouch, Mohammed Najib; Barahioui, Mohammed

    2006-01-01

    We report the case of a 3 year old boy with a combination of anorectal malformation, sacral agenesia and anterior meningocele (Currarino's triad) and provide a review of the literature of this rare syndrome. PMID:16514396

  12. Asymptomatic infection with Borrelia burgdorferi.

    PubMed

    Steere, Allen C; Sikand, Vijay K; Schoen, Robert T; Nowakowski, John

    2003-08-15

    The natural history of asymptomatic seroconversion to Borrelia burgdorferi has been unclear. We report here, on the basis of a post hoc assessment, the frequency and outcome of asymptomatic seroconversion to B. burgdorferi in participants of a large Lyme disease vaccine trial. We show that infection with B. burgdorferi may be asymptomatic but that asymptomatic infection is unusual in the United States.

  13. Asymptomatic inhaled foreign body

    PubMed Central

    Salim, Muhammad U.; Asghar, Asif; Tareen, Irum; Azhar, Muhammad

    2016-01-01

    It is very rare to have a big foreign body in the lungs without any complications or symptoms for 2 years. A 14-year-old male with episodes of minor hemoptysis for 4 weeks had a history of inhalation of a bullet 2 years earlier. He had asymptomatic for lung complications for 2 years. The bullet was removed by right thoracotomy and non-anatomical wedge stapled resection, and he followed an uneventful recovery. An aspirated foreign body although big can remain asymptomatic for a long time, especially if it has migrated to the periphery. PMID:27652366

  14. Anorectal Malformations Caused by Defects in Sonic Hedgehog Signaling

    PubMed Central

    Mo, Rong; Kim, Jae Hong; Zhang, Jianrong; Chiang, Chin; Hui, Chi-chung; Kim, Peter C. W.

    2001-01-01

    Anorectal malformations are a common clinical problem affecting the development of the distal hindgut in infants. The spectrum of anorectal malformations ranges from the mildly stenotic anus to imperforate anus with a fistula between the urinary and intestinal tracts to the most severe form, persistent cloaca. The etiology, embryology, and pathogenesis of anorectal malformations are poorly understood and controversial. Sonic hedgehog (Shh) is an endoderm-derived signaling molecule that induces mesodermal gene expression in the chick hindgut. However, the role of Shh signaling in mammalian hindgut development is unknown. Here, we show that mutant mice with various defects in the Shh signaling pathway exhibit a spectrum of distal hindgut defects mimicking human anorectal malformations. Shh null-mutant mice display persistent cloaca. Mutant mice lacking Gli2 or Gli3, two zinc finger transcription factors involved in Shh signaling, respectively, exhibit imperforate anus with recto-urethral fistula and anal stenosis. Furthermore, persistent cloaca is also observed in Gli2−/−;Gli3+/−, Gli2+/−;Gli3−/−, and Gli2−/−;Gli3−/− mice demonstrating a gene dose-dependent effect. Therefore, Shh signaling is essential for normal development of the distal hindgut in mice and mutations affecting Shh signaling produce a spectrum of anorectal malformations that may reveal new insights into their human disease equivalents. PMID:11485934

  15. Hypospadias and anorectal malformations mediated by Eph/ephrin signaling

    PubMed Central

    Yucel, Selcuk; Dravis, Christopher; Garcia, Nilda; Henkemeyer, Mark; Baker, Linda A.

    2007-01-01

    Purpose Despite extensive research, the molecular basis of hypospadias and anorectal malformations is poorly understood, likely due to a multifactorial basis. The incidence of hypospadias is increasing, thus making research in this area warranted and timely. This review presents recent molecular work broadening our understanding of these disorders. Materials and Methods A brief review of our recent work and the literature on the role of Eph/ephrin signaling in hypospadias and anorectal malformations is presented. Results Genetically engineered mice mutant for ephrin-B2 or EphB2;EphB3 manifest a variety of genitourinary and anorectal malformations. Approximately 40% of adult male heterozygous mice demonstrate perineal hypospadias. Although homozygous mice die soon after birth, 100% of homozygous males demonstrate high imperforate anus with urethral anomalies and 100% of homozygous females demonstrate persistent cloaca. Male mice compound homozygous for EphB2ki/ki;EphB3Δ/Δ/ also demonstrate hypospadias. Conclusions These mouse models provide compelling evidence of the role of B-class Eph/ephrin signaling in genitourinary/anorectal development and add to our mechanistic and molecular understanding of normal and abnormal embryonic development. As research on the B-class Ephs and ephrins continues, they will likely be shown to be molecular contributors to the multifactorial basis of hypospadias and anorectal malformations in humans as well. PMID:18431460

  16. Anorectal avulsion: Management of a rare rectal trauma

    PubMed Central

    Rispoli, C.; Andreuccetti, J.; Iannone, L.; Armellino, M.; Rispoli, G.

    2012-01-01

    INTRODUCTION Traumatic injuries of the rectum are unusual even though their treatment is challenging and often lead to high morbidity and mortality rate. PRESENTATION OF CASE This paper reports a rare case of complete rectal avulsion with multiple fracture and hemoperitoneum treated with a multistep approach in our department. DISCUSSION The anorectal avulsion is a rare rectal trauma; only few reports are available. Treatment key points of rectal trauma are: direct repair, diverting stoma and sacral drainage. CONCLUSION We reported a case of anorectal avulsion with complete detachment of external sphincter muscle. A multidisciplinary approach was mandatory in this kind of lesions. PMID:22554940

  17. Motor slowing in asymptomatic HIV infection.

    PubMed

    Fitzgibbon, M L; Cella, D F; Humfleet, G; Griffin, E; Sheridan, K

    1989-06-01

    To examine neuropsychological deficits associated with the human immunodeficiency virus (HIV), 25 asymptomatic homosexual men and sexual partners of intravenous drug users and 25 seronegative homosexual men and nonhigh-risk heterosexuals were assessed on measures of fine motor control, visual scanning, attention, depression, and global psychological functioning. Analysis suggested that HIV infection is associated with reduced fine motor control. Seropositivity is associated with elevated depression and global psychological maladjustment. When depression and global adjustment were analyzed as covariates, motor slowing was evident in the seropositive group. These findings suggest an association between motor slowing and HIV infection in asymptomatic subjects and point to the necessity of measuring affect at least as a control variable. Further study is needed to determine whether the fine motor deficit evident in this sample is limited to distinct subgrouping of the over-all sample. PMID:2762096

  18. Asymptomatic cervical bruits.

    PubMed Central

    Côté, R.; Battista, R. N.

    1984-01-01

    The diagnosis, significance and management of asymptomatic cervical bruits have been the focus of considerable controversy. The literature does not support an aggressive approach but, rather, careful follow-up of patients with this disorder. This paper reviews the available data and discusses the management options of family practitioners who may detect this disorder during a routine physical examination, during an examination prompted by an unrelated problem or preoperatively when elective surgery is being considered. PMID:6367922

  19. 21 CFR 346.50 - Labeling of anorectal drug products.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... “irritation in hemorrhoids and other anorectal disorders”). (B) “Temporarily shrinks hemorrhoidal tissue... relieves burning.” (D) “Provides temporary relief from skin irritations.” (E) “Temporarily provides a... abrasion during bowel movement”). (G) “Temporarily protects inflamed perianal skin.” (H)...

  20. 21 CFR 346.50 - Labeling of anorectal drug products.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... “irritation in hemorrhoids and other anorectal disorders”). (B) “Temporarily shrinks hemorrhoidal tissue... relieves burning.” (D) “Provides temporary relief from skin irritations.” (E) “Temporarily provides a... abrasion during bowel movement”). (G) “Temporarily protects inflamed perianal skin.” (H)...

  1. Laparoscopic abdomino-perineal resection for patients with anorectal malignant melanoma: a report of 4 cases

    PubMed Central

    Han, Jun; Shi, Chuanbing; Dong, Xiaogang; Wang, Jie; Wen, Hao; Wang, Baolin; He, Zhenyu

    2016-01-01

    Abstract Anorectal malignant melanoma is a very rare but lethal disease. Patients with anorectal malignant melanoma commonly complain for changes in bowel habits and rectal bleeding. Therefore, anorectal malignant melanoma is often misdiagnosed as hemorrhoids, polyp or rectal cancer. Surgery is the mainstay of treatment for patients with anorectal malignant melanoma. However, whether abdominoperineal resection or wide local excision is the most appropriate surgical approach is still a controversial issue. Recently, with the great development of laparoscopic techniques, more and more operations can be performed by laparoscopic techniques. However, laparoscopic abdominoperineal resection for management of anorectal malignant melanoma has been rarely reported. In this study, we reported 4 patients with anorectal malignant melanoma underwent laparoscopic abdominoperineal resection. The outcomes of these patients were relatively good during a long time follow-up. Meanwhile, we reviewed the relevant studies with particular focus surgical treatment.

  2. [Anorectal malformations: their diagnosis and the initial decisions].

    PubMed

    de Espinosa, H

    1994-05-01

    The author presents the salient aspects of anorectal malformation which allow us to simplify their anatomical diagnosis. In many cases only clinical means are used while in others adequate use of technical studies are necessary. This enables us to reach therapeutic decisions in the simplest and most orderly fashion so that patients with these anomalies may be given the opportunity of attaining normal or near normal function. PMID:7991806

  3. Kabuki Syndrome and Anorectal Malformations: Implications for Diagnosis and Treatment.

    PubMed

    Siminas, Sotirios; Baillie, Colin Tennant; Turnock, Richard

    2015-06-01

    Kabuki syndrome (KS) is a rare genetic condition characterized by a distinctive facies, intellectual disability, growth delay, and a variety of skeletal, visceral, and other anomalies, including anorectal malformations (ARMs). We present two cases of female patients with KS, diagnosed and successfully managed at our institution, one with a perineal fistula and one with a rectovestibular fistula. Our report, along with a literature review, shows that the syndrome is usually associated with "low" anomalies, with a potential for a good prognosis. Management of the anorectal anomaly in patients with KS is not essentially different from that in other nonsyndromic patients, taking into account the frequent association of the syndrome with serious congenital heart disease, which might affect the decision-making and timing of the stages of anorectal reconstruction. The frequent occurrence of learning and feeding difficulties makes establishment of toilet training and bowel management rather more challenging, requiring the expertise of a multidisciplinary team. The finding of ARMs in female patients with other characteristics of KS, although inconstant, could support the clinical suspicion for the syndrome until genetic confirmation is available, and should alert the physician for the potential of severe cardiac defects. PMID:26171318

  4. Utility of magnetic resonance imaging in anorectal disease

    PubMed Central

    Berman, Loren; Israel, Gary M; McCarthy, Shirley M; Weinreb, Jeffrey C; Longo, Walter E

    2007-01-01

    Imaging of both benign and malignant anorectal diseases has traditionally posed a challenge to clinicians, and as a result history and physical exam have been relied on heavily. CT scanning and endorectal ultrasound have become popular in assessment of anatomy and staging of tumors, but have limitations. Magnetic resonance imaging (MRI) has the capability to fill in the gaps left open by more conventional imaging modalities and continues to be promising as the definitive imaging technique in the pelvis, especially with advancement of emerging technologies in this field. A comprehensive review of this topic has been undertaken. Anorectal disease is divided into three broad categories: cancer, fistula/abscess, and pelvic floor disorders. A review of the literature is performed to evaluate the use of MRI and other imaging modalities in these three areas. Preoperative imaging is useful in the evaluation of all three areas of anorectal disease. MRI is an effective tool in delineating anatomy and, when correlating with the specific clinical scenario, is an effective adjunct in clinical decision-making in order to optimize outcome. MRI continues to be a promising and novel approach to imaging various afflictions of the anorectum and the pelvic floor. Its role is more well-established in some areas than in others, and there are still significant limitations. As technology advances, MRI will shed more light on a complex anatomical area. PMID:17589891

  5. The antegrade continence enema procedure and total anorectal reconstruction

    PubMed Central

    Zbar, Andrew P.

    2014-01-01

    Patients may present with anal incontinence (AI) following repair of a congenital anorectal anomaly years previously, or require total anorectal reconstruction (TAR) following radical rectal extirpation, most commonly for rectal cancer. Others may require removal of their colostomy following sphincter excision for Fournier's gangrene, or in cases of severe perineal trauma. Most of the data pertaining to antegrade continence enema (the ACE or Malone procedure) comes from the pediatric literature in the management of children with AI, but also with supervening chronic constipation, where the quality of life and compliance with this technique appears superior to retrograde colonic washouts. Total anorectal reconstruction requires an anatomical or physical supplement to the performance of a perineal colostomy, which may include an extrinsic muscle interposition (which may or may not be ‘dynamized'), construction of a neorectal reservoir, implantation of an incremental artificial bowel sphincter or creation of a terminal, smooth-muscle neosphincter. The advantages and disadvantages of these techniques and their outcome are presented here. PMID:24759342

  6. Altered erythrocyte Na-K pump in anorectic patients

    SciTech Connect

    Pasquali, R.; Strocchi, E.; Malini, P.; Casimirri, F.; Ambrosioni, E.; Melchionda, N.; Labo, G.

    1985-07-01

    The status of the erythrocyte sodium pump was evaluated in a group of patients suffering from anorexia nervosa and a group of healthy female control subjects. Anorectic patients showed significantly higher mean values of digoxin-binding sites/cell (ie, the number of Na-K-ATPase units) with respect to control subjects while no differences were found in the specific /sup 86/Rb uptake (which reflects the Na-K-ATPase activity) between the two groups. A significant correlation was found between relative weight and the number of Na-K-ATPase pump units (r = -0.66; P less than 0.0001). Anorectic patients showed lower serum T3 concentrations (71.3 +/- 53 ng/dL) with respect to control subjects (100.8 +/- 4.7 ng/dL; P less than 0.0005) and a significant negative correlation between T3 levels and the number of pump units (r = -0.52; P less than 0.003) was found. This study therefore shows that the erythrocyte Na-K pump may be altered in several anorectic patients. The authors suggest that this feature could be interrelated with the degree of underweight and/or malnutrition.

  7. Differences in Radiation Dosimetry and Anorectal Function Testing Imply That Anorectal Symptoms May Arise From Different Anatomic Substrates

    SciTech Connect

    Smeenk, Robert Jan; Hopman, Wim P.M.; Hoffmann, Aswin L.; Lin, Emile N.J.Th. van; Kaanders, Johannes H.A.M.

    2012-01-01

    Purpose: To explore the influence of functional changes and dosimetric parameters on specific incontinence-related anorectal complaints after prostate external beam radiotherapy and to estimate dose-effect relations for the anal wall and rectal wall. Methods and Materials: Sixty patients, irradiated for localized prostate cancer, underwent anorectal manometry and barostat measurements to evaluate anal pressures, rectal capacity, and rectal sensory functions. In addition, 30 untreated men were analyzed as a control group. In 36 irradiated patients, the anal wall and rectal wall were retrospectively delineated on planning computed tomography scans, and dosimetric parameters were retrieved from the treatment plans. Functional and dosimetric parameters were compared between patients with and without complaints, focusing on urgency, incontinence, and frequency. Results: After external beam radiotherapy, reduced anal pressures and tolerated rectal volumes were observed, irrespective of complaints. Patients with urgency and/or incontinence showed significantly lower anal resting pressures (mean 38 and 39 vs. 49 and 50 mm Hg) and lower tolerated rectal pressures (mean 28 and 28 vs. 33 and 34 mm Hg), compared to patients without these complaints. In patients with frequency, almost all rectal parameters were reduced. Several dosimetric parameters to the anal wall and rectal wall were predictive for urgency (e.g., anal D{sub mean}>38Gy), whereas some anal wall parameters correlated to incontinence and no dose-effect relation for frequency was found. Conclusions: Anorectal function deteriorates after external beam radiotherapy. Different incontinence-related complaints show specific anorectal dysfunctions, suggesting different anatomic and pathophysiologic substrates: urgency and incontinence seem to originate from both anal wall and rectal wall, whereas frequency seems associated with rectal wall dysfunction. Also, dose-effect relations differed between these complaints. This

  8. Asymptomatic monoclonal gammopathies.

    PubMed

    Bories, Claire; Jagannath, Sundar

    2014-09-01

    Monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) represent the earlier phases of plasma cell dyscrasias. Their definition is based on absence of end-organ damage with presence of a malignant clone that grows in the bone marrow. They share, as a common feature, the risk of progression to a symptomatic disease. MGUS progression risk is approximately 1% per year, and SMM has a risk of progression of 10% for the first 5 years which tapers off over time. The main purpose of identification of these earlier phases of the plasma cell dyscrasia was to identify patients who do not warrant treatment with chemotherapy, in whom the risk of treatment outweighs the benefit. Over the years, the definitions have not been modified to incorporate developments in imaging (magnetic resonance or positron emission and computed tomography), or genomics to identify patients at highest risk of progression within 2 years, where wait and watch might not be an appropriate option. In the absence of such definition, patients who have only a 50% chance of progression within 2 years are being offered therapy, which might also not be an optimal approach. In this review, we provide an overview of the definition, current prognostic factors, and risk stratifications in asymptomatic gammopathies, and discuss clinical trial outcomes in high-risk SMM. PMID:25486961

  9. 21 CFR 346.52 - Labeling of permitted combinations of anorectal active ingredients.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 5 2012-04-01 2012-04-01 false Labeling of permitted combinations of anorectal active ingredients. 346.52 Section 346.52 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... HUMAN USE Labeling § 346.52 Labeling of permitted combinations of anorectal active...

  10. 21 CFR 346.52 - Labeling of permitted combinations of anorectal active ingredients.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 5 2014-04-01 2014-04-01 false Labeling of permitted combinations of anorectal active ingredients. 346.52 Section 346.52 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... HUMAN USE Labeling § 346.52 Labeling of permitted combinations of anorectal active...

  11. Endoscopic and imaging appearance after injection of an ano-rectal bulking agent

    PubMed Central

    Papafragkakis, Haris; Changela, Kinesh; Bhatia, Taruna; Ona, Mel A; Malieckal, Anju; Paleti, Vani; Fuksbrumer, Moshe S; Anand, Sury

    2014-01-01

    The use of hyaluronic acid and dextranomer (Solesta, Salix) injection in the anal canal is an emerging modality in the treatment of fecal incontinence. However, little is known regarding the endoscopic and radiological appearance following injection of this ano-rectal bulking agent. We report computed tomography and endoscopic findings after hyaluronic acid/dextranomer injection in the ano-rectal area. PMID:25031792

  12. 21 CFR 346.52 - Labeling of permitted combinations of anorectal active ingredients.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 5 2013-04-01 2013-04-01 false Labeling of permitted combinations of anorectal active ingredients. 346.52 Section 346.52 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE ANORECTAL DRUG PRODUCTS FOR...

  13. Human papillomavirus and anorectal carcinoma knowledge in men who have sex with men.

    PubMed

    Blackwell, Christopher W; Eden, Candace

    2011-01-01

    Human papillomavirus (HPV) infection is a precursor to the development of anorectal carcinoma. Studies have indicated that men who have sex with men (MSM) have significantly higher rates of HPV and HIV than their heterosexual counterparts and are at greater risk for anorectal carcinoma. This article presents findings from a descriptive study to assess knowledge of HPV, anorectal carcinoma, and anorectal screening in a sample of MSM in Orlando, FL. The 89 participants demonstrated knowledge deficits. The average score on knowledge items was only 38% correct. Of the 49 participants who had heard of anal Papanicolau (Pap) smears, only 5 (10.2%) discussed screening with a physician, while 8 (16.3%) had discussed it with a nurse, and 16 (32.7%) with another health care professional. Findings support the need for community outreach efforts to promote knowledge and the need for discussion with providers regarding HPV and anorectal carcinoma in this vulnerable population.

  14. Radiochemotherapy Versus Surgery in Nonmetastatic Anorectal Neuroendocrine Carcinoma

    PubMed Central

    Brieau, Bertrand; Lepère, Céline; Walter, Thomas; Lecomte, Thierry; Guimbaud, Rosine; Manfredi, Sylvain; Tougeron, David; Desseigne, Françoise; Lourenco, Nelson; Afchain, Pauline; El Hajbi, Farid; Terris, Benoit; Rougier, Philippe; Coriat, Romain

    2015-01-01

    Abstract Neuroendocrine carcinomas (NEC) of the anus or the rectum are a rare disease, accounting for less than 1% of all digestive malignancies. Most are metastatic at diagnosis and treated with a platinum-based chemotherapy. No guidelines for localized tumors exist. The purpose of this study was to describe the characteristics of anorectal localized NEC, their management and their outcomes. We retrospectively reviewed patients from 11 French centers with anorectal localized NEC. We compared 2 therapeutic managements: surgery (group A) versus chemotherapy with or without radiation (group B). Progression-free survival (PFS) and overall survival (OS) were estimated with the Kaplan–Meier method. A total of 24 patients were identified with a median follow-up of 25 months (3–60 months). Median age was 63 years old and 17 had a rectal tumor (71%). Mean Ki-67 was 72% (range: 20–100), and 75% of the tumors had a high proliferative index (Ki-67 > 50%). Global PFS and OS were 13.1 and 44.1 months, respectively. Thirty-seven percent of patients were in group A and 63% in group B. There was no difference between group A and group B, whether in terms of PFS (13.0 months vs. 13.2 months, P = 0.75) or OS (49.1 months vs. 39.2 months, P = 0.42). In patients with anorectal localized NEC, chemotherapy with or without radiation obtained a similar outcome as surgery and this conservative approach could be deemed a reasonable option. PMID:26496341

  15. Sexually transmitted infections of the anus and rectum.

    PubMed

    Assi, Roland; Hashim, Peter W; Reddy, Vikram B; Einarsdottir, Hulda; Longo, Walter E

    2014-11-01

    Sexually transmitted infections (STIs) represent a significant public health concern. Several STIs, once thought to be on the verge of extinction, have recently reemerged. This change is thought to be partially related to an increase in STIs of the anus and rectum. Importantly, the global human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) epidemic has contributed to the emergence of particular anorectal lesions that require specialized approaches. In this report, we review common anorectal STIs that are frequently referred to colorectal surgeons in the United States. Epidemiology, clinical presentation, and management are summarized, including the latest treatment recommendations. The particularity of anorectal diseases in HIV/AIDS is addressed, along with recent trends in anal cytology and human papillomavirus vaccination. PMID:25386074

  16. Murine Anorectic Response to Deoxynivalenol (Vomitoxin) Is Sex-Dependent.

    PubMed

    Clark, Erica S; Flannery, Brenna M; Pestka, James J

    2015-07-29

    Deoxynivalenol (DON, vomitoxin), a common trichothecene mycotoxin found in cereal foods, dysregulates immune function and maintenance of energy balance. The purpose of this study was to determine if sex differences are similarly evident in DON's anorectic responses in mice. A bioassay for feed refusal, previously developed by our lab, was used to compare acute i.p. exposures of 1 and 5 mg/kg bw DON in C57BL6 mice. Greater anorectic responses were seen in male than female mice. Male mice had higher organ and plasma concentrations of DON upon acute exposure than their female counterparts. A significant increase in IL-6 plasma levels was also observed in males while cholecystokinin response was higher in females. When effects of sex on food intake and body weight changes were compared after subchronic dietary exposure to 1, 2.5, and 10 ppm DON, males were found again to be more sensitive. Demonstration of male predilection to DON-induced changes in food intake and weight gain might an important consideration in future risk assessment of DON and other trichothecenes.

  17. Allogeneic anorectal transplantation in rats: technical considerations and preliminary results

    PubMed Central

    Galvão, Flavio H. F.; Waisberg, Daniel R.; Seid, Victor E.; Costa, Anderson C. L.; Chaib, Eleazar; Baptista, Rachel Rossini; Capelozzi, Vera Luiza; Lanchotte, Cinthia; Cruz, Ruy J.; Araki, Jun; D’Albuquerque, Luiz Carneiro

    2016-01-01

    Fecal incontinence is a challenging condition with numerous available treatment modalities. Success rates vary across these modalities, and permanent colostomy is often indicated when they fail. For these cases, a novel potential therapeutic strategy is anorectal transplantation (ATx). We performed four isogeneic (Lewis-to-Lewis) and seven allogeneic (Wistar-to-Lewis) ATx procedures. The anorectum was retrieved with a vascular pedicle containing the aorta in continuity with the inferior mesenteric artery and portal vein in continuity with the inferior mesenteric vein. In the recipient, the native anorectal segment was removed and the graft was transplanted by end-to-side aorta-aorta and porto-cava anastomoses and end-to-end colorectal anastomosis. Recipients were sacrificed at the experimental endpoint on postoperative day 30. Surviving animals resumed normal body weight gain and clinical performance within 5 days of surgery. Isografts and 42.9% of allografts achieved normal clinical evolution up to the experimental endpoint. In 57.1% of allografts, signs of immunological rejection (abdominal distention, diarrhea, and anal mucosa inflammation) were observed three weeks after transplantation. Histology revealed moderate to severe rejection in allografts and no signs of rejection in isografts. We describe a feasible model of ATx in rats, which may allow further physiological and immunologic studies. PMID:27488366

  18. Murine Anorectic Response to Deoxynivalenol (Vomitoxin) Is Sex-Dependent

    PubMed Central

    Clark, Erica S.; Flannery, Brenna M.; Pestka, James J.

    2015-01-01

    Deoxynivalenol (DON, vomitoxin), a common trichothecene mycotoxin found in cereal foods, dysregulates immune function and maintenance of energy balance. The purpose of this study was to determine if sex differences are similarly evident in DON’s anorectic responses in mice. A bioassay for feed refusal, previously developed by our lab, was used to compare acute i.p. exposures of 1 and 5 mg/kg bw DON in C57BL6 mice. Greater anorectic responses were seen in male than female mice. Male mice had higher organ and plasma concentrations of DON upon acute exposure than their female counterparts. A significant increase in IL-6 plasma levels was also observed in males while cholecystokinin response was higher in females. When effects of sex on food intake and body weight changes were compared after subchronic dietary exposure to 1, 2.5, and 10 ppm DON, males were found again to be more sensitive. Demonstration of male predilection to DON-induced changes in food intake and weight gain might an important consideration in future risk assessment of DON and other trichothecenes. PMID:26230710

  19. Is asymptomatic malaria really asymptomatic? Hematological, vascular and inflammatory effects of asymptomatic malaria parasitemia.

    PubMed

    de Mast, Quirijn; Brouwers, Judith; Syafruddin, Din; Bousema, Teun; Baidjoe, Amrish Y; de Groot, Philip G; van der Ven, Andre J; Fijnheer, Rob

    2015-11-01

    Asymptomatic malaria infections are highly prevalent in malaria endemic regions and most of these infections remain undiagnosed and untreated. Whereas conventional malaria symptoms are by definition absent, little is known on the more subtle health consequences of these infections. The aim of our study was to analyze the hematologic, vascular and inflammatory effects of patent and subpatent asymptomatic malaria parasitemia in children and adults on the Indonesian island Sumba. Both children and adults with parasitemia had increased high-sensitive C-reactive protein levels compared to aparasitemic individuals. In addition, children, but not adults with parasitemia also had lower platelet counts and Hb levels and higher levels of von Willebrand factor and platelet factor-4, markers of endothelial and platelet activation, respectively. These findings suggest that asymptomatic malaria infections have subtle health consequences, especially in children, and should be regarded as potentially harmful.

  20. Is asymptomatic malaria really asymptomatic? Hematological, vascular and inflammatory effects of asymptomatic malaria parasitemia.

    PubMed

    de Mast, Quirijn; Brouwers, Judith; Syafruddin, Din; Bousema, Teun; Baidjoe, Amrish Y; de Groot, Philip G; van der Ven, Andre J; Fijnheer, Rob

    2015-11-01

    Asymptomatic malaria infections are highly prevalent in malaria endemic regions and most of these infections remain undiagnosed and untreated. Whereas conventional malaria symptoms are by definition absent, little is known on the more subtle health consequences of these infections. The aim of our study was to analyze the hematologic, vascular and inflammatory effects of patent and subpatent asymptomatic malaria parasitemia in children and adults on the Indonesian island Sumba. Both children and adults with parasitemia had increased high-sensitive C-reactive protein levels compared to aparasitemic individuals. In addition, children, but not adults with parasitemia also had lower platelet counts and Hb levels and higher levels of von Willebrand factor and platelet factor-4, markers of endothelial and platelet activation, respectively. These findings suggest that asymptomatic malaria infections have subtle health consequences, especially in children, and should be regarded as potentially harmful. PMID:26304688

  1. 21 CFR 346.52 - Labeling of permitted combinations of anorectal active ingredients.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... OTC drug monograph. ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Labeling of permitted combinations of anorectal active ingredients. 346.52 Section 346.52 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT...

  2. 21 CFR 346.52 - Labeling of permitted combinations of anorectal active ingredients.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... OTC drug monograph. ... 21 Food and Drugs 5 2011-04-01 2011-04-01 false Labeling of permitted combinations of anorectal active ingredients. 346.52 Section 346.52 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT...

  3. Effect of hysterectomy on anorectal and urethrovesical physiology.

    PubMed

    Prior, A; Stanley, K; Smith, A R; Read, N W

    1992-02-01

    To investigate whether vaginal or total abdominal hysterectomy is associated with changes in anorectal and urethrovesical physiology, 26 women were studied before operation and six weeks and six months afterwards. The results showed a postoperative increase in both rectal and vesical sensitivity (p less than 0.01). Similar results were observed irrespective of the type of hysterectomy. No significant changes in rectal or bladder compliance were noted, and anal pressure and urethral pressure and length were unchanged after surgery. Whole gut transit was not affected by hysterectomy. Urinary symptoms occurred de novo in 6/26 women and gastrointestinal symptoms in 2/26 women. These results show that significant changes in rectal and vesical sensitivity occur after hysterectomy for benign disease. These persist for at least six months postoperatively but are not always associated with development of urinary or gastrointestinal symptoms.

  4. The clinical features and optimal treatment of anorectal malignant melanoma

    PubMed Central

    Nam, Soomin; Kim, Chang Woo; Baek, Se Jin; Hur, Hyuk; Min, Byung Soh; Kim, Nam Kyu

    2014-01-01

    Anorectal malignant melanoma (AMM) is a very rare and aggressive disease. The purpose of this article is to review the clinical features of AMM, to understand treatment options, and optimal therapy by reviewing pertinent literature. Traditionally an abdominoperineal resection (APR) sacrificing the anal sphincter has been performed for radical resection of cancer, but recently, wide excision of AMM is attempted since quality of life after surgery is an important issue. Some authors reported that there was no difference in five-year survival between the patient who underwent an APR and wide excision. The goal of both APR and wide excision was to improve survival with R0 resection. Adjuvant chemoradiation therapy can be performed to achieve an R0 resection. AMM shows very poor prognosis. At this time, research on AMM is insufficient to suggest a treatment guideline. Thus, treatment options, and a therapeutic method should be selected carefully. PMID:25247163

  5. Randomized controlled trial of minimally invasive surgery using acellular dermal matrix for complex anorectal fistula

    PubMed Central

    A ba-bai-ke-re, Ma-Mu-Ti-Jiang; Wen, Hao; Huang, Hong-Guo; Chu, Hui; Lu, Ming; Chang, Zhong-Sheng; Ai, Er-Ha-Ti; Fan, Kai

    2010-01-01

    AIM: To compare the efficacy and safety of acellular dermal matrix (ADM) bioprosthetic material and endorectal advancement flap (ERAF) in treatment of complex anorectal fistula. METHODS: Ninety consecutive patients with complex anorectal fistulae admitted to Anorectal Surgical Department of First Affiliated Hospital, Xinjiang Medical University from March 2008 to July 2009, were enrolled in this study. Complex anorectal fistula was diagnosed following its clinical, radiographic, or endoscopic diagnostic criteria. Under spinal anesthesia, patients underwent identification and irrigation of the fistula tracts using hydrogen peroxide. ADM was securely sutured at the secondary opening to the primary opening using absorbable suture. Outcomes of ADM and ERAF closure were compared in terms of success rate, fecal incontinence rate, anorectal deformity rate, postoperative pain time, closure time and life quality score. Success was defined as closure of all external openings, absence of drainage without further intervention, and absence of abscess formation. Follow-up examination was performed 2 d, 2, 4, 6, 12 wk, and 5 mo after surgery, respectively. RESULTS: No patient was lost to follow-up. The overall success rate was 82.22% (37/45) 5.7 mo after surgery. ADM dislodgement occured in 5 patients (11.11%), abscess formation was found in 1 patient, and fistula recurred in 2 patients. Of the 13 patients with recurrent fistula using ERAF, 5 (11.11%) received surgical drainage because of abscess formation. The success rate, postoperative pain time and closure time of ADM were significantly higher than those of ERAF (P < 0.05). However, no difference was observed in fecal incontinence rate and anorectal deformity rate after treatment with ADM and ERAF. CONCLUSION: Closure of fistula tract opening with ADM is an effective procedure for complex anorectal fistula. ADM should be considered a first line treatment for patients with complex anorectal fistula. PMID:20614483

  6. Anorectal Function After Three- Versus Two-Dimensional Radiation Therapy for Carcinoma of the Prostate

    SciTech Connect

    Yeoh, Eric K. Holloway, Richard H.; Fraser, Robert J.; Botten, Rochelle; Di Matteo, Addolorata; Moore, James W.; Schoeman, Mark N.; Bartholomeusz, Dylan L.

    2009-01-01

    Purpose: To compare the effects of (three-dimensional) 3D vs. two-dimensional (2D) radiation therapy (RT) for carcinoma of the prostate on the prevalence and pathophysiology of anorectal dysfunction. Methods and Materials: Anorectal symptoms, motility, sensory function, and anal sphincter morphology were evaluated before and up to 2 years after randomly assigned hypofractionated vs. conventionally fractionated RT in 67 patients (median age, 69 years; range, 54-82 years) with localized prostate carcinoma, using either a 3D (n = 29) or 2D (n = 38) treatment technique. Results: Anorectal symptoms increased 4 to 6 weeks after RT and persisted in both patient groups. At 2 years, abnormalities included increased stool frequency (55% vs. 53%, p = NS), urgency of defecation (72% vs. 47%, p < 0.05), fecal incontinence (28% vs. 26%, p = NS), and rectal bleeding (38% and 42%, p = NS). Anorectal motility and sensory function deteriorated after RT in both groups with reductions in basal anal pressures, anal pressures in response to squeeze, rectal compliance, and rectal volumes associated with the desire to defecate. External but not internal sphincter thickness changed in the treatment groups although in different directions. However no differences in motility or sensory function were detected between the groups. Baseline anorectal motility but not treatment technique and the hypofracionated schedule were of independent prognostic significance for anorectal motor dysfunction and rectal bleeding respectively at 2 years. Conclusion: The prevalence and pathophysiology of anorectal dysfunction 2 years after RT for prostate carcinoma was largely independent of the treatment techniques used in this study.

  7. Anorectal Manometric and Urodynamic Parameters According to the Spinal Cord Injury Lesion

    PubMed Central

    2016-01-01

    Objective To assess the correlation between the anorectal function and bladder detrusor function in patients with complete spinal cord injury (SCI) according to the type of lesion. Methods Medical records of twenty-eight patients with SCI were included in this study. We compared the anorectal manometric and urodynamic (UD) parameters in total subjects. We analyzed the anorectal manometric and UD parameters between the two groups: upper motor neuron (UMN) lesion and lower motor neuron (LMN) lesion. In addition, we reclassified the total subjects into two groups according to the bladder detrusor function: overactive and non-overactive. Results In the group with LMN lesion, the mean value of maximal anal squeeze pressure (MSP) was slightly higher than that in the group with UMN lesion, and the ratio of MSP to maximal anal resting pressure (MRP) was statistically significant different between the two groups. In addition, although the mean value of MSP was slightly higher in the group with non-overactive detrusor function, there was no statistical correlation of anorectal manometric parameters between the groups with overactive and non-overactive detrusor function. Conclusion The MSP and the ratio of MSP to MRP were higher in the group with LMN lesion. In this study, we could not identify the correlation between bladder and bowel function in total subjects. We conclude that the results of UD study alone cannot predict the outcome of anorectal manometry in patients with SCI. Therefore, it is recommended to perform assessment of anorectal function with anorectal manometry in patients with SCI. PMID:27446791

  8. Serum leptin monitoring in anorectic patients during refeeding therapy.

    PubMed

    Lob, S; Pickel, J; Bidlingmaier, M; Schaaf, L; Backmund, H; Gerlinghoff, M; Stalla, G K

    2003-08-01

    Circulating concentrations of leptin are exceedingly low in severe malnutrition as seen in the acute state of anorexia nervosa (AN). During refeeding therapy plasma leptin levels increase to normal and in some cases peak at values in excess of the BMI of matched controls even before a normal body weight has been achieved. Peak leptin levels are possibly the cause of an increased energy expenditure during this stage of the disorder and might predispose to renewed weight loss (rebound phenomenon). In this study we investigated the role of leptin fluctuations as a prognostic factor of therapeutic success in AN. In 11 anorectic female patients serum leptin levels, BMI and body fat percentage were evaluated in four-week intervals during a conventional refeeding program over three months (group 1). The results of the first two measurements were used to determine a range of increases in leptin levels in relation to increases in BMI. The values between the 25th and 75th percentiles determined the reference range. In a second group of 9 anorectic female patients serum leptin levels, BMI, body fat percentage and the increase in the leptin level in relation to the BMI of each subject were investigated for three months every two weeks. These patients were also treated according to the same conventional refeeding program, but the caloric intake was reduced or increased (+/-250 kcal/d) if the increase in the leptin level, in relation to the increase in the BMI, had exceeded or fallen short of the reference range. During the refeeding therapy every subject of each group experienced increases in serum leptin levels, BMI and body fat percentage. Six subjects of group 1 and six subjects of the second group had an increase in leptin levels in relation to the increase of the BMI out of the reference range at least once. To investigate the therapeutic outcome of leptin monitoring and the following alteration of caloric intake, weight gain of the patients of both groups during the whole

  9. Temporal concordance of anorectic, behavioral, cardiovascular and amphetamine receptor binding activity of phenethylamines in rats

    SciTech Connect

    Borrelli, A.; Blosser, J.; Barrantes, M.; Colombo, P.; Kinsolving, C.R.; Ordy, M.; Watkins, B.

    1986-03-01

    Although numerous studies have described the anorectic, cardiovascular, and behavioral effects of phenthylamines, a comparison of the pharmacological concordance of these properties in a single species is needed. The objectives of this study were to compare the anorectic potency of 13 phenethylamines following po administration with their effects on spontaneous locomotor activity (SLA) and blood pressure (BP) in vivo and with amphetamine receptor affinity in vitro. The anorectic potencies (ED 50) ranged from 12 umol/kg (fenfluramine) to over 400 umol/kg (d-norephedrine and 1-pseudoephedrine). d-Amphetamine, phentermine, and d-norpseudoephedrine were among the most active and 1-pseudoephedrine and 1-nor-ephedrine the least active in increasing SLA. 1-Norephedrine, and d-norpseudoephedrine were the most active increasing BP while d-norephedrine produced a weak vasodepressor effect. A significant correlation (r = .80) was observed between anorectic potency and affinity (IC 50) for /sup 3/H-amphetamine binding sites in the hypothalamus. However, the stereoselectivity between pairs of enantiomers to inhibit food consumption was not paralleled in binding affinity. The rank order of concordance of phenethylamines in anorectic activity was most apparent in behavior and binding affinity.

  10. WNT5A Knock-Out Mouse As A New Model of Anorectal Malformation

    PubMed Central

    Tai, Cindy C.; Sala, Frederic G.; Ford, Henri R.; Wang, Kasper S.; Minoo, Parviz; Grikscheit, Tracy C.; Bellusci, Saverio

    2009-01-01

    Background Anorectal malformations (ARM) represent a variety of congenital disorders that involve abnormal termination of the anorectum. Mutations in Shh signaling and Fgf10 produce a variety of ARM phenotypes. Wnt signaling has been shown to be crucial during gastrointestinal development. We therefore hypothesized that Wnt5a may play a role in anorectal development. Methods Wild type (WT), Wnt5a+/-, and Wnt5a-/- embryos were harvested from timed pregnant mice from E15.5 to E18.5 and analyzed for anorectal phenotype. Tissues were processed for whole-mount in situ hybridization and histology. Results Wnt5a is expressed in the embryonic WT colon and rectum. Wnt5a-/- mutants exhibit multiple deformities including anorectal malformation. A fistula between the urinary and intestinal tracts can be identified as early as E15.5. By E18.5, the majority of the Wnt5a-/- mutants display a blind-ending pouch of the distal gut. Conclusions The expression pattern of Wnt5a and the ARM phenotype seen in Wnt5a-/- mutants demonstrate the critical role of Wnt5a during anorectal development. This study establishes a new model of ARM involving the Wnt5a pathway. PMID:19577771

  11. Currarino Syndrome and the Effect of a Large Anterior Sacral Meningocele on Distal Colostogram in an Anorectal Malformation

    PubMed Central

    Lee, Jason K; Towbin, Alexander J

    2016-01-01

    Currarino syndrome is a congenital disorder, consisting of a triad of anomalies including an anorectal malformation, sacral anomaly, and a presacral mass. Anterior sacral meningoceles are the most common presacral mass. A young child presented to our institution with an unrepaired anorectal malformation and a large anterior sacral meningocele. We describe how the anterior meningocele affected the imaging work-up.

  12. Anorectal melanoma metastatic to the breast: a case report and review of the literature

    PubMed Central

    Feng, Liang; Qi, Dian-Jun; Zhang, Qing-Fu

    2016-01-01

    Melanoma develops from melanocytes and typically occurs on the skin and mucosa with a high degree of malignancy. Intensive local invasion and distant metastasis of melanoma result in poor patient prognosis, owing to frequent metastases to the lungs, bones, brains, and other parts of the body. In the present study, we report a case of anorectal melanoma in a 56-year-old woman who was admitted to our hospital because of local recurrence 9 months after local resection. She subsequently underwent radical surgery. Metastasis to the left breast occurred within 4 months after radical surgery. Metastasis of anorectal melanoma to the breast is very rare. In the present case report and literature review, we analyzed the clinical manifestation, diagnosis, and treatment of anorectal melanoma metastatic to the breast. PMID:27563250

  13. Endosonography for assessment of anorectal changes in patients with fecal incontinence.

    PubMed

    Tankova, L; Draganov, V; Damyanov, N

    2001-03-01

    Our aim was to evaluate the anorectal changes in patients with fecal incontinence by using different endoultrasound techniques. Eighteen females with fecal incontinence and 14 healthy controls (females) were examined. Rigid linear transducer and 10 MHz radial scanning miniprobe were used. Statistically significant difference was found in the mean percentage of decreasing of the anorectal angle during contraction between healthy subjects (21.4%) and incontinent patients (7.5%). The mean percentage of shortening of the puborectal muscle length during squeezing was significantly lower in patients (9.6%) than in controls (17.9%). By means of miniprobe the anal sphincter defects were clearly demonstrated. Endosonography with a radial scanning miniprobe and rigid linear transducer ensures complex morphological and functional assessment of the anorectal region. PMID:11423246

  14. Disturbed Colonic Motility Contributes to Anorectal Symptoms and Dysfunction After Radiotherapy for Carcinoma of the Prostate

    SciTech Connect

    Yeoh, Eric K.; Bartholomeusz, Dylan L.; Holloway, Richard H.; Fraser, Robert J.; Botten, Rochelle; Di Matteo, Addolorata; Moore, James W.; Schoeman, Mark N.

    2010-11-01

    Purpose: To evaluate the role of colonic motility in the pathogenesis of anorectal symptoms and dysfunction after radiotherapy (RT) for carcinoma of the prostate. Patients and Methods: Thirty-eight patients, median age 71 (range, 50-81) years with localized prostate carcinoma randomized to one of two radiation dose schedules underwent colonic transit scintigraphy and assessment of anorectal symptoms (questionnaire), anorectal function (manometry), and anal sphincteric morphology (endoanal ultrasound) before and at 1 month and 1 year after RT. Results: Whole and distal colonic transit increased 1 month after RT, with faster distal colonic transit only persisting at 1 year. Frequency and urgency of defecation, fecal incontinence, and rectal bleeding increased 1 month after RT and persisted at 1 year. Basal anal pressures remained unchanged, but progressive reductions occurred in anal squeeze pressures and responses to increased intra-abdominal pressure. Rectal compliance decreased progressively in the patients, although no changes in anorectal sensory function ensued. Radiotherapy had no effect on the morphology of the internal and external anal sphincters. Distal colonic retention was weakly related to rectal compliance at 1 month, but both faster colonic transit and reduced rectal compliance were more frequent with increased fecal urgency. At 1 year, a weak inverse relationship existed between colonic half-clearance time and frequency of defecation, although both faster whole-colonic transit and reduced rectal compliance occurred more often with increased stool frequency. Conclusion: Colonic dysmotility contributes to anorectal dysfunction after RT for carcinoma of the prostate. This has implications for improving the management of anorectal radiation sequelae.

  15. Asymptomatic Clostridium difficile Colonisation and Onward Transmission

    PubMed Central

    Eyre, David W.; Griffiths, David; Vaughan, Alison; Golubchik, Tanya; Acharya, Milind; O’Connor, Lily; Crook, Derrick W.

    2013-01-01

    Introduction Combined genotyping/whole genome sequencing and epidemiological data suggest that in endemic settings only a minority of Clostridium difficile infection, CDI, is acquired from other cases. Asymptomatic patients are a potential source for many unexplained cases. Methods We prospectively screened a cohort of medical inpatients in a UK teaching hospital for asymptomatic C. difficile carriage using stool culture. Electronic and questionnaire data were used to determine risk factors for asymptomatic carriage by logistic regression. Carriage isolates were compared with all hospital/community CDI cases from the same geographic region, from 12 months before the study to 3 months after, using whole genome sequencing and hospital admission data, assessing particularly for evidence of onward transmission from asymptomatic cases. Results Of 227 participants recruited, 132 provided ≥1 stool samples for testing. 18 participants were culture-positive for C. difficile, 14/132(11%) on their first sample. Independent risk factors for asymptomatic carriage were patient reported loose/frequent stool (but not meeting CDI criteria of ≥3 unformed stools in 24 hours), previous overnight hospital stay within 6 months, and steroid/immunosuppressant medication in the last 6 months (all p≤0.02). Surprisingly antibiotic exposure in the last 6 months was independently associated with decreased risk of carriage (p = 0.005). The same risk factors were identified excluding participants reporting frequent/loose stool. 13/18(72%) asymptomatically colonised patients carried toxigenic strains from common disease-causing lineages found in cases. Several plausible transmission events to asymptomatic carriers were identified, but in this relatively small study no clear evidence of onward transmission from an asymptomatic case was seen. Conclusions Transmission events from any one asymptomatic carrier are likely to be relatively rare, but as asymptomatic carriage is common, it may

  16. Sexual Harassment and Sexual Bulllying

    MedlinePlus

    ... a Friend Who Cuts? Sexual Harassment and Sexual Bullying KidsHealth > For Teens > Sexual Harassment and Sexual Bullying ... being sexually harassed or bullied. What Are Sexual Bullying and Harassment? Just like other kinds of bullying, ...

  17. Age‐bridging among young, urban, heterosexual males with asymptomatic Chlamydia trachomatis

    PubMed Central

    Jennings, Jacky M; Luo, Robert F; Lloyd, Laura V; Gaydos, Charlotte; Ellen, Jonathan M; Rietmeijer, Cornelis A

    2007-01-01

    Objectives To determine the prevalence of age‐bridgers among urban males aged 14–24 years, asymptomatically infected with chlamydia and to determine factors that distinguish age‐bridgers from non age‐bridgers. An index was defined as an age‐bridger if within 2 months, he had had at least two sexual partners who differed from him in age by ⩾2 years. Methods Infected males provided data about themselves and up to four sexual partners in the past 2 months. Bivariate and multivariable logistic regression was used in the analysis. Results The prevalence of age bridging was 21% in Baltimore and 26% in Denver. In both cities, in bivariate analysis, age‐bridgers and their partners engaged in significantly more risky sexual behaviours. In adjusted multivariable analysis after controlling for number of sexual partners, age bridging was associated with having a sexual partner in the past 2 months, who, at time of last sexual intercourse, was drinking. Conclusion Age‐bridgers represented major proportions of the study populations and, along with their sexual partners, were more likely to engage in risky sexual behaviours. Male age‐bridgers may be key players in the transmission of sexually transmitted infections among youth linking age‐disparate sexual networks. PMID:17151025

  18. [Virus-induced anorectal diseases. Condylomata acuminata and herpes simplex].

    PubMed

    Wienert, V

    2004-03-01

    Genital warts (condylomata acuminata) are very common sexually transmitted infections which may be present in perianal, anal and rarely rectal sites. Their incidence in the population is about 0.1%. As a rule, the diagnosis is simple and can be made by inspection; some variants pose a diagnostic challenge. The therapy is not uniform; it must be adjusted to the clinical manifestations and can be conservative or operative. Herpes simplex infections are also common; they too may be transferred by sexual intercourse and then commonly appear in the perianal skin and the rectal mucosa. While the clinical diagnosis is often difficult, the treatment is simple and effective.

  19. Anorectal function and outcomes after transanal minimally invasive surgery for rectal tumors

    PubMed Central

    Karakayali, Feza Y.; Tezcaner, Tugan; Moray, Gokhan

    2015-01-01

    BACKGROUND: Transanal endoscopic microsurgery is a minimally invasive technique that allows full-thickness resection and suture closure of the defect for large rectal adenomas, selected low-risk rectal cancers, or small cancers in patients who have a high risk for major surgery. Our aim, in the given prospective study was to report our initial clinical experience with TAMIS, and to evaluate its effects on postoperative anorectal functions. MATERIALS AND METHODS: In 10 patients treated with TAMIS for benign and malignant rectal tumors, preoperative and postoperative anorectal function was evaluated with anorectal manometry and Cleveland Clinic Incontinence Score. RESULTS: The mean distance of the tumors from the anal verge was 5.6 cm, and mean tumor diameter was 2.6 cm. All resection margins were tumor free. There was no difference in preoperative and 3-week postoperative anorectalmanometry findings; only mean minimum rectal sensory volume was lower at 3 weeks after surgery. The Cleveland Clinic Incontinence Score was normal in all patients except one which resolved by 6 weeks after surgery.The mean postoperative follow-up was 28 weeks without any recurrences. CONCLUSION: Transanal minimally invasive surgery is a safe and effective procedure for treatment of rectal tumors and can be performed without impairing anorectal functions. PMID:26622116

  20. Bordetella holmesii meningitis in a 12-year-old anorectic girl.

    PubMed

    Van Balen, Tessa; Nieman, An-Emmie; Hermans, Mirjam H A; Schneeberger, Peter M; de Vries, Esther

    2012-04-01

    We describe a 12-year-old anorectic girl with Bordetella holmesii meningitis, the techniques used for its identification, and minimum inhibitory concentrations of antibiotics for 7 B. Holmesii strains collected in the Netherlands during the past 12 years. B. holmesii meningitis has not been previously reported.

  1. 21 CFR 346.22 - Permitted combinations of anorectal active ingredients.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... ingredients. 346.22 Section 346.22 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE ANORECTAL DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE Active... least 12.5 percent by weight (e.g., 0.25 gram of a 2-gram dosage unit), except cod liver oil and...

  2. 21 CFR 346.22 - Permitted combinations of anorectal active ingredients.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... ingredients. 346.22 Section 346.22 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE ANORECTAL DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE Active... least 12.5 percent by weight (e.g., 0.25 gram of a 2-gram dosage unit), except cod liver oil and...

  3. 21 CFR 346.22 - Permitted combinations of anorectal active ingredients.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... ingredients. 346.22 Section 346.22 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE ANORECTAL DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE Active... least 12.5 percent by weight (e.g., 0.25 gram of a 2-gram dosage unit), except cod liver oil and...

  4. Operative Treatment with a Laparotomy for Anorectal Problems Arising from a Self-Inserted Foreign Body

    PubMed Central

    Ryoo, Seung-Bum; Oh, Heung-Kwon; Ha, Heon-Kyun; Choe, Eun Kyung; Moon, Sang Hui

    2012-01-01

    An anorectal foreign body can cause serious complications such as incontinence, rectal perforation, peritonitis, or pelvic abscess, so it should be managed immediately. We experienced two cases of operative treatment for a self-inserted anorectal foreign body. In one, the foreign body could not be removed as it was completely impacted in the anal canal. We failed to remove it through the anus. A laparotomy and removal of the foreign body was performed by using an incision on the rectum. Primary colsure and a sigmoid loop colostomy were done. A colostomy take-down was done after three months. The other was a rectal perforation from anal masturbation with a plastic device. We performed primary repair of the perforated rectosigmoid colon, and we didea sigmoid loop colostom. A colostomy take-down was done three months later. Immediate and proper treatment for a self-inserted anorectal foreign body is important to prevent severe complications, and we report successful surgical treatments for problems caused by anorectal foreign bodies. PMID:22413083

  5. Predictive Capability of Anorectal Physiologic Tests for Unfavorable Outcomes Following Biofeedback Therapy in Dyssynergic Defecation

    PubMed Central

    Shin, Jae Kook; Kim, Eun Sook; Yoon, Jin Young; Lee, Jin Ha; Jeon, Soung Min; Bok, Hyun Jung; Park, Jae Jun; Moon, Chang Mo; Hong, Sung Pil; Lee, Yong Chan; Kim, Won Ho

    2010-01-01

    The purpose of this study is to evaluate the predictive capability of anorectal physiologic tests for unfavorable outcomes prior to the initiation of biofeedback therapy in patients with dyssynergic defecation. We analyzed a total of 80 consecutive patients who received biofeedback therapy for chronic idiopathic functional constipation with dyssynergic defecation. After classifying the patients into two groups (responders and non-responders), univariate and multivariate analyses were performed to determine the predictors associated with the responsiveness to biofeedback therapy. Of the 80 patients, 63 (78.7%) responded to biofeedback therapy and 17 (21.3%) did not. On univariate analysis, the inability to evacuate an intrarectal balloon (P=0.028), higher rectal volume for first, urgent, and maximal sensation (P=0.023, P=0.008, P=0.007, respectively), and increased anorectal angle during squeeze (P=0.020) were associated with poor outcomes. On multivariate analysis, the inability to evacuate an intrarectal balloon (P=0.018) and increased anorectal angle during squeeze (P=0.029) were both found to be independently associated with a lack of response to biofeedback therapy. Our data show that the two anorectal physiologic test factors are associated with poor response to biofeedback therapy for patients with dyssynergic defecation. These findings may assist physicians in predicting the responsiveness to therapy for this patient population. PMID:20592899

  6. How to Perform and Interpret a High-resolution Anorectal Manometry Test

    PubMed Central

    Lee, Tae Hee; Bharucha, Adil E

    2016-01-01

    High-resolution anorectal manometry (HR-ARM) and high-definition anorectal manometry (HD-ARM) catheters have closely spaced water-perfused or solid state circumferentially-oriented pressure sensors that provide much better spatiotemporal pressurization than non-high resolution catheters. This is a comprehensive review of HR-ARM and HD-ARM anorectal manometry catheter systems, the methods for conducting, analyzing, and interpreting HR-ARM and HD-ARM, and a comparison of HR-ARM with non-high resolution anorectal manometry. Compared to non-high resolution techniques, HR-ARM and HD-ARM studies take less time and are easier to interpret. However, HR-ARM and HD-ARM catheters are more expensive and fragile and have a shorter lifespan. Further studies are needed to refine our understanding of normal values and to rigorously evaluate the incremental clinical utility of HR-ARM or HD-ARM compared to non-high resolution manometry. PMID:26717931

  7. Anorectics on trial: a half century of federal regulation of prescription appetite suppressants.

    PubMed

    Colman, Eric

    2005-09-01

    Beginning with the passage of the Federal Food, Drug, and Cosmetic Act in 1938 and escalating with the 1962 Kefauver-Harris amendments, increasing pressure has been placed on pharmaceutical manufacturers to demonstrate that a drug's benefits outweigh its risks. Nowhere has the question of risk versus benefit come under greater scrutiny than with anorectics. After the approval in the 1940s and 1950s of a number of amphetamine and amphetamine-like compounds for the treatment of obesity, the U.S. Food and Drug Administration struggled to define the efficacy and safety of these agents. Labeling restrictions on duration of use and warnings about abuse and addiction ultimately contributed to the reduced use of anorectics. That trend continued until the mid-1990s, when the off-label use of fenfluramine plus phentermine (fen-phen) and the approval of dexfenfluramine gave rise to widespread, long-term use of anorectics to treat obesity. The adverse effects that came to be associated with fenfluramine and dexfenfluramine, leading to their eventual withdrawal from the market, gave pause to regulators, physicians, patients, and drug companies alike. Sibutramine, the latest anorectic to enter the market, is now the focus of a landmark trial that is examining, for the first time, whether drug-induced weight loss reduces the risk for fatal and nonfatal cardiovascular disease. PMID:16144896

  8. [Asymptomatic kidney stones: active surveillance vs. treatment].

    PubMed

    Neisius, A; Thomas, C; Roos, F C; Hampel, C; Fritsche, H-M; Bach, T; Thüroff, J W; Knoll, T

    2015-09-01

    The prevalence of kidney stones is increasing worldwide. Asymptomatic non-obstructing kidney stones are increasingly detected as an incidental finding on radiologic imaging, which has been performed more frequently over the last decades. Beside the current interventional treatment modalities such as extracorporeal shockwave lithotripsy (ESWL), ureterorenoscopy (URS) and percutaneous nephrolithotomy (PNL), active surveillance of asymptomatic kidney stones has been a focus of discussion lately, not only for attending physicians, but even more so for patients. The current German and European guidelines recommend active surveillance for patients with asymptomatic kidney stones if no interventional therapy is mandatory because of pain or medical factors. Herein we review the current literature on risks and benefits of active surveillance of asymptomatic non-obstructing kidney stones.

  9. [Asymptomatic kidney stones: active surveillance vs. treatment].

    PubMed

    Neisius, A; Thomas, C; Roos, F C; Hampel, C; Fritsche, H-M; Bach, T; Thüroff, J W; Knoll, T

    2015-09-01

    The prevalence of kidney stones is increasing worldwide. Asymptomatic non-obstructing kidney stones are increasingly detected as an incidental finding on radiologic imaging, which has been performed more frequently over the last decades. Beside the current interventional treatment modalities such as extracorporeal shockwave lithotripsy (ESWL), ureterorenoscopy (URS) and percutaneous nephrolithotomy (PNL), active surveillance of asymptomatic kidney stones has been a focus of discussion lately, not only for attending physicians, but even more so for patients. The current German and European guidelines recommend active surveillance for patients with asymptomatic kidney stones if no interventional therapy is mandatory because of pain or medical factors. Herein we review the current literature on risks and benefits of active surveillance of asymptomatic non-obstructing kidney stones. PMID:26378390

  10. Carcinoid Tumor in Accidental, Asymptomatic Meckel's Diverticulum.

    PubMed

    Baranyai, Zsolt; Jósa, Valeria; Merkel, Keresztely; Zolnai, Zsofia

    2013-01-01

    Although Meckel's diverticulum is the most common congenital gastrointestinal disorder, it is controversial whether asymptomatic diverticula in adults should be respected. The authors report the case of a patient who was operated due to ileus caused by adhesions and a Meckel's diverticulum without any sign of inflammation was accidentally noted and removed. As a surprise, the pathological examination of the diverticulum proved carcinoid tumor, a neuroendocrine malignant tumor. The case raises the importance of the removal of asymptomatic Meckel's diverticulum.

  11. The use of tampons for identifying asymptomatic N. gonorrhoeae infections.

    PubMed

    Haughie, G E; Ames, W R; Madsen, E F

    1975-12-01

    Female contacts of males with gonococcal urethritis were screened for asymptomatic infection using self-inserted tampons. Results of cultures were compared with specimens collected with cervical swabs during a pelvic examination. The sequence of collection of specimens was randomized, and specimens were promptly incubated. Among 297 patients, 40.4% had positive cervical specimens and 35.4% had positive tampon specimens. A difference in rates of recovery by method of collection was 5.0% +/- 1.7%. A better correlation in results was noted among patients using oral contraceptives and among patients whose tampon specimen was collected after a pelvic examination. A relatively small difference in results by method of collection suggests that tampons may serve as an inexpensive screening device for sexually active women, especially in settings where pelvic examinations are not routinely performed, but where immediate processing of specimens is possible.

  12. What is the role of a full physical examination in the management of asymptomatic patients with late syphilis?

    PubMed

    Dabis, R; Radcliffe, K

    2012-12-01

    According to the British Association for Sexual Health and HIV guidelines, a full physical examination is recommended in patients with possible late syphilis. The aim of this audit was to review all cases of late syphilis diagnosed at our centre since 1994 to see if a full cardiovascular and neurological examination was documented and also to see what a full examination contributed to the management of asymptomatic patients. Of the 480 medical notes audited, 295 patients were asymptomatic of whom 288 (98%) had normal physical examinations; the rest were either not documented, declined or defaulted follow-up. Seven asymptomatic patients had positive clinical findings but these did not lead to a diagnosis of cardiovascular or neurological syphilis. This audit has shown that performing a physical examination in asymptomatic patients added no benefit in diagnosing complications of late syphilis; it would appear that the physical examination did not alter the management.

  13. Asymptomatic bacteriuria. Which patients should be treated?

    PubMed

    Zhanel, G G; Harding, G K; Guay, D R

    1990-07-01

    Asymptomatic bacteriuria is common in both the community nursing home and hospital settings. Few data, however, are available about the potential complications arising from asymptomatic bacteriuria (eg, the development of symptomatic infection and renal damage) for various patient populations and for various medical conditions. On the basis of data in the literature, we believe that neonates and preschool children with asymptomatic bacteriuria should be treated. Pregnant women and "nonelderly" (less than 60 years old) men should be treated. We do not think that school-age children, nonpregnant, nonelderly women, or elderly men and women need antimicrobial treatment if their urinary tracks are normal. In addition, antimicrobial treatment is recommended for patients with asymptomatic bacteriuria and abnormal urinary tracts and those undergoing clean intermittent catheterization, genitourinary manipulation, or instrumentation. Patients with long-term indwelling catheters should not be treated. The treatment of asymptomatic bacteriuria in patients with short-term indwelling catheters and those with ileal conduits is controversial. These treatment recommendations should not necessarily be accepted as the standards of practice, since treatment is often controversial due to the lack of published data describing the natural course of asymptomatic bacteriuria in various patient populations. PMID:2196024

  14. High grade anorectal stricture complicating Crohn's disease: endoscopic treatment using insulated-tip knife

    PubMed Central

    Chon, Hyung Ku; Shin, Ik Sang; Kim, Sang Wook

    2016-01-01

    Endoscopic treatments have emerged as an alternative to surgery, in the treatment of benign colorectal stricture. Unlike endoscopic balloon dilatation, there is limited data on endoscopic electrocautery incision therapy for benign colorectal stricture, especially with regards to safety and long-term patency. We present a case of a 29-year-old female with Crohn's disease who had difficulty in defecation and passing thin stools. A pelvic magnetic resonance imaging scan, gastrograffin enema, and sigmoidoscopy showed a high-grade anorectal stricture. An endoscopic insulated-tip knife incision was successfully performed to resolve the problem. From our experience, we suggest that endoscopic insulated-tip knife treatment may be a feasible and effective modality for patients with short-segment, very rigid, fibrotic anorectal stricture. PMID:27433152

  15. High grade anorectal stricture complicating Crohn's disease: endoscopic treatment using insulated-tip knife.

    PubMed

    Chon, Hyung Ku; Shin, Ik Sang; Kim, Sang Wook; Lee, Soo Teik

    2016-07-01

    Endoscopic treatments have emerged as an alternative to surgery, in the treatment of benign colorectal stricture. Unlike endoscopic balloon dilatation, there is limited data on endoscopic electrocautery incision therapy for benign colorectal stricture, especially with regards to safety and long-term patency. We present a case of a 29-year-old female with Crohn's disease who had difficulty in defecation and passing thin stools. A pelvic magnetic resonance imaging scan, gastrograffin enema, and sigmoidoscopy showed a high-grade anorectal stricture. An endoscopic insulated-tip knife incision was successfully performed to resolve the problem. From our experience, we suggest that endoscopic insulated-tip knife treatment may be a feasible and effective modality for patients with short-segment, very rigid, fibrotic anorectal stricture.

  16. High grade anorectal stricture complicating Crohn's disease: endoscopic treatment using insulated-tip knife.

    PubMed

    Chon, Hyung Ku; Shin, Ik Sang; Kim, Sang Wook; Lee, Soo Teik

    2016-07-01

    Endoscopic treatments have emerged as an alternative to surgery, in the treatment of benign colorectal stricture. Unlike endoscopic balloon dilatation, there is limited data on endoscopic electrocautery incision therapy for benign colorectal stricture, especially with regards to safety and long-term patency. We present a case of a 29-year-old female with Crohn's disease who had difficulty in defecation and passing thin stools. A pelvic magnetic resonance imaging scan, gastrograffin enema, and sigmoidoscopy showed a high-grade anorectal stricture. An endoscopic insulated-tip knife incision was successfully performed to resolve the problem. From our experience, we suggest that endoscopic insulated-tip knife treatment may be a feasible and effective modality for patients with short-segment, very rigid, fibrotic anorectal stricture. PMID:27433152

  17. Anorectic activities of serotonin uptake inhibitors: correlation with their potencies at inhibiting serotonin uptake in vivo and /sup 3/H-mazindol binding in vitro

    SciTech Connect

    Angel, I.; Taranger, M.A.; Claustre, Y.; Scatton, B.; Langer, S.Z.

    1988-01-01

    The mechanism of anorectic action of several serotonin uptake inhibitors was investigated by comparing their anorectic potencies with several biochemical and pharmacological properties and in reference to the novel compound SL 81.0385. The anorectic effect of the potent serotonin uptake inhibitor SL 81.0385 was potentiated by pretreatment with 5-hydroxytryptophan and blocked by the serotonin receptor antagonist metergoline. A good correlation was obtained between the ED/sub 50/ values of anorectic action and the ED/sub 50/ values of serotonin uptake inhibition in vivo (but not in vitro) for several specific serotonin uptake inhibitors. Most of the drugs tested displaced (/sup 3/H)-mazindol from its binding to the anorectic recognition site in the hypothalamus, except the pro-drug zimelidine which was inactive. Excluding zimelidine, a good correlation was obtained between the affinities of these drugs for (/sup 3/H)-mazindol binding and their anorectic action indicating that their anorectic activity may be associated with an effect mediated through this site. Taken together these results suggest that the anorectic action of serotonin uptake inhibitors is directly associated to their ability to inhibit serotonin uptake and thus increasing the synaptic levels of serotonin. The interactions of these drugs with the anorectic recognition site labelled with (/sup 3/H)-mazindol is discussed in connection with the serotonergic regulation of carbohydrate intake.

  18. The Role of Abdominoperineal Resection as Surgical Therapy for Anorectal Melanoma

    PubMed Central

    Yeh, Jen Jen; Shia, Jinru; Hwu, Wen Jen; Busam, Klaus J.; Paty, Philip B.; Guillem, Jose G.; Coit, Daniel G.; Wong, W Douglas; Weiser, Martin R.

    2006-01-01

    Objectives: 1) Characterize changes in the surgical treatment of anorectal melanoma over time. 2) Determine if the extent of surgical resection is associated with outcome. 3) Identify prognostic factors correlating with survival. Summary Background Data: Although early data suggested improved survival in patients undergoing abdominoperineal resection (APR) for primary anorectal melanoma, such an aggressive approach may be unwarranted as distant relapse rates are high. We have seen a trend toward less aggressive surgical treatment of the local disease over the past 20 years. Methods: A retrospective review was performed of all patients with anorectal melanoma treated at our institution between 1984 and 2003. Extent of primary resection and pathologic factors were studied. Results: Forty-six patients underwent a curative resection with a median follow-up of 29 months, and 5-year disease-specific survival (DSS) rate of 35%. While patient and tumor characteristics remained similar, there was a dramatic shift in surgical treatment toward less radical procedures. Prior to 1997, the majority of patients (15 of 21, 71%) underwent APR. After 1997, the majority of patients (21 of 25, 84%) underwent local excision (LE) (P < 0.0001). Local recurrence was noted in 11 of 46 (24%) patients: 4 of 19 (21%) who underwent APR and 7 of 27 (26%) who underwent LE (P = not significant). Five-year DSS was similar: 34% following APR and 35% following LE. Tumor perineural invasion (PNI) was the only factor identified as an independent predictor of worse outcome (P = 0.01). Conclusion: The extent of surgical treatment is not associated with outcome in primary anorectal melanoma. Therefore, LE of the primary tumor is recommended when technically feasible. The presence of PNI is an important prognostic factor and should be considered in future clinical trials. PMID:17122627

  19. Clinical study on 71 anorectal cases treated by carbon dioxide laser

    NASA Astrophysics Data System (ADS)

    Li, Gui-hua

    1993-03-01

    This paper describes the effective result of carbon dioxide laser on type I and II internal hemorrhoids, mixed hemorrhoids, anal fissure or fistula, etc. At present, simple hemorrhoidectomy is less acceptable to patients for its excessive bleeding and severe pain during and after the operation. Therefore, the results of 71 anorectal cases of hemorrhoidectomy using carbon dioxide laser have been observed in our hospital. The rates of effective treatment and cure were 100% and 94.3%, respectively.

  20. Laparoscopic surgical technique to facilitate management of high anorectal malformations – report of seven cases

    PubMed Central

    Murawski, Maciej; Łosin, Marcin; Królak, Marek; Czauderna, Piotr

    2011-01-01

    Anorectal malformations (ARMs) occur in approximately 1 per 5000 live births. The most commonly used procedure for repair of high ARMs is posterior sagittal anorectoplasty (PSARP). This operation is performed entirely through a perineal approach. The first report of laparoscopically assisted anorectal pull-through (LAARP) for repair of ARMs was presented by Georgeson in 2000. The aim is presenting early experience with laparoscopically assisted anorectal pull-through technique in boys with high anorectal malformations. In the last 5 years 7 boys (9 months to 2 years old) with high ARMs were operated on using the LAARP technique. Laparoscopically the rectal pouch was exposed down to the urethral fistula, which was clipped and divided. Externally, the centre of the muscle complex was identified using an electrical stimulator. In the first 4 patients after a midline incision of 2 cm at the planned anoplasty site, a tunnel to the pelvis was created bluntly and dilated with Hegar probes under laparoscopic control. In the last 3 boys a minimal PSARP was done creating a channel into the pelvis. The separated rectum was pulled down and sutured to the perineum. Laparoscopic mobilization of the rectal pouch and fistula division was possible in all cases. There were no intraoperative complications except one ureteral injury. Patients were discharged home on post-operative day 5 to 7. The early results prove that LAARP, an alternative option to PSARP for treatment of imperforate anus, offers many advantages, including excellent visualization of the pelvic anatomical structures, accurate placement of the bowel into the muscle complex and a minimally invasive abdominal and perineal incision. It allows for shorter hospital stay and faster recovery. However, to compare the functional results against the standard procedure (PSARP), longer follow-up of all patients is necessary. PMID:23255974

  1. Pathophysiology and Natural History of Anorectal Sequelae Following Radiation Therapy for Carcinoma of the Prostate

    SciTech Connect

    Yeoh, Eric K.; Holloway, Richard H.; Fraser, Robert J.; Botten, Rochelle J.; Di Matteo, Addolorata C.; Butters, Julie

    2012-12-01

    Purpose: To characterize the prevalence, pathophysiology, and natural history of chronic radiation proctitis 5 years following radiation therapy (RT) for localized carcinoma of the prostate. Methods and Materials: Studies were performed in 34 patients (median age 68 years; range 54-79) previously randomly assigned to either 64 Gy in 32 fractions over 6.4 weeks or 55 Gy in 20 fractions over 4 weeks RT schedule using 2- and later 3-dimensional treatment technique for localized prostate carcinoma. Each patient underwent evaluations of (1) gastrointestinal (GI) symptoms (Modified Late Effects in Normal Tissues Subjective, Objective, Management and Analytic scales including effect on activities of daily living [ADLs]); (2) anorectal motor and sensory function (manometry and graded balloon distension); and (3) anal sphincteric morphology (endoanal ultrasound) before RT, at 1 month, and annually for 5 years after its completion. Results: Total GI symptom scores increased after RT and remained above baseline levels at 5 years and were associated with reductions in (1) basal anal pressures, (2) responses to squeeze and increased intra-abdominal pressure, (3) rectal compliance and (4) rectal volumes of sensory perception. Anal sphincter morphology was unchanged. At 5 years, 44% and 21% of patients reported urgency of defecation and rectal bleeding, respectively, and 48% impairment of ADLs. GI symptom scores and parameters of anorectal function and anal sphincter morphology did not differ between the 2 RT schedules or treatment techniques. Conclusions: Five years after RT for prostate carcinoma, anorectal symptoms continue to have a significant impact on ADLs of almost 50% of patients. These symptoms are associated with anorectal dysfunction independent of the RT schedules or treatment techniques reported here.

  2. New insights into the development and differentiation of the human anorectal epithelia. Are there clinical consequences?

    PubMed Central

    Zehm, Sarah; Illig, Romana; Moser, Patrizia; Aigner, Felix

    2010-01-01

    Purpose The epithelial lining of the anorectum still raises discussions concerning the levels of transition between the various zones and leads to an incomplete understanding of the immmunoprofile of rectal carcinoma. Since the expression of cytokeratins depends on the epithelial cell-type and the parahox-gene CDX2 is important for the development of the colorectal epithelium, we investigated different cytokeratins and CDX2 in the anorectum of human prenatal stages and in adult normal and neoplastic anorecta. Materials and Methods The differentiation and spatiotemporal distribution of the epithelial zones were examined in 33 human embryos and fetuses, in a 2-year-old child and four adults. In comparison, 17 specimens of ultralow rectal adenocarcinoma and 4 specimens of anal carcinoma were investigated. Monoclonal antibodies were directed against cytokeratin (CK) 18, 20, 7 and 14 and CDX2. Results Due to the cytokeratin profile and to CDX2 expression, the different anorectal zones could already be differentiated in human prenatal life. We showed that anorectal epithelial differentiation including the squamous epithelia ran in a craniocaudal direction, and that the anorectal zone was a transitional zone between rectal zone and anal transitional zone where CK 7, 18, 20 and CDX2 are simultaneously expressed. All cases of rectal adenocarcinoma showed positivity for CK 18, 20 and CDX2, and three also labelled for CK 7, whereas CK 14 was only expressed in the cases of anal carcinoma. Conclusions Our results elucidate the connection between the prenatal pattern and the origin of the different types of anorectal carcinoma. PMID:20563874

  3. Colonic triplication associated with anorectal malformation: case presentation of a rare embryological disorder.

    PubMed

    Gisquet, Heloise; Lemelle, Jean Louis; Lavrand, Frederic; Droulle, Pierre; Schmitt, Michel

    2006-07-01

    Tubular colonic triplication is an extremely rare hindgut malformation, with only 2 reports in the literature to date. The present authors describe the new and unusual case of a boy born with an imperforate anus, rectovesical fistula, and 3 distinct left colons. The bladder was divided by an incomplete septum. Prenatal ultrasound suggested colonic duplication. Surgical management involved resection of the triplicated segment and posterosagittal anorectal pull through. PMID:16818042

  4. Scrotal pearl is not always a sign of anorectal malformation: median raphe cyst.

    PubMed

    Soyer, Tutku; Karabulut, Ayşe Anıl; Boybeyi, Özlem; Günal, Yasemin Dere

    2013-01-01

    Pearls of meconium can be seen on the raphe of the scrotum and are considered as a sign of anorectal malformation (ARM). Scrotal pearls without ARM are rare in children and designated as median raphe cyst of the scrotum (MRC). A six-month-old boy with scrotal pearls without ARM is presented to discuss the clinical features and treatment modalities of MRC in infants. PMID:24577992

  5. Surgeon-administered conscious sedation and local anesthesia for ambulatory anorectal surgery.

    PubMed

    Hina, Miss; Hourigan, Jon S; Moore, Richard A; Stanley, J Daniel

    2014-01-01

    Anorectal procedures are often performed in an outpatient setting using a variety of anesthetic techniques. One technique that has not been well studied is surgeon-administered conscious sedation along with local anesthetic. The purpose of this study was to evaluate the use of this technique with emphasis on safety, efficacy, and patient satisfaction. Chart review was performed on 133 consecutive patients who had anorectal procedures at an outpatient surgery center. Additionally, 65 patients were enrolled prospectively and completed a satisfaction survey. Inclusively, charts of 198 patients who underwent outpatient anorectal surgery under conscious sedation and local anesthesia under the direction of a colorectal surgeon from 2004 through 2008 were reviewed. Parameters related to patient and procedural characteristics, safety, efficacy, and satisfaction were evaluated. Surgeon-administered sedation consisted of combined fentanyl and midazolam in 90 per cent. Eighty per cent of procedures were performed in the prone position and 23 per cent were in combination with an endoscopic procedure. Eighty-two per cent were classified as American Society of Anesthesiologists Grade 1 or 2. Transient mild hypoxemia or hypotension occurred in 4 and 3 per cent of the patients, respectively. Mean operative time was 29 minutes with a mean stay in the postanesthesia care unit of 37 minutes. There were no early major cardiac or respiratory complications. Ninety-seven per cent of the patients surveyed reported a high degree of satisfaction. Surgeon-administered conscious sedation with local anesthesia was well tolerated for outpatient anorectal surgeries. Additional studies are needed to confirm the safety and efficacy of this technique.

  6. Efficacy of biofeedback training in improving faecal incontinence and anorectal physiologic function.

    PubMed Central

    Loening-Baucke, V

    1990-01-01

    The efficacy of biofeedback treatment on faecal incontinence and anorectal function was evaluated in eight patients with faecal incontinence treated with biofeedback training and medical therapy. Outcome and anorectal function were compared with nine faecal incontinent patients who received medical therapy alone. Three month follow up showed that 50% of patients in the biofeedback plus conventional treatment group and 56% of those treated conventionally only had improved. One year follow up showed that 13% in the biofeedback group were free of soiling and an additional 25% had improved. The results were similar in the conventionally treated group--11% were free of soiling and an additional 44% improved. Anal pressures at rest and squeeze, the rectal distension volume that induced sustained inhibition of both the external and internal anal sphincter, and continence to rectally infused saline were significantly reduced in both groups of patients compared with controls (p less than 0.05). Biofeedback treatment had no effect on these abnormal anorectal functions in either patients who improved or those who did not. The improvement in faecal incontinence was probably due to medical intervention or regression of symptoms with time, or both, and not the result of biofeedback training. PMID:2265781

  7. Manometric investigation of anorectal function in early and late stage Parkinson's disease

    PubMed Central

    Bassotti, G.; Maggio, D.; Battaglia, E.; Giulietti, O.; Spinozzi, F.; Reboldi, G.; Serra, A. M.; Emanuelli, G.; Chiarioni, G.

    2000-01-01

    Abnormal gastrointestinal function is relatively frequent in Parkinson's disease, and constipation is a disturbing symptom in many patients. However, it remains to be established whether anorectal abnormalities are characteristic of the late stages of the disease. Clinical and anorectal manometric function were investigated in groups of early and late stage parkinsonian patients. Thirty one patients (19 men, 12 women, age range 22 to 89 years) entered the study. The disease severity was assessed by Hoehn and Yahr staging: there were four (12.9%) stage I, seven (22.6%) stage II, 10 (32.2%) stage III, and 10 (32.2%) stage IV patients. Anorectal variables were measured by standard manometric equipment and techniques. Values obtained in early stage patients (Hoehn and Yahr stage I and II) were compared with those obtained in late stage patients (Hoehn and Yahr stage III and IV). Overall, more than 70% of patients complained of chronic constipation, with chronic laxative use reported in more than 30%. Late stage patients were slightly older than their early stage counterparts. Pelvic floor dyssynergia was documented in more than 60% of patients. Manometric variables were not different in the two groups. In conclusion, defecatory dysfunction is frequent in Parkinson's disease, it is not confined to late stage patients, and it is found early in the course of the disease. This has potential implications for a targeted therapeutic approach.

 PMID:10811703

  8. [Diagnosis and primary surgical therapy of anorectal abnormalities with regard to postoperative incontinence].

    PubMed

    Holschneider, A M

    1990-01-01

    Aspects relating to diagnosis of anorectal agenesis are covered in this paper, with reference being made to the author's patients at the Cologne Department of Paediatric Surgery. Accurate preoperative diagnosis of both the type of malformation relative to anatomic pelvic floor structures and of possible concomitant malformations is considered to be the key to subsequent optimal continence. Proper choice of an anatomy-correlated, individual surgical approach is possible only on the basis of accurate analysis of the malformation concerned and its correct assignment and classification according to Wingspread or Rehbein. Optimum continence has proved to depend also on involvement of a surgeon with profound experience in and with all forms of anorectal malformations as well as on subtle approach accompanied by uninterrupted electrostimulation to identify muscular structures. Yet, even with all those prerequisites optimally satisfied, about 25 percent of all patients with severe anorectal malformations must be expected not to achieve continence. This may be attributable to one or several of the following causes: The muscular structures applied may be too hypoplastic and thus may fail to develop sufficient sphincter functionality. Postoperative management may be insufficiently careful and cause atrophy of muscle equivalents restored in the first place. Continence may be difficult or even impossible to achieve for concomitant sacral or urogenital malformations. Application of colostomy should be avoided in any case, and advantage should be taken, first of all, of all possible ways and means described in this paper for restoration of sphincter action.

  9. Influence of Rectal Decompression on Abdominal Symptoms and Anorectal Physiology following Colonoscopy in Healthy Adults

    PubMed Central

    Yi, Chih-Hsun; Liu, Tso-Tsai; Lei, Wei-Yi; Hung, Jui-Sheng

    2016-01-01

    Background. Postcolonoscopy abdominal discomfort and bloating are common. The aim of this study was to evaluate whether rectal decompression improved distension-induced abdominal symptoms and influenced anorectal physiology. Methods. In 15 healthy subjects, rectal distension was achieved by direct air inflation into the rectum by colonoscopy. Placement of rectal and sham tube was then performed in each subject on a separate occasion. The anorectal parameters and distension-induced abdominal symptoms were recorded. Results. Anorectal parameters were similar between placements of rectal tube and sham tube except for greater rectal compliance with rectal tube than with sham tube (P < 0.05). Abdominal pain and bloating were significantly reduced by rectal tube and sham tube at 1 minute (both P < 0.05) and 3 minutes (both P < 0.05). After placement of rectal tube, abdominal pain at 3 minutes correlated positively with first sensation (r = 0.53, P = 0.04), and bloating at 3 minutes also correlated positively with urge sensation (r = 0.55, P = 0.03). Conclusions. Rectal decompression with either rectal or sham tube improved distension-induced abdominal symptoms. Our study indicates that the mechanisms that improved abdominal symptoms by rectal decompression might be mediated by a central pathway instead of a peripheral mechanism.

  10. Influence of Rectal Decompression on Abdominal Symptoms and Anorectal Physiology following Colonoscopy in Healthy Adults

    PubMed Central

    Yi, Chih-Hsun; Liu, Tso-Tsai; Lei, Wei-Yi; Hung, Jui-Sheng

    2016-01-01

    Background. Postcolonoscopy abdominal discomfort and bloating are common. The aim of this study was to evaluate whether rectal decompression improved distension-induced abdominal symptoms and influenced anorectal physiology. Methods. In 15 healthy subjects, rectal distension was achieved by direct air inflation into the rectum by colonoscopy. Placement of rectal and sham tube was then performed in each subject on a separate occasion. The anorectal parameters and distension-induced abdominal symptoms were recorded. Results. Anorectal parameters were similar between placements of rectal tube and sham tube except for greater rectal compliance with rectal tube than with sham tube (P < 0.05). Abdominal pain and bloating were significantly reduced by rectal tube and sham tube at 1 minute (both P < 0.05) and 3 minutes (both P < 0.05). After placement of rectal tube, abdominal pain at 3 minutes correlated positively with first sensation (r = 0.53, P = 0.04), and bloating at 3 minutes also correlated positively with urge sensation (r = 0.55, P = 0.03). Conclusions. Rectal decompression with either rectal or sham tube improved distension-induced abdominal symptoms. Our study indicates that the mechanisms that improved abdominal symptoms by rectal decompression might be mediated by a central pathway instead of a peripheral mechanism. PMID:27651788

  11. Asymptomatic arsine nephrotoxicity. A case report.

    PubMed

    Levy, H; Lewin, J R; Ninin, D T; Schneider, H R; Milne, F J

    1979-08-01

    A completely asymptomatic patient with arsine nephrotoxicity is described. The light and electron microscopic appearances of the kidney biopsy specimen are documented. The pathogenesis of the lesions, the usual manifestations of arsine exposure, and how these differed from those seen in our patient, are discussed.

  12. National audit of asymptomatic screening in UK genitourinary medicine clinics: clinic policies audit.

    PubMed

    Carne, C A; McClean, H; Sullivan, A K; Menon-Johansson, A; Gokhale, R; Sethi, G; Mammen-Tobin, A G; Daniels, D

    2010-07-01

    Of clinics responding to the audit, 99 and 97% have policies that are compliant with the British Association for Sexual Health and HIV National Guidelines for testing of asymptomatic men and women for HIV and syphilis, respectively. All clinics offer men, and all but one clinic offer women, screening for chlamydial infection with nucleic acid amplification tests (NAATs), as recommended by the guidelines. However, for gonorrhoea screening one-third of clinics offer men urine or urethral NAATs, and one quarter of clinics offer women endocervical, vulvovaginal or urinary NAATs, and not endocervical culture, and these practices are not compliant with the guidelines. Eight clinics did not specify whether they routinely offer testing for gonorrhoea in women. One-third of clinics routinely perform rectal and oropharyngeal screening for gonorrhoea in men who have sex with men (MSM), but fewer screen for chlamydia, regardless of sexual history which is stated as a determinant of offering screening at these anatomical sites. Finally, one-fifth of clinics offer urethral microscopy to asymptomatic heterosexual men and MSM, and about one half of clinics offer urethral culture for detection of gonorrhoea in asymptomatic women, even though these practices are not compliant with the guidelines.

  13. Argon Plasma Coagulation Therapy Versus Topical Formalin for Intractable Rectal Bleeding and Anorectal Dysfunction After Radiation Therapy for Prostate Carcinoma

    SciTech Connect

    Yeoh, Eric; Tam, William; Schoeman, Mark; Moore, James; Thomas, Michelle; Botten, Rochelle; Di Matteo, Addolorata

    2013-12-01

    Purpose: To evaluate and compare the effect of argon plasma coagulation (APC) and topical formalin for intractable rectal bleeding and anorectal dysfunction associated with chronic radiation proctitis. Methods and Materials: Thirty men (median age, 72 years; range, 49-87 years) with intractable rectal bleeding (defined as ≥1× per week and/or requiring blood transfusions) after radiation therapy for prostate carcinoma were randomized to treatment with APC (n=17) or topical formalin (n=13). Each patient underwent evaluations of (1) anorectal symptoms (validated questionnaires, including modified Late Effects in Normal Tissues–Subjective, Objective, Management, and Analytic and visual analogue scales for rectal bleeding); (2) anorectal motor and sensory function (manometry and graded rectal balloon distension); and (3) anal sphincteric morphology (endoanal ultrasound) before and after the treatment endpoint (defined as reduction in rectal bleeding to 1× per month or better, reduction in visual analogue scales to ≤25 mm, and no longer needing blood transfusions). Results: The treatment endpoint was achieved in 94% of the APC group and 100% of the topical formalin group after a median (range) of 2 (1-5) sessions of either treatment. After a follow-up duration of 111 (29-170) months, only 1 patient in each group needed further treatment. Reductions in rectal compliance and volumes of sensory perception occurred after APC, but no effect on anorectal symptoms other than rectal bleeding was observed. There were no differences between APC and topical formalin for anorectal symptoms and function, nor for anal sphincteric morphology. Conclusions: Argon plasma coagulation and topical formalin had comparable efficacy in the durable control of rectal bleeding associated with chronic radiation proctitis but had no beneficial effect on anorectal dysfunction.

  14. Imaging features of primary anorectal gastrointestinal stromal tumors with clinical and pathologic correlation

    PubMed Central

    Koch, M.R.; Jagannathan, J.P.; Krajewski, K.M.; Raut, C.P.; Hornick, J.L.; Ramaiya, N.H.

    2012-01-01

    Abstract Purpose: To evaluate the imaging features of anorectal gastrointestinal stromal tumors (GISTs) with clinical and histopathologic correlation. Materials and methods: In this Institutional Review Board-approved, Health Insurance Portability and Accountability Act-compliant retrospective study, 16 patients (12 men; mean age 66 years (30–89 years)) with pathologically proven anorectal GISTs seen at our institution from January 2001 to July 2011 were identified. Electronic medical records were reviewed to obtain clinical data. Pretreatment imaging studies (computed tomography (CT) in 16 patients, magnetic resonance imaging (MRI) in 9 patients and fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT in 8 patients) were evaluated by 2 radiologists until consensus. The location, size and imaging features of the primary tumor and metastases at presentation, if any, were recorded, and correlated with clinical data and pathologic features (histologic type, presence of necrosis, mitotic activity, risk category, immunohistochemical profile). Results: The mean tumor size was 6.9 × 6.0 cm. Of the 16 tumors, 11 (68.7%) were infralevator, 4 (25%) supra and infralevator and 1 (6.3%) supralevator; 9 (56.2%) were exophytic, 6 (37.5%) both exophytic and intraluminal, and 1 (6.3%) was intraluminal. The tumors were iso- to minimally hypoattenuating to muscle on CT, iso- to minimally hypointense on T1-weighted images, hyperintense on T2-weighted images and showed variable enhancement. Necrosis was seen in 4 (25%), and hemorrhage and calcification in 2 (12.5%) patients each. The tumors were FDG avid with a mean maximum standardized uptake value of 11 (8.4–16.8). All tumors were positive for KIT and CD34. Distant metastasis to liver was seen in 1 patient (6.3%) at presentation. Conclusion: Anorectal GISTs are well-circumscribed, non-circumferential, predominantly infralevator, intramural or exophytic, FDG-avid, hypoattenuating masses, and present without

  15. Increased potency and binding of mazindol to putative brain anorectic receptors in obesity-prone rats.

    PubMed

    Levin, B E; Brown, K L; Vincent, G

    1994-12-30

    A class of sodium-sensitive, low affinity binding sites in the brain recognizes [3H]mazindol (MAZ). Competition for [3H]MAZ binding at these sites correlates with the anorectic potency of various phenethylamine drugs suggesting that these might be anorectic binding sites. Here [3H]MAZ binding, in the absence of sodium, was assessed by quantitative receptor autoradiography in rat brain. Binding was saturable, widespread and heterogenous with Kd = 3-229 microM and Bmax = 0.64-21.9 nmol/mg protein in various brain areas. By saturation studies, highest binding was in the somatosensory cortex, central amygdalar nucleus and bed nucleus of the stria terminalis. Hypothalamic subnuclei had intermediate and the piriform cortex had low binding. Rats were identified as prone to develop (DIO-prone) or resist (DR-prone) diet-induced obesity by their low vs. high 24 h urine norepinephrine excretion, respectively. While similar in body weight and basal 30 min intake of 4% sucrose, DIO-prone rats had 28% greater inhibition of sucrose intake by 3 mg/kg MAZ, i.p. (86 +/- 5%) than DR-prone rats (67 +/- 6%; P = 0.05). DIO-prone rats also had 23-55% higher levels of 10 nM [3H]MAZ binding in various hypothalamic and amygdalar nuclei, the somatosensory, piriform and gustatory cortices and thalamus. Given their greater sensitivity the highest dose of MAZ used and their higher binding of MAZ to putative brain anorectic receptors, DIO-prone rats might have a deficiency of an endogenous satiety factor which could predispose them to develop obesity when challenged with high energy, high sucrose diets.

  16. Sexual Assault

    MedlinePlus

    Sexual assault is any sexual activity to which you haven't freely given your consent. This includes completed ... trust, a friend, an acquaintance, or a stranger. Sexual assault can affect your health in many ways. It ...

  17. [Experience in the use of laser instruments in surgery of the anorectal region].

    PubMed

    Skobelkin, O K; Brekhov, E I; Ul'ianov, V I; Tolstykh, P I; Kochurkov, N V; Sten'ko, V G; Derbenev, V A; Tsvik, A M; Itskovich, L N

    1989-10-01

    The article discusses experience in surgical treatment of 480 patients with the most common diseases of the anorectal region (acute and chronic haemorrhoids, acute and chronic paraproctitis, polyps, chronic fissures of the anal canal) in which special laser tools were used. The carbonic acid laser Skalpel-1 with a wave length of 10.6 microns and power of 30 W was used as the source of laser radiation. Methods of operations with the use of these tools are described in detail. The advantages of laser instruments in the treatment of patients with the above listed diseases are shown on a rich clinical material. PMID:2593578

  18. Advantages of robot-assisted surgery in anorectal malformations: Report of a case

    PubMed Central

    Ruiz, María Rodríguez; Kalfa, Nicolas; Allal, Hossein

    2016-01-01

    Laparoscopy has been widely used to repair anorectal malformations (ARMs) by paediatric surgeons in an attempt to be less invasive, offer better cosmetic results, enable a faster return of bowel function, decrease length of hospital stay and pain, and lately to improve functional results. Robotic technology assists the paediatric surgeon by increasing dexterity and precision of movement with a robotic wrist-like mechanism that allows up to 90° of articulation and 7° of freedom. This is important in ARM surgery, where the dissection of the fistula and the pull-through of the rectum into the muscular complex are crucial to achieve continence in future. PMID:27073314

  19. Recurrent Pure Calcite Urolithiasis Confirmed by Endoscopic Removal and Infrared Spectroscopy in a Malnourished Anorectic Female

    PubMed Central

    Andreassen, Kim Hovgaard; Sloth Osther, Palle Jörn

    2016-01-01

    Abstract Often when calcite is found as a component of urinary calculi, they are considered false calculi or artifacts. We present a case of true calcite urolithiasis. The stone material was removed percutaneously from a severely malnourished anorectic woman and analyzed by infrared spectroscopy (IRS). In addition, calcite urolithiasis was confirmed in several recurrent stone events by IRS. Laxative abuse with magnesium oxide was believed to be the underlying cause of stone formation, and ammonium chloride given as one weekly dose turned out to be effective for stone prevention. PMID:27579419

  20. [Chronic disorders after interventions in the anorectal area--therapeutic possibilities].

    PubMed

    Geile, D; Haseitl, M; Osterholzer, G

    2002-01-01

    Long lasting alterations of anal function and persistent pain in a few patients after ano-rectal operations are a great therapeutic problem. Sometimes more than 6 months after LAR there are complaints about incontinence, disturbance connected to a spastic evacuation--whereas pain is more often connected with the situation after Stapler hemorrhiodectomy or other anal interventions. The therapeutic management has to consider all etiological factors and consists mainly of conservative therapy, including regulation of stool volume, slow-down of colon transit, strengthening of anal and pelvic floor muscles, regulation of co-ordination and ability of relaxation and straining, therapy of pain and--last not least--psychological support.

  1. Recurrent Pure Calcite Urolithiasis Confirmed by Endoscopic Removal and Infrared Spectroscopy in a Malnourished Anorectic Female.

    PubMed

    Christiansen, Frederikke Eichner; Andreassen, Kim Hovgaard; Sloth Osther, Palle Jörn

    2016-01-01

    Often when calcite is found as a component of urinary calculi, they are considered false calculi or artifacts. We present a case of true calcite urolithiasis. The stone material was removed percutaneously from a severely malnourished anorectic woman and analyzed by infrared spectroscopy (IRS). In addition, calcite urolithiasis was confirmed in several recurrent stone events by IRS. Laxative abuse with magnesium oxide was believed to be the underlying cause of stone formation, and ammonium chloride given as one weekly dose turned out to be effective for stone prevention. PMID:27579419

  2. Asymptomatic memory CD8+ T cells

    PubMed Central

    Khan, Arif Azam; Srivastava, Ruchi; Lopes, Patricia Prado; Wang, Christine; Pham, Thanh T; Cochrane, Justin; Thai, Nhi Thi Uyen; Gutierrez, Lucas; BenMohamed, Lbachir

    2014-01-01

    Generation and maintenance of high quantity and quality memory CD8+ T cells determine the level of protection from viral, bacterial, and parasitic re-infections, and hence constitutes a primary goal for T cell epitope-based human vaccines and immunotherapeutics. Phenotypically and functionally characterizing memory CD8+ T cells that provide protection against herpes simplex virus type 1 and type 2 (HSV-1 and HSV-2) infections, which cause blinding ocular herpes, genital herpes, and oro-facial herpes, is critical for better vaccine design. We have recently categorized 2 new major sub-populations of memory symptomatic and asymptomatic CD8+ T cells based on their phenotype, protective vs. pathogenic function, and anatomical locations. In this report we are discussing a new direction in developing T cell-based human herpes vaccines and immunotherapeutics based on the emerging new concept of “symptomatic and asymptomatic memory CD8+ T cells.” PMID:24499824

  3. Treatment approaches to asymptomatic follicular lymphoma.

    PubMed

    Sarkozy, Clémentine; Salles, Gilles

    2013-12-01

    Follicular lymphoma is a heterogeneous disease in which some patients present an indolent evolution for decades and others, a rather aggressive form of the disease requiring immediate therapy. While immunochemotherapy has emerged as a standard of care for symptomatic patients, treatment of the asymptomatic population remains controversial. Since the disease is still considered incurable, delayed initiation of therapy is an acceptable option. However, four single injections of rituximab can result in an acceptable clinical response and can improve the duration of the interval without cytotoxic therapy. With recent therapeutic approaches that enable substantial improvements in life expectancy for follicular lymphoma patients, limiting short- or long-term treatment toxicities appears as a new concern in the asymptomatic population. Based on these options, the challenge is to preserve patient quality of life and prolong survival: from the patient's perspective, his/her opinion is therefore of significant importance. PMID:24219551

  4. The maximal exercise ECG in asymptomatic men.

    PubMed

    Cumming, G R; Borysyk, L; Dufresne, C

    1972-03-18

    Lead MC5 bipolar exercise ECG was obtained in 510 asymptomatic males, aged 40 to 65, utilizing the bicycle ergometer, with maximal stress in 71% of the subjects. "Ischemic changes" occurred in 61 subjects, the frequency increasing from 4% at age 40 to 45, to 20% at age 50 to 55, to 37% at age 61 to 65. Subjects having an ischemic type ECG change on exercise had more frequent minor resting ECG changes, more resting hypertension, and a greater incidence of high cholesterol values than subjects with a normal ECG response to exercise, but there was no difference in the incidence of obesity, low fitness, or high systolic blood pressure after exercise. Current evidence suggests that asymptomatic male subjects with an abnormal exercise ECG develop clinical coronary heart disease from 2.5 to over 30 times more frequently than those with a normal exercise ECG.

  5. Education to increase sexual health screening.

    PubMed

    Wallis, Andrew

    Rates of sexually transmitted infections among young people aged 16-24 years have soared in recent years. Opportunistic screening for chlamydia and other STIs identifies asymptomatic infection but encouraging this group to take up screening remains a major challenge. National guidance recommends structured one-to-one discussions with young people to achieve behavioural change. Although opportunities for this are rare, the sexual health outreach team in Nottingham has developed an interactive educational module for use with groups of young people and combined it with sexual health screening, with initial positive results.

  6. Prevalence of asymptomatic urinary abnormalities among adolescents.

    PubMed

    Fouad, Mohamed; Boraie, Maher

    2016-05-01

    To determine the prevalence of asymptomatic urinary abnormalities in adolescents, first morning clean mid-stream urine specimens were obtained from 2500 individuals and examined by dipstick and light microscopy. Adolescents with abnormal screening results were reexamined after two weeks and those who had abnormal results twice were subjected to systemic clinical examination and further clinical and laboratory investigations. Eight hundred and three (32.1%) individuals had urinary abnormalities at the first screening, which significantly decreased to 345 (13.8%) at the second screening, (P <0.001). Hematuria was the most common urinary abnormalities detected in 245 (9.8%) adolescents who had persistent urine abnormalities; 228 (9.1%) individuals had non glomerular hematuria. The hematuria was isolated in 150 (6%) individuals, combined with leukocyturia in 83 (3.3%) individuals, and combined with proteinuria in 12 (0.5%) individuals. Leukocyturia was detected in 150 (6%) of all studied adolescents; it was isolated in 39 (1.6%) individuals and combined with proteinuria in 28 (1.1%) of them. Asymptomatic bacteriuria was detected in 23 (0.9%) of all studied adolescents; all the cases were females. Proteinuria was detected in 65 (2.6%) of all the studied adolescents; 45 (1.8%) individuals had <0.5 g/day and twenty (0.8%) individuals had 0.5-3 g/day. Asymptomatic urinary abnormalities were more common in males than females and adolescents from rural than urban areas (P <0.01) and (P <0.001), respectively. The present study found a high prevalence of asymptomatic urinary abnormalities among adolescents in our population.

  7. Sexual Health

    MedlinePlus

    ... Basic HIV/AIDS information and resources for prevention LGBT Health Information for lesbian, gay, bisexual, or transgender (LGBT) individuals Sexual Health News & Information Understanding Sexual Health ...

  8. The Paradigm Shift to Non-Treatment of Asymptomatic Bacteriuria

    PubMed Central

    Nicolle, Lindsay E.

    2016-01-01

    Asymptomatic bacteriuria, also called asymptomatic urinary infection, is a common finding in healthy women, and in women and men with abnormalities of the genitourinary tract. The characterization and introduction of the quantitative urine culture in the 1950s first allowed the reliable recognition of asymptomatic bacteriuria. The observations that a substantial proportion of patients with chronic pyelonephritis at autopsy had no history of symptomatic urinary infection, and the high frequency of pyelonephritis observed in pregnant women with untreated asymptomatic bacteriuria, supported a conclusion that asymptomatic bacteriuria was harmful. Subsequent screening and long term follow-up programs for asymptomatic bacteriuria in schoolgirls and women reported an increased frequency of symptomatic urinary tract infection for subjects with asymptomatic bacteriuria, but no increased morbidity from renal failure or hypertension, or increased mortality. Treatment of asymptomatic bacteriuria did not decrease the frequency of symptomatic infection. Prospective, randomized, comparative trials enrolling premenopausal women, children, elderly populations, patients with long term catheters, and diabetic patients consistently report no benefits with antimicrobial treatment of asymptomatic bacteriuria, and some evidence of harm. Several studies have also reported that antimicrobial treatment of asymptomatic bacteriuria increases the short term risk of pyelonephritis. Current investigations are exploring the potential therapeutic intervention of establishing asymptomatic bacteriuria with an avirulent Escherichia coli strain to prevent symptomatic urinary tract infection for selected patients. PMID:27104571

  9. Dkk1 in the Peri-Cloaca Mesenchyme Regulates Formation of Anorectal and Genitourinary Tracts

    PubMed Central

    MacDonald, Bryan T.; Borer, Joseph G.; Li, Xue

    2013-01-01

    Anorectal malformation (ARM) is a common birth defect but the developmental history and the underlying molecular mechanism are poorly understood. Using murine genetic models, we report here that a signaling molecule Dickkopf-1 (Dkk1) is a critical regulator. The anorectal and genitourinary tracts are major derivatives of caudal hindgut, or the cloaca. Dkk1 is highly expressed in the dorsal peri-cloacal mesenchymal (dPCM) progenitors. We show that deletion of Dkk1 causes the imperforate anus with rectourinary fistula. Mutant genital tubercles exhibit a preputial hypospadias phenotype and premature urethral canalization. Dkk1 mutants have an ectopic expansion of the dPCM tissue, which correlates with an aberrant increase of cell proliferation and survival. This ectopic tissue is detectable before the earliest sign of the anus formation, suggesting that it is most likely the primary or early cause of the defect. Deletion of Dkk1 results in an elevation of the Wnt/ß-catenin activity. Signaling molecules Shh, Fgf8 and Bmp4 are also upregulated. Furthermore, genetic hyperactivation of Wnt/ß-catenin signal pathway in the cloacal mesenchyme partially recapitulates Dkk1 mutant phenotypes. Together, these findings underscore the importance of DKK1 in regulating behavior of dPCM progenitors, and suggest that formation of anus and urethral depends on Dkk1-mediated dynamic inhibition of the canonical Wnt/ß-catenin signal pathway. PMID:24479159

  10. High resolution and high definition anorectal manometry and pressure topography: diagnostic advance or a new kid on the block?

    PubMed

    Lee, Yeong Yeh; Erdogan, Askin; Rao, Satish S C

    2013-12-01

    The recent development of closely spaced circumferential solid state transducers has paved the way for novel technology that includes high resolution anorectal manometry and topography (HRAM) and 3-D high definition anorectal manometry (HDAM). These techniques are increasingly being used for the assessment of anorectal neuromuscular function. However, whether they constitute a diagnostic advantage or a mere refinement of an old technology is unknown. Unlike the traditional manometry that utilized 3 or 6 unidirectional sensors, the closely spaced circumferential arrangement facilitates superior spatiotemporal mapping of pressures at rest and during various dynamic maneuvers. HDAM can provide knowledge of the three muscles that govern the anal continence namely, the puborectalis, and the internal and external anal sphincters, and can show how they mediate the rectoanal inhibitory reflex and sensorimotor responses and the spatiotemporal orientation of these muscles. Also, anal sphincter defects can be mapped and readily detected using 3-D technology. Similarly, HRAM has facilitated confirmation and development of phenotypes of dyssynergic defecation. Recently, normative data have also been reported with HRAM and HDAM, together with the influence of age, gender, and test instructions. The greater yield of anatomical and functional information may supersede the limitations of costs, fragility, and shorter life-span associated with these new techniques. Thus, HDAM and HRAM are not just new gadgets but constitute a significant and novel diagnostic advance. However, more prospective studies are needed to better define anorectal disorders with these techniques and to confirm their superiority.

  11. Effects of Anorectic Drugs on Food Intake under Progressive-Ratio and Free-Access Conditions in Rats

    ERIC Educational Resources Information Center

    LeSage, Mark G.; Stafford, David; Glowa, John R.

    2004-01-01

    The effects of two anorectic drugs, dexfenfluramine and phentermine, on food intake under different food-access conditions were examined. Experiment 1 compared the effects of these drugs on food intake under a progressive-ratio (PR) schedule and free-access conditions. Dexfenfluramine decreased food intake under both conditions, but the doses…

  12. Current management of asymptomatic carotid stenosis.

    PubMed

    Castilla-Guerra, L; Fernández-Moreno, M C; Serrano-Rodríguez, L

    2015-05-01

    Asymptomatic carotid stenosis (ACS) is a common problem in daily clinical practice, and its management is still the subject of controversy. In contrast to symptomatic carotid disease, the main studies on surgical treatment of patients with ACS have shown only a modest benefit in the primary prevention of stroke. In addition, current medical treatment has drastically decreased the risk of stroke in patients with ACS. Selecting patients amenable to endovascular treatment and determining how and when to conduct the ultrasound follow-up of these patients are issues that still need resolving. This article analyzes two new studies underway that provide evidence for better management of ACS in daily clinical practice.

  13. Differences in toileting habits between children with chronic encopresis, asymptomatic siblings, and asymptomatic nonsiblings.

    PubMed

    Borowitz, S M; Cox, D J; Sutphen, J L

    1999-06-01

    No studies have compared toileting-specific behaviors of encopretic children with those of asymptomatic children and have controlled for environmental factors such as parental attitudes, parenting styles, and bathroom facilities. This study prospectively examined the toileting habits of 86 chronically encopretic children compared with those of 27 asymptomatic siblings and 35 asymptomatic nonsiblings. Although encopretic children experienced significantly more soiling than did controls, the total number of daily bowel movements passed in the toilet (+/-SD) was comparable in the three groups (.92 +/- .76 in encopretic children compared with 1.14 +/- .43 and 1.08 +/- .47 in siblings and nonsiblings, respectively). Encopretic children experienced pain with defecation more often than did controls. During the 14-day study period, encopretic children complained of pain on 2.75 +/- 4.03 days compared with .58 +/- 1.84 days among sibling controls and 2.31 +/- 3.21 days among nonsibling controls. The mean pain score in encopretic children was .76 +/- 1.00 compared with .05 +/- .15 and .26 +/- .38 among siblings and nonsiblings, respectively. All three groups of children sat on the toilet without parental prompting the same number of times each day. In summary, children with chronic encopresis do not seem to avoid toileting, and they exhibit toileting behaviors that are very similar to those of asymptomatic siblings as well as to those of nonsibling controls. PMID:10393070

  14. Coronary angiographic findings in asymptomatic systemic sclerosis.

    PubMed

    Tarek, El-Gohary; Yasser, Amin E; Gheita, Tamer

    2006-07-01

    The objective of this study was to assess coronary arterial involvement in asymptomatic systemic sclerosis (SSc) patients. Fourteen female patients with SSc (five limited and nine diffuse) were recruited for this study. All patients fulfilled the following 1980 American College of Rheumatology criteria for classification of SSc Masi et al (Arthritis Rheum 23:581-590 1980). None of them had chest pain nor electrocardiogram (ECG) changes suggestive of myocardial ischemia. All patients underwent thorough history taking, full clinical examination, routine laboratory investigations, and basic screening for conventional atherosclerotic disease risk factors. ECG and coronary catheterization were done for all patients. We detected 19 coronary angiographic abnormalities in our cohort. Three out of nine diffuse SSc patients (33.33%) had ectasia of the coronary arteries, and all of them had slow flow but none in the limited type. One patient with limited SSc showed spasm. Three out of five patients with limited type (60%) had stenosis, one of them had uncontrolled hypertension, while none of the diffuse type had. Five patients (55.55%) of the diffuse type had tortuosity, while it was found in only two patients (40%) of the limited type. Three patients (33.3%) of the diffuse type had calcification of the coronaries, while it was seen in two patients (40%) of the limited type. Pathological involvement of coronary arteries in asymptomatic SSc patients is not uncommon but not paralleled by clinical symptomatology.

  15. Relationship factors and sexual dysfunction. Implications for assessment and treatment.

    PubMed

    Hartman, L M

    1980-11-01

    Conceptual issues pertaining to behavioural treatment of sexual dysfunctions are examined. A study is described in which twenty couples referred to an outpatient family therapy unit were assigned one of four group classifications based on their combined scores for specific measures of marital happiness and sexual functioning. The groups included asymptomatic-control, sexual dysfunction, marital conflict, and combined classifications. Results clearly indicate that sexual dysfunction and marital distress may operate independent of one another. Implications for assessment, treatment, and future research are discussed.

  16. Maintaining physical activity during refeeding improves body composition, intestinal hyperpermeability and behavior in anorectic mice

    PubMed Central

    Achamrah, Najate; Nobis, Séverine; Breton, Jonathan; Jésus, Pierre; Belmonte, Liliana; Maurer, Brigitte; Legrand, Romain; Bôle-Feysot, Christine; Rego, Jean Luc do; Goichon, Alexis; Rego, Jean Claude do; Déchelotte, Pierre; Fetissov, Sergueï O; Claeyssens, Sophie; Coëffier, Moïse

    2016-01-01

    A role of gut-brain axis emerges in the pathophysiology of anorexia nervosa and maintaining adapted physical activity during refeeding remains discussed. We aimed to assess gastrointestinal protein metabolism and investigate the contribution of physical activity during refeeding in C57BL/6 mice with activity-based anorexia (ABA). ABA mice exhibited lower body weight and food intake with increase of lean mass/fat mass ratio and fat oxidation. Colonic permeability was increased in ABA. Ad libitum food access was then restored and ABA group was divided into two subgroups, with access to running wheel (ABA-PA) or not (ABA-NPA). After refeeding, fat free mass was completely restored only in ABA-PA. Colonic permeability was enhanced in ABA-NPA. Finally, muscle kynurenine conversion into kynurenic acid was lower in ABA-NPA who also exhibited altered behavior. Maintaining physical activity during refeeding may thus limit colonic hyperpermeability and improve behavior in anorectic mice. PMID:26906060

  17. Maintaining physical activity during refeeding improves body composition, intestinal hyperpermeability and behavior in anorectic mice.

    PubMed

    Achamrah, Najate; Nobis, Séverine; Breton, Jonathan; Jésus, Pierre; Belmonte, Liliana; Maurer, Brigitte; Legrand, Romain; Bôle-Feysot, Christine; do Rego, Jean Luc; Goichon, Alexis; Rego, Jean Claude do; Déchelotte, Pierre; Fetissov, Sergueï O; Claeyssens, Sophie; Coëffier, Moïse

    2016-01-01

    A role of gut-brain axis emerges in the pathophysiology of anorexia nervosa and maintaining adapted physical activity during refeeding remains discussed. We aimed to assess gastrointestinal protein metabolism and investigate the contribution of physical activity during refeeding in C57BL/6 mice with activity-based anorexia (ABA). ABA mice exhibited lower body weight and food intake with increase of lean mass/fat mass ratio and fat oxidation. Colonic permeability was increased in ABA. Ad libitum food access was then restored and ABA group was divided into two subgroups, with access to running wheel (ABA-PA) or not (ABA-NPA). After refeeding, fat free mass was completely restored only in ABA-PA. Colonic permeability was enhanced in ABA-NPA. Finally, muscle kynurenine conversion into kynurenic acid was lower in ABA-NPA who also exhibited altered behavior. Maintaining physical activity during refeeding may thus limit colonic hyperpermeability and improve behavior in anorectic mice. PMID:26906060

  18. Anorectal giant condyloma acuminatum (Buschke-Loewenstein tumor): CT and radiographic manifestations

    SciTech Connect

    Balthazar, E.J.; Streiter, M.; Megibow, A.J.

    1984-03-01

    Giant condyloma acuminatum (Buschke-Loewenstein tumor) is an unusual variety of venereal wart characterized by a large size, cauliflower-like appearance, and locally invasive nature. CT examination of two patients with anorectal giant condylomata revealed the papillomatous and invasive nature of the lesion and the extent of tumor; there was infiltration of the subcutaneous tissue, perirectal fascial planes, and luminal narrowing with marked thickening of the rectal wall. The pathologic specimens showed benign histologic finding in one case and a mixed pattern with areas of malignant degeneration in the other. CT accurately demonstrated the exact location and extent of the lesions. The presence of malignant degeneration in this inherently invasive lesion can be established only on histologic examination.

  19. Mutations and Down-Regulation of CDX1 in Children with Anorectal Malformations

    PubMed Central

    Zhang, Tao; Tang, Xiao Bing; Wang, Li Li; Bai, Yu Zuo; Qiu, Guang Rong; Yuan, Zheng Wei; Wang, Wei Lin

    2013-01-01

    Background: Anorectal malformations (ARMs) represent a variety of congenital disorders that involve abnormal termination of the anorectum. This study was to reveal relation between CDX1 and human ARMs phenotypes. Methods: 108 Chinese patients and 120 Chinese controls were included in this study. We analyzed the relation between two by PCR, qRT-PCR, western blot and immunofluorescence. Results: Four heterozygous mutations in CDX1 gene were identified in ARMs patients (3.7%, 4/108), no found in controls. CDX1 protein expression was significantly decreased in the ARMs compared with the control anorectum. All samples analyzed in ARMs group exhibited down-regulated CDX1 mRNA expression in comparison to matched normal group, demonstrated significant differences statistically. Conclusion: The findings represented the relation between CDX1 mutations and CDX1 genotype. Furthermore, it was suggested that the downregulation of CDX1 might be related to the development of ARMs. PMID:23329892

  20. Anorectal abscess

    MedlinePlus

    ... in infants and toddlers who are still in diapers and who have a history of anal fissures. ... prevent such infections. In infants and toddlers, frequent diaper changes and proper cleaning during diaper changes can ...

  1. Asymptomatic brucellosis infection in humans: implications for diagnosis and prevention.

    PubMed

    Zhen, Q; Lu, Y; Yuan, X; Qiu, Y; Xu, J; Li, W; Ke, Y; Yu, Y; Huang, L; Wang, Y; Chen, Z

    2013-09-01

    Human brucellosis is mainly caused by contact with Brucella-infected animals and their secretions and carcasses. Individuals who are continuously in contact with animals are considered to be at a high risk but only some show symptoms and are diagnosed as cases of brucellosis. Here, we showed that asymptomatic brucellosis infections occur among humans. Asymptomatic infections mainly result from less frequent contact with Brucella and/or contact with low-virulence Brucella. In our study, patients with asymptomatic infection had low antibody titres and different contact patterns. Awareness of asymptomatic infection is important for early diagnosis of brucellosis and prevention of chronic infection.

  2. Relationship Among Anal Sphincter Injury, Patulous Anal Canal, and Anal Pressures in Patients with Anorectal Disorders

    PubMed Central

    Prichard, David; Harvey, Doris M.; Fletcher, Joel G.; Zinsmeister, Alan R.; Bharucha, Adil E.

    2015-01-01

    Background & Aims The anal sphincters and puborectalis are routinely imaged with an endoanal magnetic resonance imaging (MRI) coil, which does not assess co-aptation of the anal canal at rest. Using a MRI torso coil, we identified a patulous anal canal in some patients with anorectal disorders. We aimed to evaluate the relationship between anal sphincter and puborectalis injury, a patulous anal canal, and anal pressures. Methods We performed a retrospective analysis of data from 119 patients who underwent MRI and manometry analysis of anal anatomy and pressures, respectively, from February 2011 through March 2013 at the Mayo Clinic. Anal pressures were determined by high-resolution manometry, anal sphincter and puborectalis injury was determined by endoanal MRI, and anal canal integrity was determined by torso MRI. Associations between manometric and anatomical parameters were evaluated with univariate and multivariate analyses. Results Fecal incontinence (55 patients, 46%) and constipation (36 patients. 30%) were the main indications for testing; 49 patients (41%) had a patulous anal canal, which was associated with injury to more than 1 muscle (all P≤.001) and internal sphincter (P<.01), but not puborectalis (P=.09) or external sphincter (P=.06) injury. Internal (P<.01) and external sphincter injury (P=.02) and a patulous canal (P<.001), but not puborectalis injury, predicted anal resting pressure. A patulous anal canal was the only significant predictor (P<.01) of the anal squeeze pressure increment. Conclusions Patients with anorectal disorders commonly have a patulous anal canal, associated with more severe anal injury, anal resting pressure, and squeeze pressure increment. It is therefore important to identify patulous anal canal because it appears to be a marker of not only anal sphincter injury but disturbances beyond sphincter injury, such as damage to the anal cushions or anal denervation. PMID:25869638

  3. Disruption of the temporally regulated cloaca endodermal β-catenin signaling causes anorectal malformations

    PubMed Central

    Miyagawa, S; Harada, M; Matsumaru, D; Tanaka, K; Inoue, C; Nakahara, C; Haraguchi, R; Matsushita, S; Suzuki, K; Nakagata, N; Ng, R C-L; Akita, K; Lui, V C-H; Yamada, G

    2014-01-01

    The cloaca is temporally formed and eventually divided by the urorectal septum (URS) during urogenital and anorectal organ development. Although congenital malformations, such as anorectal malformations (ARMs), are frequently observed during this process, the underlying pathogenic mechanisms remain unclear. β-Catenin is a critical component of canonical Wnt signaling and is essential for the regulation of cell differentiation and morphogenesis during embryogenesis. The expression of β-catenin is observed in endodermal epithelia, including URS epithelia. We modulated the β-catenin gene conditionally in endodermal epithelia by utilizing tamoxifen-inducible Cre driver line (ShhCreERT2). Both β-catenin loss- and gain-of-function (LOF and GOF) mutants displayed abnormal clefts in the perineal region and hypoplastic elongation of the URS. The mutants also displayed reduced cell proliferation in the URS mesenchyme. In addition, the β-catenin GOF mutants displayed reduced apoptosis and subsequently increased apoptosis in the URS epithelium. This instability possibly resulted in reduced expression levels of differentiation markers, such as keratin 1 and filaggrin, in the perineal epithelia. The expression of bone morphogenetic protein (Bmp) genes, such as Bmp4 and Bmp7, was also ectopically induced in the epithelia of the URS in the β-catenin GOF mutants. The expression of the Msx2 gene and phosphorylated-Smad1/5/8, possible readouts of Bmp signaling, was also increased in the mutants. Moreover, we introduced an additional mutation for a Bmp receptor gene: BmprIA. The ShhCreERT2/+; β-cateninflox(ex3)/+; BmprIAflox/− mutants displayed partial restoration of URS elongation compared with the β-catenin GOF mutants. These results indicate that some ARM phenotypes in the β-catenin GOF mutants were caused by abnormal Bmp signaling. The current analysis revealed the close relation of endodermal β-catenin signaling to the ARM phenotypes. These results are considered to

  4. Resected specimen evaluation, anorectal manometry, endoanal ultrasonography and clinical follow-up after STARR procedures

    PubMed Central

    Naldini, Gabriele; Cerullo, Guido; Menconi, Claudia; Martellucci, Jacopo; Orlandi, Simone; Romano, Nicola; Rossi, Mauro

    2011-01-01

    AIM: To investigate stapled transanal rectal resection (STARR) procedures as surgical techniques for obstructed defecation syndrome (ODS) by analyzing specimen evaluation, anorectal manometry, endoanal ultrasonography and clinical follow-up. METHODS: From January to December 2007, we have treated 30 patients. Fifteen treated with double PPH-01 staplers and 15 treated using new CCS 30 contour. Resected specimen were measured with respect to average surface and volume. All patients have been evaluated at 24 mo with clinical examination, anorectal manometry and endoanal ultrasonography. RESULTS: Average surface in the CCS 30 group was 54.5 cm2 statistically different when compared to the STARR group (36.92 cm2). The average volume in the CCS 30 group was 29.8 cc, while in the PPH-01 it was 23.8 cc and difference was statistically significant. The mean hospital stay in the CCS 30 group was 3.1 d, while in the PPH-01 group the median hospital stay was 3.4 d. As regards the long-term follow-up, an overall satisfactory rate of 83.3% (25/30) was achieved. Endoanal ultrasonography performed 1 year following surgery was considered normal in both of the studied groups. Mean resting pressure was higher than the preoperative value (67.2 mmHg in the STARR group and 65.7 mmHg in the CCS30 group vs 54.7 mmHg and 55.3 mmHg, respectively). Resting and squeezing pressures were lower in those patients not satisfied, but data are not statistically significant. CONCLUSION: The STARR procedure with two PPH-01 is a safe surgical procedure to correct ODS. The new Contour CCS 30 could help to increase the amount of the resected tissue without differences in early complications, post-operative pain and in hospital stay compared to the STARR with two PPH-01 technique. PMID:21633641

  5. Sexual health knowledge of male and female Latino immigrants.

    PubMed

    Seal, Paula S; Garcés-Palacio, Isabel C; Halanych, Jewell H; Scarinci, Isabel C

    2012-08-01

    To explore sexual health knowledge among Latino immigrants in a Southern U.S. city, we conducted 20 qualitative interviews, (10 Women and 10 Men). We explored knowledge and factors associated with sexual health among male and female Latino immigrants in a Southern U.S. city experiencing a major growth of Latino immigrants in the past 10 years. Both genders demonstrated limited knowledge of Human Papillomavirus (HPV) and risks of sexually transmitted infection (STI) acquisition. Neither gender perceived that they could have an asymptomatic STI, including HPV. Gender differences exist in sexual behaviors and perceptions of STI risk. Females indicated that female Latinas tend to have older sexual initiation age, fewer lifetime sexual partners and more pro-active sexual health than did Latinos when referring to Latino males. Consequently, male and female Latino immigrants could benefit from culturally relevant programs to alleviate STI disparities.

  6. Sexual Assault

    MedlinePlus

    ... to anyone of any age, race or ethnicity, religion, ability, appearance, sexual orientation, or gender identity. However, ... to anyone of any age, race or ethnicity, religion, ability, appearance, sexual orientation, or gender identity. However, ...

  7. Asymptomatic humans transmit dengue virus to mosquitoes

    PubMed Central

    Duong, Veasna; Lambrechts, Louis; Paul, Richard E.; Ly, Sowath; Lay, Rath Srey; Long, Kanya C.; Huy, Rekol; Tarantola, Arnaud; Scott, Thomas W.; Sakuntabhai, Anavaj; Buchy, Philippe

    2015-01-01

    Three-quarters of the estimated 390 million dengue virus (DENV) infections each year are clinically inapparent. People with inapparent dengue virus infections are generally considered dead-end hosts for transmission because they do not reach sufficiently high viremia levels to infect mosquitoes. Here, we show that, despite their lower average level of viremia, asymptomatic people can be infectious to mosquitoes. Moreover, at a given level of viremia, DENV-infected people with no detectable symptoms or before the onset of symptoms are significantly more infectious to mosquitoes than people with symptomatic infections. Because DENV viremic people without clinical symptoms may be exposed to more mosquitoes through their undisrupted daily routines than sick people and represent the bulk of DENV infections, our data indicate that they have the potential to contribute significantly more to virus transmission to mosquitoes than previously recognized. PMID:26553981

  8. Asymptomatic post-rheumatic giant left atrium

    PubMed Central

    Özkartal, Tardu; Tanner, Felix C; Niemann, Markus

    2016-01-01

    A 78-year-old asymptomatic woman was referred to our clinic for a second opinion regarding indication for mitral valve surgery. An echocardiogram showed a moderate mitral stenosis with a concomitant severe regurgitation. The most striking feature, however, was a giant left atrium with a parasternal anteroposterior diameter of 79 mm and a left atrial volume index of 364 mL/m². There are various echocardiographic definitions of a giant left atrium, which are mainly based on measurements of the anteroposterior diameter of the left atrium using M-mode in the parasternal long axis view. Since the commonly accepted method for echocardiographic evaluation of left atrial size is left atrial volume index, we propose a cut-off value of 140 mL/m2 for the definition of a “giant left atrium”. PMID:27354895

  9. Asymptomatic humans transmit dengue virus to mosquitoes.

    PubMed

    Duong, Veasna; Lambrechts, Louis; Paul, Richard E; Ly, Sowath; Lay, Rath Srey; Long, Kanya C; Huy, Rekol; Tarantola, Arnaud; Scott, Thomas W; Sakuntabhai, Anavaj; Buchy, Philippe

    2015-11-24

    Three-quarters of the estimated 390 million dengue virus (DENV) infections each year are clinically inapparent. People with inapparent dengue virus infections are generally considered dead-end hosts for transmission because they do not reach sufficiently high viremia levels to infect mosquitoes. Here, we show that, despite their lower average level of viremia, asymptomatic people can be infectious to mosquitoes. Moreover, at a given level of viremia, DENV-infected people with no detectable symptoms or before the onset of symptoms are significantly more infectious to mosquitoes than people with symptomatic infections. Because DENV viremic people without clinical symptoms may be exposed to more mosquitoes through their undisrupted daily routines than sick people and represent the bulk of DENV infections, our data indicate that they have the potential to contribute significantly more to virus transmission to mosquitoes than previously recognized.

  10. Asymptomatic post-rheumatic giant left atrium.

    PubMed

    Özkartal, Tardu; Tanner, Felix C; Niemann, Markus

    2016-06-26

    A 78-year-old asymptomatic woman was referred to our clinic for a second opinion regarding indication for mitral valve surgery. An echocardiogram showed a moderate mitral stenosis with a concomitant severe regurgitation. The most striking feature, however, was a giant left atrium with a parasternal anteroposterior diameter of 79 mm and a left atrial volume index of 364 mL/m². There are various echocardiographic definitions of a giant left atrium, which are mainly based on measurements of the anteroposterior diameter of the left atrium using M-mode in the parasternal long axis view. Since the commonly accepted method for echocardiographic evaluation of left atrial size is left atrial volume index, we propose a cut-off value of 140 mL/m(2) for the definition of a "giant left atrium".

  11. Sexual Health.

    PubMed

    Hansen, Lisa; Mann, Janice; McMahon, Sharon; Wong, Thomas

    2004-08-25

    HEALTH ISSUE: Much attention is devoted to women's reproductive health, but the formative and mature stages of women's sexual lives are often overlooked. We have analyzed cross-sectional data from the Sexual Behaviour module of the 2000/2001 Canadian Community Health Survey (CCHS), and reviewed the literature and available indicators of the sexual health of Canadian women. KEY FINDINGS: Contemporary Canadian adolescents are becoming sexually active at younger ages than in previous generations. The gender gap between young males and females in age at first intercourse has virtually disappeared. The mean age at first intercourse for CCHS respondents aged 15-24 years was between 16 and 17. Canadian-born respondents are significantly younger at first intercourse than those who were born outside of Canada. Few adolescents recognize important risks to their sexual health. Older Canadians are sexually active, and continue to find emotional and physical satisfaction in their sexual relationships. DATA GAPS AND RECOMMENDATIONS: Both health surveys and targeted research must employ a broader understanding of sexuality to measure changes in and determinants of the sexual health of Canadians. There is reluctance to direct questions about sexual issues to younger Canadians, even though increased knowledge of sexual health topics is associated with delayed onset of sexual intercourse. Among adults, sex-positive resources are needed to address aspects of aging, rather than medicalizing age-related sexual dysfunction. Age and gender-appropriate sexual health care, education, and knowledge are important not only for women of reproductive age, but for Canadians at all stages of life.

  12. Management of Asymptomatic Renal Stones in Astronauts

    NASA Technical Reports Server (NTRS)

    Reyes, David; Locke, James

    2016-01-01

    Introduction: Management guidelines were created to screen and manage asymptomatic renal stones in U.S. astronauts. The risks for renal stone formation in astronauts due to bone loss and hypercalcuria are unknown. Astronauts have a stone risk which is about the same as commercial aviation pilots, which is about half that of the general population. However, proper management of this condition is still crucial to mitigate health and mission risks in the spaceflight environment. Methods: An extensive review of the literature and current aeromedical standards for the monitoring and management of renal stones was done. The NASA Flight Medicine Clinic's electronic medical record and Longitudinal Survey of Astronaut Health were also reviewed. Using this work, a screening and management algorithm was created that takes into consideration the unique operational environment of spaceflight. Results: Renal stone screening and management guidelines for astronauts were created based on accepted standards of care, with consideration to the environment of spaceflight. In the proposed algorithm, all astronauts will receive a yearly screening ultrasound for renal calcifications, or mineralized renal material (MRM). Any areas of MRM, 3 millimeters or larger, are considered a positive finding. Three millimeters approaches the detection limit of standard ultrasound, and several studies have shown that any stone that is 3 millimeters or less has an approximately 95 percent chance of spontaneous passage. For mission-assigned astronauts, any positive ultrasound study is followed by low-dose renal computed tomography (CT) scan, and flexible ureteroscopy if CT is positive. Other specific guidelines were also created. Discussion: The term "MRM" is used to account for small areas of calcification that may be outside the renal collecting system, and allows objectivity without otherwise constraining the diagnostic and treatment process for potentially very small calcifications of uncertain

  13. Female sexuality.

    PubMed

    Rao, T S Sathyanarana; Nagaraj, Anil Kumar M

    2015-07-01

    Sex is a motive force bringing a man and a woman into intimate contact. Sexuality is a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy, and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviors, practices, roles and relationships. Though generally, women are sexually active during adolescence, they reach their peak orgasmic frequency in their 30 s, and have a constant level of sexual capacity up to the age of 55 with little evidence that aging affects it in later life. Desire, arousal, and orgasm are the three principle stages of the sexual response cycle. Each stage is associated with unique physiological changes. Females are commonly affected by various disorders in relation to this sexual response cycle. The prevalence is generally as high as 35-40%. There are a wide range of etiological factors like age, relationship with a partner, psychiatric and medical disorders, psychotropic and other medication. Counseling to overcome stigma and enhance awareness on sexuality is an essential step in management. There are several effective psychological and pharmacological therapeutic approaches to treat female sexual disorders. This article is a review of female sexuality. PMID:26330647

  14. Female sexuality

    PubMed Central

    Rao, T.S. Sathyanarana; Nagaraj, Anil Kumar M.

    2015-01-01

    Sex is a motive force bringing a man and a woman into intimate contact. Sexuality is a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy, and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviors, practices, roles and relationships. Though generally, women are sexually active during adolescence, they reach their peak orgasmic frequency in their 30 s, and have a constant level of sexual capacity up to the age of 55 with little evidence that aging affects it in later life. Desire, arousal, and orgasm are the three principle stages of the sexual response cycle. Each stage is associated with unique physiological changes. Females are commonly affected by various disorders in relation to this sexual response cycle. The prevalence is generally as high as 35–40%. There are a wide range of etiological factors like age, relationship with a partner, psychiatric and medical disorders, psychotropic and other medication. Counseling to overcome stigma and enhance awareness on sexuality is an essential step in management. There are several effective psychological and pharmacological therapeutic approaches to treat female sexual disorders. This article is a review of female sexuality. PMID:26330647

  15. Noninvasive testing of asymptomatic bilateral hilar adenopathy

    SciTech Connect

    Carr, P.L.; Singer, D.E.; Goldenheim, P.; Bernardo, J.; Mulley, A.G. )

    1990-03-01

    The diagnostic strategy for asymptomatic patients with persistent bilateral bilar adenopathy often involves invasive procedures. The authors used Bayesian analysis to: (1) estimate the relative prevalences of diseases causing bilateral bilar adenopathy; (2) assess changes in the prevalence of disease by race, the presence of other clinical symptoms, and geography; and (3) determine the value of relevant noninvasive tests, including the angiotensin-converting enzyme (ACE) assay, gallium scan, and purified protein derivative (PPD), in order to assess when a strategy of watchful waiting is appropriate. The analysis indicated that the ACE assay, particularly when paired with the PPD, can identify many patients who might safely be managed without immediate invasive biopsy. Patients who are ACE+ and PPD- have an estimated probability of sarcoidosis of 0.95 or greater; patients who are ACE- and PPD+ have a probability of tuberculosis of 0.86 if black, 0.79 if white. In contrast, gallium scanning has no diagnostic role in this clinical situation. Bronchoscopic or mediastinoscopic biopsy has a limited role for patients who are ACE+ PPD- or ACE- PPD+ because of limited sensitivity. Patients who are both ACE- and PPD-, particularly if white, may have a high enough risk of lymphoma to consider invasive biopsy.

  16. Sexually transmitted parasitic diseases.

    PubMed

    Levine, G I

    1991-03-01

    Sexual activity is the primary method of transmission for several important parasitic diseases and has resulted in a significant prevalence of enteric parasitic infection among male homosexuals. The majority of parasitic sexually transmitted diseases involve protozoan pathogens; however, nematode and arthropod illnesses are also included in this group. Trichomoniasis, caused by Trichomonas vaginalis, is the most common parasitic STD. Infection with this organism typically results in the signs and symptoms of vaginitis. Trichomoniasis can be diagnosed in the office setting by performing a microscopic evaluation of infected vaginal secretions and can be successfully treated with metronidazole. Both pediculosis pubis, caused by the crab louse Pthirus pubis, and scabies, caused by the itch mite Sarcoptes scabiei, present with severe pruritus. A papular or vesicular rash and linear burrows seen in the finger webs and genital area are characteristic of scabies. Pediculosis pubis is diagnosed by observing adult lice or their nits in areas that bear coarse hair. The diagnosis of scabies is confirmed by scraping suspicious burrows and viewing the mite or its byproducts under the microscope. Lindane, 1% used in treating scabies, is also very effective for treating pediculosis pubis. Synthetic pyrethrins, also applied as a cream or lotion, are less toxic alternatives for the treatment of either condition. Oral-anal and oral-genital sexual practices predispose male homosexuals to infection with many enteric pathogens, including parasitic protozoans and helminths. The most common of these parasitic infections are amebiasis, caused by Entamoeba histolytica, and giardiasis caused by Giardia lamblia. Both entities may cause acute or chronic diarrhea, as well as other abdominal symptoms. Most gay men with amebiasis are asymptomatic, and invasive disease in this group is extremely rare. Both amebiasis and giardiasis can be diagnosed on the basis of microscopic examination of stool

  17. Reversal of the anorectic effect of (+)-fenfluramine in the rat by the selective cholecystokinin receptor antagonist MK-329.

    PubMed

    Cooper, S J; Dourish, C T; Barber, D J

    1990-01-01

    1. Experiments were conducted to determine whether or not the effect of (+)-fenfluramine (3.0 mg kg-1, i.p.) on food intake can be antagonized by the selective cholecystokinin receptor antagonist MK-239 (formerly L364,718; (3S(-)-N-(2,3-dihydro-1-methyl-2-oxo-5-phenyl-1-H-1,4-benzodiazepin++ +-3-yl)-1H- indole-2-carboxamide). Two feeding paradigms were employed. In the first, non-deprived rats were familiarized with eating a highly palatable, sweetened mash in a 30 min test. In the second, freely-feeding rats were trained to consume powdered chow in their home-cages, and their intake was monitored over the first 6 h of the night-period. 2. In doses of 30.0 and 100.0 micrograms kg-1, s.c., MK-329 almost completely blocked the anorectic effect of (+)-fenfluramine in the palatable food intake test. These doses of MK-329 have previously been reported to antagonize the anorectic effect produced by exogenous cholecystokinin-octapeptide (CCK8) in rats. Both doses of MK-329 were also effective in significantly attenuating the anorectic effect of (+)-fenfluramine in nocturnal free-feeding animals over a 6 h-period. 3. MK-329 (10.0-100.0 micrograms kg-1, s.c.) failed to antagonize the anorectic effect of either the specific dopamine D2-receptor agonist quinpirole (0.3 mg kg-1, s.c.) or the beta-carboline FG 7142 (10.0 mg kg-1, i.p.) in the palatable food intake test. 4. MK-329 (10.0-300.Opgkg-1, s.c.) had no effect, when administered alone, on the level of palatable food intake in non-deprived rats, even when substantial satiation was produced by a pre-feeding procedure. Furthermore, MK-329 had no effect, when administered alone, on nocturnal food intake in freelyfeeding rats. 5. In conclusion, not only was MK-329 a potent antagonist of the effect of CCK8 on food intake, it also blocked the effect of (+)-fenfluramine to a significant degree. The effect of MK-329 was selective in that the anorectic effects of either quinpirole or FG 7142 remained unaffected. Administered

  18. Sexual selection.

    PubMed

    Hosken, David J; House, Clarissa M

    2011-01-25

    Sexual selection is a concept that has probably been misunderstood and misrepresented more than any other idea in evolutionary biology, confusion that continues to the present day. We are not entirely sure why this is, but sexual politics seems to have played its role, as does a failure to understand what sexual selection is and why it was initially invoked. While in some ways less intuitive than natural selection, sexual selection is conceptually identical to it, and evolution via either mechanism will occur given sufficient genetic variation. Recent claims that sexual selection theory is fundamentally flawed are simply wrong and ignore an enormous body of evidence that provides a bedrock of support for this major mechanism of organic evolution. In fact it is partly due to this solid foundation that current research has largely shifted from documenting whether or not sexual selection occurs, to addressing more complex evolutionary questions. PMID:21256434

  19. Compulsory sexuality.

    PubMed

    Emens, Elizabeth F

    2014-02-01

    Asexuality is an emerging identity category that challenges the common assumption that everyone is defined by some type of sexual attraction. Asexuals--those who report feeling no sexual attraction to others--constitute one percent of the population, according to one prominent study. In recent years, some individuals have begun to identify as asexual and to connect around their experiences interacting with a sexual society. Asexuality has also become a protected classification under the antidiscrimination law of one state and several localities, but legal scholarship has thus far neglected the subject. This Article introduces asexuality to the legal literature as a category of analysis, an object of empirical study, and a phenomenon of medical science. It then offers a close examination of the growing community of self-identified asexuals. Asexual identity has revealing intersections with the more familiar categories of gender, sexual orientation, and disability, and inspires new models for understanding sexuality. Thinking about asexuality also sheds light on our legal system. Ours is arguably a sexual law, predicated on the assumption that sex is important. This Article uses asexuality to develop a framework for identifying the ways that law privileges sexuality. Across various fields, these interactions include legal requirements of sexual activity, special carve-outs to shield sexuality from law, legal protections from others' sexuality, and legal protections for sexual identity. Applying this framework, the Article traces several ways that our sexual law burdens, and occasionally benefits, asexuals. This Article concludes by closely examining asexuality's prospects for broader inclusion into federal, state, and local antidiscrimination laws.

  20. Internet Sexualities

    NASA Astrophysics Data System (ADS)

    Döring, Nicola

    The term “internet sexuality” (or OSA, online sexual activities) refers to sexual-related content and activities observable on the internet (cf. Adams, Oye, & Parker, 2003; Cooper, McLoughlin, & Campbell, 2000; Leiblum & Döring, 2002). It designates a variety of sexual phenomena (e.g., pornography, sex education, sexual contacts) related to a wide spectrum of online services and applications (e.g., websites, online chat rooms, peer-to-peer networks). If an even broader range of computer networks - such as the Usenet or bulletin board systems - is included in this extensional definition, one speaks of “online sexuality” or “cybersexuality.”

  1. Sexual Abuse

    MedlinePlus

    Navigation Physical Abuse Sexual Abuse Domestic Violence Psychological Abuse Financial Abuse Neglect Critical Issues What Communities Can Do The Role of Professionals and Concerned Citizens Help for Victims ...

  2. Adolescent sexuality.

    PubMed

    Grant, L M; Demetriou, E

    1988-12-01

    The consequences of adolescent sexual behavior are an enormous burden both for the adolescent and society. The problem is not that teens are sexually active but rather that they have little preparation and guidance in developing responsible sexual behavior. Developmentally, adolescents reach physical maturity before they are cognitively able to appreciate the consequences of their behavior. A teenager's primary source of information regarding sexuality is his or her peer group, all of whom are experiencing and reinforcing the same behaviors. The family, the major socializer of other behaviors, is not as powerful a force in shaping responsible sexual behavior because of parental discomfort with sex education and sexual discussions. This is the result of a social milieu in which sex is frequently portrayed but rarely linked with responsible behavior or accurate, nonjudgmental information. The pediatric practitioner is in an ideal position to intervene in these dynamics. In the office, the practitioner can provide accurate sexual information to both parents and adolescents, support parental-child communication on sexual issues, and provide appropriate services or referral. In the community, the practitioner can advocate for school-based sex education as well as act as an information resource. Finally, the practitioner can advocate for the health care needs for adolescents on a national level, supporting legislation that provides adolescents with information and access to services necessary to make responsible sexual decisions.

  3. [Research progress in genetic abnormalities and etiological factors of congenital anorectal malformation].

    PubMed

    Zhang, Yanli; Ren, Hongxia

    2016-01-01

    Congenital anorectal malformation (ARM) is one of the most common gastrointestinal congenital diseases, accounting for 1/4 in digestive tract malformation, and is one of the congenital malformations in routine surveillance by the World Health Organization. Because of the variety of risk factors and the complexity of the pathological changes, etiology of ARM is still not clear. It is mostly considered that ARM is resulted from hereditary factors and environmental factors in the development of embryogenesis. Through animal experiments, scholars have found that Hox, Shh, Fgf, Wnt, Cdx and TCF4, Eph and ephrin play crucial role during the development of digestive tract. When the genes/signaling pathway dysfunction occurs, ARM may happen. In addition, ARM is related to the external factors in pregnancy. Because of the complexity of related factors in the development of human embryogenesis, the research progress of human ARM is very slow. This paper reviews relevant literatures in genetic factors and environmental factors, in order to provide the theoretical basis for the treatment and prevention of ARM. PMID:26797848

  4. ANMS-ESNM Position Paper and Consensus Guidelines On Biofeedback Therapy for Anorectal Disorders

    PubMed Central

    Rao, Satish S.C.; Benninga, Marc A; Bharucha, Adil E; Chiarioni, Giuseppe; Di Lorenzo, Carlo; Whitehead, William E

    2015-01-01

    Anorectal disorders such as dyssynergic defecation, fecal incontinence, levator ani syndrome and solitary rectal ulcer syndrome are common, and affect both the adult and pediatric populations. Although they are treated with several treatment approaches, over the last two decades, biofeedback therapy using visual and verbal feedback techniques has emerged as an useful option. Because it is safe, it is commonly recommended. However, the clinical efficacy of biofeedback therapy in adults and children is not clearly known, and there is a lack of critical appraisal of the techniques used and the outcomes of biofeedback therapy for these disorders. The American Neurogastroenterology and Motility Society and the European Society of Neurogastroenterology and Motility convened a task force to examine the indications, study performance characteristics, methodologies used and the efficacy of biofeedback therapy, and to provide evidence-based recommendations. Based on the strength of evidence, biofeedback therapy is recommended for the short term and long term treatment of constipation with dyssynergic defecation (Level I, Grade A), and for the treatment of fecal incontinence (Level II, Grade B). Biofeedback therapy may be useful in the short-term treatment of Levator Ani Syndrome with dyssynergic defecation (Level II, Grade B), and solitary rectal ulcer syndrome with dyssynergic defecation (Level III, Grade C), but the evidence is fair. Evidence does not support the use of biofeedback for the treatment of childhood constipation (Level 1, Grade D). PMID:25828100

  5. Systematic stereoscopic analyses for cloacal development: The origin of anorectal malformations

    PubMed Central

    Matsumaru, Daisuke; Murashima, Aki; Fukushima, Junichi; Senda, Syuhei; Matsushita, Shoko; Nakagata, Naomi; Miyajima, Masayasu; Yamada, Gen

    2015-01-01

    The division of the embryonic cloaca is the most essential event for the formation of digestive and urinary tracts. The defective development of the cloaca results in anorectal malformations (ARMs; 2–5 per 10,000 live births). However, the developmental and pathogenic mechanisms of ARMs are unclear. In the current study, we visualized the epithelia in the developing cloaca and nephric ducts (NDs). Systemic stereoscopic analyses revealed that the ND-cloaca connection sites shifted from the lateral-middle to dorsal-anterior part of the cloaca during cloacal division from E10.5 to E11.5 in mouse embryos. Genetic cell labeling analyses revealed that the cells in the ventral cloacal epithelium in the early stages rarely contributed to the dorsal part. Moreover, we revealed the possible morphogenetic movement of endodermal cells within the anterior part of the urogenital sinus and hindgut. These results provide the basis for understanding both cloacal development and the ARM pathogenesis. PMID:26354024

  6. Preliminary Analysis of the Surgical Treatment of Anorectal Malformations in Russia.

    PubMed

    Morozov, Dmitry; Pimenova, Evgeniya; Oculov, Evgeniy; Gusev, Alexey; Utkina, Kseniya

    2015-12-01

    The article provides the analysis of a survey of the professional community of Russian pediatric surgeons, dedicated to the treatment of anorectal malformations (ARM). The authors evaluated the differences and similarities in classification, surgical procedures, time of definitive repair, and postoperative management of ARM in different hospitals and centers. This was done by a survey upon specialists and experts in Russia followed by a symposium with live surgery, open discussion, and vote. Overall, 85% of the delegates supported the idea to create several regional centers of pediatric coloproctology as the way to improve the treatment of ARM in Russia. Moreover, 80% of delegates agreed to create a universal database of ARM information. The development of neonatal surgery and videoendoscopic surgical methods in the treatment of patients with ARM requires creation of a national guideline by the Russian Association of Pediatric Surgeons. Next step will concern standardization of the diagnosis and surgical treatment of children with ARM. This study is a collaborative effort to provide Russian Consensus on treatment of ARM.

  7. Asymptomatic myocardial ischemia following cold provocation

    SciTech Connect

    Shea, M.J.; Deanfield, J.E.; deLandsheere, C.M.; Wilson, R.A.; Kensett, M.; Selwyn, A.P.

    1987-09-01

    Cold is thought to provoke angina in patients with coronary disease either by an increase in myocardial demand or an increase in coronary vascular resistance. We investigated and compared the effects of cold pressor stimulation and symptom-limited supine bicycle exercise on regional myocardial perfusion in 35 patients with stable angina and coronary disease and in 10 normal subjects. Regional myocardial perfusion was assessed with positron emission tomography and rubidium-82. Following cold pressor stimulation 24 of 35 patients demonstrated significant abnormalities of regional myocardial perfusion with reduced cation uptake in affected regions of myocardium: 52 +/- 9 to 43 +/- 9 (p less than 0.001 vs normal subjects). Among these 24 patients only nine developed ST depression and only seven had angina. In contrast, 29 of 35 patients underwent supine exercise, and abnormal regional myocardial perfusion occurred in all 29, with a reduction in cation intake from 48 +/- 10 to 43 +/- 14 (p less than 0.001 vs normal subjects). Angina was present in 27 of 29 and ST depression in 25 of 29. Although the absolute decrease in cation uptake was somewhat greater following cold as opposed to exercise, the peak heart rate after cold was significantly lower than that after exercise (82 +/- 12 vs 108 +/- 16 bpm, p less than 0.05). Peak systolic blood pressures after cold and exercise were similar (159 +/- 24 vs 158 +/- 28). Thus, cold produces much more frequent asymptomatic disturbances of regional myocardial perfusion in patients with stable angina and coronary disease than is suggested by pain or ECG changes.

  8. Asymptomatic encephalitis in calves experimentally infected with bovine herpesvirus-5

    PubMed Central

    Isernhagen, Allan Jürgen; Cosenza, Mariana; da Costa, Marcio Carvalho; Médici, Kerlei Cristina; Balarin, Mara Regina Stipp; Bracarense, Ana Paula Frederico Rodrigues Loureiro; Alfieri, Amauri Alcindo; Lisbôa, Júlio Augusto Naylor

    2011-01-01

    This study demonstrated that bovine herpesvirus 5 (BoHV)-5 infected calves can develop encephalitis and remain asymptomatic. Seven calves were infected intranasally and monitored for 30 days. Cerebrospinal fluid (CSF) analysis was performed from the onset of neurological signs. Multiple sections of brain and the trigeminal ganglion were submitted to histopathology. Virus detection (PCR and isolation) was performed on CSF and tissues. Four calves developed signs of neurologic disease and died. Three calves remained asymptomatic and were euthanized 30 days post-infection. Cerebrospinal fluid mononuclear pleocytosis occurred in symptomatic and asymptomatic calves. BoHV-5 was isolated and viral DNA was detected in multiple areas of the encephalon of all calves. The viral DNA was detected in the CSF of 2 calves showing neurological signs. Histologically, inflammation was noted in the brain of all calves and confirmed that the encephalitis caused by BoHV-5 may be mild and asymptomatic. PMID:22654135

  9. Neuropsychological abnormalities in AIDS and asymptomatic HIV seropositive patients.

    PubMed Central

    Villa, G; Monteleone, D; Marra, C; Bartoli, A; Antinori, A; Pallavicini, F; Tamburrini, E; Izzi, I

    1993-01-01

    Neuropsychological and immunological parameters were studied in 36 AIDS patients with early disease and without clinical, laboratory, and neuroradiological signs of CNS impairment, and also in 33 asymptomatic HIV seropositive subjects. Many AIDS patients performed abnormally on timed psychomotor tasks, tasks involving sequencing and "set-shifting", and memory tasks stressing attention, learning, active retrieval, and monitoring of information. Asymptomatic HIV seropositive subjects as a group did not perform significantly worse than controls. However, on the basis of a cut off number of pathological performances on neuropsychological tasks, 52.8% of AIDS and 30.3% of asymptomatic HIV seropositive subjects had cognitive impairment, compared with 3.9% of HIV seronegative controls. Low values of CD4+ cells and of CD4+/CD8+ ratio and high titres of P-24 antigen in the blood prevailed among subjects with cognitive impairment, especially in the asymptomatic HIV seropositive group. PMID:8350104

  10. Bartonella clarridgeiae bacteremia detected in an asymptomatic blood donor.

    PubMed

    Vieira-Damiani, Gislaine; Diniz, Pedro Paulo Vissotto de Paiva; Pitassi, Luiza Helena Urso; Sowy, Stanley; Scorpio, Diana Gerardi; Lania, Bruno Grosselli; Drummond, Marina Rovani; Soares, Tânia Cristina Benetti; Barjas-Castro, Maria de Lourdes; Breitschwerdt, Edward B; Nicholson, William L; Velho, Paulo Eduardo Neves Ferreira

    2015-01-01

    Human exposure to Bartonella clarridgeiae has been reported only on the basis of antibody detection. We report for the first time an asymptomatic human blood donor infected with B. clarridgeiae, as documented by enrichment blood culture, PCR, and DNA sequencing.

  11. [Asymptomatic myxoma of the tricuspid valve septal leaflet].

    PubMed

    Jedliński, Ireneusz; Jamrozek-Jedlińska, Maria; Bugajski, Paweł; Kalawski, Ryszard; Poprawski, Kajetan; Słomczyński, Marek

    2012-01-01

    We presented a case of asymptomatic myxoma of the tricuspid valve septal leaflet. The tumour was diagnosed accidentally during rutine transthoracic echocardiography and confirmed by transesophageal echocardiography. It was resected and the septal leaflet repaired during surgery.

  12. Asymptomatic infection with American cutaneous leishmaniasis: epidemiological and immunological studies

    PubMed Central

    Andrade-Narvaez, Fernando J; Loría-Cervera, Elsy Nalleli; Sosa-Bibiano, Erika I; Van Wynsberghe, Nicole R

    2016-01-01

    American cutaneous leishmaniasis (ACL) is a major public health problem caused by vector-borne protozoan intracellular parasites from the genus Leishmania, subgenera Viannia and Leishmania. Asymptomatic infection is the most common outcome after Leishmania inoculation. There is incomplete knowledge of the biological processes explaining the absence of signs or symptoms in most cases while other cases present a variety of clinical findings. Most studies of asymptomatic infection have been conducted in areas of endemic visceral leishmaniasis. In contrast, asymptomatic ACL infection has been neglected. This review is focused on the following: (1) epidemiological studies supporting the existence of asymptomatic ACL infection and (2) immunological studies conducted to understand the mechanisms responsible for controlling the parasite and avoiding tissue damage. PMID:27759762

  13. Sexual prejudice.

    PubMed

    Herek, Gregory M; McLemore, Kevin A

    2013-01-01

    Despite shifts toward greater acceptance in U.S. public opinion and policy, lesbian, gay, and bisexual people remain widely stigmatized. This article reviews empirical research on sexual prejudice, that is, heterosexuals' internalization of cultural stigma, manifested in the form of negative attitudes toward sexual minorities and same-sex desires and behaviors. After briefly reviewing measurement issues, we discuss linkages between sexual prejudice and religion, gender, sexuality, and related variables, and consider how the cultural institutions encompassing these domains create a social context within which individual expressions of prejudice can meet important psychological needs. These include needs for securing social acceptance, affirming values that are central to one's self-concept, and avoiding anxiety and other negative emotions associated with threats to self-esteem. We conclude by discussing factors that may motivate heterosexuals to reduce their own sexual prejudice, including intergroup contact, as well as avenues for future empirical inquiry.

  14. Investigation of anal motor characteristics of the sensorimotor response (SMR) using 3-D anorectal pressure topography

    PubMed Central

    Cheeney, Gregory; Remes-Troche, Jose M.; Attaluri, Ashok

    2011-01-01

    Desire to defecate is associated with a unique anal contractile response, the sensorimotor response (SMR). However, the precise muscle(s) involved is not known. We aimed to examine the role of external and internal anal sphincter and the puborectalis muscle in the genesis of SMR. Anorectal 3-D pressure topography was performed in 10 healthy subjects during graded rectal balloon distention using a novel high-definition manometry system consisting of a probe with 256 pressure sensors arranged circumferentially. The anal pressure changes before, during, and after the onset of SMR were measured at every millimeter along the length of anal canal and in 3-D by dividing the anal canal into 4 × 2.1-mm grids. Pressures were assessed in the longitudinal and anterior-posterior axis. Anal ultrasound was performed to assess puborectalis morphology. 3-D topography demonstrated that rectal distention produced an SMR coinciding with desire to defecate and predominantly induced by contraction of puborectalis. Anal ultrasound showed that the puborectalis was located at mean distance of 3.5 cm from anal verge, which corresponded with peak pressure difference between the anterior and posterior vectors observed at 3.4 cm with 3-D topography (r = 0.77). The highest absolute and percentage increases in pressure during SMR were seen in the superior-posterior portion of anal canal, reaffirming the role of puborectalis. The SMR anal pressure profile showed a peak pressure at 1.6 cm from anal verge in the anterior and posterior vectors and distinct increase in pressure only posteriorly at 3.2 cm corresponding to puborectalis. We concluded that SMR is primarily induced by the activation and contraction of the puborectalis muscle in response to a sensation of a desire to defecate. PMID:21109594

  15. One-stage vs. three-stage repair in anorectal malformation with rectovestibular fistula

    PubMed Central

    Amanollahi, Omid; Ketabchian, Saman

    2016-01-01

    Background: Anorectal malformations (ARMs) disease is one of the congenital anomalies with an incidence of about 1 in 5000 neonate births, and treatment requires surgical intervention. Selecting the one- or three-step surgical procedure to treat the disease, especially in female neonates with rectovestibular fistula, is a subject of debate. This study aims to compare the advantages and disadvantages of these two methods. Materials and Methods: Forty female neonates with ARM and rectovestibular fistula between March 2011 and March 2013 were included in the study, and they were divided into two equal groups. Allocation of the first case was random, and all cases were then allocated alternatively (every other subject was assigned to a treatment group) until each group received 20 cases equally patients of study group underwent a one-stage posterior sagittal anorectoplasty (PSARP) and in control group patients underwent a three-stage operation (colostomy, PSARP, and closure of colostomy). The complications during and after the surgery were recorded in both groups, and the results were compared. Results: In the control group, only one case (5%) of wound infection and dehiscence was seen, whereas in the one-stage study group, six cases (30%) of wound infection and dehiscence were seen (P value = 0.046). However, regarding the incidence of other complications, such as iatrogenic vaginal injury as well as final recovery, no considerable differences were seen between the two groups. Conclusions: Despite more surgical site infections and dehiscence in the one-stage repair, but due to the numerous advantages compared to the three-stage method, which is more time-consuming, more costly, and causes more adverse effect on parents and children, performing the one-stage repair is recommended for this anomaly. PMID:27251519

  16. Dose-Effect Relationships for Individual Pelvic Floor Muscles and Anorectal Complaints After Prostate Radiotherapy

    SciTech Connect

    Smeenk, Robert Jan; Hoffmann, Aswin L.; Hopman, Wim P.M.; Lin, Emile N.J. Th. van; Kaanders, Johannes H.A.M.

    2012-06-01

    Purpose: To delineate the individual pelvic floor muscles considered to be involved in anorectal toxicity and to investigate dose-effect relationships for fecal incontinence-related complaints after prostate radiotherapy (RT). Methods and Materials: In 48 patients treated for localized prostate cancer, the internal anal sphincter (IAS) muscle, the external anal sphincter (EAS) muscle, the puborectalis muscle (PRM), and the levator ani muscles (LAM) in addition to the anal wall (Awall) and rectal wall (Rwall) were retrospectively delineated on planning computed tomography scans. Dose parameters were obtained and compared between patients with and without fecal urgency, incontinence, and frequency. Dose-effect curves were constructed. Finally, the effect of an endorectal balloon, which was applied in 28 patients, was investigated. Results: The total volume of the pelvic floor muscles together was about three times that of the Awall. The PRM was exposed to the highest RT dose, whereas the EAS received the lowest dose. Several anal and rectal dose parameters, as well as doses to all separate pelvic floor muscles, were associated with urgency, while incontinence was associated mainly with doses to the EAS and PRM. Based on the dose-effect curves, the following constraints regarding mean doses could be deduced to reduce the risk of urgency: {<=}30 Gy to the IAS; {<=}10 Gy to the EAS; {<=}50 Gy to the PRM; and {<=}40 Gy to the LAM. No dose-effect relationships for frequency were observed. Patients treated with an endorectal balloon reported significantly less urgency and incontinence, while their treatment plans showed significantly lower doses to the Awall, Rwall, and all pelvic floor muscles. Conclusions: Incontinence-related complaints show specific dose-effect relationships to individual pelvic floor muscles. Dose constraints for each muscle can be identified for RT planning. When only the Awall is delineated, substantial components of the continence apparatus are

  17. Reconstructive perineoplasty in the management of non-healing wounds after anorectal surgery.

    PubMed

    Bernardi, C; Pescatori, M

    2001-04-01

    Non-healing wounds (NHW) following anorectal surgery cause great distress to the patient and may be followed by a retracting scar causing anal deformity and incontinence. The management of NHW is controversial. The aim of this study was to review our experience with reconstructive perineoplasty in the treatment of such condition. From January 1992 to June 2000, we treated 12 patients affected by NHW (4 men and 8 women, mean age 47 years), not responding to conservative treatment. None had Crohn's disease or HIV infection. Pre- and postoperative anal manometry and ultrasound were carried out in 8 patients. All had microspinal anesthesia, mechanical preparation of the intestine, and perineal wound cleansing. Reconstructive perineoplasty was performed by means of local flaps (i. e. cutaneous, fasciocutaneous, myocutaneous). Median follow-up was 13 months (range, 1 to 70). Postoperative complications were as follows: 5 perineal suture dehiscences (1 total, 4 partial), the flap being resutured in one case under local anesthesia; one patient required dilatations for mild anal stricture. No case of gross fecal incontinence, retracting scar or perineal ulcer was observed. Among those patients who had disordered anal continence prior to surgery, all but one improved continence score following perineoplasty from 2.8+/-2.2 to 1.8+/-1.2 (mean +/- sdm, not significant). Following reconstructive perineoplasty, no significant change was observed in functional and morphologic patterns of the anal sphincters either at manometry or by ultrasound. Reconstructive perineoplasty resulted in a good functional and clinical outcome in most cases and, therefore, may be considered an effective procedure in the management of NHW.

  18. Potential diagnostic role of renal scintigraphy in the management of patients with high anorectal malformation.

    PubMed

    Harisankar, Chidambaram Natrajan Balasubramanian; Mittal, Bhagwant Rai; Bhattacharya, Anish; Sunil, Hejjaji Venkataramarao; Singh, Baljinder; Rao, Katragadda Lakshmi Narasimha

    2009-01-01

    Urological problems are the leading associated anomalies in patients with anorectal malformation (ARM). In this study, we evaluated the role of scintigraphy in managing patients with high ARM. The records of infants with urologic anomalies on abdominal ultrasound and referred for scintigraphic evaluation were retrospectively analyzed. Diuretic renography in these patients was performed using (99m)Tc-diethyl triamine penta-acetic acid ((99m)Tc-DTPA) or (99m)Tc-ethylene cysteine ((99m)Tc-EC) while cortical scintigraphy was performed with (99m)Tc-dimercaptosuccinate (DMSA). Whenever available, EC was preferred in children of age less than 1 year. Forty patients (38 males, 2 females) were analyzed. The mean age of the population was 25 months (range 15 days-21 years). Eighteen of the forty patients were less than 3 months of age. Twenty seven of the patients were less than one year of age. The most common renal anomaly was unilaterally non-visualized kidney affecting 15 out of the 40 patients. The visualised kidney was abnormal in 8/15 patients. Hydronephrotic changes were noticed in 12 of 40 patients of whom 2 had pelvi ureteric junction obstruction that was confirmed and treated surgically. Horse shoe kidney was present in 1 patient while 2 had an ectopic kidney. Scarring/ pyelonephritic changes were found in 7/40 patients. Five patients had already progressed to chronic renal failure at the time of scintigraphy. Only 8 patients of the 40 had bilaterally normal kidneys. In conclusion, this study suggests that urologic abnormalities often found in infants with high ARM may remain clinically silent and eventually lead to chronic renal failure. Proper evaluation by diuretic renography and cortical scintigraphy can lead to early identification of potentially treatable conditions hence reducing the likelihood of developing severe renal damage.

  19. Incidence, Surgical Treatment, and Prognosis of Anorectal Melanoma From 1973 to 2011

    PubMed Central

    Chen, Haiyan; Cai, Yibo; Liu, Yue; He, Jinjie; Hu, Yeting; Xiao, Qian; Hu, Wangxiong; Ding, Kefeng

    2016-01-01

    Abstract Anorectal melanoma (AM) is a rare type of melanoma that accounts for 0.4% to 1.6% of total malignant melanomas. The incidence of AM increases over time, and it remains highly lethal, with a 5-year survival rate of 6% to 22%. Considering the rare nature of this disease, most studies on AM comprise isolated case reports and single-center trials, which could not provide comprehensive assessment of the disease. Therefore, we conducted a population-based study by using the Surveillance, Epidemiology, and End Results (SEER) program to provide the latest and best available evidence of AM. We extracted all cases of AM registered in the SEER database from 1973 to 2011 (April 2014 release) and calculated age-adjusted incidence. Only cases with active follow-up were included to predict factors associated with prognosis. Survival outcomes were also compared among different types of surgery. We identified 640 AM cases, which consisted of 265 rectal melanoma and 375 anal melanoma. The estimated annual incidence rates of AM per 1 million population were 0.259 in males and 0.407 in females, and it increased with advanced age and over time. Tumor stage and surgical treatment were independent predictors of survival. Results implied that surgery improved the prognosis of patients with local- and regional-stage AM but could not prolong the survival of patients with distant-stage AM. Moreover, the outcome of less extensive excision was not statistically different from that of more extensive excision. This study provides an up-to-date estimation of the incidence and prognosis of AM by using SEER data. The incidence of AM continuously increases over time, despite its rarity. This disease also exhibits poor prognosis. Thus, AM must be further investigated in future studies. We also recommend surgery as the optimal treatment for local- and regional-stage AM patients but not for those with distant metastasis. PMID:26886623

  20. Local anesthesia is superior to spinal anesthesia for anorectal surgical procedures.

    PubMed

    Fleischer, M; Marini, C P; Statman, R; Capella, J; Shevde, K

    1994-11-01

    In this prospective study we compared local with spinal anesthesia for anorectal surgical procedures with regard to pain control, recovery time before unassisted ambulation, incidence of postoperative complications, length of hospital stay, and cost effectiveness in 80 consecutive patients. Patients were allocated in two groups: group 1 (n = 52) received local anesthesia, and group 2 (n = 28) had spinal anesthesia. There were no intraoperative complications related to the anesthetic technique, and there was no difference between groups in the number of doses of narcotics required to control postoperative pain (1.2 +/- 1.5 vs 1.8 +/- 1.7 in group 1 and 2 respectively, P > 0.05). Recovery time before unassisted ambulation was significantly longer in group 2 (139 +/- 96 minutes in group 2 vs 82 +/- 62 minutes in group 1, P < 0.05). There were 21/52 complications in group 1 in contrast to 21/28 in group 2, (P < 0.05). There was no difference between groups in the postoperative incidence of nausea, vomiting, headache, weakness, and constipation; however, the incidence of postoperative urinary retention was significantly higher in group 2 (5/52 in group 1 vs 9/28 in group 2, P < 0.05). As a result of urinary retention, more patients in group 2 required overnight hospitalization (12/52 in group 1 vs 21/28 in group 2, P < 0.05). Patients in group 2 required 36 hospital days in contrast to 21 days for patients in group 1, P < 0.05. The difference in hospital days resulted in $18,000 greater cost for patients in group 2.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Healthy Sexuality

    MedlinePlus

    ... a person is biologically male or female), gender identity (how people identify themselves as male, female or ... positive health benefits, such as reducing stress, improving self-esteem, and cardiovascular health. A person’s physical sexual ...

  2. Sexual Health

    MedlinePlus

    ... our e-newsletter! Aging & Health A to Z Sexual Health Basic Facts & Information All adults, including older people, ... the opportunity to enjoy a satisfying and fulfilling sex life. In fact, most of them do, even ...

  3. Travel-related sexually transmitted infections.

    PubMed

    Korzeniewski, Krzysztof; Juszczak, Dariusz

    2015-01-01

    Sexually transmitted infections (STIs) are among the most common notifiable health problems worldwide, with particularly high rates in developing countries. Men and women with multiple sexual partners at home or a previous history of STIs are more likely to have casual sexual exposure (CSE) while travelling. Over the last several decades 5% to even 50% of short-term travellers engaged in CSE during foreign trips. It is estimated that only 50% of travellers use condoms during casual sex abroad. Sexual contact with commercial sex workers is an exceptionally high-risk behaviour. The common risk factor is also young age. Adolescents and young adults constitute 25% of the sexually active population, but represent almost 50% of all new acquired STIs. Many STIs are asymptomatic and therefore can be difficult to identify and control. The clinical manifestation of STIs can be grouped into a number of syndromes, such as genital ulcer or erosion, urethral or vaginal discharge, pelvic inflammatory disease. STIs are divided into curable infections caused by bacteria (gonorrhoea, chlamydiasis, syphilis, chancroid, lymphogranuloma venereum, granuloma inguinale) or protozoa (trichomoniasis) and incurable viral infections (genital herpes, genital warts, HIV). STIs are not only a cause of acute morbidity, but may result in complications including male and female infertility, ectopic pregnancy, cervical cancer, premature mortality or miscarriage. Monogamous sex with a stable, uninfected partner or sexual abstinence remains the only way to avoid the risk of becoming infected with STIs. PMID:26726895

  4. Asymptomatic severe aortic stenosis: challenges in diagnosis and management.

    PubMed

    Izumi, Chisato

    2016-08-01

    Optimal management for asymptomatic severe aortic stenosis (AS) remains controversial. Considering the increase in elderly patients, improved surgical outcomes and the introduction of transcatheter aortic valve implantation, we must reconsider the optimal management of asymptomatic severe AS. In this article, previous studies regarding the natural history of asymptomatic severe AS were reviewed to obtain a clinical perspective of AS in the growing elderly patient population. The incidence of sudden death in asymptomatic severe AS varies among studies from 0.25% to 1.7% per year, with differences related to study design and patient background. Except for very severe AS, sudden death or AS-related cardiac death without preceding symptoms is uncommon if 'watchful' waiting strategy is possible. Therefore, early operation is reasonable in very severe AS, but it is not recommended for all patients with severe AS. Using exercise tests, plasma levels of natriuretic peptides and other parameters, risk stratification of asymptomatic severe AS is needed to select patients who may have greater benefit following early operation. On the other hand, 'watchful' waiting is not always possible in real world of our practice. Patient education and periodic echocardiography are essential in 'watchful' waiting, which is not simply waiting strategy without careful monitoring. Individualised discussion regarding the indication for early operation is necessary, considering age, clinical background, predicted natural history and operative risk in each patient. PMID:27091844

  5. Significant asymptomatic bacteriuria among Nigerian type 2 diabetics.

    PubMed Central

    Alebiosu, C. O.; Osinupebi, O. A.; Olajubu, F. A.

    2003-01-01

    Significant asymptomatic bacteriuria is a risk factor for symptomatic urinary infection and septicemia among predisposed individuals such as diabetics. We investigated the pattern of asymptomatic bacteriuria among our type 2 diabetics with a view to documenting the prevalence, type of organisms responsible and the antibiotic susceptibility pattern. One hundred and twenty-four type 2 Nigerian diabetics (55 males and 69 females) submitted midstream urine specimens for culture. Thirty-three patients had significant bacteriuria (9 males and 24 females), showing the frequency of occurrence of asymptomatic bacteriuria to be 26.6%. The most common organism isolated was Klebsiella pneumonia at 42.4%. Gram-negative bacilli made up about 23 (69.7%) of the isolates. Isolates were poorly sensitive to the readily available antibiotics (ampicillin, tetracycline and cotrimoxazole), but a large number of the organisms isolated were sensitive to nitrofurantoin, gentamicin, ciprofloxacin and ofloxacin. Sensitivity to erythromycin, nalidixic acid and cefuroxime was moderate. Asymptomatic bacteriuria is, thus, more prevalent among the Nigerian diabetic population than in the non-diabetics. A changing pattern of disease is observed with Klebsiella sp. now accounting for the majority of asymptomatic bacteriuria among diabetics. The organisms are not sensitive to the commonly available antibacterial agents. PMID:12793791

  6. Ultrasonographic evaluation of the shoulder in asymptomatic overhead athletes.

    PubMed

    Ocguder, Durmus Ali; Tosun, Ozgur; Bektaser, Bulent; Cicek, Nuriye; Ipek, Ali; Bozkurt, Murat

    2010-08-01

    This study aimed to evaluate the efficiency of ultrasonography (US) in the examination of soft tissue anatomical structures of the shoulder in overhead athletes. The study evaluated the shoulders of overhead elite premier league athletes involved in basketball, handball, volleyball, body building, and water polo. US examination of both shoulders was performed prospectively in 45 asymptomatic overhead athletes and 43 asymptomatic volunteers matched for age. On US examination, subacromial-subdeltoid bursa effusion was observed in 16 of the dominant shoulders and in 2 of the non-dominant shoulders of 45 overhead athletes and in none of the asymptomatic volunteers. The mean thickness of the subacromial-subdeltoid bursa was significantly larger in the dominant and non-dominant shoulders of the overhead athletes than in the asymptomatic volunteers (p < 0.001, p < 0.05 respectively). Ultrasonography appeared as an effective, convenient and non-invasive tool for the early diagnosis of shoulder pathologies occurring in overhead athletes, even in the asymptomatic stage.

  7. Sexual sadism in sexual offenders and sexually motivated homicide.

    PubMed

    Briken, Peer; Bourget, Dominique; Dufour, Mathieu

    2014-06-01

    This article gives a clinically oriented overview of forensically relevant forms of sexual sadism disorder and its specific relationship to sexual homicide. In sexual homicide perpetrators, peculiar patterns of sexual sadism may be a motivational pathway to kill. Sexual sadism increases the risk for reoffending in sexual offenders. Through psychotherapy and pharmacological interventions, treatment of sadistic sex offenders has to consider special characteristics that may be different from those of nonsadistic sex offenders. Many of these offenders share a combination of sexual sadistic motives and an intact self-regulation, sometimes combined with a high level of sexual preoccupation.

  8. Insurability for asymptomatic hematuria or proteinuria during childhood.

    PubMed

    Feld, L G; Stapleton, F B

    1993-08-01

    The objective of this survey was to describe life insurance underwriting practices concerning children with asymptomatic hematuria and proteinuria. A questionnaire was sent to 200 companies licensed to issue life insurance policies in the state of New York. The medical director of each company was asked to respond to the insurability of children with asymptomatic hematuria and proteinuria. Two case summaries were provided with the questionnaire. Of 97 companies, 66 would offer insurance to the patient with hematuria, although 38 (58%) would charge additional premiums. In response to the problem of proteinuria, 61 companies would offer life insurance, although 50 (82%) would require higher premium charges (P < 0.002 compared with hematuria). We conclude that children with asymptomatic hematuria and proteinuria can usually obtain life insurance, although often at higher cost. Invasive diagnostic tests are not necessary for insurers to offer insurance.

  9. [Post-traumatic and postoperative asymptomatic urinoma. 2 case reports].

    PubMed

    Werner, W; Reichelt, O; Schubert, J

    2001-11-29

    A urinoma is a collection of extravasated urine developing after injury to the urinary tract, almost always asymptomatic, but requiring urgent surgical treatment. A Medline search for the term urinoma in publications appearing between 1996 and 1998, turned up only two reports describing an asymptomatic course. We now describe two cases of urinomas that remained asymptomatic over a period of four months. Although initially misinterpreted, a subsequent revisionary operation nevertheless resulted in a cure. In case 1, the urinoma appeared after an operation to treat recurrent rectal cancer; in case 2, the causal mechanism was an avulsed ureter. Treatment is orientated to the location (intra- or retroperitoneal) and extent of the injury, and comprises temporary stenting, drainage and, where necessary, plastic reconstruction. Even in the absence of a clinical correlate, any urinary retention newly discovered on ultrasonography must be investigated by uroradiography.

  10. Non-compaction cardiomyopathy in an asymptomatic athlete.

    PubMed

    Manus, Margaret Kapor; Roy, Satyajeet; Stag, Rosemarie; Hyman, Daniel

    2016-01-01

    Prevention of sudden cardiac death in athletes requires the screening and recognition of pathologies that often remain clinically silent for years until provoked by a physiologic stressor. This can result in the manifestation of disease and even death. Left ventricular non-compaction cardiomyopathy (LVNC), newly classified as a distinct entity arising in the adult population, is a cardiomyopathy that at initial presentation can manifest as a wide spectrum of symptoms from asymptomatic to ventricular arrhythmias, systemic embolism and even sudden cardiac death. We present the case of an asymptomatic athlete found to have LVNC and discuss the implications this finding may have on sports participation. PMID:27535732

  11. Spatial working memory in asymptomatic HIV-infected subjects.

    PubMed

    Grassi, B; Garghentini, G; Campana, A; Grassi, E; Bertelli, S; Cinque, P; Epifani, M; Lazzarin, A; Scarone, S

    1999-01-01

    Many clinical and research findings converge to indicate that frontal lobe, basal ganglia, and related neuronal connections are primarily involved in human immunodeficiency virus (HIV) infection; frontal lobe, mainly the prefrontal cortex, has a specialized role in working memory processes. This study focused on neuropsychological evaluation of the spatial component of working memory in a sample of 34 asymptomatic HIV-infected subjects as compared with 34 age- and sex-matched seronegative control subjects. A computer-administered test assessing spatial working memory was used for the neuropsychological evaluation. The findings did not show any spatial working memory impairment during the asymptomatic phase of HIV infection.

  12. [Substantial increase in gonorrhea and syphilis among clients of Amsterdam Sexually Transmitted Diseases Clinic].

    PubMed

    Fennema, J S; Cairo, I; Coutinho, R A

    2000-03-25

    In the Sexually Transmitted Diseases (STD) clinic of the Amsterdam Municipal Health Service standardized data are collected about all visitors, which makes it possible to gain insight into the STD trends. In 1999, 706 new cases of gonorrhoea and 76 new cases of infectious syphilis were diagnosed, increases of 46% and 111% respectively compared with 1998. The largest increase was seen among men who had sex with men. In this group the number of diagnosed cases of anorectal gonorrhoea in 1999 was twice as high as in 1998 (186 versus 94) and the number of infectious syphilis cases four times as high (40 versus 9). These data indicate an increase in unsafe sexual behaviour, possibly because of a change in attitudes about AIDS, now that effective antiretroviral treatment is available.

  13. Sexual Education and Morality.

    ERIC Educational Resources Information Center

    Spiecker, Ben

    1992-01-01

    Distinguishes five interpretations of sexual education including factual knowledge; self-control; stressing love; sexual training; and sexual morality. Suggests that sexual education should be understood as teaching children the moral tendencies relevant to sexual conduct. Argues that infantile sexual desire is based on a contradiction in terms…

  14. Comparison of Anorectic Potencies of the Trichothecenes T-2 Toxin, HT-2 Toxin and Satratoxin G to the Ipecac Alkaloid Emetine

    PubMed Central

    Wu, Wenda; Zhou, Hui-Ren; Pan, Xiao; Pestka, James J.

    2015-01-01

    Trichothecene mycotoxins, potent translational inhibitors that are associated with human food poisonings and damp-building illnesses, are of considerable concern to animal and human health. Food refusal is a hallmark of exposure of experimental animals to deoxynivalenol (DON) and other Type B trichothecenes but less is known about the anorectic effects of foodborne Type A trichothecenes (e.g., T-2 toxin, HT-2 toxin), airborne Type D trichothecenes (e.g. satratoxin G [SG]) or functionally analogous metabolites that impair protein synthesis. Here, we utilized a well-described mouse model of food intake to compare the anorectic potencies of T-2 toxin, HT-2 toxin, and SG to that of emetine, a medicinal alkaloid derived from ipecac that inhibits translation. Intraperitoneal (IP) administration with T-2 toxin, HT-2 toxin, emetine and SG evoked anorectic responses that occurred within 0.5 h that lasted up to 96, 96, 3 and 96 h, respectively, with lowest observed adverse effect levels (LOAELs) being 0.1, 0.1, 2.5 and 0.25 mg/kg BW, respectively. When delivered via natural routes of exposure, T-2 toxin, HT-2 toxin, emetine (oral) and SG (intranasal) induced anorectic responses that lasted up to 48, 48, 3 and 6 h, respectively with LOAELs being 0.1, 0.1, 0.25, and 0.5 mg/kg BW, respectively. All four compounds were generally much more potent than DON which was previously observed to have LOAELs of 1 and 2.5 mg/kg BW after IP and oral dosing, respectively. Taken together, these anorectic potency data will be valuable in discerning the relative risks from trichothecenes and other translational inhibitors of natural origin. PMID:25932382

  15. Increased peak flow variability in children with asymptomatic hyperresponsiveness.

    PubMed

    Gibson, P G; Mattoli, S; Sears, M R; Dolovich, J; Hargreave, F E

    1995-10-01

    The relevance of increased methacholine airway responsiveness detected in children with no current or past symptoms of asthma is not known. We wished to determine whether the presence of airway hyperresponsiveness in asymptomatic children is also associated with abnormal variability of peak expiratory flow (PEF). In 12 asymptomatic children with methacholine hyperresponsiveness, we examined the diurnal variation of peak expiratory flow (PEF) and response to inhaled bronchodilator. Twelve asthmatic children with a comparable range of methacholine hyperresponsiveness, and 12 normal children without methacholine responsiveness, were used as positive and negative controls. The children were aged 11 (range 9-14) yrs. The mean diurnal variation of PEF in those children with asymptomatic hyperresponsiveness was increased at 9.3%, to a degree comparable to the symptomatic asthmatic children (10.7%), and greater than the normal children (5.7%). Methacholine stimulated airway constriction was associated with symptoms in subjects from each group, indicating that the children were capable of perceiving airway constriction. We conclude that asymptomatic children with methacholine airway hyperresponsiveness have other evidence of mild variable airflow obstruction with increased diurnal PEF variability, and can perceive airflow limitation. The lack of symptoms in the children with airway hyperresponsiveness could be due to an insufficient stimulus to cause symptomatic obstruction, or the absence of eosinophilic airway inflammation, which may be a requirement for the development of symptomatic airway hyperresponsiveness.

  16. Aortic coarctation, aneurysm, and ventricular dysfunction in an asymptomatic infant.

    PubMed

    García, Ana I; Aguilar, Juan M; García, Enrique

    2016-06-01

    Aortic arch coarctation with post-coarctation aneurysm is rare in infants. We present the case of an asymptomatic 3-month-old infant with severe left ventricular dysfunction in this setting. The patient underwent surgical repair, and the left ventricular ejection fraction improved to recovery the 4th post-operative month. PMID:26980403

  17. [Screening of parasitic diseases in the asymptomatic immigrant population].

    PubMed

    Goterris, Lidia; Bocanegra, Cristina; Serre-Delcor, Núria; Moure, Zaira; Treviño, Begoña; Zarzuela, Francesc; Espasa, Mateu; Sulleiro, Elena

    2016-07-01

    Parasitic diseases suppose an important health problem in people from high endemic areas, so these must be discarded properly. Usually, these infections develop asymptomatically but, in propitious situations, are likely to reactivate themselves and can cause clinical symptoms and/or complications in the receiving country. Moreover, in some cases it is possible local transmission. Early diagnosis of these parasitic diseases made by appropriate parasitological techniques and its specific treatment will benefit both, the individual and the community. These techniques must be selected according to geoepidemiological criteria, patient's origin, migration route or time spent outside the endemic area; but other factors must also be considered as its sensitivity and specificity, implementation experience and availability. Given the high prevalence of intestinal parasites on asymptomatic immigrants, it is recommended to conduct a study by coproparasitological techniques. Because of its potential severity, the screening of asymptomatic malaria with sensitive techniques such as PCR (polymerase chain reaction) is also advisable. Serological screening for Chagas disease should be performed on all Latin American immigrants, except for people from the Caribbean islands. Other important parasites, which should be excluded, are filariasis and urinary schistosomiasis, by using microscopic examination. The aim of this paper is to review the different techniques for the screening of parasitic diseases and its advices within the care protocols for asymptomatic immigrants.

  18. Human giardiasis in Serbia: asymptomatic vs symptomatic infection*

    PubMed Central

    Nikolić, A.; Klun, I.; Bobić, B.; Ivović, V.; Vujanić, M.; Živković, T.; Djurković-Djaković, O.

    2011-01-01

    Despite the public health importance of giardiasis in all of Europe, reliable data on the incidence and prevalence in Western Balkan Countries (Serbia, Bosnia and Herzegovina, Croatia, Montenegro and FYR Macedonia) are scarce, and the relative contribution of waterborne and food-borne, or person-to-person and/or animalto- person, transmission of human giardiasis is not yet clear. To provide baseline data for the estimation of the public health risk caused by Giardia, we here review the information available on the epidemiological characteristics of asymptomatic and symptomatic human infection in Serbia. Although asymptomatic cases of Giardia represent a major proportion of the total cases of infection, high rates of Giardia infection were found in both asymptomatic and symptomatic populations. No waterborne outbreaks of giardiasis have been reported, and it thus seems that giardiasis mostly occurs sporadically in our milieu. Under such circumstances, control measures to reduce the high prevalence of giardiasis in Serbia have focused on person-to-person transmission, encouraging proper hygiene, but for more targeted intervention measures, studies to identify other risk factors for asymptomatic and symptomatic infections are needed. PMID:21678797

  19. [Asymptomatic, right reno-ureteral calculi in a cake kidney].

    PubMed

    Cocimano, V; Marino, G; Genovese, M G; Cavallotti, G P; Cevoli, R

    1989-01-01

    The primary caudal site of the urogenital anlage in the embryo explains why certain positional anomalies occur during cranial migration and are the outcome of various associated factors. A case of ectopic fusion in the ileo-sacral site known as cake kidney whose peculiarity consists of totally asymptomatic right multiple reno-ureteral lithiasis identified by chance is reported.

  20. [Screening of parasitic diseases in the asymptomatic immigrant population].

    PubMed

    Goterris, Lidia; Bocanegra, Cristina; Serre-Delcor, Núria; Moure, Zaira; Treviño, Begoña; Zarzuela, Francesc; Espasa, Mateu; Sulleiro, Elena

    2016-07-01

    Parasitic diseases suppose an important health problem in people from high endemic areas, so these must be discarded properly. Usually, these infections develop asymptomatically but, in propitious situations, are likely to reactivate themselves and can cause clinical symptoms and/or complications in the receiving country. Moreover, in some cases it is possible local transmission. Early diagnosis of these parasitic diseases made by appropriate parasitological techniques and its specific treatment will benefit both, the individual and the community. These techniques must be selected according to geoepidemiological criteria, patient's origin, migration route or time spent outside the endemic area; but other factors must also be considered as its sensitivity and specificity, implementation experience and availability. Given the high prevalence of intestinal parasites on asymptomatic immigrants, it is recommended to conduct a study by coproparasitological techniques. Because of its potential severity, the screening of asymptomatic malaria with sensitive techniques such as PCR (polymerase chain reaction) is also advisable. Serological screening for Chagas disease should be performed on all Latin American immigrants, except for people from the Caribbean islands. Other important parasites, which should be excluded, are filariasis and urinary schistosomiasis, by using microscopic examination. The aim of this paper is to review the different techniques for the screening of parasitic diseases and its advices within the care protocols for asymptomatic immigrants. PMID:27474244

  1. Bartonella clarridgeiae Bacteremia Detected in an Asymptomatic Blood Donor

    PubMed Central

    Vieira-Damiani, Gislaine; Pitassi, Luiza Helena Urso; Sowy, Stanley; Scorpio, Diana Gerardi; Lania, Bruno Grosselli; Drummond, Marina Rovani; Soares, Tânia Cristina Benetti; Barjas-Castro, Maria de Lourdes; Breitschwerdt, Edward B.; Nicholson, William L.; Velho, Paulo Eduardo Neves Ferreira

    2014-01-01

    Human exposure to Bartonella clarridgeiae has been reported only on the basis of antibody detection. We report for the first time an asymptomatic human blood donor infected with B. clarridgeiae, as documented by enrichment blood culture, PCR, and DNA sequencing. PMID:25392353

  2. Time to rethink management strategies in asymptomatic carotid artery disease.

    PubMed

    Naylor, A Ross

    2011-10-11

    Despite level I evidence, no worldwide consensus of opinion exists on how best to manage patients with asymptomatic carotid artery disease. In this article, I present the evidence supporting intervention in these patients, highlighting a number of 'inconvenient truths' that challenge the current 'one size fits all' approach to treatment. I will demonstrate that, even if one could identify and treat every individual with a 60-99% asymptomatic stenosis, >95% of all strokes will still occur. Evidence shows that 94% of all carotid endarterectomy and carotid artery stenting procedures in asymptomatic patients in the US are ultimately unnecessary, costing health-care providers US$2 billion annually. Evidence also exists that the risk of stroke in patients treated medically is lower than when the asymptomatic trials were recruiting, challenging the appropriateness of basing contemporary guidelines upon historical data. A small cohort of 'high-risk for stroke' patients will undoubtedly benefit from intervention and our goal must be to identify and treat these individuals, rather than continuing with a policy of mass intervention that benefits very few patients in the long term.

  3. Noninvasive evaluation and management of the "asymptomatic" carotid bruit.

    PubMed

    Kartchner, M M; McRae, L P

    1977-12-01

    Cervical bruits in patients who are asymptomatic or who have nonhemispheric neurological symptoms present a universal challenge. Of 4,000 patients evaluated noninvasively for carotid occlusive disease, 1,287 presented with "asymptomatic" bruits (697 had nonhemispheric neurological symptoms and 590 were clinically asymptomatic). Carotid phonoangiography (CPA), the visual analysis of carotid bruits, identifies bruits indicative of significant stenosis, documents progression, and differentiates bruits of carotid bifurcation and sub-bifurcation origin. Sub-bifurication bruits were diagnosed in 619, insignificant bifurcation bruits in 426, and significant carotid bruits in 242 patients by CPA. Oculoplethysmography (OPG) evaluates the hemodynamic significance of carotid bruits by comparative timing of simultaneously recorded ocular and ear lobe pulses. OPG detected 273 asymptomatic bruit patients with significant internal carotid flow reduction and indicated 5% of the bifurcation bruits were of external carotid origin. An accuracy of 89% in determining greater than 40% stenosis by OPG/CPA in 295 patients having arteriography increases to 97% when both OPG and CPA are positive. Six-month to 70-month clinical follow-up of the 1,287 patients documented 154 carotid endarterectomies and 38 strokes. Analysis of the strokes favors arteriography and operation only for those patients with appropriately positive or progressive OPG/CPA or with focal transient ischemic attacks (TIAs).

  4. Aortic coarctation, aneurysm, and ventricular dysfunction in an asymptomatic infant.

    PubMed

    García, Ana I; Aguilar, Juan M; García, Enrique

    2016-06-01

    Aortic arch coarctation with post-coarctation aneurysm is rare in infants. We present the case of an asymptomatic 3-month-old infant with severe left ventricular dysfunction in this setting. The patient underwent surgical repair, and the left ventricular ejection fraction improved to recovery the 4th post-operative month.

  5. The asymptomatic smooth palatal mass. A dangerously deceptive growth.

    PubMed

    Johnson, J T; Edwards, P A

    1980-09-01

    Occasionally, significant or even malignant disease may be asymptomatic or mimic a benign disorder. A neoplasm arising in a minor salivary gland is just such an entity. In evaluating these tumors, an adequate index of suspicion is integral to prompt diagnosis and early institution of treatment.

  6. Prevalence of chronic obstructive pulmonary disease in asymptomatic smokers

    PubMed Central

    Sansores, Raúl H; Velázquez-Uncal, Mónica; Pérez-Bautista, Oliver; Villalba-Caloca, Jaime; Falfán-Valencia, Ramcés; Ramírez-Venegas, Alejandra

    2015-01-01

    Background Physicians do not routinely recommend smokers to undergo spirometry unless they are symptomatic. Objective To test the hypothesis that there are a significant number of asymptomatic smokers with chronic obstructive pulmonary disease (COPD), we estimated the prevalence of COPD in a group of asymptomatic smokers. Methods Two thousand nine hundred and sixty-one smokers with a cumulative consumption history of at least 10 pack-years, either smokers with symptoms or smokers without symptoms (WOS) were invited to perform a spirometry and complete a symptom questionnaire. Results Six hundred and thirty-seven (21.5%) smokers had no symptoms, whereas 2,324 (78.5%) had at least one symptom. The prevalence of COPD in subjects WOS was 1.5% when considering the whole group of smokers (45/2,961) and 7% when considering only the group WOS (45/637). From 329 smokers with COPD, 13.7% were WOS. Subjects WOS were younger, had better lung function and lower cumulative consumption of cigarettes, estimated as both cigarettes per day and pack-years. According to severity of airflow limitation, 69% vs 87% of subjects were classified as Global Initiative for Chronic Obstructive Lung Disease stages I–II in the WOS and smokers with symptoms groups, respectively (P<0.001). A multivariate analysis showed that forced expiratory volume in 1 second (mL) was the only predictive factor for COPD in asymptomatic smokers. Conclusion Prevalence of COPD in asymptomatic smokers is 1.5%. This number of asymptomatic smokers may be excluded from the benefit of an “early” intervention, not just pharmacological but also from smoking cessation counseling. The higher forced expiratory volume in 1 second may contribute to prevent early diagnosis. PMID:26586941

  7. Vaginal and endocervical microorganisms in symptomatic and asymptomatic non-pregnant females: risk factors and rates of occurrence.

    PubMed

    Tibaldi, C; Cappello, N; Latino, M A; Masuelli, G; Marini, S; Benedetto, C

    2009-07-01

    Physiological or non-physiological factors may affect the vaginal flora. The occurrence of genital microorganisms in non-pregnant females of all ages was studied, as were the risk factors associated with each microorganism. A retrospective analysis of vaginal and endocervical cultures and wet smears from 27,172 non-pregnant women, between 1996 to 2005, was performed taking into consideration clinical and socio-demographic characteristics. No microorganisms were observed in 55.7% of the individuals studied and 44.3% had positive cultures. There was no microbiological aetiology in 49% of women with genital symptoms. Poor hygiene, chemical irritants, sexual behaviour, vaginal blood, birth control type, and/or the lack of an oestrogen effect may have caused the symptoms. The highest occurrence of Gram-negative bacteria (p<0.01), mainly Escherichia coli, was observed in prepubescent girls. The highest occurrence of Candida species (p<0.01) was in women of childbearing age, and of Gram-positive bacteria (p<0.01) in menopausal women. Adolescents, particularly asymptomatic girls, carried more frequently Ureaplasma urealyticum and Chlamydia trachomatis (p<0.01). Hormonal contraception and consistent condom use was protective against bacterial vaginosis and U. urealyticum colonization. Users of intrauterine devices had an increased risk of bacterial vaginosis or of contracting U. urealyticum, Mycoplasma hominis and Candida species. Genital complaints were an independent indicator of Candida species, Gram-negative and Gram-positive bacteria, Trichomonas vaginalis and bacterial vaginosis.Chlamydia trachomatis infections were often asymptomatic. It is concluded that the hormonal milieu and non-physiological factors are major determinants of the vaginal flora. If diagnosis of genital infections is based on symptoms alone and not on culture results, it may be erroneous. Sexual abuse should be investigated when a child presents with a sexually transmitted disease. PMID:19558525

  8. The role of the area postrema in the anorectic effects of amylin and salmon calcitonin: behavioral and neuronal phenotyping.

    PubMed

    Braegger, Fiona E; Asarian, Lori; Dahl, Kirsten; Lutz, Thomas A; Boyle, Christina N

    2014-10-01

    Amylin reduces meal size by activating noradrenergic neurons in the area postrema (AP). Neurons in the AP also mediate the eating-inhibitory effects of salmon calcitonin (sCT), a potent amylin agonist, but the phenotypes of the neurons mediating its effect are unknown. Here we investigated whether sCT activates similar neuronal populations to amylin, and if its anorectic properties also depend on AP function. Male rats underwent AP lesion (APX) or sham surgery. Meal patterns were analysed under ad libitum and post-deprivation conditions. The importance of the AP in mediating the anorectic action of sCT was examined in feeding experiments of dose-response effects of sCT in APX vs. sham rats. The effect of sCT to induce Fos expression was compared between surgery groups, and relative to amylin. The phenotype of Fos-expressing neurons in the brainstem was examined by testing for the co-expression of dopamine beta hydroxylase (DBH) or tryptophan hydroxylase (TPH). By measuring the apposition of vesicular glutamate transporter-2 (VGLUT2)-positive boutons, potential glutamatergic input to amylin- and sCT-activated AP neurons was compared. Similar to amylin, an intact AP was necessary for sCT to reduce eating. Further, co-expression between Fos activation and DBH after amylin or sCT did not differ markedly, while co-localization of Fos and TPH was minor. Approximately 95% of neurons expressing Fos and DBH after amylin or sCT treatment were closely apposed to VGLUT2-positive boutons. Our study suggests that the hindbrain pathways engaged by amylin and sCT share many similarities, including the mediation by AP neurons. PMID:25040689

  9. [Adolescent sexuality].

    PubMed

    Calero, Juan del Rey

    2010-01-01

    The social Adolescent features are insecurity, narcissism, eroticism, more impetuosity than reason. 1/3 of adolescents have risk behaviour for health. The pregnancy rate in adolescent are 9/1,000 (11,720, the abort about 50 %). The total abort (2009) were 114,480. Increase the rate of 8,4 (1990) to 14,6/ 1,000 (2009). The sexual education fails. The consulting about contraceptives get pregnancy of the OR 3,2, condom OR 2,7. The adolescent are influenced in his matter: oeer have 70-75 % of influence, mother 30-40 %, father 15 %, for yhe environment and education Cyberspace access to information: 33 % exposed to unwanted sexual materials, 1 in 7 solicited sexual online. The argument have 4 central topic: Morality and Responsibility, Desire (responsibility vs gratification), Danger (fear related to pregnancy and STD/VIH), and Victimization. The prevention of STD: so called safe sex, delayed, and abstinence, Prevention HPV vaccine. The information is not enough, are necessary personal integral formation in values as self control, abstinence, mutual respect, responsibility, reasonable decisions. PMID:21877398

  10. Asymptomatic Effluent Protozoa Colonization in Peritoneal Dialysis Patients.

    PubMed

    Simões-Silva, Liliana; Correia, Inês; Barbosa, Joana; Santos-Araujo, Carla; Sousa, Maria João; Pestana, Manuel; Soares-Silva, Isabel; Sampaio-Maia, Benedita

    Currently, chronic kidney disease (CKD) is a global health problem. Considering the impaired immunity of CKD patients, the relevance of infection in peritoneal dialysis (PD), and the increased prevalence of parasites in CKD patients, protozoa colonization was evaluated in PD effluent from CKD patients undergoing PD. Overnight PD effluent was obtained from 49 asymptomatic stable PD patients. Protozoa analysis was performed microscopically by searching cysts and trophozoites in direct wet mount of PD effluent and after staining smears. Protozoa were found in PD effluent of 10.2% of evaluated PD patients, namely Blastocystis hominis, in 2 patients, and Entamoeba sp., Giardia sp., and Endolimax nana in the other 3 patients, respectively. None of these patients presented clinical signs or symptoms of peritonitis at the time of protozoa screening. Our results demonstrate that PD effluent may be susceptible to asymptomatic protozoa colonization. The clinical impact of this finding should be further investigated. PMID:27659930

  11. Characterization of rotavirus electropherotypes excreted by symptomatic and asymptomatic infants.

    PubMed Central

    Fernández, J.; Sandino, A. M.; Pizarro, J.; Avendaño, L. F.; Pizarro, J. M.; Spencer, E.

    1991-01-01

    Human rotavirus isolates from 1100 stool samples were analyzed by polyacrylamide gel electrophoresis, and 48 different migration patterns were detected. Heterogeneity in the migration of segment 10 was observed in both long and short electropherotypes in which three long and two short patterns were identified. In spite of these variations all short and long electropherotypes were subgrouped by enzyme immunoassay as subgroups I and II respectively. Mixed infections were detected in 17% of cases and the subgrouping correlated with the corresponding electropherotypes. The same electropherotypes were present in severe, mild and asymptomatic cases and no electropherotype was particularly associated with greater virulence. Furthermore, the electropherotypes isolated from nosocomial asymptomatic cases were the same as those detected from those admitted with severe diarrhea. It seems unlikely that electropherotyping can be used to identify more virulent strains of rotavirus. Images Fig. 1 Fig. 3 PMID:1847104

  12. Asymptomatic Effluent Protozoa Colonization in Peritoneal Dialysis Patients.

    PubMed

    Simões-Silva, Liliana; Correia, Inês; Barbosa, Joana; Santos-Araujo, Carla; Sousa, Maria João; Pestana, Manuel; Soares-Silva, Isabel; Sampaio-Maia, Benedita

    Currently, chronic kidney disease (CKD) is a global health problem. Considering the impaired immunity of CKD patients, the relevance of infection in peritoneal dialysis (PD), and the increased prevalence of parasites in CKD patients, protozoa colonization was evaluated in PD effluent from CKD patients undergoing PD. Overnight PD effluent was obtained from 49 asymptomatic stable PD patients. Protozoa analysis was performed microscopically by searching cysts and trophozoites in direct wet mount of PD effluent and after staining smears. Protozoa were found in PD effluent of 10.2% of evaluated PD patients, namely Blastocystis hominis, in 2 patients, and Entamoeba sp., Giardia sp., and Endolimax nana in the other 3 patients, respectively. None of these patients presented clinical signs or symptoms of peritonitis at the time of protozoa screening. Our results demonstrate that PD effluent may be susceptible to asymptomatic protozoa colonization. The clinical impact of this finding should be further investigated.

  13. Heterogeneous and Dynamic Prevalence of Asymptomatic Influenza Virus Infections

    PubMed Central

    Furuya-Kanamori, Luis; Cox, Mitchell; Milinovich, Gabriel J.; Magalhaes, Ricardo J. Soares; Mackay, Ian M.

    2016-01-01

    Influenza infection manifests in a wide spectrum of severity, including symptomless pathogen carriers. We conducted a systematic review and meta-analysis of 55 studies to elucidate the proportional representation of these asymptomatic infected persons. We observed extensive heterogeneity among these studies. The prevalence of asymptomatic carriage (total absence of symptoms) ranged from 5.2% to 35.5% and subclinical cases (illness that did not meet the criteria for acute respiratory or influenza-like illness) from 25.4% to 61.8%. Statistical analysis showed that the heterogeneity could not be explained by the type of influenza, the laboratory tests used to detect the virus, the year of the study, or the location of the study. Projections of infection spread and strategies for disease control require that we identify the proportional representation of these insidious spreaders early on in the emergence of new influenza subtypes or strains and track how this rate evolves over time and space. PMID:27191967

  14. Heterogeneous and Dynamic Prevalence of Asymptomatic Influenza Virus Infections.

    PubMed

    Furuya-Kanamori, Luis; Cox, Mitchell; Milinovich, Gabriel J; Magalhaes, Ricardo J Soares; Mackay, Ian M; Yakob, Laith

    2016-06-01

    Influenza infection manifests in a wide spectrum of severity, including symptomless pathogen carriers. We conducted a systematic review and meta-analysis of 55 studies to elucidate the proportional representation of these asymptomatic infected persons. We observed extensive heterogeneity among these studies. The prevalence of asymptomatic carriage (total absence of symptoms) ranged from 5.2% to 35.5% and subclinical cases (illness that did not meet the criteria for acute respiratory or influenza-like illness) from 25.4% to 61.8%. Statistical analysis showed that the heterogeneity could not be explained by the type of influenza, the laboratory tests used to detect the virus, the year of the study, or the location of the study. Projections of infection spread and strategies for disease control require that we identify the proportional representation of these insidious spreaders early on in the emergence of new influenza subtypes or strains and track how this rate evolves over time and space. PMID:27191967

  15. Sexuality and Young Children.

    ERIC Educational Resources Information Center

    Honig, Alice Sterling

    2000-01-01

    Describes normal aspects of sexuality during the early years, including masturbation and children's fanciful sexual ideas. Presents inappropriately mature sexual knowledge as a danger sign of abuse. Discusses whether and what teachers/caregivers should tell children about sexuality, and notes the importance of teaching staff about sexual identity…

  16. Is surgery necessary for 'mild' or 'asymptomatic' hyperparathyroidism?

    PubMed

    Niederle, Bruno; Wémeau, Jean-Louis

    2015-09-01

    A large majority of the currently diagnosed patients with hyperparathyroidism (PHPT) are mild or asymptomatic, mainly women after menopause. Following the debate held at the 16th European Congress of Endocrinology in Wroclaw (Poland) from May 3-7, 2014, arguments are here presented by a surgeon and a medical practitioner considering these situations rather have to profit from surgery, or simply from survey. For the trained endocrine surgeon, it is evident that parathyroidectomy confirms the diagnosis and undoubtedly reduces the discomfort felt by certain patients, prevents all risks of complications, removes patients and medical teams from the monitoring and represents a real individual financial benefit. On the other hand, the medical practitioner considers that mild or asymptomatic PHPT is commonly stable, and very rare are the subjects at risk of complications, particularly of fractures; prevention of vascular and metabolic disorders, nephrolithiasis and bone rarefaction justify regular physical exercise, a safe alimentation, a sufficient calcium and high water intake, the correction of the frequent deficit in vitamin D; finally has also to be considered the impossibility to refer to specialized (endocrine) surgeons, the enormous cohort of subjects more than 50 years with 'mild' or 'asymptomatic' PHPT. The surgeon and the medical practitioner agree to consider that in patients with 'mild' or 'asymptomatic' disease, there is no place for medical treatments, in particular calcimimetics and bisphophonates. Both agree that further studies are needed to clarify the long-term prognosis of operated and non-operated PHPT in term of fractures, cardiovascular risk and mortality. Individual and collective cost/benefit ratios of surgery or survey are also still imperfectly evaluated.

  17. Asymptomatic “Candidatus Neoehrlichia mikurensis” Infections in Immunocompetent Humans

    PubMed Central

    Siński, Edward; Kowalec, Maciej; Zajkowska, Joanna; Pancewicz, Sławomir A.

    2014-01-01

    In Europe, human infections with “Candidatus Neoehrlichia mikurensis” have mainly been restricted to immunocompromised patients. We report here the first cases of asymptomatic “Ca. Neoehrlichia mikurensis” infection in immunocompetent humans (5/316 [1.6%] were infected). Due to the potential threats of infections with “Ca. Neoehrlichia mikurensis” in healthy persons to the safety of the blood supply, further study of this phenomenon is required. PMID:24899023

  18. Prevalence and Risk Factors for Asymptomatic Clostridium difficile Carriage

    PubMed Central

    Alasmari, Faisal; Seiler, Sondra M.; Hink, Tiffany; Burnham, Carey-Ann D.; Dubberke, Erik R.

    2014-01-01

    Background. Clostridium difficile infection (CDI) incidence has increased dramatically over the last decade. Recent studies suggest that asymptomatic carriers may be an important reservoir of C. difficile in healthcare settings. We sought to identify the prevalence and risk factors for asymptomatic C. difficile carriage on admission to the hospital. Methods. Patients admitted to Barnes-Jewish Hospital without diarrhea were enrolled from June 2010 through October 2011. Demographic information and healthcare and medication exposures 90 days prior to admission were collected. Stool specimens or rectal swabs were collected within 48 hours of admission and stored at −30°C until cultured. Clostridium difficile isolates were typed and compared with isolates from patients with CDI. Results. A stool/swab specimen was obtained for 259 enrolled subjects on admission. Two hundred four (79%) were not colonized, 40 (15%) had toxigenic C. difficile (TCD), and 15 (6%) had nontoxigenic C. difficile. There were no differences between TCD-colonized and -uncolonized subjects for age (mean, 56 vs 58 years; P = .46), comorbidities, admission from another healthcare facility (33% vs 24%; P = .23), or recent hospitalization (50% vs 50%; P = .43). There were no differences in antimicrobial exposures in the 90 days prior to admission (55% vs 56%; P = .91). Asymptomatic carriers were colonized with strains similar to strains from patients with CDI, but the relative proportions were different. Conclusions. There was a high prevalence of TCD colonization on admission. In contrast to past studies, TCD colonization was not associated with recent antimicrobial or healthcare exposures. Additional investigation is needed to determine the role of asymptomatic TCD carriers on hospital-onset CDI incidence. PMID:24755858

  19. Asymptomatic "Candidatus Neoehrlichia mikurensis" infections in immunocompetent humans.

    PubMed

    Welc-Falęciak, Renata; Siński, Edward; Kowalec, Maciej; Zajkowska, Joanna; Pancewicz, Sławomir A

    2014-08-01

    In Europe, human infections with "Candidatus Neoehrlichia mikurensis" have mainly been restricted to immunocompromised patients. We report here the first cases of asymptomatic "Ca. Neoehrlichia mikurensis" infection in immunocompetent humans (5/316 [1.6%] were infected). Due to the potential threats of infections with "Ca. Neoehrlichia mikurensis" in healthy persons to the safety of the blood supply, further study of this phenomenon is required. PMID:24899023

  20. Treatment of liver hydatidosis: How to treat an asymptomatic carrier?

    PubMed Central

    Frider, Bernardo; Larrieu, Edmundo

    2010-01-01

    Liver hydatidosis is the most common clinical presentation of cystic echinococcosis (CE). Ultrasonographic mass surveys have demonstrated the true prevalence, including the asymptomatic characteristic of the majority of cases, providing new insight into the natural history of the disease. This raises the question of whether to treat or not to treat these patients, due to the high and unsuspected prevalence of CE. The high rate of liver/lung frequencies of cyst localization, the autopsy findings, and the involution of cysts demonstrated in long time follow-up of asymptomatic carriers contribute to this discussion. The decision to treat an asymptomatic patient by surgery, albendazole, or puncture aspiration injection and reaspiration or to wait and watch, is based on conflicting reports in the literature, the lack of complications in untreated patients over time, and the spontaneous disappearance and involution of cysts. All these points contribute to difficulties of individual clinical decisions. The patients should be informed of the reasons and the risks of watchful/waiting without treatment, the possibility of complications, and the risks of the other options. As more information on the natural history of liver hydatidosis is acquired, selection of the best treatment will be come easier. Without this knowledge it would be very difficult to establish definitive rules of treatment. At present, it is possible to manage these patients over time and to wait for the best moment for treatment. Follow-up studies must be conducted to achieve this objective. PMID:20806427

  1. Asymptomatic spread of huanglongbing and implications for disease control.

    PubMed

    Lee, Jo Ann; Halbert, Susan E; Dawson, William O; Robertson, Cecile J; Keesling, James E; Singer, Burton H

    2015-06-16

    Huanglongbing (HLB) is a bacterial infection of citrus trees transmitted by the Asian citrus psyllid Diaphorina citri. Mitigation of HLB has focused on spraying of insecticides to reduce the psyllid population and removal of trees when they first show symptoms of the disease. These interventions have been only marginally effective, because symptoms of HLB do not appear on leaves for months to years after initial infection. Limited knowledge about disease spread during the asymptomatic phase is exemplified by the heretofore unknown length of time from initial infection of newly developing cluster of young leaves, called flush, by adult psyllids until the flush become infectious. We present experimental evidence showing that young flush become infectious within 15 d after receiving an inoculum of Candidatus Liberibacter asiaticus (bacteria). Using this critical fact, we specify a microsimulation model of asymptomatic disease spread and intensity in a grove of citrus trees. We apply a range of psyllid introduction scenarios to show that entire groves can become infected with up to 12,000 psyllids per tree in less than 1 y, before most of the trees show any symptoms. We also show that intervention strategies that reduce the psyllid population by 75% during the flushing periods can delay infection of a full grove, and thereby reduce the amount of insecticide used throughout a year. This result implies that psyllid surveillance and control, using a variety of recently available technologies, should be used from the initial detection of invasion and throughout the asymptomatic period.

  2. Asymptomatic spread of huanglongbing and implications for disease control

    PubMed Central

    Lee, Jo Ann; Halbert, Susan E.; Dawson, William O.; Robertson, Cecile J.; Keesling, James E.; Singer, Burton H.

    2015-01-01

    Huanglongbing (HLB) is a bacterial infection of citrus trees transmitted by the Asian citrus psyllid Diaphorina citri. Mitigation of HLB has focused on spraying of insecticides to reduce the psyllid population and removal of trees when they first show symptoms of the disease. These interventions have been only marginally effective, because symptoms of HLB do not appear on leaves for months to years after initial infection. Limited knowledge about disease spread during the asymptomatic phase is exemplified by the heretofore unknown length of time from initial infection of newly developing cluster of young leaves, called flush, by adult psyllids until the flush become infectious. We present experimental evidence showing that young flush become infectious within 15 d after receiving an inoculum of Candidatus Liberibacter asiaticus (bacteria). Using this critical fact, we specify a microsimulation model of asymptomatic disease spread and intensity in a grove of citrus trees. We apply a range of psyllid introduction scenarios to show that entire groves can become infected with up to 12,000 psyllids per tree in less than 1 y, before most of the trees show any symptoms. We also show that intervention strategies that reduce the psyllid population by 75% during the flushing periods can delay infection of a full grove, and thereby reduce the amount of insecticide used throughout a year. This result implies that psyllid surveillance and control, using a variety of recently available technologies, should be used from the initial detection of invasion and throughout the asymptomatic period. PMID:26034273

  3. Asymptomatic spread of huanglongbing and implications for disease control.

    PubMed

    Lee, Jo Ann; Halbert, Susan E; Dawson, William O; Robertson, Cecile J; Keesling, James E; Singer, Burton H

    2015-06-16

    Huanglongbing (HLB) is a bacterial infection of citrus trees transmitted by the Asian citrus psyllid Diaphorina citri. Mitigation of HLB has focused on spraying of insecticides to reduce the psyllid population and removal of trees when they first show symptoms of the disease. These interventions have been only marginally effective, because symptoms of HLB do not appear on leaves for months to years after initial infection. Limited knowledge about disease spread during the asymptomatic phase is exemplified by the heretofore unknown length of time from initial infection of newly developing cluster of young leaves, called flush, by adult psyllids until the flush become infectious. We present experimental evidence showing that young flush become infectious within 15 d after receiving an inoculum of Candidatus Liberibacter asiaticus (bacteria). Using this critical fact, we specify a microsimulation model of asymptomatic disease spread and intensity in a grove of citrus trees. We apply a range of psyllid introduction scenarios to show that entire groves can become infected with up to 12,000 psyllids per tree in less than 1 y, before most of the trees show any symptoms. We also show that intervention strategies that reduce the psyllid population by 75% during the flushing periods can delay infection of a full grove, and thereby reduce the amount of insecticide used throughout a year. This result implies that psyllid surveillance and control, using a variety of recently available technologies, should be used from the initial detection of invasion and throughout the asymptomatic period. PMID:26034273

  4. Early immune responses accompanying human asymptomatic Ebola infections

    PubMed Central

    Leroy, E M; Baize, S; Debre, P; Lansoud-Soukate, J; Mavoungou, E

    2001-01-01

    In a recent study we identified certain asymptomatic individuals infected by Ebola virus (EBOV) who mounted specific IgG and early and strong inflammatory responses. Here, we further characterized the primary immune response to EBOV during the course of asymptomatic infection in humans. Inflammatory responses occurred in temporal association with anti-inflammatory phase composed by soluble antagonist IL-1RA, circulating TNF receptors, IL-10 and cortisol. At the end of the inflammatory process, mRNA expression of T-cell cytokines (IL-2 and IL-4) and activation markers (CD28, CD40L and CTLA4) was up-regulated, strongly suggesting T-cell activation. This T-cell activation was followed by EBOV-specific IgG responses (mainly IgG3 ang IgG1), and by marked and sustained up-regulation of IFNγ, FasL and perforin mRNA expression, suggesting activation of cytotoxic cells. The terminal down-regulation of these latter markers coincided with the release of the apoptotic marker 41/7 NMP in blood and with the disappearance of viral RNA from PBMC, suggesting that infected cells are eliminated by cytotoxic mechanisms. Finally, RT-PCR analysis of TCR-Vβ repertoire usage showed that TCR-Vβ12 mRNA was never expressed during the infection. Taken together, these findings improve our understanding about immune response during human asymptomatic Ebola infection, and throw new light on protection against Ebola virus. PMID:11472407

  5. Management of early asymptomatic gastrointestinal stromal tumors of the stomach

    PubMed Central

    Scherübl, Hans; Faiss, Siegbert; Knoefel, Wolfram-Trudo; Wardelmann, Eva

    2014-01-01

    Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract. Approximately two thirds of clinically manifest tumors occur in the stomach, nearly one third in the small bowel, and the rest in the colorectal region with a few cases in the esophagus. GIST originate within the smooth muscle layer in the wall of the tubular gastrointestinal tract and grow mostly toward the serosa, far less often toward the mucosa. In the latter case, ulceration may develop and can cause gastrointestinal bleeding as the cardinal symptom. However, most GIST of the stomach are asymptomatic. They are increasingly detected incidentally as small intramural or submucosal tumors during endoscopy and particularly during endoscopic ultrasound. Epidemiological and molecular genetic findings suggest that early asymptomatic GIST of the stomach (< 1 cm) show self-limiting tumorigenesis. Thus, early (< 1 cm) asymptomatic gastric GIST (synonym: micro-GIST) are found in 20%-30% of the elderly. The mostly elderly people with early gastric GIST have an excellent GIST-specific prognosis. Patients with early GIST of the stomach can therefore be managed by endoscopic surveillance. PMID:25031785

  6. [Sexually transmitted infections: epidemiology and control].

    PubMed

    Díez, M; Díaz, A

    2011-01-01

    Sexually transmitted infections (STI) include a group of diseases of diverse infectious etiology in which sexual transmission is relevant. The burden of disease that STI represent globally is unknown for several reasons. Firstly, asymptomatic infections are common in many STI; secondly, diagnostic techniques are not available in some of the most affected countries; finally, surveillance systems are inexistent or very deficient in many areas of the world. The Word Health Organization has estimated that in 1999 there were 340 million new cases of syphilis, gonorrhoea, chlamydia infection and trichomoniasis. An increasing trend in the incidence of gonorrhoea and syphilis has been noticed in the last years in the European Union, including Spain. Co-infection with other STI, especially HIV, should be ruled out in all STI patients. Chlamydia screening is also of particular importance since this is the most common STI in Europe and frequently goes unnoticed. STI prevention and control should be based on health education, early diagnosis and treatment, screening for asymptomatic infections, contact investigation and vaccination for those diseases for which a vaccine is available. PMID:21750856

  7. Usefulness of quantifying leukocytes in first-voided urine to predict positivity for Chlamydia trachomatis in asymptomatic men at high risk for chlamydial infection.

    PubMed

    Ito, Shin; Horie, Kengo; Seike, Kensaku; Yasuda, Mitsuru; Tsuchiya, Tomohiro; Yokoi, Shigeaki; Nakano, Masahiro; Deguchi, Takashi

    2014-12-01

    Chlamydia trachomatis causes acute non-gonococcal urethritis, but some infected men are asymptomatic. We examined leukocytes in uncentrifuged first-voided urine (FVU) from asymptomatic men at high risk for chlamydial infection by automated urine particle analyzers to assess whether the quantification of urinary leukocytes could predict chlamydial infection in these men. We enrolled 209 asymptomatic men, whose female sexual partners had been diagnosed as having a genital chlamydial infection. Their FVU specimens were examined for quantification of leukocytes with automated urine particle analyzers and tested for Neisseria gonorrhoeae, C. trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum by nucleotide acid amplification tests. Eleven men positive for N. gonorrhoeae or M. genitalium were excluded from further analysis. In the remaining 198 men, 84 positive for C. trachomatis (42.4%) had 1.8-1666.9 white blood cells (WBCs)/μl (median, 43.3 WBCs/μl) in their FVU, whereas 114 negative for C. trachomatis had 0.1-1378 WBCs/μl (median, 4.8 WBCs/μl). A receiver operating characteristic (ROC) curve was constructed to examine the sensitivity and specificity of leukocytes counts for predicting chlamydial infection. A cut-off point of leukocyte counts of 12.5 WBCs/μl was determined from the ROC curve, resulting in a sensitivity of 86.9% and specificity of 88.6% for predicting chlamydial infection. Leukocyte quantification in FVU by automated urine particle analyzers showed good performance in predicting the positivity and negativity for chlamydial infection in asymptomatic men. This test could potentially develop into a relevant tool for preselecting asymptomatic men prior to C. trachomatis screening.

  8. Kinetics of serum and local cytokine profile in experimental intravaginal trichomoniasis induced with Trichomonas vaginalis isolates from symptomatic and asymptomatic women.

    PubMed

    Malla, N; Yadav, M; Gupta, I

    2007-02-01

    Trichomoniasis, the most common non-viral sexually transmitted disease, is caused by infection with the protist Trichomonas vaginalis. The clinical spectrum varies from an asymptomatic to a severe symptomatic state. However, the exact factors leading to varied symptomatology have not been well elucidated. The role of cytokines in the pathogenesis of many microbial diseases has been reported. The present study reports the cytokine levels (IL-2, IL-4, IFN-gamma) on different days post infection (3rd, 7th, 14th, 21st and 28th d.p.i.) in serum and vaginal washes (VWs) of mice infected intravaginally with T. vaginalis isolates from 15 symptomatic and 15 asymptomatic women. Significantly higher production of IL-2 and IFN-gamma was observed on the 3rd to 28th d.p.i., and IL-4 on the 7th to 21st d.p.i., in infected as compared to uninfected mice. A significant increase in cytokine IL-2 and IFN-gamma was observed on the 3rd to 28th d.p.i. in serum and VWs of mice infected with T. vaginalis isolates from asymptomatic as compared to symptomatic women. IL-2 (P < 0.001) and IFN-gamma (P < 0.05) concentrations were significantly higher on the 14th d.p.i. in serum samples as compared to VWs of mice infected with T. vaginalis isolates from asymptomatic and symptomatic women, while no significant difference was observed in IL-4 concentration between the two groups of mice. The study indicates the involvement of a Th-1 (IL-2 and IFN-gamma) like response in mice infected with isolates from asymptomatic women as compared to symptomatic women and suggests that Th-1 type cytokines might be playing a role in maintaining low levels of infection. PMID:17241398

  9. Military Sexual Trauma

    MedlinePlus

    ... used by VA to refer to experiences of sexual assault or repeated, threatening sexual harassment that a Veteran ... make an estimate of the actual rates of sexual assault and harassment experiences among all individuals serving in ...

  10. A Comparison of the Anorectic Effect and Safety of the Alpha2-Adrenoceptor Ligands Guanfacine and Yohimbine in Rats with Diet-Induced Obesity

    PubMed Central

    Dudek, Magdalena; Knutelska, Joanna; Bednarski, Marek; Nowiński, Leszek; Zygmunt, Małgorzata; Mordyl, Barbara; Głuch-Lutwin, Monika; Kazek, Grzegorz; Sapa, Jacek; Pytka, Karolina

    2015-01-01

    The search for drugs with anorectic activity, acting within the adrenergic system has attracted the interest of researchers. Partial α2-adrenoceptor agonists might offer the potential for effective and safe treatment of obesity. We compared the effectiveness and safety of α2-adrenoceptor ligands in reducing body mass. We also analyzed if antagonist and partial agonists of α2-adrenoceptor––yohimbine and guanfacine––act similarly, and determined which course of action is connected with anorectic activity. We tested intrinsic activity and effect on the lipolysis of these compounds in cell cultures, evaluated their effect on meal size, body weight in Wistar rats with high-fat diet-induced obesity, and determined their effect on blood pressure, heart rate, lipid profile, spontaneous locomotor activity, core temperature and glucose, as well as glycerol and cortisol levels. Both guanfacine and yohimbine showed anorectic activity. Guanfacine was much more effective than yohimbine. Both significantly reduced the amount of intraperitoneal adipose tissue and had a beneficial effect on lipid profiles. Decreased response of α2A-adrenoceptors and partial stimulation of α2B-receptors seem to be responsible for the anorectic action of guanfacine. The stimulation of α1-adrenoceptors by guanfacine is responsible for cardiovascular side effects but may also be linked with improved anorexic effect. α1-adrenoceptor blockade is connected with the side effects of yohimbine, but it is also associated with the improvement of lipid profiles. Guanfacine has been approved by the Food and Drug Administration (FDA) to treat hypertension and conduct disorder, but as it reduces body weight, it is worth examining its effectiveness and safety in models of obesity. PMID:26506439

  11. Comparison of Anorectic and Emetic Potencies of Deoxynivalenol (Vomitoxin) to the Plant Metabolite Deoxynivalenol-3-Glucoside and Synthetic Deoxynivalenol Derivatives EN139528 and EN139544

    PubMed Central

    Wu, Wenda; Zhou, Hui-Ren; Bursian, Steven J.; Pan, Xiao; Link, Jane E.; Berthiller, Franz; Adam, Gerhard; Krantis, Anthony; Durst, Tony; Pestka, James J.

    2014-01-01

    The mycotoxin deoxynivalenol (DON) elicits robust anorectic and emetic effects in several animal species. However, less is known about the potential for naturally occurring and synthetic congeners of this trichothecene to cause analogous responses. Here we tested the hypothesis that alterations in DON structure found in the plant metabolite deoxynivalenol-3-glucoside (D3G) and two pharmacologically active synthetic DON derivatives, EN139528 and EN139544, differentially impact their potential to evoke food refusal and emesis. In a nocturnal mouse food consumption model, oral administration with DON, D3G, EN139528, or EN139544 at doses from 2.5 to 10 mg/kg BW induced anorectic responses that lasted up to 16, 6, 6, and 3 h, respectively. Anorectic potency rank orders were EN139544>DON>EN139528>D3G from 0 to 0.5 h but DON>D3G>EN139528>EN139544 from 0 to 3 h. Oral exposure to each of the four compounds at a common dose (2.5 mg/kg BW) stimulated plasma elevations of the gut satiety peptides cholecystokinin and to a lesser extent, peptide YY3–36 that corresponded to reduced food consumption. In a mink emesis model, oral administration of increasing doses of the congeners differentially induced emesis, causing marked decreases in latency to emesis with corresponding increases in both the duration and number of emetic events. The minimum emetic doses for DON, EN139528, D3G, and EN139544 were 0.05, 0.5, 2, and 5 mg/kg BW, respectively. Taken together, the results suggest that although all three DON congeners elicited anorectic responses that mimicked DON over a narrow dose range, they were markedly less potent than the parent mycotoxin at inducing emesis. PMID:25173790

  12. Comparison of anorectic and emetic potencies of deoxynivalenol (vomitoxin) to the plant metabolite deoxynivalenol-3-glucoside and synthetic deoxynivalenol derivatives EN139528 and EN139544.

    PubMed

    Wu, Wenda; Zhou, Hui-Ren; Bursian, Steven J; Pan, Xiao; Link, Jane E; Berthiller, Franz; Adam, Gerhard; Krantis, Anthony; Durst, Tony; Pestka, James J

    2014-11-01

    The mycotoxin deoxynivalenol (DON) elicits robust anorectic and emetic effects in several animal species. However, less is known about the potential for naturally occurring and synthetic congeners of this trichothecene to cause analogous responses. Here we tested the hypothesis that alterations in DON structure found in the plant metabolite deoxynivalenol-3-glucoside (D3G) and two pharmacologically active synthetic DON derivatives, EN139528 and EN139544, differentially impact their potential to evoke food refusal and emesis. In a nocturnal mouse food consumption model, oral administration with DON, D3G, EN139528, or EN139544 at doses from 2.5 to 10 mg/kg BW induced anorectic responses that lasted up to 16, 6, 6, and 3 h, respectively. Anorectic potency rank orders were EN139544>DON>EN139528>D3G from 0 to 0.5 h but DON>D3G>EN139528>EN139544 from 0 to 3 h. Oral exposure to each of the four compounds at a common dose (2.5 mg/kg BW) stimulated plasma elevations of the gut satiety peptides cholecystokinin and to a lesser extent, peptide YY3-36 that corresponded to reduced food consumption. In a mink emesis model, oral administration of increasing doses of the congeners differentially induced emesis, causing marked decreases in latency to emesis with corresponding increases in both the duration and number of emetic events. The minimum emetic doses for DON, EN139528, D3G, and EN139544 were 0.05, 0.5, 2, and 5 mg/kg BW, respectively. Taken together, the results suggest that although all three DON congeners elicited anorectic responses that mimicked DON over a narrow dose range, they were markedly less potent than the parent mycotoxin at inducing emesis.

  13. Barriers to asymptomatic screening and other STD services for adolescents and young adults: focus group discussions

    PubMed Central

    Tilson, Elizabeth C; Sanchez, Victoria; Ford, Chandra L; Smurzynski, Marlene; Leone, Peter A; Fox, Kimberley K; Irwin, Kathleen; Miller, William C

    2004-01-01

    Background Sexually transmitted diseases (STDs) are a major public health problem among young people and can lead to the spread of HIV. Previous studies have primarily addressed barriers to STD care for symptomatic patients. The purpose of our study was to identify perceptions about existing barriers to and ideal services for STDs, especially asymptomatic screening, among young people in a southeastern community. Methods Eight focus group discussions including 53 White, African American, and Latino youth (age 14–24) were conducted. Results Perceived barriers to care included lack of knowledge of STDs and available services, cost, shame associated with seeking services, long clinic waiting times, discrimination, and urethral specimen collection methods. Perceived features of ideal STD services included locations close to familiar places, extended hours, and urine-based screening. Television was perceived as the most effective route of disseminating STD information. Conclusions Further research is warranted to evaluate improving convenience, efficiency, and privacy of existing services; adding urine-based screening and new services closer to neighborhoods; and using mass media to disseminate STD information as strategies to increase STD screening. PMID:15189565

  14. Inguinal Lymph Node and Anorectal Mucosal Biopsies for Human Immunodeficiency Virus Research Protocols in an Emerging Nation: Patient Outcomes and Lessons Learned

    PubMed Central

    Rothenberger, Meghan K.; Mutuluuza, C. Kityo; Ssali, F.; Jasurda, Jake; Schmidt, Thomas; Schacker, Timothy W.; Beilman, Greg J.

    2015-01-01

    Abstract Background: Lymph nodes and gut-associated lymphatic tissue are important reservoirs of the human immunodeficiency virus (HIV). Little is known about these reservoirs in different geographic populations. We report the surgical outcomes of excisional lymph node and anorectal mucosal biopsies performed internationally and describe the lessons learned. Methods: Patients were recruited through the Joint Clinical Research Center (JCRC) in Kampala, Uganda, where procedures were performed. Studies were approved by the Institutional Review Boards of the JCRC and the University of Minnesota. Instruments and supplies were shipped to Uganda and prepared onsite. Drugs and skin preparations were purchased locally. Lymph nodes were removed through 1–3 cm incisions with ligatures on lymphovascular pedicles. Incisions were closed with subcuticular sutures and epidermal tape. Two to four pieces of anorectal mucosa were obtained through anoscopes using biopsy forceps. Results: One hundred thirty-eight lymph node biopsies and 98 anorectal mucosal biopsies were performed on 71 patients. Forty-one patients were HIV-positive. Many patients had multiple procedures. Two minor complications resulted: One hematoma and one lymphocele. Despite the cost of travel and lodging, cost per biopsy was lower in Uganda compared with the United States. Conclusion: Invasive clinical research can be performed with minimal morbidity in emerging nations with outcomes similar to those found in the United States, but with lower cost. PMID:25650809

  15. Sexual excitement.

    PubMed

    Stoller, R J

    1976-08-01

    Sexual excitement depends on a scenario the person to be aroused has been writing since childhood. The story is an adventure, an autobiography disguised as fiction, in which the hero/heroine hides crucial intrapsychic conflicts, mysteries, screen memories of actual traumatic events and the resolution of these elements into a happy ending, best celebrated by orgasm. The function of the fantasy is to take these painful experiences and convert them to pleasure-triumph. In order to sharpen excitement-the vibration between the fear of original traumas repeating and the hope of a pleasurable conclusion this time-one introduces into the story elements of risk (approximations of the trauma) meant to prevent boredom and safety factors (sub-limnal signals to the storyteller that the risk are not truly dangerous). Sexual fantasy can be studied by means of a person's daydreams (including those chosen in magazines, books, plays, television, movies, and outright pornography), masturbatory behavior, object choice, foreplay, techniques of intercourse, or postcoital behavior. PMID:949223

  16. Sexual excitement.

    PubMed

    Stoller, R J

    1976-08-01

    Sexual excitement depends on a scenario the person to be aroused has been writing since childhood. The story is an adventure, an autobiography disguised as fiction, in which the hero/heroine hides crucial intrapsychic conflicts, mysteries, screen memories of actual traumatic events and the resolution of these elements into a happy ending, best celebrated by orgasm. The function of the fantasy is to take these painful experiences and convert them to pleasure-triumph. In order to sharpen excitement-the vibration between the fear of original traumas repeating and the hope of a pleasurable conclusion this time-one introduces into the story elements of risk (approximations of the trauma) meant to prevent boredom and safety factors (sub-limnal signals to the storyteller that the risk are not truly dangerous). Sexual fantasy can be studied by means of a person's daydreams (including those chosen in magazines, books, plays, television, movies, and outright pornography), masturbatory behavior, object choice, foreplay, techniques of intercourse, or postcoital behavior.

  17. Sexual dysfunction in epilepsy.

    PubMed

    Morrell, M J

    1991-01-01

    Sexual dysfunction may arise more frequently in men and women with epilepsy than with other chronic illnesses, manifesting primarily as diminished sexual desire and potency. Studies using retrospective self-report of sexual attitude and behavior find an incidence of sexual dysfunction ranging from 14-66%. Sexual dysfunction may be more common in partial than in generalized epilepsies. Sexual dysfunction in epilepsy may result from a disturbance in social or psychological factors affecting sexual responsiveness. Alternatively, epileptiform discharges may disrupt the function of structures mediating sexual behavior, particularly the limbic cortex, or alter the release of hypothalamic or pituitary hormones. Antiepileptic drugs modulate hormone release from the hypothalamic-pituitary-gonadal axis and may have direct inhibitory effects on sexual behavior. Evidence both supports and refutes each of these etiologies in the sexual dysfunction seen with epilepsy. Specific evaluation and treatment protocols for patients with sexual dysfunction are available.

  18. Multidimensional sexual perfectionism.

    PubMed

    Stoeber, Joachim; Harvey, Laura N; Almeida, Isabel; Lyons, Emma

    2013-11-01

    Perfectionism is a multidimensional personality characteristic that can affect all areas of life. This article presents the first systematic investigation of multidimensional perfectionism in the domain of sexuality exploring the unique relationships that different forms of sexual perfectionism show with positive and negative aspects of sexuality. A sample of 272 university students (52 male, 220 female) completed measures of four forms of sexual perfectionism: self-oriented, partner-oriented, partner-prescribed, and socially prescribed. In addition, they completed measures of sexual esteem, sexual self-efficacy, sexual optimism, sex life satisfaction (capturing positive aspects of sexuality) and sexual problem self-blame, sexual anxiety, sexual depression, and negative sexual perfectionism cognitions during sex (capturing negative aspects). Results showed unique patterns of relationships for the four forms of sexual perfectionism, suggesting that partner-prescribed and socially prescribed sexual perfectionism are maladaptive forms of sexual perfectionism associated with negative aspects of sexuality whereas self-oriented and partner-oriented sexual perfectionism emerged as ambivalent forms associated with positive and negative aspects. PMID:23842783

  19. Effects of Different Anesthetic Techniques on Serum Leptin, C-reactive Protein, and Cortisol Concentrations in Anorectal Surgery

    PubMed Central

    Buyukkocak, Unase; Daphan, Cagatay; Caglayan, Osman; Aydinuraz, Kuzey; Kaya, Tahsin; Saygun, Oral; Agalar, Fatih

    2006-01-01

    Aim To compare the effects of intratracheal general anesthesia (ITGA) and regional (saddle block) anesthesia on leptin, C-reactive protein (CRP), and cortisol blood concentrations during anorectal surgery. Methods Fifty-eight patients suffering from hemorrhoidal disease, pilonidal sinus, anal fissure, or anal fistula were included the study. Patients were randomly assigned into one of the two groups (n = 29). Patients in one group received ITGA. After thiopental and fentanyl induction, vecuronium was used as a muscle relaxant. Anesthesia was maintained with sevoflurane. In the other group we applied saddle block, injecting hyperbaric bupivacaine into the subarachnoid space, through the L3-L4 intervertebral space, in the sitting position. Blood samples were collected for leptin, CRP, and cortisol analysis before the induction of anesthesia at 3 and 24 hours postoperatively. Results Preoperative leptin, CRP, and cortisol concentrations were comparable between the groups. There was no significant difference in postoperative levels of leptin and CRP in both groups. Although not significant, leptin and CRP concentrations were lower in the saddle block group at three hours postoperatively (mean ± SD, 6.95 ± 8.59 and 6.02 ± 12.25, respectively) than in the ITGA group (mean ± SD, 9.04 ± 9.89 and 8.40 ± 15.75, respectively). During early postoperative period, cortisol increased slightly in the ITGA group and remained at similar level in the saddle block group, but later decreased in both groups. Cortisol levels in the saddle block group were significantly lower than in the ITGA group at 3 hours postoperatively (343.7 ± 329.6 vs 611.4 ± 569.8; P = 0.034). Conclusion Saddle block, a regional anesthetic technique, may attenuate stress response in patients undergoing anorectal surgery, by blocking afferent neural input during early postoperative period. PMID:17167859

  20. Preliminary ultrasound evaluation of the rotator cable in asymptomatic volunteers☆

    PubMed Central

    Orlandi, D.; Sconfienza, L.M.; Fabbro, E.; Ferrero, G.; Martini, C.; Lacelli, F.; Serafini, G.; Silvestri, E.

    2012-01-01

    Purpose To characterize the rotator cable high-resolution ultrasound appearance in asymptomatic shoulders of volunteers of different age. Materials and methods IRB approval and volunteers’ written consent was obtained. Excluding subjects with known shoulder affections, we screened 24 asymptomatic volunteers. Supraspinatus and infraspinatus tendons high-resolution ultrasound evaluation was performed according to standard scan protocols, further excluding shoulders with partial/full-thickness cuff tears. Thus, we studied 24 shoulders in 12 young volunteers (age range 21–39 years, mean age 33 ± 8 years) and 21 shoulders in 11 elderly volunteers (age range 62–83 years, mean age 75 ± 45 years). For each shoulder, we noted rotator cable visibility and its thickness and width. Fisher’s and U Mann–Whitney statistics were used. Results Rotator cable was less frequently detected in young than in elderly volunteers (5/24 vs. 11/21 shoulders; P = 0.034). When detected, rotator cable was significantly thicker in young (range 1.2–1.5 mm, mean thickness 1.3 ± 0.1 mm) than in elderly (range 0.9–1.4 mm, mean thickness 1.2 ± 0.1 mm) volunteers (P = 0.025), while its width was not significantly different in young (range 4.5–7.1 mm, mean 5.6 ± 1.1 mm) compared to elderly (range 2.5–7.1 mm, mean 4.2 ± 1.4 mm) volunteers (P = 0.074) although a tendency can be highlighted. Conclusions Ultrasound demonstrated the different consistency of rotator cable in young and elderly asymptomatic patients, with high interobserver reproducibility. PMID:23396940

  1. Temporal trends in safety of carotid endarterectomy in asymptomatic patients

    PubMed Central

    Munster, Alex B.; Franchini, Angelo J.; Qureshi, Mahim I.; Thapar, Ankur

    2015-01-01

    Objective: To systematically review temporal changes in perioperative safety of carotid endarterectomy (CEA) in asymptomatic individuals in trial and registry studies. Methods: The MEDLINE and EMBASE databases were searched using the terms “carotid” and “endarterectomy” and “asymptomatic” from 1947 to August 23, 2014. Articles dealing with 50%–99% stenosis in asymptomatic individuals were included and low-volume studies were excluded. The primary endpoint was 30-day stroke or death and the secondary endpoint was 30-day all-cause mortality. Statistical analysis was performed using random-effects meta-regression for registry data and for trial data graphical interpretation alone was used. Results: Six trials (n = 4,431 procedures) and 47 community registries (n = 204,622 procedures) reported data between 1983 and 2013. Registry data showed a significant decrease in postoperative stroke or death incidence over the period 1991–2010, equivalent to a 6% average proportional annual reduction (95% credible interval [CrI] 4%–7%; p < 0.001). Considering postoperative all-cause mortality, registry data showed a significant 5% average proportional annual reduction (95% CrI 3%–9%; p < 0.001). Trial data showed a similar visual trend. Conclusions: CEA is safer than ever before and high-volume registry results closely mirror the results of trials. New benchmarks for CEA are a stroke or death risk of 1.2% and a mortality risk of 0.4%. This information will prove useful for quality improvement programs, for health care funders, and for those re-examining the long-term benefits of asymptomatic revascularization in future trials. PMID:26115734

  2. Education, individual time preferences, and asymptomatic disease detection.

    PubMed

    Kim, Younoh; Radoias, Vlad

    2016-02-01

    Asymptomatic conditions such as hypertension are generally hard to diagnose, absent routine medical examinations. This is especially problematic in developing countries, where most citizens do not engage in routine examinations due to limited economic resources. We study the roles of education and individual time preferences in asymptomatic disease detection and management. Using discrete choice models on a sample of 4209 hypertensive Indonesian adults surveyed between November 2007 and April 2008, we find that both education and individual time preferences play important roles. However, the effects are different for people in good health than they are for people in bad health. Education does not seem to matter for disease detection when respondents are in good general health, and its effects on disease management vary largely in magnitudes between these groups. In terms of disease detection, more educated respondents have a higher probability of being diagnosed, but only conditional on being in poor general health. Time preferences, on the other hand, matter for respondents in good general health, but the effect is not significant for those in bad health. More impatient respondents that are in good health have a higher probability of being under-diagnosed because they are more likely to forgo routine physicals. The findings point to two distinct channels through which education can affect health, and suggest that different types of policies need to be implemented, in order to reach the entire population. Traditional programs that stimulate education and improve the socio-economic status of individuals in developing countries are helpful, but they do not address the whole problem. Besides its more usual positive effects, education can also negatively affect the health of asymptomatic patients, because it reflects a higher opportunity cost of engaging in preventative health screenings.

  3. The Prognostic Significance of Asymptomatic Carotid Bruits in the Elderly

    PubMed Central

    Shorr, Ronald I; Johnson, Karen C; Wan, Jim Y; Sutton-Tyrrell, Kim; Pahor, Marco; Bailey, James E; Applegate, William B

    1998-01-01

    OBJECTIVE To determine the association between asymptomatic carotid bruits and the development of subsequent stroke in older adults with isolated systolic hypertension. DESIGN Retrospective cohort study. SETTING The Systolic Hypertension in the Elderly Program (SHEP), a 5-year randomized trial testing the efficacy of treating systolic hypertension in noninstitutionalized persons aged 60 years or older. From the original 4,736 SHEP participants, we identified a cohort of 4,442 persons who had no prior history of stroke, transient ischemic attack, or myocardial infarction at randomization. MEASUREMENTS AND MAIN RESULTS The end point for this ancillary study was the development of a stroke. The average follow-up was 4.2 years. Carotid bruits were found in 284 (6.4%) of the participants at baseline. Strokes developed in 21 (7.4%) of those with carotid bruits and in 210 (5.0%) of those without carotid bruits. The unadjusted risk of stroke among persons with carotid bruits was 1.53 (95% confidence interval [CI] 0.98, 2.40). Adjusting for age, gender, race, blood pressure, smoking, lipid levels, self-reported aspirin use, and treatment group assignment, the relative risk of stroke among persons with asymptomatic carotid bruits was 1.29 (95% CI 0.80, 2.06). Among SHEP enrollees aged 60 to 69 years, there was a trend (p=.08) toward increased risk (relative risk [RR] 2.05; 95% CI 0.92, 4.68) of subsequent stroke in persons with, compared to those without, carotid bruits. However, among enrollees aged 70 years or over, there was no relation between carotid bruit and subsequent stroke (RR 0.98; 95% CI 0.55, 1.76). In no other subgroup of SHEP enrollees did the presence of carotid bruit independently predict stroke. CONCLUSIONS Although we cannot rule out a small increased risk of stroke associated with bruits in asymptomatic SHEP enrollees aged 60 to 69 years, the utility of carotid bruits as a marker for increased risk of stroke among asymptomatic elderly with isolated

  4. Nearly Asymptomatic Eight-Month Thoracic Aortic Dissection

    PubMed Central

    Kumar, Arjun; Kumar, Krishan; Zeltser, Roman; Makaryus, Amgad N.

    2016-01-01

    Thoracic aortic dissection is a rare, but lethal, medical condition that is either misdiagnosed as a myocardial infarction or overlooked completely. Though thoracic aortic dissections are commonly diagnosed in patients exhibiting sharp chest pain, there are some notable cases where patients do not report the expected severity of pain. We report a unique case of a patient with a thoracic aortic dissection who was initially nearly asymptomatic for eight months, in order to heighten awareness, highlight diagnosis protocol, and improve prognosis for this commonly misdiagnosed, but fatal, condition. PMID:27257400

  5. Diagnosis and importance of asymptomatic bacteriuria in adults.

    PubMed

    Jackson, G G

    1975-01-01

    There are now laboratory means of screening and identifying people who, although they are free from the signs of urinary tract infection, fit into abnormal groups owing to the high numbers of bacteria and leukocytes in their urine. Chronic bacteriuria and pathologic pyuria, with or without symptoms, have important physiologic and pathologic consequences. It is the physicians opportunity to recognize and treat these asymptomatic as well as symtomatic urinary tract infections. If untreated and uncorrected the result, with progressive frequency over a period of 10-15 years, is increased morbidity, especially with pregnancies, structural damage to the kidneys, kidney stones, uremia, hypertension, and premature death.

  6. Dataset of mitochondrial genome variants associated with asymptomatic atherosclerosis

    PubMed Central

    Sazonova, Margarita A.; Zhelankin, Andrey V.; Barinova, Valeria A.; Sinyov, Vasily V.; Khasanova, Zukhra B.; Postnov, Anton Y.; Sobenin, Igor A.; Bobryshev, Yuri V.; Orekhov, Alexander N.

    2016-01-01

    This dataset report is dedicated to mitochondrial genome variants associated with asymptomatic atherosclerosis. These data were obtained using the method of next generation pyrosequencing (NGPS). The whole mitochondrial genome of the sample of patients from the Moscow region was analyzed. In this article the dataset including anthropometric, biochemical and clinical parameters along with detected mtDNA variants in patients with carotid atherosclerosis and healthy individuals was presented. Among 58 of the most common homoplasmic mtDNA variants found in the observed sample, 7 variants occurred more often in patients with atherosclerosis and 16 variants occurred more often in healthy individuals. PMID:27222855

  7. Asymptomatic pulmonary embolism: a common event in high risk patients

    SciTech Connect

    Williams, J.W.; Eikman, E.A.; Greenberg, S.

    1982-03-01

    Ventilation and perfusion lung scans were obtained before and at weekly intervals following hip surgery or major amputation in 158 patients. Pulmonary arteriograms were obtained in 21 of 33 patients developing perfusion patterns strongly suggesting embolism; 19 of the 21 arteriograms demonstrated pulmonary embolism. From autopsy and clinical data, 36 patients were diagnosed as having an embolus while under study, and 12 patients were suspected of having had an embolus during their illness but prior to entry into the study. Only four of these 48 patients experienced symptoms suggestive of pulmonary embolism. We conclude that asymptomatic pulmonary embolism is a common event in the populations studied.

  8. Asymptomatic leukemic-cell infiltration of the pancreas: US findings.

    PubMed

    Collado, Laura; Dardanelli, Esteban; Sierre, Sergio; Moguillansky, Silvia; Lipsich, José

    2011-06-01

    Pancreatic infiltration of leukemic cells is a very rare manifestation at the onset of acute lymphoblastic leukemia (ALL) in childhood. Pancreatic enlargement in this situation is unusual and pancreatic involvement is often associated with biliary obstruction, cholestasis and pancreatitis. We report a 3-month-old girl who presented with asymptomatic leukemic infiltration of the pancreas, demonstrated by US with heterogeneous pancreatic enlargement associated with multiple hypoechogenic lesions, without cholestasis. Although these manifestations are rare, ALL should be considered a cause of pancreatic enlargement.

  9. Addressing Sexual Harassment

    ERIC Educational Resources Information Center

    Young, Ellie L.; Ashbaker, Betty Y.

    2008-01-01

    This article discusses ways on how to address the problem of sexual harassment in schools. Sexual harassment--simply defined as any unwanted and unwelcome sexual behavior--is a sensitive topic. Merely providing students, parents, and staff members with information about the school's sexual harassment policy is insufficient; schools must take…

  10. Sexuality and the law.

    PubMed

    Portelli, C J

    1998-01-01

    Federal, state, and local laws in the US now govern almost every aspect of sexuality. This includes sexuality at the workplace, sexuality education, adolescent sexuality, access to sexuality information and sexually explicit materials, sexual orientation, and sexually transmitted disease(STD)/HIV transmission. Almost 33% of the US Supreme Court's docket this past term concerned sexuality issues. In contrast to 50 years ago, when sexuality law was confined to the criminal arena, contemporary "sex crimes" primarily relate to nonconsensual and exploitative behaviors. It is time for lawmakers, judges, lawyers, policy analysts, lobbyists, and advocates to realize they cannot legislate or litigate how, when, or why people fall in love. Rather, the role of the law should be to create and preserve models of justice and equality that seek to preserve one's individual rights to privacy and freedom to choose in matters related to one's sexuality. This includes free access to age-appropriate sexuality information, the right to marriage and children regardless of sexual orientation, comprehensive sexuality education that encompasses information about avoiding unwanted pregnancies and HIV/STDs, access to contraception and abortion, protection from sexually abusive or exploitative relationships, and access to sexual health care. PMID:12295182

  11. Sexuality and Violence.

    ERIC Educational Resources Information Center

    Sanctuary, Gerald

    The author examines specific manifestations of violence in relation to sexuality: (1) forcible rape rate; (2) war atrocities; (3) sexual violence in prisons; and (4) pornography. Drawing much from Hannah Arendt's book on violence, he views sexual violence as symptomatic of a lack of sexual power, not a sign of its possession. The causes are seen…

  12. Sexual Harassment in Education.

    ERIC Educational Resources Information Center

    Brooks, Nancy A.

    1988-01-01

    Three situations of sexual harassment, typical of the complaints received by various departments and offices on all Indiana University campuses, are presented. According to the National Advisory Council on Women's Educational Programs, "academic sexual harassment is the use of authority to emphasize the sexuality or sexual identity of a student in…

  13. Sexually transmitted diseases in homosexual males in Seville, Spain.

    PubMed Central

    Rodriguez-Pichardo, A; Aznar, J; Camacho, F; Borobio, M V; Perea, E J

    1991-01-01

    BACKGROUND AND METHODS--The absence of any official statistics on the prevalence of STD in homosexual men in Spain induced us to carry out a prospective study of new homosexual patients who consulted the STD Clinic of the School of Medicine in Seville, between January 1988 and December 1989. The aim of the study was to determine the prevalence of symptomatic and asymptomatic infections in this group of patients. RESULTS--1805 patients were seen during the study period; 318 patients were homosexual of whom 309 agreed to participate in the study. Of the 309 homosexual men, 108 (35%) had symptoms and the remaining 201 (65%) were asymptomatic. In the symptomatic group the diagnoses were: syphilis 28 (25.9%); urethritis 40 (37%) (of these 40, 11 had Neisseria gonorrhoeae, five had Chlamydia trachomatis, five had Ureaplasma urealyticum, one had Herpes simplex virus and in 18 no pathogen was detected); genital herpes seven (6.4%). Eleven (10%) had concomitant infections. The following infections were found in the asymptomatic group: syphilis 23 (11.4%), N gonorrhoeae six (3%), C trachomatis two (1%), Herpes simplex virus one (0.5%). Antibodies against HIV were detected in 30 (9.6%) of the total group. CONCLUSIONS--Sexually transmitted diseases are common amongst homosexual men in Seville and many of these are asymptomatic. PMID:1916797

  14. Solution Structure and Constrained Molecular Dynamics Study of Vitamin B12 Conjugates of the Anorectic Peptide PYY(3-36).

    PubMed

    Henry, Kelly E; Kerwood, Deborah J; Allis, Damian G; Workinger, Jayme L; Bonaccorso, Ron L; Holz, George G; Roth, Christian L; Zubieta, Jon; Doyle, Robert P

    2016-05-01

    Vitamin B12 -peptide conjugates have considerable therapeutic potential through improved pharmacokinetic and/or pharmacodynamic properties imparted on the peptide upon covalent attachment to vitamin B12 (B12 ). There remains a lack of structural studies investigating the effects of B12 conjugation on peptide secondary structure. Determining the solution structure of a B12 -peptide conjugate or conjugates and measuring functions of the conjugate(s) at the target peptide receptor may offer considerable insight concerning the future design of fully optimized conjugates. This methodology is especially useful in tandem with constrained molecular dynamics (MD) studies, such that predictions may be made about conjugates not yet synthesized. Focusing on two B12 conjugates of the anorectic peptide PYY(3-36), one of which was previously demonstrated to have improved food intake reduction compared with PYY(3-36), we performed NMR structural analyses and used the information to conduct MD simulations. The study provides rare structural insight into vitamin B12 conjugates and validates the fact that B12 can be conjugated to a peptide without markedly affecting peptide secondary structure. PMID:27027248

  15. Ectopic Expression of Ptf1a Induces Spinal Defects, Urogenital Defects, and Anorectal Malformations in Danforth's Short Tail Mice

    PubMed Central

    Matsumoto, Ken-ichirou; Suda, Hiroko; Ando, Takashi; Sei, Akira; Mizuta, Hiroshi; Takagi, Katsumasa; Nakahara, Mai; Muta, Mayumi; Yamada, Gen; Nakagata, Naomi; Iida, Aritoshi; Ikegawa, Shiro; Nakamura, Yusuke; Araki, Masatake; Abe, Kuniya; Yamamura, Ken-ichi

    2013-01-01

    Danforth's short tail (Sd) is a semidominant mutation on mouse chromosome 2, characterized by spinal defects, urogenital defects, and anorectal malformations. However, the gene responsible for the Sd phenotype was unknown. In this study, we identified the molecular basis of the Sd mutation. By positional cloning, we identified the insertion of an early transposon in the Sd candidate locus approximately 12-kb upstream of Ptf1a. We found that insertion of the transposon caused overexpression of three neighboring genes, Gm13344, Gm13336, and Ptf1a, in Sd mutant embryos and that the Sd phenotype was not caused by disruption of an as-yet-unknown gene in the candidate locus. Using multiple knockout and knock-in mouse models, we demonstrated that misexpression of Ptf1a, but not of Gm13344 or Gm13336, in the notochord, hindgut, cloaca, and mesonephros was sufficient to replicate the Sd phenotype. The ectopic expression of Ptf1a in the caudal embryo resulted in attenuated expression of Cdx2 and its downstream target genes T, Wnt3a, and Cyp26a1; we conclude that this is the molecular basis of the Sd phenotype. Analysis of Sd mutant mice will provide insight into the development of the spinal column, anus, and kidney. PMID:23436999

  16. Time course of asymptomatic interstitial pulmonary oedema at high altitude.

    PubMed

    Bouzat, Pierre; Walther, Guillaume; Rupp, Thomas; Doucende, Gregory; Payen, Jean-François; Levy, Patrick; Verges, Samuel

    2013-03-01

    The time course of asymptomatic pulmonary oedema during high-altitude exposure and its potential relationship with changes in cardiac function remain to clarify. Eleven volunteers were rapidly exposed to 4350m during a 4-day period. Each subject received clinical examination and thoracic ultrasonography to assess ultrasound lung comets (USLC) on day 1, 2 and 3 after arrival. Echocardiography was performed on day 2 and 4 at 4350m. All subjects had a significant increase in the number of USLC on day 1 (n=8±3), day 2 (n=7±4) and day 3 (n=3±2) compared to sea level (n=1±1) (P<0.01). Although left ventricle diastolic function and systolic tricuspid regurgitation gradient were significantly different at altitude compared to sea level, they did not correlate with the number of USLC (P>0.05). Asymptomatic pulmonary oedema seems to be transiently present in fast-ascending recreational climbers. The lack of correlation between the number of USLC and indices of cardiac changes suggest that non-cardiogenic mechanisms may underlie this transient increase in lung water. PMID:23279868

  17. Articulated dental cast analysis of asymptomatic and symptomatic populations.

    PubMed

    Cordray, Frank E

    2016-06-30

    Dental instrumentation has long provided insight into the mechanism of musculo-skeletal function of the gnathic system. While large population studies associate dental arch displacement (DAD), especially laterally, with symptoms, mandibular condyle displacement (CD) resulting from DAD has not been targeted as possibly etiologic in the production of common muscle contraction headache (CMCH) and temporo-mandibular dysfunction (TMD). The objective was to evaluate the three-dimensional nature of DAD and CD between the seated condylar position (SCP) and the intercuspal position (ICP) and to compare results derived from large deprogrammed asymptomatic and symptomatic populations. A total of 1 192 sets of dental casts collected from asymptomatic and symptomatic populations were articulated in the SCP. The initial occlusal contact, DAD, and condylar displacement were evaluated for frequency, direction, and magnitude of displacement between the SCP and ICP. The data revealed significant displacement between the SCP and ICP of the condyles (displaced most frequently inferior (down) and posterior (distal)) and substantially increased frequency and magnitude of displacement of the dental arches (with posterior premature occlusal contacts, increased overjet, decreased overbite, midline differences, and occlusal classification changes) in symptomatic subjects. These discrepancies were statistically significant and clinically significant. The data support the concept of increased DAD and CD with dysfunction. Transverse condylar displacement, commonly presenting with dental cross bite, may be associated with CMCH and TMD. Displacement of the mandibular condyle may be an etiologic factor in CMCH and dysfunction of the temporo-mandibular joint.

  18. Articulated dental cast analysis of asymptomatic and symptomatic populations

    PubMed Central

    Cordray, Frank E

    2016-01-01

    Dental instrumentation has long provided insight into the mechanism of musculo-skeletal function of the gnathic system. While large population studies associate dental arch displacement (DAD), especially laterally, with symptoms, mandibular condyle displacement (CD) resulting from DAD has not been targeted as possibly etiologic in the production of common muscle contraction headache (CMCH) and temporo-mandibular dysfunction (TMD). The objective was to evaluate the three-dimensional nature of DAD and CD between the seated condylar position (SCP) and the intercuspal position (ICP) and to compare results derived from large deprogrammed asymptomatic and symptomatic populations. A total of 1 192 sets of dental casts collected from asymptomatic and symptomatic populations were articulated in the SCP. The initial occlusal contact, DAD, and condylar displacement were evaluated for frequency, direction, and magnitude of displacement between the SCP and ICP. The data revealed significant displacement between the SCP and ICP of the condyles (displaced most frequently inferior (down) and posterior (distal)) and substantially increased frequency and magnitude of displacement of the dental arches (with posterior premature occlusal contacts, increased overjet, decreased overbite, midline differences, and occlusal classification changes) in symptomatic subjects. These discrepancies were statistically significant and clinically significant. The data support the concept of increased DAD and CD with dysfunction. Transverse condylar displacement, commonly presenting with dental cross bite, may be associated with CMCH and TMD. Displacement of the mandibular condyle may be an etiologic factor in CMCH and dysfunction of the temporo-mandibular joint. PMID:27357324

  19. [Symptomatic cyst of the pancreas and asymptomatic bilateral phaeochromocytoma

    PubMed

    Karvar, S; Breidert, M; Nagel, M; Kirsch, C; Pinkert, J; Ehninger, G

    2001-01-01

    Symptomatic cyst of the pancreas and asymptomatic bilateral phaeochromocytoma. HISTORY AND CLINICAL FINDINGS: A 39-year-old woman was admitted to our department of gastroenterology with recurrent epigastrical pain. Ten years previously the diagnosis of von Hippel-Lindau (VHL)-syndrome has been established. Two years before a germ line mutation in exon 3 of the VHL-tumour suppressor gene has been detected. The patient has a healthy son with a normal VHL-gene and four healthy siblings who had refused a genetic blood test. INVESTIGATIONS: At abdominal ultrasound at the head of the pancreas three 4 2 cm large cysts and in the region of the left adrenal gland a 2,9 2,7 cm large tumor were visible. MRI of the abdomen revealed in addition a 2,2 1,5 cm large tumour of the right adrenal gland. An asymptomatic biadrenal phaeochromocytoma was detected by elevated urine catecholamines and 123I-MIBG-scintigraphy. TREATMENT AND COURSE: The cysts of the pancreas were punctured under endosonographical control and analysis of the cyst fluid was not suspicious of a malignant cystic tumour. The patient had no further abdominal complaints. After oral treatment with the alpha-blocker phentolamine the biadrenal phaeochromocytoma was treated by retroperitoneal laparoscopic surgery in an organ-sparing fashion. Postoperatively ACTH-stimulating test revealed a normal cortisol response. CONCLUSION: Adrenocortical function can be preserved by la-paroscopic adrenal-sparing surgery in bilateral phaeochromocytoma.

  20. Depressive symptoms and spiritual wellbeing in asymptomatic heart failure patients.

    PubMed

    Mills, Paul J; Wilson, Kathleen; Iqbal, Navaid; Iqbal, Fatima; Alvarez, Milagros; Pung, Meredith A; Wachmann, Katherine; Rutledge, Thomas; Maglione, Jeanne; Zisook, Sid; Dimsdale, Joel E; Lunde, Ottar; Greenberg, Barry H; Maisel, Alan; Raisinghani, Ajit; Natarajan, Loki; Jain, Shamini; Hufford, David J; Redwine, Laura

    2015-06-01

    Depression adversely predicts prognosis in individuals with symptomatic heart failure. In some clinical populations, spiritual wellness is considered to be a protective factor against depressive symptoms. This study examined associations among depressive symptoms, spiritual wellbeing, sleep, fatigue, functional capacity, and inflammatory biomarkers in 132 men and women with asymptomatic stage B heart failure (age 66.5 years ± 10.5). Approximately 32 % of the patients scored ≥10 on the Beck Depression Inventory, indicating potentially clinically relevant depressive symptoms. Multiple regression analysis predicting fewer depressive symptoms included the following significant variables: a lower inflammatory score comprised of disease-relevant biomarkers (p < 0.02), less fatigue (p < 0.001), better sleep (p < 0.04), and more spiritual wellbeing (p < 0.01) (overall model F = 26.6, p < 0.001, adjusted R square = 0.629). Further analyses indicated that the meaning (p < 0.01) and peace (p < 0.01) subscales, but not the faith (p = 0.332) subscale, of spiritual wellbeing were independently associated with fewer depressive symptoms. Interventions aimed at increasing spiritual wellbeing in patients lives, and specifically meaning and peace, may be a potential treatment target for depressive symptoms asymptomatic heart failure. PMID:25533643

  1. Articulated dental cast analysis of asymptomatic and symptomatic populations.

    PubMed

    Cordray, Frank E

    2016-01-01

    Dental instrumentation has long provided insight into the mechanism of musculo-skeletal function of the gnathic system. While large population studies associate dental arch displacement (DAD), especially laterally, with symptoms, mandibular condyle displacement (CD) resulting from DAD has not been targeted as possibly etiologic in the production of common muscle contraction headache (CMCH) and temporo-mandibular dysfunction (TMD). The objective was to evaluate the three-dimensional nature of DAD and CD between the seated condylar position (SCP) and the intercuspal position (ICP) and to compare results derived from large deprogrammed asymptomatic and symptomatic populations. A total of 1 192 sets of dental casts collected from asymptomatic and symptomatic populations were articulated in the SCP. The initial occlusal contact, DAD, and condylar displacement were evaluated for frequency, direction, and magnitude of displacement between the SCP and ICP. The data revealed significant displacement between the SCP and ICP of the condyles (displaced most frequently inferior (down) and posterior (distal)) and substantially increased frequency and magnitude of displacement of the dental arches (with posterior premature occlusal contacts, increased overjet, decreased overbite, midline differences, and occlusal classification changes) in symptomatic subjects. These discrepancies were statistically significant and clinically significant. The data support the concept of increased DAD and CD with dysfunction. Transverse condylar displacement, commonly presenting with dental cross bite, may be associated with CMCH and TMD. Displacement of the mandibular condyle may be an etiologic factor in CMCH and dysfunction of the temporo-mandibular joint. PMID:27357324

  2. Myelopathy in a previously asymptomatic HIV-1-infected patient.

    PubMed

    Eyer-Silva, W A; Auto, I; Pinto, J F; Morais-de-Sá, C A

    2001-01-01

    A wide variety of disorders of diverse pathogenic mechanisms can trigger spinal cord dysfunction in HIV-1-infected patients. The most common such condition is HIV-1-associated myelopathy (HM) which characteristically complicates advanced HIV-1 disease in patients with low CD4 cell counts and previous AIDS-defining diagnoses. We describe an unusual presentation of HM in a previously asymptomatic patient with a relatively preserved CD4 cell count (458 cells/mm3) who was even unaware of his serological status. The patient presented with a clinically severe, slowly progressive myelopathy and could not walk unassisted. Significant neurological improvement could be obtained as rapidly as within 4 weeks after the institution of an antiretroviral combination of only two nucleoside analog HIV-1 reverse transcriptase inhibitors (zidovudine and didanosine). An HIV-1 protease inhibitor was also prescribed at that point but could only be added to intensify the regimen 3 months later, when significant neurological improvement had already been recorded. We also review the disorders reported to derange spinal cord function in previously asymptomatic HIV-1-infected patients.

  3. Different antibiotic regimens for treating asymptomatic bacteriuria in pregnancy

    PubMed Central

    Guinto, Valerie T; De Guia, Blanca; Festin, Mario R; Dowswell, Therese

    2014-01-01

    Background Asymptomatic bacteriuria occurs in 5% to 10% of pregnancies and, if left untreated, can lead to serious complications. Objectives To assess which antibiotic is most effective and least harmful as initial treatment for asymptomatic bacteriuria in pregnancy. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (March 2010) and reference lists of retrieved studies. Selection criteria Randomized controlled trials comparing two antibiotic regimens for treating asymptomatic bacteriuria. Data collection and analysis Review authors independently screened the studies for inclusion and extracted data. Main results We included five studies involving 1140 women with asymptomatic bacteriuria. We did not perform meta-analysis; each trial examined different antibiotic regimens and so we were not able to pool results. In a study comparing a single dose of fosfomycin trometamol 3 g with a five-day course of cefuroxime, there was no significant difference in persistent infection (risk ratio (RR) 1.36, 95% confidence interval (CI) 0.24 to 7.75), shift to other antibiotics (RR 0.08, 95% CI 0.00 to 1.45), or in allergy or pruritus (RR 2.73, 95% CI 0.11 to 65.24). A comparison of seven-day courses of 400 mg pivmecillinam versus 500 mg ampicillin, both given four times daily, showed no significant difference in persistent infection at two weeks or recurrent infection, but there was an increase in vomiting (RR 4.57, 95% CI 1.40 to 14.90) and women were more likely to stop treatment early with pivmecillinam (RR 8.82, 95% CI 1.16 to 66.95). When cephalexin 1 g versus Miraxid® (pivmecillinam 200 mg and pivampicillin 250 mg) were given twice-daily for three days, there was no significant difference in persistent or recurrent infection. A one- versus seven-day course of nitrofurantoin resulted in more persistent infection with the shorter course (RR 1.76, 95% CI 1.29 to 2.40), but no significant difference in symptomatic infection at two weeks

  4. Sexuality and Islam.

    PubMed

    Dialmy, Abdessamad

    2010-06-01

    This paper deals with three major questions: (1) What are the sexual norms defined by the sacred texts (Koran and Sunna)? (2) What are the sexual practices currently observed among Moslems? (3) To which extent are current sexual practices of Moslems dissociated from Islamic sexual norms? Sexual standards in Islam are paradoxical: on the one hand, they allow and actually are an enticement to the exercise of sexuality but, on the other hand, they discriminate between male and female sexuality, between marital and pre- or extramarital sexuality, and between heterosexuality and homosexuality. Men are given more rights with regard to the expression of their sexuality; women are forbidden to have extramarital sex (with their slaves) and both genders to have homosexual relationships. The combination of these paradoxical standards with modernisation leads to the current back and forth swing of sexual practices between repression and openness. Partial modernisation leads to greater sexual tolerance. But restrictive sexual standards have gathered strength and have become idealised as a result of the current radicalisation of Islam. This swing of the pendulum between repression and openness is illustrated by phenomena such as public harassment, premarital sexuality, female pleasure, prostitution, and homosexuality. Currently, Islam is not any more the only reference which provides guidance concerning sexual practices but secularisation of sexual laws is still politically unthinkable today. So the only solution is to achieve reform in the name of Islam, through the reinterpretation of repressive holy texts.

  5. Sexual interest, attitudes, knowledge, and sexual history in relation to sexual behavior in the institutionalized aged.

    PubMed

    White, C B

    1982-02-01

    Although the idea that sexuality is a lifelong need is gaining greater research support and greater acceptability to the general public, few consider the institutionalized aged as having sexual needs or being able to benefit from sexual intimacy. The research presented here indicates that sexual activity in the institutionalized aged is related to their attitudes and behavior toward sexuality and to their sexual interest level and prior frequency of sexual activity. Institutionalized aged persons evidence sexual needs and do engage in sexual behavior.

  6. Parental Sexual Attitudes, Family Sexual Communication, and Adolescent Sexual Behavior.

    ERIC Educational Resources Information Center

    Fisher, Terri D.

    Some researchers have reported that when parents are the main source of sex education, their adolescent children are less likely to engage in premarital sexual activity and are more likely to use effective contraception. This study used the variables of gender and parental sexual attitudes (liberal or conservative) to categorize 349 college…

  7. Acceptance of Treatment of Sexually Transmitted Infections for Stable Sexual Partners by Female Sex Workers in Kampala, Uganda

    PubMed Central

    Mayanja, Yunia; Mukose, Aggrey David; Nakubulwa, Susan; Omosa-Manyonyi, Gloria

    2016-01-01

    Background The prevalence of sexually transmitted infections (STIs) among female sex workers (FSWs) in sub-Saharan Africa remains high. Providing treatment to the affected FSWs is a challenge, and more so to their stable sexual partners. There is scanty research information on acceptance of STI treatment for stable sexual partners by FSWs. We conducted a study to assess acceptance of STI treatment for stable sexual partners by FSWs, and to identify factors associated with acceptance. Methods We enrolled 241 FSWs in a cross sectional study; they were aged ≥ 18 years, had a stable sexual partner and a diagnosis of STI. Factors associated with acceptance of STI treatment for stable sexual partners were analysed in STATA (12) using Poisson regression. Mantel-Haenszel tests for interaction were performed. Results Acceptance of partner treatment was 50.6%. Majority (83.8%) of partners at the last sexual act were stable partners, and 32.4% of participants had asymptomatic STIs. Factors independently associated with acceptance were: earning ≤ $4 USD per sexual act (aPR 0.68; 95% CI: 0.49–0.94) and a clinical STI diagnosis (aPR 1.95; 95% CI: 1.30–2.92). The effect of low income on acceptance of partner treatment was seen in those with less education. Conclusion Acceptance of STI treatment for stable sexual partners was lower than that seen in other studies. Interventions to improve economic empowerment among FSWs may increase acceptance of partner treatment. PMID:27171270

  8. Polymerase Chain Reaction as a Diagnostic Tool for Six Sexually Transmitted Infections - Preliminary Results

    PubMed Central

    GRAD, ALECSANDRA IULIA; VICA, MIHAELA LAURA; MATEI, HOREA VLADI; GRAD, DORU LUCIAN; COMAN, IOAN; TATARU, DUMITRU ALEXANDRU

    2015-01-01

    Background and aim Sexually transmitted infections are a very frequent and under-diagnosed cause of illness worldwide. A high number of detection methods and a large range of specimens in which sexually transmitted infections can be determined are available at the moment. Polymerase chain reaction performed on first void urine offers the advantage of being non-invasive, self-collectable and has high sensitivity and specificity. We looked to determine the frequency of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma hominis, Mycoplasma genitalium and Ureaplasma urealyticum in symptomatic and asymptomatic patients. Methods Six sexually transmitted infections were determined in the first void urine of 15 symptomatic and asymptomatic patients by polymerase chain reaction. We used “Epicenter MasterPure™ Complete DNA and RNA Purification Kit” for the DNA purification and “Seeplex® STD6 ACE Detection” for the DNA amplification. The results were examined in UV light. Results A number of 5 patients had positive results for Chlamydia trachomatis or Neisseria gonorrhoeae. Sexually transmitted infections are more frequent in men between 27 and 40 years old. Conclusions Polymerase chain reaction is a good diagnostic tool for sexually transmitted infections because it has a high sensitivity and specificity. Chlamydia trachomatis is the most frequent sexually transmitted infection, followed by Neisseria gonorrhoeae. PMID:26528045

  9. [Association between asymptomatic hyperuricaemia and metabolic syndrome in the adolescents].

    PubMed

    Koborová, Ivana; Gurecká, Radana; Hlavatá, Anna; Šebeková, Katarína

    2015-01-01

    In humans, uric acid represents a biologically active end-product of purine nucleotides. Several studies in children and adolescents documented an association between hyperuricaemia and the components metabolic syndrome. High intake of fructose-sweetened beverages might increase uricaemia, since fructose is the only saccharide which metabolism results in the formation of uric acid. Current knowledge does not allow distinguishing whether hyperuricaemia is causally related to the components of metabolic syndrome, or rather represents a marker of an enhanced risk, and poor outcome. No guidelines exist whether or not to treat asymptomatic hyperuricaemia in the adolescents. Randomized controlled prospective clinical studies are needed to elucidate whether uric acid-lowering management would beneficially affect the prevalence of metabolic syndrome, and the incidence of cardiovascular disease.

  10. Management of asymptomatic gene carriers of transthyretin familial amyloid polyneuropathy.

    PubMed

    Schmidt, Hartmut H-J; Barroso, Fabio; González-Duarte, Alejandra; Conceição, Isabel; Obici, Laura; Keohane, Denis; Amass, Leslie

    2016-09-01

    Transthyretin familial amyloid polyneuropathy (TTR-FAP) is a rare, severe, and irreversible, adult-onset, hereditary disorder caused by autosomal-dominant mutations in the TTR gene that increase the intrinsic propensity of transthyretin protein to misfold and deposit systemically as insoluble amyloid fibrils in nerve tissues, the heart, and other organs. TTR-FAP is characterized by relentless, progressively debilitating polyneuropathy, and leads to death, on average, within 10 years of symptom onset without treatment. With increased availability of disease-modifying treatment options for a wider spectrum of patients with TTR-FAP, timely detection of the disease may offer substantial clinical benefits. This review discusses mutation-specific predictive genetic testing in first-degree relatives of index patients diagnosed with TTR-FAP and the structured clinical follow-up of asymptomatic gene carriers for prompt diagnosis and early therapeutic intervention before accumulation of substantial damage. Muscle Nerve 54: 353-360, 2016.

  11. Timing of testing and treatment for asymptomatic diseases

    SciTech Connect

    Kırkızlar, Eser; Faissol, Daniel M.; Griffin, Paul M.; Swann, Julie L.

    2010-07-01

    Many papers in the medical literature analyze the cost-effectiveness of screening for diseases by comparing a limited number of a priori testing policies under estimated problem parameters. However, this may be insufficient to determine the best timing of the tests or incorporate changes over time. In this paper, we develop and solve a Markov Decision Process (MDP) model for a simple class of asymptomatic diseases in order to provide the building blocks for analysis of a more general class of diseases. We provide a computationally efficient method for determining a cost-effective dynamic intervention strategy that takes into account (i) the results of the previous test for each individual and (ii) the change in the individual’s behavior based on awareness of the disease. We demonstrate the usefulness of the approach by applying the results to screening decisions for Hepatitis C (HCV) using medical data, and compare our findings to current HCV screening recommendations.

  12. [Detection of asymptomatic prolactinoma by a mass screening program].

    PubMed

    Ichihara, K; Miyai, K

    1990-06-01

    Mass screening for prolactinoma was performed among the general population of 10,550 normal adults (8,450 men and 2,100 women) using a paired assay method for serum PRL. Forty subjects with hyperprolactinemia were studied. There were five patients with pituitary prolactinoma, and 10 with 'big' prolactinemia. The patients with prolactinoma had few if any complaints. The occurrence of asymptomatic big prolactinemia showed marked female predominance. The implication of such a screening program for laboratory medicine in future is two-fold: 1) prospect of laboratory 'physician' taking active role in the promotion of mass screening program to cover wide range of disorders affecting adult population and 2) feasibility of analyzing or discovering subclinical disorders of academic interest, being allowed to explore every single individual in the population.

  13. Asymptomatic myocardial infarction in Kawasaki disease: Long-term prognosis

    SciTech Connect

    Shiraishi, I.; Onouchi, Z.; Hayano, T.; Hamaoka, K.; Kiyosawa, N. )

    1991-04-01

    Eight patients with Kawasaki disease who had sustained asymptomatic myocardial infarction 8-15 years ago (mean, 13.1 years) were reexamined by various noninvasive cardiac function tests to assess long-term prognosis. At present, electrocardiograms (ECGs) are normal in six patients. However, all eight patients had a prolonged preejection period (PEP) to left ventricular ejection time (LVET) ratio 30 s after amylnitrate (AN) inhalation. Six patients had perfusion defects by exercise thallium-201 myocardial scintigraphy, and two patients developed ST segment depression in treadmill exercise testing. These patients are symptom-free even though their physical activity has not been restricted. Yet they proved to have serious abnormalities suggesting sequelae of myocardial infarction or existing myocardial ischemia. Judging from the results of noninvasive cardiac function tests and recently performed coronary angiography, five of the eight patients require coronary bypass surgery.

  14. Asymptomatic bacteriuria in spinal cord patients and the elderly.

    PubMed

    Reid, G; Nicolle, L E

    1999-11-01

    The prevalence and incidence of symptomatic and asymptomatic bacteriuria will remain high for many years to come. Antimicrobial agents are necessary to treat symptomatic UTI because no natural methods have been shown to be effective. Treatment of ABU is not appropriate. There is growing resistance to antibiotics, biocides, and antiseptics and, simultaneously, a decreasing rate of introduction of new antibacterial agents; thus the problem of resistance is magnified and potentially complicates the management of patients with SCI and elderly persons. New options of managing health and of preventing ABU and UTI and the complications arising from these diseases must be investigated vigorously and urgently. In particular, further study of the role of bacterial biofilms, the normal microflora, the influence of diet and hygiene, and the importance of the host immune response in the process of urinary tract colonization and infection is relevant and necessary.

  15. Indian concepts on sexuality

    PubMed Central

    Chakraborty, Kaustav; Thakurata, Rajarshi Guha

    2013-01-01

    India is a vast country depicting wide social, cultural and sexual variations. Indian concept of sexuality has evolved over time and has been immensely influenced by various rulers and religions. Indian sexuality is manifested in our attire, behavior, recreation, literature, sculptures, scriptures, religion and sports. It has influenced the way we perceive our health, disease and device remedies for the same. In modern era, with rapid globalization the unique Indian sexuality is getting diffused. The time has come to rediscover ourselves in terms of sexuality to attain individual freedom and to reinvest our energy to social issues related to sexuality. PMID:23858263

  16. Inappropriate sexual behavior.

    PubMed

    Philo, S W; Richie, M F; Kaas, M J

    1996-11-01

    Inappropriate sexual behavior, or sexually aggressive behavior, is a term which encompasses a variety of behaviors, including obscene gesturing, touching or hugging another person, exposing body parts or disrobing, and masturbating in public. Inappropriate sexual behavior often elicits feelings of anxiety, embarrassment, or unease in the caregiver and the result is often disruption in continuity of care for the patient. The cause of inappropriate sexual behavior varies among individuals and careful assessment of the etiology of the behavior is the first essential step in intervening. Nursing interventions focus upon providing opportunities for expression of appropriate sexual behavior while attempting to extinguish inappropriate sexual behavior.

  17. Screening and Management of Asymptomatic Renal Stones in Astronauts

    NASA Technical Reports Server (NTRS)

    Reyes, David; Locke, James; Sargsyan, Ashot; Garcia, Kathleen

    2017-01-01

    Management guidelines were created to screen and manage asymptomatic renal stones in U.S. astronauts. The true risk for renal stone formation in astronauts due to the space flight environment is unknown. Proper management of this condition is crucial to mitigate health and mission risks. The NASA Flight Medicine Clinic electronic medical record and the Lifetime Surveillance of Astronaut Health databases were reviewed. An extensive review of the literature and current aeromedical standards for the monitoring and management of renal stones was also done. This work was used to develop a screening and management protocol for renal stones in astronauts that is relevant to the spaceflight operational environment. In the proposed guidelines all astronauts receive a yearly screening and post-flight renal ultrasound using a novel ultrasound protocol. The ultrasound protocol uses a combination of factors, including: size, position, shadow, twinkle and dispersion properties to confirm the presence of a renal calcification. For mission-assigned astronauts, any positive ultrasound study is followed by a low-dose renal computed tomography scan and urologic consult. Other specific guidelines were also created. A small asymptomatic renal stone within the renal collecting system may become symptomatic at any time, and therefore affect launch and flight schedules, or cause incapacitation during a mission. Astronauts in need of definitive care can be evacuated from the International Space Station, but for deep space missions evacuation is impossible. The new screening and management algorithm has been implemented and the initial round of screening ultrasounds is under way. Data from these exams will better define the incidence of renal stones in U.S. astronauts, and will be used to inform risk mitigation for both short and long duration spaceflights.

  18. Progression of asymptomatic peripheral artery disease over 1 year.

    PubMed

    Mohler, Emile R; Bundens, Warner; Denenberg, Julie; Medenilla, Elizabeth; Hiatt, William R; Criqui, Michael H

    2012-02-01

    The pathophysiology and time course of an individual converting from asymptomatic peripheral artery disease (PAD) to symptomatic claudication is unclear. The objectives of this study were: (1) to characterize the extent of atherosclerotic disease in individuals with an abnormal ankle-brachial index (ABI), but without claudication; and over 1 year of follow-up to (2) evaluate the progression of PAD using ultrasound imaging, (3) determine changes in the ABI and leg pain symptoms, and (4) correlate PAD progression with changes in the ABI and leg symptoms. We hypothesized that PAD progression would be associated with the development of claudication and changes in the ABI, 6-minute walk distance (6-MWD), and walking quality of life. Individuals with a reduced ABI but without typical intermittent claudication noted on community screening were invited to undergo baseline and 1-year follow-up assessment, including duplex ultrasound. The initial and repeat evaluations included measurement of the ABI, lower extremity duplex arterial mapping, and assessment of leg pain and functional status. Of the 50 people studied, 44 (88%) had significant atherosclerotic lesions in the lower extremity arteries, affecting 80 legs. A total of 33 of 50 individuals (66%) returned for the 1-year follow-up visit. On ultrasound examination, two of 18 normal legs developed PAD, and in 48 legs with PAD at baseline, 17 legs (35%) developed new or progressive lesions. Thirteen legs developed new claudication. Overall, there was no significant worsening in the ABI, 6-MWD, or the Walking Impairment Questionnaire (WIQ). However, legs with new lesions or lesion progression were significantly more likely to develop claudication, and the 13 legs (seven subjects) developing claudication showed a significant decline in the 6-MWD. In conclusion, these data indicate that a significant number of people with asymptomatic PAD show progression over 1 year, that such individuals are more likely to develop

  19. Radiochemotherapy Versus Surgery in Nonmetastatic Anorectal Neuroendocrine Carcinoma: A Multicenter Study by the Association des Gastro-Entérologues Oncologues.

    PubMed

    Brieau, Bertrand; Lepère, Céline; Walter, Thomas; Lecomte, Thierry; Guimbaud, Rosine; Manfredi, Sylvain; Tougeron, David; Desseigne, Françoise; Lourenco, Nelson; Afchain, Pauline; El Hajbi, Farid; Terris, Benoit; Rougier, Philippe; Coriat, Romain

    2015-10-01

    Neuroendocrine carcinomas (NEC) of the anus or the rectum are a rare disease, accounting for less than 1% of all digestive malignancies. Most are metastatic at diagnosis and treated with a platinum-based chemotherapy. No guidelines for localized tumors exist. The purpose of this study was to describe the characteristics of anorectal localized NEC, their management and their outcomes.We retrospectively reviewed patients from 11 French centers with anorectal localized NEC. We compared 2 therapeutic managements: surgery (group A) versus chemotherapy with or without radiation (group B). Progression-free survival (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method.A total of 24 patients were identified with a median follow-up of 25 months (3-60 months). Median age was 63 years old and 17 had a rectal tumor (71%). Mean Ki-67 was 72% (range: 20-100), and 75% of the tumors had a high proliferative index (Ki-67 > 50%). Global PFS and OS were 13.1 and 44.1 months, respectively. Thirty-seven percent of patients were in group A and 63% in group B. There was no difference between group A and group B, whether in terms of PFS (13.0 months vs. 13.2 months, P = 0.75) or OS (49.1 months vs. 39.2 months, P = 0.42).In patients with anorectal localized NEC, chemotherapy with or without radiation obtained a similar outcome as surgery and this conservative approach could be deemed a reasonable option.

  20. Diagnosis of Asymptomatic Bacteriuria and Associated Risk Factors Among Pregnant Women in Mangalore, Karnataka, India

    PubMed Central

    Baby, Neha Maria; Kuruvilla, Thomas .S.; Machado, Santhosh

    2014-01-01

    Background: Asymptomatic bacteriuria (AB) is common inwomen and increases in prevalence with age or sexual activity. Prompt detection and treatment of this condition and associated factors decreases complications like acute pyleonephritis, intrauterine growth retardation and preterm labour. Chromogenic media is a versatile tool in rapid primary screening of the causative organisms considerably reducing daily routine workload. Aim: To determine the prevalence of AB among pregnant women in a tertiary care set-up and analyse the contributory risk factors, its effects on pregnancy and the role of chromogenic media in the laboratory diagnosis of these cases. Materials and Methods: Urine samples of all pregnant women attending pre-natal check-ups with no genitourinary complaints, history of fever or antibiotic intake were collected for Gram stain, culture and antibiotic sensitivity tests. A second urine specimen for culture and sensitivity testing was obtained from those with significant bacteriuria. The results were compared with patients showing negative urine cultures. Results: The overall prevalence of this clinical condition in our study was 13.2%. The significant isolates were Klebsiella pneumonia and E.coli and the most common risk factor was a previous history of urinary tract infection. The isolates were easily identified by using chromogenic agar ( HiCrome ) but colonies of uncommon pathogens like Acinetobacter and Streptococcus species appeared white and needed further identification. Conclusion: Screening of pregnant women for AB at first prenatal checkup helps analyse the associated factors and prevents its effects on pregnancy. The use of a chromogenic media can enhance reporting accuracy and will be an effective tool to monitor these cases routinely. PMID:25386490

  1. [Sexuality in aging].

    PubMed

    Berner, Yitshal N

    2002-07-01

    During aging, impairment in many physiological functions is manifested. This is exhibited in sexual functioning, which is an intricate interaction involving a number of systems: endocrinal, motor, sensor, physical and sensual. Sexual activity is a component of the well-being of the individual, while sexuality is part of self-identity at any age. Sexual activity is a primary base to human relations, and it is a basic right of every person in society. Sexuality and sexual activity are considered to be part of youth, hence, the combination of sexuality and aging is considered strange. In many instances, sexual activity in the elderly is considered exceptional and possibly requiring certain intervention of the society establishment. Recent technological advances enable sexual activity, despite physiological and even anatomical shortcomings. Knowledge of the changes in sexual activity with aging, as well as having open communication on the subject, are the best tools for maintaining sexual activity with appropriate limitation during aging. The purpose of this short review is to present the different aspects of sexuality and sexual activity in aging.

  2. Validation of questionnaires to assess quality of life related to fecal incontinence in children with anorectal malformations and Hirschsprung's disease

    PubMed Central

    Mathias, Arthur Loguetti; Tannuri, Ana Cristina Aoun; Ferreira, Mariana Aparecida Elisei; Santos, Maria Mercês; Tannuri, Uenis

    2016-01-01

    Abstract Objective: Surgical treatment of anorectal malformations (ARMs) and Hirschsprung's disease (HD) leads to alterations in bowel habits and fecal incontinence, with consequent quality of life impairment. The objectives were to create and validate a Questionnaire for the Fecal Incontinence Index (FII) based on the Holschneider score, as well as a Questionnaire for the Assessment of Quality of Life Related to Fecal Incontinence in Children and Adolescents (QQVCFCA), based on the Fecal Incontinence Quality of Life. Methods: The questionnaires were applied to 71 children submitted to surgical procedure, in two stages. Validity was tested by comparing the QQVCFCA and a generic quality of life questionnaire (SF-36), and between QQVCFCA and the FII. A group of 59 normal children was used as control. Results: At two stages, 45.0% (32/71) and 42.8% (21/49) of the patients had fecal incontinence. It was observed that the QQVCFCA showed a significant correlation with the SF-36 and FII (Pearson's correlation 0.57), showing that the quality of life is directly proportional to improvement in fecal incontinence. Quality of life in patients with fecal incontinence is still globally impaired, when compared with control subjects (p<0.05, Student's t-test). There were also significant differences between the results of children with ARMs and children with HD. Conclusions: QQVCFCA and FII are useful tools to assess the quality of life and fecal incontinence in these groups of children. Children with ARMs submitted to surgical procedure and HD have similar quality of life impairment. PMID:26522822

  3. Incidence, Surgical Treatment, and Prognosis of Anorectal Melanoma From 1973 to 2011: A Population-Based SEER Analysis.

    PubMed

    Chen, Haiyan; Cai, Yibo; Liu, Yue; He, Jinjie; Hu, Yeting; Xiao, Qian; Hu, Wangxiong; Ding, Kefeng

    2016-02-01

    Anorectal melanoma (AM) is a rare type of melanoma that accounts for 0.4% to 1.6% of total malignant melanomas. The incidence of AM increases over time, and it remains highly lethal, with a 5-year survival rate of 6% to 22%. Considering the rare nature of this disease, most studies on AM comprise isolated case reports and single-center trials, which could not provide comprehensive assessment of the disease. Therefore, we conducted a population-based study by using the Surveillance, Epidemiology, and End Results (SEER) program to provide the latest and best available evidence of AM.We extracted all cases of AM registered in the SEER database from 1973 to 2011 (April 2014 release) and calculated age-adjusted incidence. Only cases with active follow-up were included to predict factors associated with prognosis. Survival outcomes were also compared among different types of surgery.We identified 640 AM cases, which consisted of 265 rectal melanoma and 375 anal melanoma. The estimated annual incidence rates of AM per 1 million population were 0.259 in males and 0.407 in females, and it increased with advanced age and over time. Tumor stage and surgical treatment were independent predictors of survival. Results implied that surgery improved the prognosis of patients with local- and regional-stage AM but could not prolong the survival of patients with distant-stage AM. Moreover, the outcome of less extensive excision was not statistically different from that of more extensive excision.This study provides an up-to-date estimation of the incidence and prognosis of AM by using SEER data. The incidence of AM continuously increases over time, despite its rarity. This disease also exhibits poor prognosis. Thus, AM must be further investigated in future studies. We also recommend surgery as the optimal treatment for local- and regional-stage AM patients but not for those with distant metastasis.

  4. The Anal Fistula Plug versus the mucosal advancement flap for the treatment of Anorectal Fistula (PLUG trial)

    PubMed Central

    van Koperen, Paul J; Bemelman, Willem A; Bossuyt, Patrick MM; Gerhards, Michael F; Eijsbouts, Quirijn AJ; van Tets, Willem F; Janssen, Lucas WM; Dijkstra, F Robert; van Dalsen, Annette D; Slors, J Frederik M

    2008-01-01

    Background Low transsphincteric fistulas less than 1/3 of the sphincter complex are easy to treat by fistulotomy with a high success rate. High transsphincteric fistulas remain a surgical challenge. Various surgical procedures are available, but recurrence rates of these techniques are disappointingly high. The mucosal flap advancement is considered the gold standard for the treatment of high perianal fistula of cryptoglandular origin by most colorectal surgeons. In the literature a recurrence rate between 0 and 63% is reported for the mucosal flap advancement. Recently Armstrong and colleagues reported on a new biologic anal fistula plug, a bioabsorbable xenograft made of lyophilized porcine intestinal submucosa. Their prospective series of 15 patients with high perianal fistula treated with the anal fistula plug showed promising results. The anal fistula plug trial is designed to compare the anal fistula plug with the mucosal flap advancement in the treatment of high perianal fistula in terms of success rate, continence, postoperative pain, and quality of life. Methods/design The PLUG trial is a randomized controlled multicenter trial. Sixty patients with high perianal fistulas of cryptoglandular origin will be randomized to either the fistula plug or the mucosal advancement flap. Study parameters will be anorectal fistula closure-rate, continence, post-operative pain, and quality of life. Patients will be followed-up at two weeks, four weeks, and 16 weeks. At the final follow-up closure rate is determined by clinical examination by a surgeon blinded for the intervention. Discussion Before broadly implementing the anal fistula plug results of randomized trials using the plug should be awaited. This randomized controlled trial comparing the anal fistula plug and the mucosal advancement flap should provide evidence regarding the effectiveness of the anal fistula plug in the treatment of high perianal fistulas. Trial registration ISRCTN: 97376902 PMID:18573198

  5. Incidence, Surgical Treatment, and Prognosis of Anorectal Melanoma From 1973 to 2011: A Population-Based SEER Analysis.

    PubMed

    Chen, Haiyan; Cai, Yibo; Liu, Yue; He, Jinjie; Hu, Yeting; Xiao, Qian; Hu, Wangxiong; Ding, Kefeng

    2016-02-01

    Anorectal melanoma (AM) is a rare type of melanoma that accounts for 0.4% to 1.6% of total malignant melanomas. The incidence of AM increases over time, and it remains highly lethal, with a 5-year survival rate of 6% to 22%. Considering the rare nature of this disease, most studies on AM comprise isolated case reports and single-center trials, which could not provide comprehensive assessment of the disease. Therefore, we conducted a population-based study by using the Surveillance, Epidemiology, and End Results (SEER) program to provide the latest and best available evidence of AM.We extracted all cases of AM registered in the SEER database from 1973 to 2011 (April 2014 release) and calculated age-adjusted incidence. Only cases with active follow-up were included to predict factors associated with prognosis. Survival outcomes were also compared among different types of surgery.We identified 640 AM cases, which consisted of 265 rectal melanoma and 375 anal melanoma. The estimated annual incidence rates of AM per 1 million population were 0.259 in males and 0.407 in females, and it increased with advanced age and over time. Tumor stage and surgical treatment were independent predictors of survival. Results implied that surgery improved the prognosis of patients with local- and regional-stage AM but could not prolong the survival of patients with distant-stage AM. Moreover, the outcome of less extensive excision was not statistically different from that of more extensive excision.This study provides an up-to-date estimation of the incidence and prognosis of AM by using SEER data. The incidence of AM continuously increases over time, despite its rarity. This disease also exhibits poor prognosis. Thus, AM must be further investigated in future studies. We also recommend surgery as the optimal treatment for local- and regional-stage AM patients but not for those with distant metastasis. PMID:26886623

  6. Mediators of sexual revictimization risk in adult sexual assault victims.

    PubMed

    Ullman, Sarah E; Vasquez, Amanda L

    2015-01-01

    This study examined sexual risk behaviors and sexual refusal assertiveness in relationship to child sexual abuse, emotion dysregulation, and adult sexual revictimization. Path analyses of 1,094 survivors who had sex in the past year were done to examine sexual risk behavior and sexual refusal assertiveness mediational pathways by which child sexual abuse severity and emotion dysregulation may affect revictimization over one year in adult female sexual assault survivors. Exchanging sex for money and sexual refusal assertiveness were significantly associated with emotion dysregulation, whereas exchanging sex for money, and not sexual refusal assertiveness, was only significantly related to child sexual abuse severity. Both exchanging sex for money and sex refusal assertiveness mediated the relationship between emotion dysregulation and adult sexual revictimization. Exchanging sex for money mediated the child sexual abuse severity-revictimization relationship. These findings demonstrate the importance of considering both risky and protective sexual behaviors in research and prevention programming that address sexual revictimization in women. PMID:25942287

  7. Insight into alteration of gut microbiota in Clostridium difficile infection and asymptomatic C. difficile colonization.

    PubMed

    Zhang, Lihua; Dong, Danfeng; Jiang, Cen; Li, Zhen; Wang, Xuefeng; Peng, Yibing

    2015-08-01

    Clostridium difficile is well recognized as the common pathogen of nosocomial diarrhea, meanwhile, asymptomatic colonization with C. difficile in part of the population has also drawn public attention. Although gut microbiota is known to play an important role in the pathogenesis of C. difficile infection (CDI), whether there is any alteration of gut microbial composition in asymptomatic C. difficile carriers hasn't been clearly described. The purpose of this study was to explore the differences in gut microbiome among CDI patients, asymptomatic C. difficile carriers and healthy individuals. We performed fecal microbiota analysis on the samples of eight CDI patients, eight asymptomatic C. difficile carriers and nine healthy subjects using 16S rRNA gene pyrosequencing. CDI patients and asymptomatic carriers showed reduced microbial richness and diversity compared with healthy subjects, accompanied with a paucity of phylum Bacteroidetes and Firmicutes as well as an overabundance of Proteobacteria. Some normally commensal bacteria, especially butyrate producers, were significantly depleted in CDI patients and asymptomatic carriers. Furthermore, the differences observed in microbial community structure between CDI patients and asymptomatic carriers suggested that the gut microbiota may be a potential factor of disease state for CDI. Our study demonstrates the characterization and diversity of gut microbiota in CDI and asymptomatic C. difficile colonization, which will provide new ideas for surveillance of the disease state and development of microbiota-targeted agents for CDI prevention and treatment.

  8. Sexual Dysfunction and Infertility

    MedlinePlus

    ... American Society for Reproductive Medicine Sexual dysfunction and infertility What is sexual dysfunction and how common is ... and 40% of women. For couples dealing with infertility, it is even more common. Often, people ignore ...

  9. Zika and Sexual Transmission

    MedlinePlus

    ... Address What's this? Submit What's this? Submit Button Zika and Sexual Transmission Language: English Español Português ... Healthcare Providers: Sexual Transmission of Zika Basics of Zika Virus and Sex Transmission Zika can be passed ...

  10. Sexually Transmitted Diseases

    MedlinePlus

    Sexually transmitted diseases (STDs) are infections that are passed from one person to another through sexual contact. The causes of STDs ... often help with the symptoms and keep the disease under control. Correct usage of latex condoms greatly ...

  11. Sexual Problems in Women

    MedlinePlus

    There are many problems that can keep a woman from enjoying sex. They include Lack of sexual ... concerns about marriage or relationship problems. For some women, the problem results from past sexual trauma. Occasional ...

  12. Children and Sexuality.

    ERIC Educational Resources Information Center

    Corbett, Susan Miller

    1991-01-01

    Presents a newsletter that discusses methods parents can use to handle sexual questions or behavior in young children. An accompanying letter to parents addresses young children's sexual behavior and ways parents can respond to this behavior. (GH)

  13. An Overview of Sexual Harassment

    ERIC Educational Resources Information Center

    Stier, William F., Jr.

    2005-01-01

    Sexual harassment, according to the Equal Employment Opportunity Commission (EEOC), is when any unwelcome sexual advances for sexual favors, and other verbal or physical conduct of a sexual nature takes place. For sexual harassment to take place there must be some type of behavior, language, or material of a sexual nature, which is offensive.…

  14. Testosterone and Sexual Function.

    PubMed

    Gannon, John R; Walsh, Thomas J

    2016-05-01

    Testosterone and sexual function are related. Current evidence suggests that testosterone replacement therapy (TRT) may improve sexual dysfunction. Sexual dysfunction in men who are hypogonadal, mixed, or eugonadal have all been examined through numerous studies. The most recent large analysis showed an overall improvement in sexual function outcomes in men treated with TRT. This improvement is difficult to measure and seems to differ based on the baseline hormonal status of the patient at the beginning of treatment. PMID:27132579

  15. Schooling & Sexualities: Teaching for a Positive Sexuality.

    ERIC Educational Resources Information Center

    Laskey, Louise, Ed.; Beavis, Catherine, Ed.

    This collection of papers contains a Foreword by Jane Kenway, an Introduction by Louise Laskey and Catherine Beavis, and four sections. Section 1, Schools and the Social Construction of Sexuality, contains 3 chapters: (1) Power and Partnership? Challenging the Sexual Construction of Schooling (D. Denborough); (2) Where Do You Draw the Line?…

  16. Global epidemiology of sexually transmitted diseases.

    PubMed

    Da Ros, Carlos T; Schmitt, Caio da Silva

    2008-01-01

    Sexually transmitted diseases (STDs) are among the first ten causes of unpleasant diseases in young adult males in developing countries and the second major cause of unpleasant diseases in young adult women. Adolescents and young adults (15-24 years old) make up only 25% of the sexually active population, but represent almost 50% of all new acquired STDs. In general, STDs are epidemics and present an enormous health and economic consequences. An adequate screening for STDs should be done on a routine basis in every part of the world. Many STDs are asymptomatic and therefore can difficult to control. The purpose of reporting of STDs is to ensure that persons who are infected will be quickly diagnosed and appropriately treated to control the spread of infection and also so that partners are notified, tested and appropriately treated. It is estimated that reported cases of STDs represent only 50%-80% of reportable STD infections in the United States, reflecting limited screening and low disease reporting. High-risk sexual behavior is a highly contributive factor of this process as it often leads to teenage pregnancies and HIV/AIDS. One possible explanation for this behavior is that people do not have enough information about the transmission of STDs or ignore the precautions required for safe sex. Approximately 60% of new HIV infections worldwide occur in young people. The frequency of high-risk behaviors among youths may also be influenced by opportunity to engage in them, particularly the amount of time that they are unsupervised by adults. However, in diagnosing and treating these patients, we can effectively prevent the spread of HIV/AIDS. Individuals infected with STDs are 5-10 times more likely than uninfected individuals to acquire or transmit HIV through sexual contact. The breaking of the genital tract lining or skin creates a portal of entry for HIV and, hence, HIV-infected individuals with other STDs are more likely to shed HIV in their genital secretions

  17. Food Restriction-Induced Changes in Gonadotropin-Inhibiting Hormone Cells are Associated with Changes in Sexual Motivation and Food Hoarding, but not Sexual Performance and Food Intake

    PubMed Central

    Klingerman, Candice M.; Williams, Wilbur P.; Simberlund, Jessica; Brahme, Nina; Prasad, Ankita; Schneider, Jill E.; Kriegsfeld, Lance J.

    2011-01-01

    We hypothesized that putative anorectic and orexigenic peptides control the motivation to engage in either ingestive or sex behaviors, and these peptides function to optimize reproductive success in environments where energy fluctuates. Here, the putative orexigenic peptide, gonadotropin-inhibiting hormone (GnIH, also known as RFamide-related peptide-3), and the putative anorectic hormones leptin, insulin, and estradiol were examined during the course of food restriction. Groups of female Syrian hamsters were restricted to 75% of their ad libitum food intake or fed ad libitum for 4, 8, or 12 days. Two other groups were food-restricted for 12 days and then re-fed ad libitum for 4 or 8 days. After testing for sex and ingestive behavior, blood was sampled and assayed for peripheral hormones. Brains were immunohistochemically double-labeled for GnIH and the protein product of the immediate early gene, c-fos, a marker of cellular activation. Food hoarding, the number of double-labeled cells, and the percent of GnIH-Ir cells labeled with Fos-Ir were significantly increased at 8 and 12 days after the start of food restriction. Vaginal scent marking and GnIH-Ir cell number significantly decreased after the same duration of restriction. Food hoarding, but not food intake, was significantly positively correlated with cellular activation in GnIH-Ir cells. Vaginal scent marking was significantly negatively correlated with cellular activation in GnIH-Ir cells. There were no significant effects of food restriction on plasma insulin, leptin, estradiol, or progesterone concentrations. In the dorsomedial hypothalamus (DMH) of energetically challenged females, strong projections from NPY-Ir cells were found in close apposition to GnIH-Ir cells. Together these results are consistent with the idea that metabolic signals influence sexual and ingestive motivation via NPY fibers that project to GnIH cells in the DMH. PMID:22649396

  18. HPV and Chlamydia trachomatis co-detection in young asymptomatic women from high incidence area for cervical cancer.

    PubMed

    Bellaminutti, Serena; Seraceni, Silva; De Seta, Francesco; Gheit, Tarik; Tommasino, Massimo; Comar, Manola

    2014-11-01

    Chlamydia trachomatis causing chronic inflammatory diseases has investigated as possible human papillomavirus (HPV) cofactor in cervical cancer. The aim of this study is to evaluate the prevalence of Chlamydia trachomatis and HPV co-infection in different cohorts of asymptomatic women from a Northern Italy area at high incidence for cervical cancer. Cervical samples from 441 females were collected from Cervical Cancer Screening Program, Sexually Transmitted Infectious and Assisted Reproductive Technology centres. HPV and Chlamydia trachomatis were detected simultaneously and genotyped using a highly sensitive bead based assay. The overall prevalence of Chlamydia trachomatis was estimated 9.7%, in contrast with the reported national data of 2.3%, and co-infection with HPV was diagnosed in the 17% of the samples. In females ≤ 25 years of age, the infection reached a peak of 22% and co-infection with HPV of 45.8% (P < 0.001). Of note, in young females diagnosed with low grade cervical lesions, no significant difference between Chlamydia trachomatis and HPV distribution was observed, while differently, HPV co-infection was found significantly associated to the presence of intraepithelial lesions when compared to older females (20% vs. 1%; P < 0.001). In this study, the use of a high sensitive molecular technique exhibited higher analytical sensitivity than the referred assays for the diagnosis of Chlamydia trachomatis and HPV co-infection in asymptomatic females, leading to reduction of the potential to identify incorrectly the infection status. An active screening for timely treatment of Chlamydia trachomatis infection is suggested in young females to evaluate a possible decrease in incidence of pre-cancer intraepithelial lesions.

  19. Components of Sexual Identity

    ERIC Educational Resources Information Center

    Shively, Michael G.; DeCecco, John P.

    1977-01-01

    This paper examines the four components of sexual identity: biological sex, gender identity, social sex-role, and sexual orientation. Theories about the development of each component and how they combine and conflict to form the individual's sexual identity are discussed. (Author)

  20. Sexual Harassment in Education.

    ERIC Educational Resources Information Center

    Campbell, D'Ann

    1986-01-01

    In a recent BEST (Bureau of Evaluative Studies and Testing, Indiana University, Bloomington) survey, 10 percent of Indiana University women who responded had experienced some form of sexual harassment. Sexual harassment in education is any attention of a sexual nature from an instructor or professor which makes a student uncomfortable in class or…

  1. Low incidence of spontaneous bacterial peritonitis in asymptomatic cirrhotic outpatients

    PubMed Central

    Cadranel, Jean-François; Nousbaum, Jean-Baptiste; Bessaguet, Christophe; Nahon, Pierre; Nguyen-Khac, Eric; Moreau, Richard; Thévenot, Thierry; Silvain, Christine; Bureau, Christophe; Nouel, Olivier; Pilette, Christophe; Paupard, Thierry; Pauwels, Arnaud; Sapey, Thierry; Grangé, Jean-Didier; Tran, Albert

    2013-01-01

    AIM: To compare the incidence of spontaneous bacterial peritonitis in cirrhotic outpatients and inpatients undergoing therapeutic paracentesis METHODS: From January 1 to May 31, 2004, 1041 patients from 70 different hospitals underwent 2123 therapeutic abdominal paracentesis (AP) performed as a outpatient procedure in 355 and as inpatient procedure in 686 cases respectively. The following parameters were compared prospectively between outpatients and inpatients: spontaneous bacterial peritonitis (SBP) prevalence, age, gender, cause of cirrhosis, symptoms, score and grade according to Child-Pugh classification, cirrhosis complications, antibiotics treatment, serum creatinine, platelet count and ascitic protein concentration. RESULTS: SBP was observed in 91 patients. In the whole population the SBP prevalence was 8.7% (95%CI: 7.2-10.6) it was 11.7% (95%CI: 9.5-14.3) in inpatients and 3.1% (95%CI: 1.7-5.5) in outpatients (P < 0.00001). SBP prevalence was 8.3% (95%CI: 4.3-15.6) in symptomatic outpatients vs 1.2% (95%CI: 0.4-3.4) in asymptomatic outpatients (P < 0.002). Patients undergoing outpatient AP were significantly different from those undergoing inpatient AP; they were older (61.1 ± 11.1 years vs 59.4 ± 11.7 years; P = 0.028), cause of cirrhosis was less often alcohol (83 .7 vs 88.2%; P < 0.001), Child-Pugh score was lower (8.9 vs 10.1; P < 0.001) and more often B than C (63.7% vs 38%; P < 0.001). In addition, in outpatients the platelet count was higher (161 ± 93 Giga/L vs 143 ± 89 Giga/L; P = 0.003), serum total bilirubin concentration was lower (38.2 ± 60.7 μmol/L vs 96.3 ± 143.3 μmol/L; P < 0.0001), and ascitic protein concentration higher (17.9 ± 10.7 g/L vs 14.5 ± 10.9 g/L; P < 0.001) than in inpatients. CONCLUSION: In asymptomatic cirrhotic outpatients, the incidence of spontaneous bacterial peritonitis is low thus exploratory paracentesis could be avoided in these patients without significant risk. PMID:23556041

  2. Relevance of prehypertension as a diagnostic category in asymptomatic adults

    PubMed Central

    Nary, Fernando Costa; Santos, Raul D.; Laurinavicius, Antonio Gabriele; Conceição, Raquel Dilguerian de Oliveira; de Carvalho, José Antonio Maluf

    2013-01-01

    ABSTRACT Objective: To assess the association of prehypertension with metabolic, inflammatory and cardiovascular risk profile in asymptomatic individuals. Methods: Between 2006 and 2009, 11,011 asymptomatic adults (mean age: 43 years; 22% females), underwent a check-up protocol. They were divided into 3 groups: normotensive group (arterial pressure=120/80mmHg), prehypertensive group (arterial pressure >120/80mmHg and <140/90mmHg) and hypertensive group (arterial pressure≥140/90mmHg or prior diagnosis of hypertension). Each group metabolic and cardiovascular group profile was assessed. Results: The prevalence of normotension, prehypertension and hypertension was 27.9%, 53.9% and 18.2%, respectively. Prehypertensive individuals were older (mean age: 42.7 versus 40 years; p<0.001) than normotensive patients, and had higher body mass index (mean: 26.7kg/m2 versus 24kg/m2; p<0.001), higher plasma triglycerides levels (mean: 139mg/dL versus 108mg/dL; p<0.001), higher LDL-choleterol levels (mean: 128mg/dL versus 117mg/dL; p<0.001), and lower HDL-cholesterol (mean: 46.7mg/dL versus 52.7mg/dL; p<0.001). Prehypertensive individuals were more likely to have impaired fasting glucose (OR: 1.69; 95%CI: 1.39-2.04), overweight and obesity - body mass index >25kg/m2 (OR: 2.48; 95%CI: 2.24-2.74), hepatic steatosis: (OR: 2.23; 95%CI: 1.97-2.53), metabolic syndrome (OR: 3.05; 95%CI: 2.67-3.49), and high-sensitivity C-reactive protein levels>2mg/L (OR: 1.52; 95%CI: 1.35-1.71). Conclusion: Prehypertension is associated with an increased prevalence of metabolic syndrome, hepatic steatosis and subclinical inflammation. PMID:24136756

  3. Seroepidemiology of Asymptomatic Dengue Virus Infection in Jeddah, Saudi Arabia

    PubMed Central

    Jamjoom, Ghazi A.; Azhar, Esam I.; Kao, Moujahid A.; Radadi, Raja M.

    2016-01-01

    BACKGROUND Although virologically confirmed dengue fever has been recognized in Jeddah, Saudi Arabia, since 1994, causing yearly outbreaks, no proper seroepidemiologic studies on dengue virus have been conducted in this region. Such studies can define the extent of infection by this virus and estimate the proportion that may result in disease. The aim of this study was to measure the seroprevalence of past dengue virus infection in healthy Saudi nationals from different areas in the city of Jeddah and to investigate demographic and environmental factors that may increase exposure to infection. METHODS Sera were collected from 1984 Saudi subjects attending primary health care centers in six districts of Jeddah. These included general patients of various ages seeking routine vaccinations, antenatal care or treatment of different illnesses excluding fever or suspected dengue. A number of blood donors were also tested. Serum samples were tested by enzyme immunoassay (EIA) for IgG antibodies to dengue viruses 1, 2, 3, 4. A questionnaire was completed for each patient recording various anthropometric data and factors that may indicate possible risk of exposure to mosquito bites and dengue infection. Patients with missing data and those who reported a history of dengue fever were excluded from analysis, resulting in a sample of 1939 patients to be analyzed. RESULTS The overall prevalence of dengue virus infection as measured by anti-dengue IgG antibodies from asymptomatic residents in Jeddah was 47.8% (927/1939) and 37% (68/184) in blood donors. Infection mostly did not result in recognizable disease, as only 19 of 1956 subjects with complete information (0.1%) reported having dengue fever in the past. Anti dengue seropositivity increased with age and was higher in males than females and in residents of communal housing and multistory buildings than in villas. One of the six districts showed significant increase in exposure rate as compared to the others. Availability of

  4. Asymptomatic Unilateral Hyperlucent Lung in a Prospective Kidney Donor.

    PubMed

    Lunia, Prajay; Karkhanis, Vinaya; Joshi, J M

    2015-09-01

    A 50 year old lady, prospective kidney donor was referred to our department for opinion in view of abnormal clinical findings during preoperative evaluation. She was asymptomatic from respiratory point of view. Her vital parameters were normal and on auscultation found to have decreased breath sounds and fine crackles throughout left hemithorax. Chest x-ray (CXR) showed left sided hyperlucency with small hilum (Figure 1). High resolution computed tomography (HRCT) showed scattered areas of bronchiectasis with associated air trapping throughout left lung with small left pulmonary artery (Figure 2). Sputum for acid fast bacilli (AFB) was negative. Spirometry showed moderate obstructive abnormality with forced expiratory volume in one second (FEV1) - 51% predicted, forced vital capacity (FVC) - 60% and FEV1/FVC - 76% with no bronchodilator reversibility. On post bronchodilator study there was paradoxical fall in FEV1/FVC to 72% consistent with small airway disease. Arterial blood gas analysis was normal. Technetium (Tc) 99m MAA lung perfusion scan (Figure3) showed normal perfusion of right lung contributing 75.4% of relative function and left lung contributing only 24.6%. Diagnosis of Swyer-James-MacLeod syndrome (SJMS) probably due to a childhood viral infection was made. Operative complications in such cases like difficult weaning and extubation, post-operative respiratory infections, collapse and respiratory failure are likely. However, our patient had an uneventful operative and post-operative course. SJMS is characterized by unilateral hyperlucency of a part of or the entire lung which was first described in 1953 by Swyer and James and later in 1954 by Macleod.1,2 It is considered to be an acquired disease as a result of post-infectious obliterative bronchiolitis. Productive cough, shortness of breath and sometimes hemoptysis are presenting symptoms. Some patients are asymptomatic and not diagnosed until they are adults.3 Radiologically it presents as predominant

  5. Transsexuals' sexual stories.

    PubMed

    Schrock, Douglas P; Reid, Lori L

    2006-02-01

    When viewed through a popular cultural lens, male-to-female transsexuals' sexual biographies can appear to indicate male transvestitism, heterosexuality, or homosexuality rather than transsexuality. How do transsexuals subvert such implications and construct transsexual identities? Drawing on K. Plummer's (1995) approach to sexual stories, we examine how nine male-to-female transsexuals construct their sexual pasts to accomplish what sociologists call "identity work." Interviewees used gendered sexual scripts, cultural discourse on the biological basis of male sexual arousal, and a discourse of therapeutic individualism to narratively defetishize autoerotic crossdressing, queer straight sex, refashion transvestic sex, and straighten out gay sex.

  6. Sexual Misconduct and Enactment

    PubMed Central

    Plakun, Eric M.

    1999-01-01

    Sexual misconduct remains a significant problem in the behavioral health professions. Although it is tempting to view sexual misconduct as perpetrated by “bad” clinicians against patients who are “victims,” this is an oversimplification of a complex problem. In this article, the author explores the psychoanalytic concept of enactment as a mechanism that can lead well-meaning clinicians to engage in sexual misconduct; defines enactment and differentiates it from near neighbor phenomena; uses case examples to illustrate how enactments may lead to sexual misconduct or may offer opportunities to deepen and enhance psychotherapeutic work; and offers recommendations for prevention of sexual misconduct. PMID:10523431

  7. Sexual misconduct and enactment.

    PubMed

    Plakun, E M

    1999-01-01

    Sexual misconduct remains a significant problem in the behavioral health professions. Although it is tempting to view sexual misconduct as perpetrated by "bad" clinicians against patients who are "victims," this is an oversimplification of a complex problem. In this article, the author explores the psychoanalytic concept of enactment as a mechanism that can lead well-meaning clinicians to engage in sexual misconduct; defines enactment and differentiates it from near neighbor phenomena; uses case examples to illustrate how enactments may lead to sexual misconduct or may offer opportunities to deepen and enhance psychotherapeutic work; and offers recommendations for prevention of sexual misconduct.

  8. Sexual misconduct and enactment.

    PubMed

    Plakun, E M

    1999-01-01

    Sexual misconduct remains a significant problem in the behavioral health professions. Although it is tempting to view sexual misconduct as perpetrated by "bad" clinicians against patients who are "victims," this is an oversimplification of a complex problem. In this article, the author explores the psychoanalytic concept of enactment as a mechanism that can lead well-meaning clinicians to engage in sexual misconduct; defines enactment and differentiates it from near neighbor phenomena; uses case examples to illustrate how enactments may lead to sexual misconduct or may offer opportunities to deepen and enhance psychotherapeutic work; and offers recommendations for prevention of sexual misconduct. PMID:10523431

  9. Necrophilia and sexual homicide.

    PubMed

    Stein, Michelle L; Schlesinger, Louis B; Pinizzotto, Anthony J

    2010-03-01

    A closed case-file review of 211 sexual homicides identified 16 cases of necrophilia. The results of this unique descriptive study of necrophilia associated with sexual homicide provide information on crime-scene locations, methods of killing, body disposition, premortem sexual assault, specifics of the necrophilic acts, methods of victim abduction, and motivational dynamics. The findings suggest that the most common explanation for necrophilia-the offender's desire to have an unresisting partner-may not always be applicable in cases where this rare paraphilia is connected to sexual murder. The possibility of using crime-scene behaviors in these cases to investigate serial sexual murders is offered.

  10. Dialysis and sexuality.

    PubMed

    Beal-Lloyd, Donna; Groh, Carla J

    2012-01-01

    End stage renal disease is a major health issue in the United States. Dialysis, the major form of renal replacement therapy, has physical and psychological implications that can have a major impact on both men's and women's sexuality and sexual performance. Nurses are in a key position to assist men and women on dialysis to develop healthy and realistic approaches to their sexuality. This article reviews the literature on dialysis and sexuality, and recommends nursing interventions that can assist persons on dialysis achieve the level of sexual intimacy and satisfaction they desire. PMID:23061112

  11. Association of sexual activity and bacteriuria in women with non-insulin-dependent diabetes mellitus.

    PubMed

    Pérez-Luque, E L; de la Luz Villalpando, M; Malacara, J M

    1992-01-01

    A group of 215 patients with non-insulin-dependent diabetes mellitus (NIDDM) (147 women and 68 men) were selected by home interview, and accepted to undergo clinical examination including urine culture, in order to determine the frequency of bacteriuria and its possible associations with clinical and laboratory findings. Bacteriuria was found in 17.7% of women and 1.5% of men. Univariate and multivariate analysis performed for the group of women revealed sexual intercourse and pyuria as the only factors associated with the frequency of bacteriuria. It was concluded that asymptomatic bacteriuria may be associated with sexual activity in women with NIDDM.

  12. Sexual activity and aging.

    PubMed

    Ni Lochlainn, Mary; Kenny, Rose Anne

    2013-08-01

    Sexuality is an important component of emotional and physical intimacy that men and women experience throughout their lives. Research suggesting that a high proportion of men and women remain sexually active well into later life refutes the prevailing myth that aging and sexual dysfunction are inexorably linked. Age-related physiological changes do not render a meaningful sexual relationship impossible or even necessarily difficult. Many of these physiological changes are modifiable. There are various therapeutic options available to patients to achieve maximum sexual capacity in old age. This article reviews the prevalence of sexual activity among older adults, the problems these adults encounter with sexual activity, and the role of the health care professional in addressing these problems. The physiological sex-related changes that occur as part of the normal aging process in men and women are reviewed, as well as the effect of age-related physical and psychological illness on sexual function. The attitudes and perceptions of the media and general public toward sexual activity and aging are summarized. An understanding of the sexual changes that accompany the aging process may help general practitioners and other doctors to give practical and useful advice on sexuality as well as refute the misconception that aging equates to celibacy. A thorough awareness of this aspect of older people's quality of life can raise meaningful expectations for aging patients. PMID:23540950

  13. Sexual self-schemas, sexual dysfunction, and the sexual responses of women with a history of childhood sexual abuse.

    PubMed

    Rellini, Alessandra H; Meston, Cindy M

    2011-04-01

    Accumulating evidence points to the mediating effects of sexual self-schemas on the sexual difficulties of women with a history of childhood sexual abuse (CSA). The following study adds to the extant literature by investigating (1) sexual function and (2) sexual satisfaction utilizing validated measures, and reporting on the relationship between sexual self-schemas and physiological (vaginal photoplethysmography), subjective, and affective responses during laboratory exposure to sexual stimuli. In a community sample of women with (N = 48) and without (N = 48) a history of CSA, we tested (1) the mediation of negative affect on the relation between sexual self-schemas and sexual function/satisfaction, (2) the mediation of negative affect in the relation between CSA and sexual function/satisfaction, and (3) the mediation of sexual self-schemas in the relation between a history of CSA and negative affect prior to sexual stimuli. We found that more Embarrassed/Conservative and less Romantic/Passionate sexual self-schemas predicted negative affect prior to exposure to sexual stimuli which, in turn, predicted levels of sexual satisfaction. The lower sexual satisfaction of CSA survivors was partially mediated by higher reports of negative affect prior to sexual stimuli. However, negative affect prior to sexual stimuli was not mediated by the sexual self-schemas of CSA survivors. Thus, although sexual self-schemas predicted sexual satisfaction, they did not predict variance in negative affect prior to sexual videos experienced by women with a history of CSA. PMID:21140286

  14. Drugs and sexual behavior.

    PubMed

    Bruno, Antonio; Scimeca, Giuseppe; Marino, Antonio G; Mento, Carmela; Micò, Umberto; Romeo, Vincenzo M; Pandolfo, Gianluca; Zoccali, Rocco; Muscatello, Maria R A

    2012-01-01

    This study investigated the association between drugs and sexual behavior in a sample of polydrug substance abusers recruited from several Italian therapeutic communities; participants were 90 polydrug substance abusers (opiates, cocaine, amphetamine, inhalants, marijuana/sedatives or hallucinogens abusers) who were compared with 90 nonsubstance-abusing individuals. Sexual behavior was measured by the Italian version of the Sex and the Average Woman (or Man; SAWM), a questionnaire that assesses different kind of sexual attitudes. Results showed that drug-abusing individuals are particularly inclined to search for sexual intercourse and are open to different kinds of sexual experiences; however, they have difficulties in establishing committed and deep relationships with their partners, showing signs of inhibition, affective detachment or anger. Their sexual lives are also surrounded by negative emotions, disturbing thoughts and maladjusted behaviors. The importance of integrating sexual problems into therapeutic strategies is discussed. PMID:23457886

  15. Hepatitis C virus infection in the asymptomatic British blood donor.

    PubMed

    Mutimer, D J; Harrison, R F; O'Donnell, K B; Shaw, J; Martin, B A; Atrah, H; Ala, F A; Skidmore, S; Hubscher, S G; Neuberger, J M

    1995-01-01

    Blood donor screening for hepatitis C virus (HCV) antibodies is now routine. Most blood transfusion services recommend that seropositive donors are referred for further investigation. Southern European studies suggest that many asymptomatic seropositive donors have clinically significant liver disease. Seropositive donors in areas of high prevalence may not, however, be representative of British donors. We have prospectively examined the prevalence and severity of HCV infection in a British volunteer blood donor population. During a 14 month period, only 0.35% (999/287,332) of all donors in the West Midlands were anti-HCV (screening assay) positive. Only 5% (52/999) of these were confirmed true seropositive. Nearly 80% (41/52) of seropositive donors were referred to the Queen Elizabeth Hospital Liver Unit for further investigation. Most underwent complete investigation, including liver biopsy. Forty of forty-one donors had biochemical, histological, or virological evidence of persistent viral infection. Histological changes were generally mild and none was cirrhotic. Covertly infected patients had less severe disease than those with an overt risk factor for HCV exposure. In the British Midlands, the prevalence of blood donor seropositivity is low. In contrast with seropositive Southern European donors, the British donor is more likely to belong to an at-risk group for parenteral exposure and is less likely to have severe histological changes. This study highlights the importance of developing locally relevant guidelines for the counselling and investigation of anti-HCV-positive blood donors. PMID:7493294

  16. COMPARISON OF METHODS TO IDENTIFY Neisseria meningitidis IN ASYMPTOMATIC CARRIERS

    PubMed Central

    RIZEK, Camila F.; LUIZ, André Machado; de ASSIS, Gracilene Ramos; COSTA, Silvia Figueiredo; LEVIN, Anna Sara; LOPES, Marta Heloisa

    2016-01-01

    SUMMARY Neisseria meningitidis is a cause of several life-threatening diseases and can be a normal commensal in the upper respiratory tract of healthy carriers. The carrier rate is not well established especially because there is no standard method for the isolation of N. meningitidis. Therefore, the aim of this study was to compare identification methods for the carrier state. Two swabs were collected from 190 volunteers: one was cultured and the other had DNA extracted directly from the sample. The Polymerase Chain Reaction (PCR) was performed to determine species and serogroups and compared the results between the methods. PCR for species determination used two pairs of primers and when there was only one amplicon, it was sequenced. The culture technique was positive in 23 (12.1%) subjects while the direct extraction method was positive in 132 (69.5%), p < 0.001. Among the 135 subjects with positive N. meningitides tests, 88 (65.2%) were serogroup C; 3 (2.2%) serogroup B; 5 (3.7%) were positive for both serogroup B and C, and 39 (28.9%) did not belong to any of the tested serogroups. In this study, PCR from DNA extracted directly from swabs identified more N. meningitidis asymptomatic carriers than the culture technique. PMID:27680165

  17. Evaluation of the patient with asymptomatic microscopic hematuria.

    PubMed

    Ziemba, Justin; Guzzo, Thomas J; Ramchandani, Parvati

    2015-08-01

    Asymptomatic microscopic hematuria (AMH) is relatively common in clinical practice but the etiology remains unclear in the majority of patients; it is rarely related to genitourinary malignancies. The 2012 guidelines of the American Urological Association recommend an evaluation after a single positive urinalysis with mandatory upper tract evaluation in all patients, preferably with CT urography (CTU). The likelihood of detecting significant upper track abnormalities, particularly malignancies is low with CTU, while incidental extraurinary abnormalities are often found, the majority of which are not clinically significant. The workup for these incidental findings has significant financial and clinical implications. Primary care physicians, who are most apt to encounter patients with AMH, have a low rate of adherence to the AUA guidelines, possibly as a result of the broadening of criteria for AMH evaluation by the AUA, with resultant uncertainty amongst primary care physicians about the appropriate candidates for such evaluation. Selection of subgroups of patients with risk factors for GU malignancies who may benefit from a complete evaluation is essential, as opposed to evaluation of all patients classified as having AMH.

  18. Prevalence of asymptomatic cardiac valve anomalies in idiopathic scoliosis.

    PubMed

    Colomina, M J; Puig, L; Godet, C; Villanueva, C; Bago, J

    2002-01-01

    The prevalence of asymptomatic cardiac valve anomalies was determined in 82 patients (69 females and 13 males) diagnosed as having idiopathic scoliosis and scheduled for corrective surgery (mean age at surgery 16.3 years). The preoperative study in each patient included echocardiography and ultrasound Doppler. Twenty-three valvular anomalies were found in 20 patients (24.4%). The most frequent was mitral valve prolapse. The occurrence of valvular anomalies did not correlate with sex, curve magnitude, or age at diagnosis. Eighteen patients presented a total of 20 comorbid conditions: positive family history of scoliosis (five cases), isthmic spondylolisthesis (five cases), nervous anorexia (two cases), hereditary exostosis, cystic fibrosis, ureteral stenosis, mammary hypoplasia, slipped capital femoral epiphysis, psoriasis, celiac disease, and lactose intolerance. A significant relationship was found between valvular anomalies and comorbidity. Valvular anomalies were detected in 11 out of 64 patients (17.2%) with no comorbidity and in nine out of 18 patients (50%) with a comorbid condition (Chi-square 8.2, p = 0.004). In this latter group of patients, routine echocardiographic study seems advisable in the preoperative evaluation. PMID:12170360

  19. Evaluation of the patient with asymptomatic microscopic hematuria.

    PubMed

    Ziemba, Justin; Guzzo, Thomas J; Ramchandani, Parvati

    2015-08-01

    Asymptomatic microscopic hematuria (AMH) is relatively common in clinical practice but the etiology remains unclear in the majority of patients; it is rarely related to genitourinary malignancies. The 2012 guidelines of the American Urological Association recommend an evaluation after a single positive urinalysis with mandatory upper tract evaluation in all patients, preferably with CT urography (CTU). The likelihood of detecting significant upper track abnormalities, particularly malignancies is low with CTU, while incidental extraurinary abnormalities are often found, the majority of which are not clinically significant. The workup for these incidental findings has significant financial and clinical implications. Primary care physicians, who are most apt to encounter patients with AMH, have a low rate of adherence to the AUA guidelines, possibly as a result of the broadening of criteria for AMH evaluation by the AUA, with resultant uncertainty amongst primary care physicians about the appropriate candidates for such evaluation. Selection of subgroups of patients with risk factors for GU malignancies who may benefit from a complete evaluation is essential, as opposed to evaluation of all patients classified as having AMH. PMID:26100195

  20. Guidelines for noninvasive evaluation of asymptomatic carotid bruits.

    PubMed

    Kartchner, M M; McRae, L P

    1981-01-01

    Basic recommendations for follow-up utilizing OPG/CPA results are as follows: Grade 1: Repeat studies in 12 months in the absence of specific focal TIAs or increase of bifurcation level bruit. Grade 2: Serial studies in 6 to 12 months in the absence of focal TIAs which provide their own indications for evaluation. If stability is established, 12-month interval testing is adequate. Grade 3: Serial studies in 3 to 6 months until a progression trend is established. Anticipation of major surgery with possible hypotension or severe blood loss is an indication for arteriography and possible endarterectomy. Grade 4: If repeat studies confirm grade 4 status, prophylactic carotid arteriography and endarterectomy should be seriously considered. If surgery is not employed, repeat OPG/CPA evaluation at 2 to 4 month intervals detects further progression toward total occlusion. Grade 5: Indications for arteriography in anticipation of surgery are tempered by the lower probability (30%) of a surgically correctable stenosis and the clinical status of the patient. In conclusion, we feel that OPG/CPA represents one valid means of noninvasively evaluating the presence and underlying hemodynamic significance of an asymptomatic bruit with sufficient reliability to justify angiography and prophylactic carotid endarterectomy on the basis of appropriate findings.

  1. Neurocognitive correlates of alexithymia in asymptomatic individuals with HIV.

    PubMed

    Bogdanova, Yelena; Díaz-Santos, Mirella; Cronin-Golomb, Alice

    2010-04-01

    Alexithymia, an impairment of affective and cognitive emotional processing, is often associated with human immunodeficiency virus (HIV) and may reflect effects of the virus on brain areas that are also important for multiple cognitive functions, such as the prefrontal and anterior cingulate cortices. We hypothesized that there would be a correlation between extent of alexithymia and cognitive performance associated with these brain areas, including attention, executive function, and visuospatial processing. Thirty-four asymptomatic HIV+ participants and 34 matched healthy HIV- volunteers were administered the Toronto Alexithymia Scale, a series of neuropsychological tests, and measures of apathy, depression, and quality of life (QoL). The HIV+ participants had significantly higher levels of alexithymia, depression and apathy than the HIV- group. The extent of alexithymia and two of its processing components (Difficulty Describing Feelings [DDF] and Externally Oriented Thinking), but not depression, correlated with performance on measures of executive and visuospatial abilities, consistent with dysfunction of the frontostriatal circuits and their cortical projections. Apathy was related to alexithymia and two processing components (Difficulty Identifying Feelings and DDF) but to only one cognitive measure. The higher rate of alexithymia, as well as cognitive dysfunction, in HIV may be a consequence of the infection on the frontostriatal system and its cortical connections. Our findings also demonstrated a dissociation of apathy and alexithymia in HIV, pointing to overlapping but distinct neural substrates within frontostriatal circuits. Alexithymia correlated strongly with QoL ratings, underscoring the importance of assessment and treatment of HIV-associated emotional and cognitive processing deficits.

  2. Mammographic Breast Density Patterns in Asymptomatic Mexican Women

    PubMed Central

    Calderón-Garcidueñas, Ana Laura; Sanabria-Mondragón, Mónica; Hernández-Beltrán, Lourdes; López-Amador, Noé; Cerda-Flores, Ricardo M.

    2012-01-01

    Breast density (BD) is a risk factor for breast cancer. Aims. To describe BD patterns in asymptomatic Mexican women and the pathological mammographic findings. Methods and Material. Prospective, descriptive, and comparative study. Women answered a questionnaire and their mammograms were analyzed according to BI-RADS. Univariate (χ2) and conditional logistic regression analyses were performed. Results. In 300 women studied the BD patterns were fat 56.7% (170), fibroglandular 29% (87), heterogeneously dense 5.7% (17), and dense pattern 8.6% (26). Prevalence of fat pattern was significantly different in women under 50 years (37.6%, 44/117) and older than 50 (68.8%, 126/183). Patterns of high breast density (BD) (dense + heterogeneously dense) were observed in 25.6% (30/117) of women ≤50 years and 7.1% (13/183) of women >50. Asymmetry in BD was observed in 22% (66/300). Compression cone ruled out underlying disease in 56 cases. In the remaining 10, biopsy revealed one fibroadenoma, one complex cyst, and 6 invasive and 2 intraductal carcinomas. 2.6% (8/300) of patients had non-palpable carcinomas. Benign lesions were observed in 63.3% (190/300) of cases, vascular calcification in 150 cases (78.9%), and fat necrosis in 38 cases (20%). Conclusions. Mexican women have a low percentage of high-density patterns. PMID:23346398

  3. Asymptomatic abdominal wall endometrioma 15 years after cesarean section.

    PubMed

    Tica, V I; Tomescu, C L; Tomescu, Aneta; Micu, Luminiţa; Zaher, M; Bafani, S; Beghim, M; Serbănescu, L; Tica, Irina

    2006-01-01

    Abdominal wall endometriosis is rare and its diagnosis is difficult. However, the consequences may be serious, like recurrences or even malignant transformation. We report a rarer case of asymptomatic abdominal wall endometrioma, accidentally found during a surgical procedure for a second cesarean section, in a 39-years old patient, without any relevant history of endometriosis. The tumor was subcutaneous, 3/3 cm in size, located in the left angle of the incision from the 15 years previously performed cesarean section and freely mobile in relation with the skin and the fascia. It was excised, with clear margins (to prevent recurrences), during the procedure. The patient was discharged after five days. The postoperative period and the follow-up at one and three months were uneventful. The pathological examination clarified the diagnosis by revealing an endometrioma with decidual reaction. Such a condition may be, therefore, evoked before an abdominal wall tumor, even without specific symptoms, even in a 39-years old woman and longtime after the possible causal surgery. Pathological examination remains the ultimate diagnostic tool. Relevant prophylactic attitude at the end of the cesarean section may be considered.

  4. Nitric oxide radicals in leucocytes and vaginal washes of Trichomonas vaginalis -infected symptomatic and asymptomatic women.

    PubMed

    Yadav, M; Dubey, M L; Gupta, I; Malla, N

    2006-03-01

    The clinical spectrum of Trichomonas vaginalis infection varies from asymptomatic to mild, moderate or severe vaginitis. Nitric oxide and other reactive nitrogen radicals produced by immune effector cells are important cytotoxic and cytostatic mediators against several microorganisms including parasites. In the present study, inducible nitric oxide synthase (iNOS) and reactive nitrogen intermediates (RNI) were determined in leucocyte cultures (stimulated with T. vaginalis in vitro) and vaginal washes (VWs) of 22 symptomatic and 20 asymptomatic T. vaginalis-infected and 20 healthy women by immunoblotting and Griess method respectively. The iNOS protein was detected in leucocytes and VWs of all the symptomatic and asymptomatic women, but was not detected in any of the samples from healthy women. Mean iNOS protein band intensity was significantly higher in leucocytes as compared to VWs (P<0.001) of both symptomatic and asymptomatic women and was also higher in leucocytes of asymptomatic as compared to symptomatic women (P<0.05). Mean RNI concentration was also significantly higher in leucocytes (P<0.01) and VWs (P<0.05) of asymptomatic as compared to symptomatic women, and was also higher in samples of infected as compared to healthy women (P<0.001). These results suggest that reactive nitrogen radicals may have a role in limiting T. vaginalis infection in asymptomatic women. PMID:16529664

  5. Outcome and survival of asymptomatic PML in natalizumab-treated MS patients

    PubMed Central

    Dong-Si, Tuan; Richman, Sandra; Wattjes, Mike P; Wenten, Made; Gheuens, Sarah; Philip, Jeffrey; Datta, Shoibal; McIninch, James; Bozic, Carmen; Bloomgren, Gary; Richert, Nancy

    2014-01-01

    Objective As of 3 September 2013, 399 cases of natalizumab-associated progressive multifocal leukoencephalopathy (PML) were confirmed in multiple sclerosis (MS) patients. We evaluated outcomes of natalizumab-treated MS patients who were asymptomatic at PML diagnosis. Methods Analyses included data available as of 5 June 2013. Asymptomatic patients diagnosed with PML by magnetic resonance imaging (MRI) findings and JC virus DNA detection in the central nervous system were compared with patients presenting with symptoms at diagnosis. Demographics, MRI, and survival over 12 months were analyzed. Expanded Disability Status Scale (EDSS) and Karnofsky Performance Scale (KPS) scores were recorded pre-PML, at diagnosis, and at 6 and 12 months post-diagnosis. Results A total of 372 PML cases were analyzed; 30 patients were asymptomatic and 342 were symptomatic at PML diagnosis. Classifications of PML lesions on MRI in asymptomatic versus symptomatic patients were unilobar in 68% versus 37%, multilobar in 21% versus 24%, and widespread in 11% versus 40%. In both groups with unilobar lesions, frontal lobe lesions predominated. Prior to PML, mean EDSS and KPS scores were similar for asymptomatic and symptomatic patients. At diagnosis, mean EDSS score was significantly lower for asymptomatic patients (4.1; n = 11) than for symptomatic patients (5.4; n = 193; P = 0.038). Six months after PML diagnosis, asymptomatic patients had less functional disability than symptomatic patients. As of 5 June 2013, 96.7% of asymptomatic patients and 75.4% of symptomatic patients were alive. Interpretation PML patients asymptomatic at diagnosis had better survival and less functional disability than those who were symptomatic at diagnosis. PMID:25493267

  6. Respiratory Viral Detections During Symptomatic and Asymptomatic Periods in Young Andean Children

    PubMed Central

    Howard, Leigh M.; Johnson, Monika; Williams, John V.; Zhu, Yuwei; Gil, Ana I.; Edwards, Kathryn M.; Griffin, Marie R.; Lanata, Claudio F.; Grijalva, Carlos G.

    2015-01-01

    Background Viruses are commonly detected in children with acute respiratory illnesses (ARI) and in asymptomatic children. Longitudinal studies of viral detections during asymptomatic periods surrounding ARI could facilitate interpretation of viral detections but are currently scant. Methods We used reverse transcription-polymerase chain reaction (RT-PCR) to analyze respiratory samples from young Andean children for viruses during asymptomatic periods within 8-120 days of index ARI (cough or fever). We compared viral detections over time within children and explored RT-PCR cycle thresholds (CT) as surrogates for viral loads. Results At least one respiratory virus was detected in 367 (43%) of 859 samples collected during asymptomatic periods, with more frequent detections in periods with rhinorrhea (49%) than those without (34%, p<0.001). Relative to index ARI with human rhinovirus (HRV), adenovirus (AdV), respiratory syncytial virus (RSV), and parainfluenza virus (PIV) detected, the same virus was also detected during 32%, 22%, 10%, and 3% of asymptomatic periods, respectively. RSV was only detected 8-30 days after index RSV ARI, whereas HRV and AdV were detected throughout asymptomatic periods. Human metapneumovirus (MPV) and influenza were rarely detected during asymptomatic periods (<3%). No significant differences were observed in the CT for HRV or AdV during asymptomatic periods relative to ARI. For RSV, CT were significantly lower during ARI relative to the asymptomatic period (p=0.03). Conclusions These findings indicate that influenza, MPV, PIV, and RSV detections in children with ARI usually indicate a causal relationship. When HRV or AdV is detected during ARI, the causal relationship is less certain. PMID:26121205

  7. Sexually transmitted disease control in China (1949-1994).

    PubMed

    Shao, C; Xu, W; Ye, G

    1996-12-01

    This paper summarizes the historical experiences in venereal disease control in China during the 1950s. Venereal diseases had been all but eliminated in the whole country till 1964. However, along with the implementation of open-door policy and economic reform in the 1980s, the social environment was changed to a great extent in this country. Sexually transmitted diseases (STDs) were re-introduced in the Chinese mainland and new foci of infection established themselves in some cities. During the recent 8 years the national STD case-reporting and sentinel surveillance systems have been set up. The results of surveillance show that the annual incidence of STD has been on the increase. The existing factors associated with the increasing incidence of STD mainly are; population movement, increasing affluence in a part of population, the availability of multiple sexual partners (including the prostitution) and asymptomatic STD increased. Finally, the strategies for STD control are discussed in detail. PMID:9387394

  8. Late Adolescent Girls' Sexual Experiences and Sexual Satisfaction

    ERIC Educational Resources Information Center

    Impett, Emily A.; Tolman, Deborah L.

    2006-01-01

    This study presented and tested a model of sexual satisfaction for late adolescent girls. In this model, sexual self-concept and approach sexual motives were tested as predictors of adolescent girls' sexual satisfaction with their most recent experience of sexual intercourse. A total of 116 girls in 12th grade (ages 16-19) completed measures of…

  9. Abnormal findings on knee magnetic resonance imaging in asymptomatic NBA players.

    PubMed

    Walczak, Brian E; McCulloch, Patrick C; Kang, Richard W; Zelazny, Anthony; Tedeschi, Fred; Cole, Brian J

    2008-01-01

    The purpose of this study was to evaluate the knees of asymptomatic National Basketball Association (NBA) players via magnetic resonance imaging (MRI) and confirm or dispute findings reported in the previous literature. It is thought that a variety of significant abnormalities affecting the knee exist in asymptomatic patients and that these findings can be accurately identified on MRI. Two months prior to the 2005 season, bilateral knee MRI examinations of 14 asymptomatic NBA players (28 knees) were evaluated for abnormalities of the articular cartilage, menisci, and patellar and quadriceps tendons. The presence of joint effusion, subchondral edema, and cystic lesions and the integrity of the collateral and cruciate ligaments were also assessed.

  10. Youth Who Sexual Offended

    PubMed Central

    Koh, Li Lian; Zeng, Gerald; Teoh, Jennifer

    2015-01-01

    There has been an increased focus on understanding youth sexual offending in recent years, but there has been limited empirical research on the causes, pathways, and treatment of youth who have sexually offended—especially within a non-Western context. The Good Lives and Self-Regulation Models have often been used to understand and rehabilitate adult sexual offenders, but (unfortunately) there is scant research on youth who sexually offended using these models. The present study aims to describe the different primary goods that are associated with youth sexual offending behaviors in an Asian context. In addition, the study sought to explore whether the age of victim (child vs. nonchild) and nature of sexual offense (penetrative vs. nonpenetrative) influenced the youth’s engagement in offense pathways. The results suggest that pleasure, relatedness, and inner peace were the primary human goods that were most sought after by a sample of 168 youth who sexually offended in Singapore. In addition, offender classification (in relation to the age of victim and nature of sexual offense) influenced the pathways to sexual offending. Therefore, these findings have important clinical implications for assessment, management, and intervention planning for youth who sexually offended. PMID:24048701

  11. [Sexually transmitted diseases: epidemiological and social aspects].

    PubMed

    Marin, V; Bertoncello, C

    2002-01-01

    STDs represent a major public health problem for two reasons: their serious sequelae and the facts that they facilitate transmission of HIV. This article presents WHO estimates new cases of some of curable STDs, and italian data from national reporting system (published from ISTAT and ISS). The number of new reported cases decreases in Italy, but reported cases are not all cases. People with STDs tend not to seek treatment or to self-medicate, this behaviour is common in youths. In many cases STDs are asymptomatic in both sexes, particularly in women. Women are also much more vulnerable biologically, culturally, socioeconomically. There is also a lack of notification by physicians. Important social determinants of STDs diffusion are migration and travels. Prevention and control of STDs need collaboration between medical disciplines: gynaecology, urology, dermo-venerology, microbiology, epidemiology, public health. Contributions of nurses, laboratory technician and social workers are also required. The role of public health specialists in the prevention is strictly related to health education. Health education will promote responsible sexual behaviour and early recourse to health services by people with STDs and their sexual partners. PMID:12070901

  12. Management of small asymptomatic abdominal aortic aneurysms – a review

    PubMed Central

    Silaghi, H; Branchereau, A; Malikov, S; Andercou, Aurel

    2007-01-01

    The approach for abdominal aortic aneurysms (AAAs) larger than 55 mm is well defined due to the risk of rupture being higher than 10% per year, and a 30-day perioperative mortality rate between 2.5% and 5%. However, the approach for small asymptomatic AAAs is less well defined. There are different definitions given to describe a small AAA. The one the authors accepted and applied is “a localized, permanent and irreversible dilation of the aorta of at least 50% in relation to the normal adjacent infrarenal or suprarenal aorta, with a maximum diameter between 30–55 mm”. The investigators of the largest study on small AAAs (United Kingdom Small Aneurysm Trial [UK-SAT]) concluded, in brief, that ultrasound monitoring is the most appropriate solution because the results do not support a policy of surgical restoration for AAAs with a diameter of between 40 mm and 55 mm. The aim of the present review article is to highlight several challenges that could change the limits or create a more flexible deciding factor in the management of AAAs. There are multiple factors that influence surgical decision-making, and the limit on aneurysm diameter that indicates surgery should depend on the patient’s age, life expectancy, general status, associated diseases, diameter in relation to body mass, risk factors, sex, anxiety and compliance during the follow-up period. Monitoring is an acceptable alternative for AAAs between 40 mm and 55 mm, and is probably the best solution for high-risk patients. Surgery is the most reasonable solution for patients who are at moderate risk, have a significant life expectancy, are less than 70 to 75 years of age, and/or have aortic aneurysms larger than 50 mm. PMID:22477326

  13. T1 Relaxation Time in Lungs of Asymptomatic Smokers

    PubMed Central

    Alamidi, Daniel F.; Kindvall, Simon S. I.; Hubbard Cristinacce, Penny L.; McGrath, Deirdre M.; Young, Simon S.; Naish, Josephine H.; Waterton, John C.; Wollmer, Per; Diaz, Sandra; Olsson, Marita; Hockings, Paul D.; Lagerstrand, Kerstin M.; Parker, Geoffrey J. M.; Olsson, Lars E.

    2016-01-01

    Purpose Interest in using T1 as a potential MRI biomarker of chronic obstructive pulmonary disease (COPD) has recently increased. Since tobacco smoking is the major risk factor for development of COPD, the aim for this study was to examine whether tobacco smoking, pack-years (PY), influenced T1 of the lung parenchyma in asymptomatic current smokers. Materials and Methods Lung T1 measurements from 35 subjects, 23 never smokers and 12 current smokers were retrospectively analyzed from an institutional review board approved study. All 35 subjects underwent pulmonary function test (PFT) measurements and lung T1, with similar T1 measurement protocols. A backward linear model of T1 as a function of FEV1, FVC, weight, height, age and PY was tested. Results A significant correlation between lung T1 and PY was found with a negative slope of -3.2 ms/year (95% confidence interval [CI] [-5.8, -0.6], p = 0.02), when adjusted for age and height. Lung T1 shortens with ageing among all subjects, -4.0 ms/year (95%CI [-6.3, -1.7], p = 0.001), and among the never smokers, -3.7 ms/year (95%CI [-6.0, -1.3], p = 0.003). Conclusions A correlation between lung T1 and PY when adjusted for both age and height was found, and T1 of the lung shortens with ageing. Accordingly, PY and age can be significant confounding factors when T1 is used as a biomarker in lung MRI studies that must be taken into account to detect underlying patterns of disease. PMID:26958856

  14. Dental occlusion influences knee muscular performances in asymptomatic females.

    PubMed

    Grosdent, Stéphanie; O'Thanh, Roseline; Domken, Olivier; Lamy, Marc; Croisier, Jean-Louis

    2013-09-14

    Some authors claim that occlusal appliances can enhance athletic performance. Therefore this study investigated the influence of dental occlusion on knee muscle strength performance. Twelve healthy female subjects (mean age 24.1 ± 3.1 years) without temporomandibular joint dysfunction participated in this study. Isokinetic quadriceps and hamstring strength were assessed in relation to three randomized jaw conditions: mouth closed in maximum intercuspidation without splint, mouth closed on a balanced splint which optimized contact over the dental arch, mouth closed on a piece of resin of 1 mm which created an imbalanced occlusion. Tests were performed at 60°/s and 240°/s in concentric and 30°/s in eccentric exertions. Concentric performances did not show any significant difference between the 3 jaw conditions (p > 0.05). By contrast, in the eccentric trials related to quadriceps performance, significant differences (p < 0.05) were observed between the resin condition and the two other modalities (without splint or with a balanced splint). The imbalanced occlusion created by the resin component corresponded to an average decrease of 9% in eccentric peak torque. The eccentric hamstring peak torques also showed a significant difference (p < 0.05) between measurements with splint and with resin (7% decrease when occlusion was imbalanced). In conclusion, among asymptomatic females, artificial imbalanced occlusion induces immediate and significant alteration of knee eccentric muscle performances. Therefore, occlusion examination should be undertaken on a regular and frequent basis for high-level athletes. Moreover, for athletes using mouthguards, muscular performance assessments should be planned with and without the dental protection.

  15. Dental occlusion influences knee muscular performances in asymptomatic females.

    PubMed

    Grosdent, Stéphanie; O'Thanh, Roseline; Domken, Olivier; Lamy, Marc; Croisier, Jean-Louis

    2014-02-01

    Some authors claim that occlusal appliances can enhance athletic performance. Therefore, this study investigated the influence of dental occlusion on knee muscle strength performance. Twelve healthy female subjects (mean age, 24.1 ± 3.1 years) without temporomandibular joint dysfunction participated in this study. Isokinetic quadriceps and hamstring strength were assessed in relation to 3 randomized jaw conditions: mouth closed in maximum intercuspidation without splint, mouth closed on a balanced splint which optimized contact over the dental arch, mouth closed on a piece of resin of 1 mm which created an imbalanced occlusion. Tests were performed at 60 and 240°·s in concentric and 30°·s in eccentric exertions. Concentric performances did not show any significant difference between the 3 jaw conditions (p > 0.05). In contrast, in the eccentric trials related to quadriceps performance, significant differences (p ≤ 0.05) were observed between the resin condition and the 2 other modalities (without splint or with a balanced splint). The imbalanced occlusion created by the resin component corresponded to an average decrease of 9% in eccentric peak torque. The eccentric hamstring peak torques also showed a significant difference (p ≤ 0.05) between measurements with splint and with resin (7% decrease when occlusion was imbalanced). In conclusion, among asymptomatic females, artificial imbalanced occlusion induces immediate and significant alteration of knee eccentric muscle performances. Therefore, occlusion examination should be undertaken on a regular and frequent basis for high-level athletes. Moreover, for athletes using mouthguards, muscular performance assessments should be planned with and without the dental protection.

  16. Cool dialysate reduces asymptomatic intradialytic hypotension and increases baroreflex variability.

    PubMed

    Chesterton, Lindsay J; Selby, Nicholas M; Burton, James O; McIntyre, Chris W

    2009-04-01

    Intradialytic hypotension (IDH) remains an important cause of morbidity and mortality in chronic hemodialysis (HD) patients and can be ameliorated by cool temperature HD. The baroreflex arc is under autonomic control and is essential in the short-term regulation of blood pressure (BP). This study aimed to investigate if the baroreflex sensitivity (BRS) response to HD differed between standard and cool-temperature dialysate. Ten patients (mean age 67+/-2 years) prone to IDH were recruited into a randomized, crossover study to compare BRS variation at dialysate temperatures of 37 degrees C (HD(37)) and 35 degrees C (HD(35)). Each patient underwent continuous beat-to-beat BP monitoring during a dialysis session of HD(37) and HD(35). During HD(37) 2 patients developed symptomatic IDH, as opposed to 1 with HD(35). However, asymptomatic IDH occurred with a frequency of 0.4 episodes per session with HD(35) and 6.2 episodes per session during HD(37) (odds ratio15.5; 95%CI 5.6-14.2). Although absolute BRS measurements did not differ between the 2 modalities, BRS variability increased during HD(35). Our study has demonstrated that in IDH-prone patients, cool HD resulted in a reduction in heart rate and a greater reduction in cardiac output and stroke volume. Mean arterial pressure was maintained through a significantly greater increase in total peripheral resistance. Furthermore, although absolute BRS values during HD were not significantly altered by a reduction in dialysate temperature, there was a greater percentage increase in BRS values during cool HD. Understanding the varied causes of, and categorizing impaired hemodynamic responses to HD will enable further individualization of HD prescriptions according to patient need.

  17. Early diagnosis of asymptomatic oral and oropharyngeal squamous cancers.

    PubMed

    Mashberg, A; Samit, A

    1995-01-01

    An examination of the oral cavity and oropharynx in asymptomatic patients at high risk requires an orderly visual inspection of the entire oral and oropharyngeal mucosa with particular attention to the tongue, floor of mouth, soft palate, uvula, tonsillar pillars, and the lingual aspects of the retromolar trigones. Completion and clear documentation of the entire examination should be recorded. Detected lesions that do not resolve in a reasonable length of time--two to three weeks--require intense and assiduous investigation. The following specifics should be considered. 1. Alcohol drinkers and cigarette smokers, especially those 40 years of age and older, are at very high risk for the development of upper aerodigestive tract and lung squamous carcinomas. 2. The floor of the mouth, the ventrolateral tongue, and the soft palate complex are the high-risk sites within the oral cavity and oropharynx. 3. Persistent mucosal erythroplasia rather than leukoplakia is the earliest visual sign of oral and oropharyngeal carcinoma. These lesions should not be regarded merely as precancerous changes. The evidence indicates that these lesions in high-risk sites should be considered to be invasive carcinoma or carcinoma in situ unless proven otherwise by biopsy. 4. Toluidine blue staining is a useful diagnostic adjunct, particularly as a method of ruling out false-negative clinical impressions. It may also be used as a rinse in high-risk patients to encompass the entire oral mucosa after a negative clinical examination and as a guide to improve biopsy yields. 5. If oral or oropharyngeal cancer is identified, evaluations of the larynx, hypopharynx, esophagus, and lungs should be performed to rule out multiple primary cancers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7583906

  18. Mechanism of gastroesophageal reflux in recumbent asymptomatic human subjects.

    PubMed

    Dent, J; Dodds, W J; Friedman, R H; Sekiguchi, T; Hogan, W J; Arndorfer, R C; Petrie, D J

    1980-02-01

    We investigated the mechanism of gastroesophageal reflux (GER) in 10 health volunteer subjects. Continuous recordings of intraluminal esophageal pH and pressure were obtained on two consecutive nights from 6:00 p.m. to 6:30 a.m. in each subject. During each study, the subject remained recumbent, except to eat a standardized meal after 1 h of basal recording. A manometric assembly with seven recording lumens monitored: (a) lower esophageal sphincter (LES) pressure via a sleeve device 6.5 cm in length, (b) esophageal-body motor activity, (c) swallowing activity in the pharynx, and (d) gastric pressure. An electrode 5 cm above the LES recorded esophageal pH. Sleep was monitored by electroencephalogram. All subjects showed wide variations of basal LES pressure. GER was not related to low steady-state basal LES pressure, but rather occurred during transient 5-30 s episodes of inappropriate complete LES relaxation. The inappropriate LES relaxations were usually either spontaneous or immediately followed appropriate sphincter relaxation induced by swallowing. The majority of GER episodes occurred within the first 3 h after eating. During the night LES relaxation and GER occurred only during transient arousals from sleep or when the subjects were fully awake, but not during stable sleep. After GER the esophagus was generally cleared of refluxed acid by primary peristalsis and less frequently by secondary peristalsis. Nonperistaltic contractions were less effective than peristalsis for clearing acid from the esophagus. We conclude that in asymptomatic recumbent subjects GER is related to transient inappropriate LES relaxations rather than to low steady-state basal LES pressure and also, that primary perstalsis is the major mechanism that clears the esophagus of refluxed material.

  19. Masculinity, Femininity, Androgyny and Sexuality.

    ERIC Educational Resources Information Center

    Rockford, Marcia; Galbraith, Gary G.

    The purpose of this study was to investigate the relationships between masculinity, feminity, and androgyny and measures of sexual behavior, attitudes and knowledge. Sexual attitudes and knowledge were assessed by use of the Sexual Knowledge and Attitudes Test, and sexual behavior was assessed by means of the Sexual Experiences Inventory. Subjects…

  20. Sexual conflict in hermaphrodites.

    PubMed

    Schärer, Lukas; Janicke, Tim; Ramm, Steven A

    2015-01-01

    Hermaphrodites combine the male and female sex functions into a single individual, either sequentially or simultaneously. This simple fact means that they exhibit both similarities and differences in the way in which they experience, and respond to, sexual conflict compared to separate-sexed organisms. Here, we focus on clarifying how sexual conflict concepts can be adapted to apply to all anisogamous sexual systems and review unique (or especially important) aspects of sexual conflict in hermaphroditic animals. These include conflicts over the timing of sex change in sequential hermaphrodites, and in simultaneous hermaphrodites, over both sex roles and the postmating manipulation of the sperm recipient by the sperm donor. Extending and applying sexual conflict thinking to hermaphrodites can identify general evolutionary principles and help explain some of the unique reproductive diversity found among animals exhibiting this widespread but to date understudied sexual system. PMID:25237131

  1. Mediators of Sexual Revictimization Risk in Adult Sexual Assault Victims

    PubMed Central

    Ullman, Sarah E.; Vasquez, Amanda L.

    2015-01-01

    This study examined sexual risk behaviors and sexual refusal assertiveness in relationship to child sexual abuse (CSA), emotion dysregulation, and adult sexual revictimization. Path analyses of 1,094 survivors who had sex in the past year were done to examine sexual risk behavior, and sexual refusal assertiveness mediational pathways by which CSA severity and emotion dysregulation may affect revictimization over one year in adult female sexual assault survivors. Exchanging sex for money and sexual refusal assertiveness were significantly associated with emotion dysregulation, whereas exchanging sex for money, and not sexual refusal assertiveness, was only significantly related to CSA severity. Both exchanging sex for money and sex refusal assertiveness mediated the relationship between emotion dysregulation and adult sexual revictimization. Exchanging sex for money mediated the CSA severity-revictimization relationship. These findings demonstrate the importance of considering both risky and protective sexual behaviors in research and prevention programming that address sexual revictimization in women. PMID:25942287

  2. Comparison of trans-perineal ultrasound-guided pressure augmented saline colostomy distension study and conventional contrast radiographic colostography in children with anorectal malformation

    PubMed Central

    Ekwunife, Okechukwu Hyginus; Umeh, Eric Okechukwu; Ugwu, Jideofor Okechukwu; Ebubedike, Uzoamaka Rufina; Okoli, Chinedu Christian; Modekwe, Victor Ifeanyichukwu; Elendu, Kelechi Collins

    2016-01-01

    Background: In children with high and intermediate anorectal malformation, distal colostography is an important investigation done to determine the relationship between the position of the rectal pouch and the probable site of the neo-anus as well as the presence or absence of a fistula. Conventionally, this is done using contrast with fluoroscopy or still X-ray imaging. This, however, has the challenges of irradiation, availability and affordability, especially in developing countries. This study compared the accuracy of trans-perineal ultrasound-guided pressure augmented saline colostomy distension study (SCDS) with conventional contrast distal colostography (CCDC) in the determination of the precise location of the distal rectal pouch and in detecting the presence and site of fistulous communication between the rectum and the urogenital tract was studied. Materials and Methods: Trans-perineal ultrasound-guided pressure augmented SCDS, CCDC and intra-operative measurements were done sequentially for qualified infants with anorectal malformation and colostomy. Pouch skin distance and presence or absence of recto urinary or genital fistula was measured prospectively in each case. Statistical significance was inferred at P-value of <0.01. Results: There were thirteen infants, 9 males and 4 females. The age at onset of investigation ranged from 2 to 12 months with a median value of 9 months. Using paired t-test at a confidence interval of 95%, the P value when SCDS values are compared with CCDC is 0.19; and 0.06 when SCDS was compared with intra-operative measurements. Hence, there is no statistical difference as P > 0.01. On its ability to detect presence or absence of a fistula: SCDS had a sensitivity of 50.0%, specificity of 100.0%, accuracy of 69.2%, negative predictive value of fistulas of 55.6% and a positive predictive value of fistulas of 100.0%. Conclusion: Ultrasound-guided pressure augmented SCDS can safely and reliably be used to assess the distal colonic

  3. Impact of mosquito bites on asexual parasite density and gametocyte prevalence in asymptomatic chronic Plasmodium falciparum infections and correlation with IgE and IgG titers.

    PubMed

    Lawaly, Ramatoulaye; Konate, Lassana; Marrama, Laurence; Dia, Ibrahima; Diallo, Diawo; Diène Sarr, Fatoumata; Schneider, Bradley S; Casademont, Isabelle; Diallo, Mawlouth; Brey, Paul T; Sakuntabhai, Anavaj; Mecheri, Salah; Paul, Richard

    2012-06-01

    An immunomodulatory role of arthropod saliva has been well documented, but evidence for an effect on Plasmodium sp. infectiousness remains controversial. Mosquito saliva may orient the immune response toward a Th2 profile, thereby priming a Th2 response against subsequent antigens, including Plasmodium. Orientation toward a Th1 versus a Th2 profile promotes IgG and IgE proliferation, respectively, where the former is crucial for the development of an efficient antiparasite immune response. Here we assessed the direct effect of mosquito bites on the density of Plasmodium falciparum asexual parasites and the prevalence of gametocytes in chronic, asymptomatic infections in a longitudinal cohort study of seasonal transmission. We additionally correlated these parasitological measures with IgE and IgG antiparasite and anti-salivary gland extract titers. The mosquito biting density was positively correlated with the asexual parasite density but not asexual parasite prevalence and was negatively correlated with gametocyte prevalence. Individual anti-salivary gland IgE titers were also negatively correlated with gametocyte carriage and were strongly positively correlated with antiparasite IgE titers, consistent with the hypothesis that mosquito bites predispose individuals to develop an IgE antiparasite response. We provide evidence that mosquito bites have an impact on asymptomatic infections and differentially so for the production of asexual and sexual parasites. An increased research focus on the immunological impact of mosquito bites during asymptomatic infections is warranted, to establish whether strategies targeting the immune response to saliva can reduce the duration of infection and the onward transmission of the parasite.

  4. Asymptomatic natural Chlamydia pecorum infection reduces growth rates in calves by up to 48 percent

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Intracellular Chlamydia (C.) bacteria cause in cattle some acute but rare diseases such as abortion, sporadic bovine encephalomyelitis, kerato-conjunctivitis, pneumonia, enteritis and polyarthritis. Much more frequent, essentially ubiquitous worldwide, are low-level, asymptomatic chlamydial infecti...

  5. Computer-enhanced thallium scintigrams in asymptomatic men with abnormal exercise tests

    SciTech Connect

    Uhl, G.S.; Kay, T.N.; Hickman, J.R., Jr.

    1981-12-01

    The usefulness of computer-enhanced thallium-201 myocardial perfusion scintigraphy in excluding the diagnosis of coronary artery disease in asymptomatic patients showing abnormal exercise electrocardiograms is evaluated. Multigated thallium scans were obtained immediately following and 3 or 4 hours after maximal exercise testing in 191 consecutive asymptomatic Air Force aircrew members who had shown abnormal exercise electrocardiograms and who were due to undergo coronary angiography. Computer enhancement of the raw images is found to lead to four false positive and two false negative scintigrams as revealed by angiographic results, while the group of 15 with subcritical coronary disease exhibited equivocal results. Results reveal that enhanced thallium scintigrams are an accurate diagnostics tool in detecting myocardial ischemia in asymptomatic patients and may be used in counseling asymptomatic patients on their likelihood of having coronary artery disease.

  6. Evolution and human sexuality.

    PubMed

    Gray, Peter B

    2013-12-01

    The aim of this review is to put core features of human sexuality in an evolutionary light. Toward that end, I address five topics concerning the evolution of human sexuality. First, I address theoretical foundations, including recent critiques and developments. While much traces back to Darwin and his view of sexual selection, more recent work helps refine the theoretical bases to sex differences and life history allocations to mating effort. Second, I consider central models attempting to specify the phylogenetic details regarding how hominin sexuality might have changed, with most of those models honing in on transitions from a possible chimpanzee-like ancestor to the slightly polygynous and long-term bonded sociosexual partnerships observed among most recently studied hunter-gatherers. Third, I address recent genetic and physiological data contributing to a refined understanding of human sexuality. As examples, the availability of rapidly increasing genomic information aids comparative approaches to discern signals of selection in sexuality-related phenotypes, and neuroendocrine studies of human responses to sexual stimuli provide insight into homologous and derived mechanisms. Fourth, I consider some of the most recent, large, and rigorous studies of human sexuality. These provide insights into sexual behavior across other national samples and on the Internet. Fifth, I discuss the relevance of a life course perspective to understanding the evolution of human sexuality. Most research on the evolution of human sexuality focuses on young adults. Yet humans are sexual beings from gestation to death, albeit in different ways across the life course, and in ways that can be theoretically couched within life history theory.

  7. [Depressive symptoms and sexuality].

    PubMed

    Porto, Robert

    2014-10-01

    The mutually reinforcing dyad of depressive symptoms and erectile dysfunction is scientifically established. The cure of depression improves sexual dysfunction (SD) and the treatment of SD induces improvement of depression. Most of anti-depressants induce negative sexual side effects that lead to non-compliance of these treatments. The knowledge of interrelation between depression, anti-depressants and sexuality is of great importance in clinical practice.

  8. Mycoplasma genitalium: An Overlooked Sexually Transmitted Pathogen in Women?

    PubMed Central

    Ona, Samsiya; Molina, Rose L.; Diouf, Khady

    2016-01-01

    Mycoplasma genitalium is a facultative anaerobic organism and a recognized cause of nongonococcal urethritis in men. In women, M. genitalium has been associated with cervicitis, endometritis, pelvic inflammatory disease (PID), infertility, susceptibility to human immunodeficiency virus (HIV), and adverse birth outcomes, indicating a consistent relationship with female genital tract pathology. The global prevalence of M. genitalium among symptomatic and asymptomatic sexually active women ranges between 1 and 6.4%. M. genitalium may play a role in pathogenesis as an independent sexually transmitted pathogen or by facilitating coinfection with another pathogen. The long-term reproductive consequences of M. genitalium infection in asymptomatic individuals need to be investigated further. Though screening for this pathogen is not currently recommended, it should be considered in high-risk populations. Recent guidelines from the Centers for Disease Control regarding first-line treatment for PID do not cover M. genitalium but recommend considering treatment in patients without improvement on standard PID regimens. Prospective studies on the prevalence, pathophysiology, and long-term reproductive consequences of M. genitalium infection in the general population are needed to determine if screening protocols are necessary. New treatment regimens need to be investigated due to increasing drug resistance. PMID:27212873

  9. [Sexual reproduction in animals].

    PubMed

    Jordana, R; Herrea, L

    1974-01-01

    Both asexual and sexual reproduction are described, with most attention given the latter, and all basic aspects of reproduction are discussed including gender, gametogenesis, genes and chromosomes, fecundation, and hormonal control. Female and male reproductive hormones and their modes of operation are given special attention. Innate reproductive and sexual behavior in various species is detailed and a discussion of the role of sexual attraction in human and animal reproduction is included. Contraception and abortion are described as human efforts to separate sexuality and reproduction unique in the biological world.

  10. Prime time sexual harrassment.

    PubMed

    Grauerholz, E; King, A

    1997-04-01

    This study explores the explicit and implicit messages of sexual harassment that viewers receive when viewing prime-time television in the US. A content analysis of 48 hours of prime-time television reveals that sexual harassment on television is both highly visible and invisible. Sexual harassment is rendered visible simply by its prominence in these programs. Incidents involving quid-pro-quo harassment and environmental harassment occur with regularity on television. Furthermore, about 84% of the shows studied contained at least one incident of sexual harassment; yet these acts of sexual harassment remained largely invisible because none of the behaviors were labeled as sexual harassment. These incidents are presented in humorous ways, and victims are generally unharmed and very effective at ending the harassment. Although such programs may actually reflect the reality of many women's lives in terms of prevalence of sexual harassment, they perpetuate several myths about sexual harassment, such as that sexual harassment is not serious and that victims should be able to handle the situations themselves. PMID:12294811

  11. Sexually Transmitted Proctitis

    PubMed Central

    Sigle, Gavin W.; Kim, Rebekah

    2015-01-01

    There are many different sexually transmitted infections that can cause proctitis. Recognition of the common symptoms with anoscopic examination is crucial in accurate diagnosis of the pathogen. Clinicians should have a high index of suspicion of more than one inciting pathogen. Treatment should be prompt and extended to sexual partners who have been exposed to the disease. Effective treatment can alleviate the discomfort and potentially serious complications associated with sexually transmitted proctitides. This article illustrates and discusses the clinical presentations, diagnostic pearls, and treatments of sexually transmitted proctitides. PMID:26034402

  12. Uncovering Sexual Problems

    PubMed Central

    Cohen, May

    1977-01-01

    While patients frequently make it difficult for us to uncover their sexual concerns, a much greater difficulty is due to physicians' unwillingness to deal with this subject. Physicians need to acquire basic knowledge about human sexuality as well as skills in making patients feel comfortable and open. A non-judgmental attitude is essential. The physician will also be able to anticipate and prevent sexual distress by education. Expertise must be developed in differentiating those problems requiring referral for specialized sexual counselling from those which the family physician can handle. PMID:21304865

  13. Crossover sexual offenses.

    PubMed

    Heil, Peggy; Ahlmeyer, Sean; Simons, Dominique

    2003-10-01

    Crossover sexual offenses are defined as those in which victims are from multiple age, gender, and relationship categories. This study investigates admissions of crossover sexual offending from sex offenders participating in treatment who received polygraph testing. For 223 incarcerated and 266 paroled sexual offenders, sexual offenses were recorded from criminal history records and admissions during treatment coupled with polygraph testing. The majority of incarcerated offenders admitted to sexually assaulting both children and adults from multiple relationship types. In addition, there was a substantial increase in offenders admitting to sexually assaulting victims from both genders. In a group of incarcerated offenders who sexually assaulted children, the majority of offenders admitted to sexually assaulting both relatives and nonrelatives, and there was a substantial increase in the offenders admitting to assaulting both male and female children. Although similar trends were observed for the sample of parolees, the rates were far less dramatic. Parolees appeared to have greater levels of denial, had participated in fewer treatment sessions, and perceived greater supervision restrictions as a result of admitting additional offenses. These findings support previous research indicating that many sexual offenders do not exclusively offend against a preferred victim type. PMID:14571530

  14. Asymptomatic Intrahepatic Portosystemic Venous Shunt: To Treat or Not To Treat?

    PubMed

    Palvanov, Arkadiy; Marder, Ruth Leah; Siegel, David

    2016-09-01

    Intrahepatic portosystemic venous shunts (IPSVSs) are rare vascular malformations. They can be asymptomatic or present with various symptoms including encephalopathy. We present two cases of IPSVS, one involving a patient presenting with altered mental status and the other discovered incidentally. While there is no question that patients presenting with symptomatic IPSVS should undergo definitive treatment, there is no consensus regarding elective therapy for asymptomatic lesions. PMID:27574389

  15. Asymptomatic Intrahepatic Portosystemic Venous Shunt: To Treat or Not To Treat?

    PubMed

    Palvanov, Arkadiy; Marder, Ruth Leah; Siegel, David

    2016-09-01

    Intrahepatic portosystemic venous shunts (IPSVSs) are rare vascular malformations. They can be asymptomatic or present with various symptoms including encephalopathy. We present two cases of IPSVS, one involving a patient presenting with altered mental status and the other discovered incidentally. While there is no question that patients presenting with symptomatic IPSVS should undergo definitive treatment, there is no consensus regarding elective therapy for asymptomatic lesions.

  16. Impact of Daily Cotrimoxazole on Clinical Malaria and Asymptomatic Parasitemias in HIV-Exposed, Uninfected Infants

    PubMed Central

    Davis, Nicole L.; Barnett, Eric J.; Miller, William C.; Dow, Anna; Chasela, Charles S.; Hudgens, Michael G.; Kayira, Dumbani; Tegha, Gerald; Ellington, Sascha R.; Kourtis, Athena P.; van der Horst, Charles; Jamieson, Denise J.; Juliano, Jonathan J.

    2015-01-01

    Background. Cotrimoxazole preventive therapy (CPT) is recommended for all human immunodeficiency virus (HIV)–exposed infants to avoid opportunistic infections. Cotrimoxazole has antimalarial effects and appears to reduce clinical malaria infections, but the impact on asymptomatic malaria infections is unknown. Methods. We conducted an observational cohort study using data and dried blood spots (DBSs) from the Breastfeeding, Antiretrovirals and Nutrition study to evaluate the impact of CPT on malaria infection during peak malaria season in Lilongwe, Malawi. We compared malaria incidence 1 year before and after CPT implementation (292 and 682 CPT-unexposed and CPT-exposed infants, respectively), including only infants who remained HIV negative by 36 weeks of age. Malaria was defined as clinical, asymptomatic (using DBSs at 12, 24, and 36 weeks), or a composite outcome of clinical or asymptomatic. Linear and binomial regression with generalized estimating equations were used to estimate the association between CPT and malaria. Differences in characteristics of parasitemias and drug resistance polymorphisms by CPT status were also assessed in the asymptomatic infections. Results. CPT was associated with a 70% (95% confidence interval, 53%–81%) relative reduction in the risk of asymptomatic infection between 6 and 36 weeks of age. CPT appeared to provide temporary protection against clinical malaria and more sustained protection against asymptomatic infections, with no difference in parasitemia characteristics. Conclusions. CPT appears to reduce overall malaria infections, with more prolonged impacts on asymptomatic infections. Asymptomatic infections are potentially important reservoirs for malaria transmission. Therefore, CPT prophylaxis may have important individual and public health benefits. PMID:25900173

  17. Peak CSF Velocities in Patients with Symptomatic and Asymptomatic Chiari I Malformation

    PubMed Central

    Krueger, K.D.; Haughton, V.M.; Hetzel, S.

    2011-01-01

    BACKGROUND AND PURPOSE PCMR is used to evaluate the Chiari I malformation. We compared quantitative PCMR in symptomatic and asymptomatic patients with Chiari I. MATERIALS AND METHODS PCMR image data in an axial section near the foramen magnum in a consecutive series of patients with Chiari I malformations were evaluated. Patients were classified as symptomatic for a Chiari I if they had apnea spells and/or exertional headaches and as asymptomatic if they had symptoms not considered specific for a Chiari I malformation. The PCMR CSF flow study was obtained with the same protocol for all patients and with the neck in neutral, flexed, and extended positions. Images were inspected for CSF flow jets and synchronous bidirectional flow. Peak CSF flow velocities were calculated with commercial software. Differences between the 2 groups were tested with mixed-effects ANOVA and Wilcoxon rank sum or Fisher exact probability tests with significance set at the .05 level. RESULTS Twenty-six patients with Chiari I were classified as symptomatic, and 24, as asymptomatic. Abnormal flow jets tended to occur more often in the symptomatic than in the asymptomatic patients (P = .054). Peak CSF velocities ranged from 2 to 20 cm/s in the symptomatic and the asymptomatic groups and did not differ significantly between the 2 groups or with neck position. CONCLUSIONS Peak CSF flow velocities near the foramen magnum did not differentiate symptomatic and asymptomatic patients with Chiari I. PMID:20884747

  18. Asymptomatic and chronic carriage of Leptospira interrogans serovar Pomona in California sea lions (Zalophus californianus).

    PubMed

    Prager, K C; Greig, Denise J; Alt, David P; Galloway, Renee L; Hornsby, Richard L; Palmer, Lauren J; Soper, Jennifer; Wu, Qingzhong; Zuerner, Richard L; Gulland, Frances M D; Lloyd-Smith, James O

    2013-05-31

    Since 1970, periodic outbreaks of leptospirosis, caused by pathogenic spirochetes in the genus Leptospira, have caused morbidity and mortality of California sea lions (Zalophus californianus) along the Pacific coast of North America. Yearly seasonal epizootics of varying magnitude occur between the months of July and December, with major epizootics occurring every 3-5 years. Genetic and serological data suggest that Leptospira interrogans serovar Pomona is the infecting serovar and is enzootic in the California sea lion population, although the mechanism of persistence is unknown. We report asymptomatic carriage of Leptospira in 39% (33/85) of wild, free-ranging sea lions sampled during the epizootic season, and asymptomatic seroconversion with chronic asymptomatic carriage in a rehabilitated sea lion. This is the first report of asymptomatic carriage in wild, free-ranging California sea lions and the first example of seroconversion and asymptomatic chronic carriage in a sea lion. Detection of asymptomatic chronic carriage of Leptospira in California sea lions, a species known to suffer significant disease and mortality from the same Leptospira strain, goes against widely-held notions regarding leptospirosis in accidental versus maintenance host species. Further, chronic carriage could provide a mechanism for persistent circulation of Leptospira in the California sea lion population, particularly if these animals shed infectious leptospires for months to years. PMID:23419822

  19. Asymptomatic and chronic carriage of Leptospira interrogans serovar Pomona in California sea lions (Zalophus californianus).

    PubMed

    Prager, K C; Greig, Denise J; Alt, David P; Galloway, Renee L; Hornsby, Richard L; Palmer, Lauren J; Soper, Jennifer; Wu, Qingzhong; Zuerner, Richard L; Gulland, Frances M D; Lloyd-Smith, James O

    2013-05-31

    Since 1970, periodic outbreaks of leptospirosis, caused by pathogenic spirochetes in the genus Leptospira, have caused morbidity and mortality of California sea lions (Zalophus californianus) along the Pacific coast of North America. Yearly seasonal epizootics of varying magnitude occur between the months of July and December, with major epizootics occurring every 3-5 years. Genetic and serological data suggest that Leptospira interrogans serovar Pomona is the infecting serovar and is enzootic in the California sea lion population, although the mechanism of persistence is unknown. We report asymptomatic carriage of Leptospira in 39% (33/85) of wild, free-ranging sea lions sampled during the epizootic season, and asymptomatic seroconversion with chronic asymptomatic carriage in a rehabilitated sea lion. This is the first report of asymptomatic carriage in wild, free-ranging California sea lions and the first example of seroconversion and asymptomatic chronic carriage in a sea lion. Detection of asymptomatic chronic carriage of Leptospira in California sea lions, a species known to suffer significant disease and mortality from the same Leptospira strain, goes against widely-held notions regarding leptospirosis in accidental versus maintenance host species. Further, chronic carriage could provide a mechanism for persistent circulation of Leptospira in the California sea lion population, particularly if these animals shed infectious leptospires for months to years.

  20. Transcriptional regulation differs in affected facioscapulohumeral muscular dystrophy patients compared to asymptomatic related carriers

    PubMed Central

    Arashiro, Patricia; Eisenberg, Iris; Kho, Alvin T.; Cerqueira, Antonia M. P.; Canovas, Marta; Silva, Helga C. A.; Pavanello, Rita C. M.; Verjovski-Almeida, Sergio; Kunkel, Louis M.; Zatz, Mayana

    2009-01-01

    Facioscapulohumeral muscular dystrophy (FSHD) is a progressive muscle disorder that has been associated with a contraction of 3.3-kb repeats on chromosome 4q35. FSHD is characterized by a wide clinical inter- and intrafamilial variability, ranging from wheelchair-bound patients to asymptomatic carriers. Our study is unique in comparing the gene expression profiles from related affected, asymptomatic carrier, and control individuals. Our results suggest that the expression of genes on chromosome 4q is altered in affected and asymptomatic individuals. Remarkably, the changes seen in asymptomatic samples are largely in products of genes encoding several chemokines, whereas the changes seen in affected samples are largely in genes governing the synthesis of GPI-linked proteins and histone acetylation. Besides this, the affected patient and related asymptomatic carrier share the 4qA161 haplotype. Thus, these polymorphisms by themselves do not explain the pathogenicity of the contracted allele. Interestingly, our results also suggest that the miRNAs might mediate the regulatory network in FSHD. Together, our results support the previous evidence that FSHD may be caused by transcriptional dysregulation of multiple genes, in cis and in trans, and suggest some factors potentially important for FSHD pathogenesis. The study of the gene expression profiles from asymptomatic carriers and related affected patients is a unique approach to try to enhance our understanding of the missing link between the contraction in D4Z4 repeats and muscle disease, while minimizing the effects of differences resulting from genetic background. PMID:19339494

  1. Guidelines for Teaching about Sexuality.

    ERIC Educational Resources Information Center

    Grigg, Elizabeth

    1997-01-01

    Nurse educators who are comfortable with their own sexuality, have sensitive and perceptive communication skills, and are knowledgeable about sexual health are best equipped to integrate sexuality education into the nursing curriculum. (SK)

  2. Childhood Sexual Abuse and Suicide

    MedlinePlus

    ... Sexual Abuse and Suicide 2014 One third of sexual assault victims were under the age of 12. 1 ... D. (2005). Adult perpetrator gender asymmetries in child sexual assault victim selection: Results from the 2000 National Incident- ...

  3. Cardiac Biomarkers and Left Ventricular Hypertrophy in Asymptomatic Hemodialysis Patients

    PubMed Central

    Koycheva, Reneta Yovcheva; Cholakov, Vasil; Andreev, Jivko; Penev, Margarit; Iliev, Rosen; Nancheva, Krasimira; Tsoneva, Vanya

    2016-01-01

    BACKGROUND: Cardiac biomarkers are often elevated in dialysis patients showing the presence of left ventricular dysfunction. The aim of the study is to establish the plasma levels of high-sensitivity cardiac troponin T (hs TnT), precursor of B-natriuretic peptide (NT-proBNP) and high sensitivity C-reactive protein (hs CRP) and their relation to the presence of left ventricular hypertrophy (LVH) in patients undergoing hemodialysis without signs of acute coronary syndrome or heart failure. MATERIAL AND METHODS: We studied 48 patients - 26 men and 22 women. Pre and postdialysis levels of hs cTnT, NT-proBNP and hs CRP were measured at week interim procedure. Patients were divided in two groups according to the presence of echocardiographic evidence of LVH - gr A - 40 patients (with LVH), and gr B - 8 patients (without LVH). RESULTS: In the whole group of patients was found elevated predialysis levels of all three biomarkers with significant increase (p < 0.05) after dialysis with low-flux dialyzers. Predialysis values of NT-proBNP show moderate positive correlation with hs cTnT (r = 0.47) and weaker with hs CRP (r = 0.163). Such dependence is observed in postdialysis values of these biomarkers. There is a strong positive correlation between the pre and postdialysis levels: for hs cTnT (r = 0.966), for NT-proBNP (r = 0.918) and for hs CRP (r = 0.859). It was found a significant difference in the mean values of hs cTnT in gr. A and gr. B (0.07 ± 0.01 versus 0.03 ± 0.01 ng/mL, p < 0.05) and NT-proBNP (15,605.8 ± 2,072.5 versus 2,745.5 ± 533.55 pg/mL, p < 0.05). Not find a significant difference in hs CRP in both groups. CONCLUSIONS: The results indicate the relationship of the studied cardiac biomarkers with LVH in asymptomatic patients undergoing hemodialysis treatment. PMID:27275331

  4. Understanding the Anorectic Student

    ERIC Educational Resources Information Center

    Rothenberg, Susan A.

    1976-01-01

    A teacher may be the first to recognize the symptoms of self-inflicted starvation, anorexia nervosa, a psychological complex malady, should be supportive of the child and alert the school principal to the problem, which should be dealt with by parents and a psychiatrist. (JD)

  5. Anorectal conditions: hemorrhoids.

    PubMed

    Fox, Audralan; Tietze, Pamela H; Ramakrishnan, Kalyanakrishnan

    2014-04-01

    Hemorrhoids are engorged fibrovascular cushions lining the anal canal. Constipation, increased intra-abdominal pressure, and prolonged straining predispose to hemorrhoids. Approximately 1 in 20 Americans and almost one-half of individuals older than 50 years experience symptomatic hemorrhoids. Bright red, painless rectal bleeding during defecation is the most common presentation. Even if hemorrhoids are seen on examination, patients with rectal bleeding who are at risk of colorectal cancer (eg, adults older than 50 years) should still undergo colonoscopy to exclude cancer as the etiology. Nonsurgical treatment for nonthrombosed hemorrhoids includes increased fiber intake, sitz baths, and drugs. If nonsurgical management is unsuccessful, rubber band ligation is the most effective office-based procedure for grades I, II, and III hemorrhoids. Surgical hemorrhoidectomy is indicated after failure of nonsurgical management and office-based procedures and also as initial management for grades III and IV hemorrhoids. Several different procedures can be used. For acutely thrombosed external hemorrhoids, excision and evacuation of the clot, ideally within 72 hours of symptom onset, is the optimal management. Prolapsed and strangulated hemorrhoids are best managed with stool softeners, analgesics, rest, warm soaks, and ice packs until recovery; residual hemorrhoids are banded or excised later. PMID:24742083

  6. Anorectal conditions: hemorrhoids.

    PubMed

    Fox, Audralan; Tietze, Pamela H; Ramakrishnan, Kalyanakrishnan

    2014-04-01

    Hemorrhoids are engorged fibrovascular cushions lining the anal canal. Constipation, increased intra-abdominal pressure, and prolonged straining predispose to hemorrhoids. Approximately 1 in 20 Americans and almost one-half of individuals older than 50 years experience symptomatic hemorrhoids. Bright red, painless rectal bleeding during defecation is the most common presentation. Even if hemorrhoids are seen on examination, patients with rectal bleeding who are at risk of colorectal cancer (eg, adults older than 50 years) should still undergo colonoscopy to exclude cancer as the etiology. Nonsurgical treatment for nonthrombosed hemorrhoids includes increased fiber intake, sitz baths, and drugs. If nonsurgical management is unsuccessful, rubber band ligation is the most effective office-based procedure for grades I, II, and III hemorrhoids. Surgical hemorrhoidectomy is indicated after failure of nonsurgical management and office-based procedures and also as initial management for grades III and IV hemorrhoids. Several different procedures can be used. For acutely thrombosed external hemorrhoids, excision and evacuation of the clot, ideally within 72 hours of symptom onset, is the optimal management. Prolapsed and strangulated hemorrhoids are best managed with stool softeners, analgesics, rest, warm soaks, and ice packs until recovery; residual hemorrhoids are banded or excised later.

  7. [Treatment of anorectal diseases].

    PubMed

    Herold, A

    2007-02-14

    HAEMORRHOIDAL DISEASE: Stage orientated treatment of haemorrhoidal disease using conservative and operative measures provides high healing rates with low complication- and recurrence rates. ANAL FISSURE: Muscle relaxing ointments (Nitrates, Ca-channel-blocker) are the treatment of choice for chronic anal fissure. In cases of insufficiency fissurectomy provides high healing rates. ABSCESS AND ANAL FISTULA: Anal fistulae are treated with respect of their involvement of the anal sphincters. Distal fistulae are completely excised reaching high healing rates, proximal fistulae are treated using local flap procedures with healing rates reaching 50 to 80%. ANAL INCONTINENCE: Treatment of anal incontinence is depending on the severity and on the etiology of the disease. The following procedures are used: conservative: improving consistency, physical exercises, electrostimulation Biofeedback-Training surgical: Sphincterreconstruction, Pre-anal Repair, Post-anal Repair, Total Pelvic Floor Repair, Dynamic Graciloplasty, Artificial Anal Sphincter, Sacralnervestimulation, Stoma

  8. Parental Non-verbal Sexual Communication: Its Relationship to Sexual Behaviour and Sexual Guilt.

    PubMed

    Joffe, H; Franca-Koh, A C

    2001-01-01

    The study explores the link between remembered non-verbal sexual communication in the home, current sexual behaviours and feelings of sexual guilt, among a sample of young British men and women. Non-verbal sexual communication encapsulates: openness about nudity in the home; the showing of affection between parents; signs of parental sexual activity and contraceptive use; and intimation of mother's menstruation. One hundred and thirty-seven young adults completed questionnaires measuring remembered parental non-verbal sexual communication, current sexual behaviour and sexual guilt. Higher levels of parental non-verbal sexual communication were found to be linked to: earlier onset of sexual activity, fewer sexual partners and lower feelings of aspects of sexual guilt. The findings are discussed in terms of how to advance this area of study. PMID:22049235

  9. [Sexual violence. Towards a healthy sexuality].

    PubMed

    Londono Velez, A

    1998-06-01

    Different forms of violence against women and girls reflect existing inequalities between men and women and between adults and children, as well as concepts of masculinity based on aggressiveness and exercise of force as means of affirming virility. Such forms of masculinity manifest themselves through sexual violence. Women who remain in violent relationships are paralyzed by the lack of a self-defense mechanism, by economic and psychic dependence, and by low self-esteem resulting from a long history of submission. Violence against women and girls consists in a series of behaviors, beliefs, and practices aimed at compromising the full exercise of their rights, often with societal tolerance. Sexual violence represents an assault on basic human rights and on the victims' personality, body, and conscience, and on the conscience of their families and even their communities. A number of measures should be taken to eliminate sexual violence, including sex education within the family, school, and elsewhere. PMID:12348803

  10. [Female sexual disorders nowadays].

    PubMed

    Rajtman, Marta

    2013-01-01

    This article makes a brief overview of the most frequent female sexual disorders seen in our clinical practice. It highlights the increasing number of women presenting with hypoactive sexual desire and the efforts practitioners put on helping these female patients. The article also shows the pharmacological strategies that are investigated to solve these dysfuntions. PMID:24260752

  11. Maternal Sexuality and Breastfeeding

    ERIC Educational Resources Information Center

    Bartlett, Alison

    2005-01-01

    In this paper I consider the ways in which lactation has been discussed as a form of maternal sexuality, and the implications this carries for our understanding of breastfeeding practices and sexuality. Drawing on knowledge constructed in the western world during the last half of the twentieth century, the paper identifies a shift between the…

  12. Sexual Reproduction and Breeding

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In the second edition of Plant Propagation Concepts and Laboratory Exercises, we have combined the first edition chapters 36: Sexual Reproduction in Angiosperms and 37: Breeding Horticultural Plants into the present single chapter Sexual Reproduction and Breeding. These topics are so closely relate...

  13. Sexual Addiction: Diagnostic Problems

    ERIC Educational Resources Information Center

    Giugliano, John R.

    2009-01-01

    In recent years clinicians report a great deal of concern about definition, diagnostic assessment, and treatment modalities when dealing with what might be called out-of-control sexual behavior. Many terms have been used to describe the phenomenon of problematic sexual behavior. Many of these concepts overlap, some are no longer popular, and some…

  14. Teaching Sexuality through Media

    ERIC Educational Resources Information Center

    Cragin, Becca

    2015-01-01

    A central project of feminism has been raising awareness of the role cultural formations of sexuality play in women's inequality (Ritzenhoff and Hermes). Feminists who regularly include discussions of sexuality in their teaching are familiar with the pedagogical challenges of the subject as well as its importance. This article is intended for…

  15. [Female sexual disorders nowadays].

    PubMed

    Rajtman, Marta

    2013-01-01

    This article makes a brief overview of the most frequent female sexual disorders seen in our clinical practice. It highlights the increasing number of women presenting with hypoactive sexual desire and the efforts practitioners put on helping these female patients. The article also shows the pharmacological strategies that are investigated to solve these dysfuntions.

  16. Sexual Murderers' Implicit Theories

    ERIC Educational Resources Information Center

    Beech, Anthony; Fisher, Dawn; Ward, Tony

    2005-01-01

    Interviews with 28 sexual murderers were subjected to grounded theory analysis. Five implicit theories (ITs) were identified: dangerous world, male sex drive is uncontrollable, entitlement, women as sexual objects, and women as unknowable. These ITs were found to be identical to those identified in the literature as being present in rapists. The…

  17. Sexuality, Power, and Politics.

    ERIC Educational Resources Information Center

    Hartsock, Nancy C. M.

    The source of contemporary attitudes toward sexuality, power, and politics is found in the literature of the ancient Greeks, specifically, Plato's "Republic" and "Symposium," Aristotle's "Politics," and the plays of Aeschylus and Aristophanes. The "Symposium" can be read as an account of how sexuality can be incorporated into the public life of…

  18. Hypoactive Sexual Desire

    ERIC Educational Resources Information Center

    Kaplan, Helen S.

    1977-01-01

    Low-libido disorders are highly prevalent, may be extremely distressful to patients and their partners, and influence the course and prognosis of therapy. This paper focuses on this important aspect of human sexuality. Some clinical features of hypoactive sexual desire are described, and some hypotheses about etiology and prognosis are presented.…

  19. Sexual Victimization of Youth

    ERIC Educational Resources Information Center

    Small, Kevonne; Zweig, Janine M.

    2007-01-01

    An estimated 7.0% to 8.1% of American youth report being sexually victimized at some point in their life time. This article presents a background to youth sexual victimization, focusing on prevalence data, challenging issues when studying this problem, risk factors, and common characteristics of perpetrators. Additionally, a type of sexual…

  20. Sexual Behavior of Adolescents.

    ERIC Educational Resources Information Center

    Wagner, Hilmar

    1978-01-01

    Confined to discussion of heterosexual activities, this article examines adolescent sexual behavior in terms of promiscuity; the search for a sexual behavior code; the impact of the media; and the influence of peer groups, religious identification, and the adult double standard. (JC)

  1. Your Sexual Health

    MedlinePlus

    ... vaginal dryness and lead to pain during intercourse. • Stress and anxiety • Relationship problems • Illness, including depression • Past negative sexual ... alcohol, smoking, illegal drug use, and medical conditions. Anxiety, stress, problems with your partner, and past negative sexual ...

  2. Literacy and Sexual Identity.

    ERIC Educational Resources Information Center

    Moje, Elizabeth Birr; MuQaribu, Mudhillun

    2003-01-01

    Calls for more attention to literacy teaching practices and teacher education that acknowledge sexual identity and orientation as key aspects of youth identity development. Discusses experience-based pedagogy and classroom interactions around sexual identities and texts. Notes the need for research and scholarship in the field of literacy and…

  3. Schizophrenia and Sexual Behavior

    ERIC Educational Resources Information Center

    Shulman, Bernard H.

    1971-01-01

    Generally, the schizophrenic is far less active sexually than the rest of the population, and gets less satisfaction out of such activity. Just as he gives up in other areas he eventually abdicates his sexual role, withdrawing from temptations that seem to promise torment. (Author)

  4. Myths of Sexuality Education.

    ERIC Educational Resources Information Center

    Morris, Ronald

    1997-01-01

    Suggests that sexuality education needs to take into account the myths by which teachers educate and students learn. Defines myth as a narrative, paradigm, or vision. Argues that myth provides depth to sexuality education, but that existing myths serve the purpose poorly. Proposes alternative narratives to the dominant myth. (DSK)

  5. Sexual Desire Disorders

    PubMed Central

    Montgomery, Keith A.

    2008-01-01

    Hypoactive sexual desire disorder (HSDD) and sexual aversion disorder (SAD) are an under-diagnosed group of disorders that affect men and women. Despite their prevalence, these two disorders are often not addressed by healthcare providers and patients due their private and awkward nature. As physicians, we need to move beyond our own unease in order to adequately address our patients’ sexual problems and implement appropriate treatment. Using the Sexual Response Cycle as the model of the physiological changes of humans during sexual stimulation and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition this article will review the current literature on the desire disorders focusing on prevalence, etiology, and treatment. PMID:19727285

  6. Challenges in sexual medicine.

    PubMed

    Cellek, Selim; Giraldi, Annamaria

    2012-09-01

    The sexual medicine field has been in mode of revolution until recently. Like all other fields of biomedical research, the economic situation around the world has had a negative impact on the field's momentum-research funding bodies, regulatory bodies and pharmaceutical companies seem to have placed sexual medicine in their low-priority list. But this is not the only challenge the field is facing. The successful development of phosphodiesterase type 5 (PDE5) inhibitors for treatment of erectile dysfunction (ED) means that research in this area seems to have slowed. However, there remain several unmet medical needs within sexual medicine such as premature ejaculation, severe ED and hypoactive sexual desire disorder, which await novel therapeutic approaches. Despite these challenges, research into finding and developing such therapies is likely to continue in the sexual medicine field, in an effort to improve the lives of our patients, who wait for effective therapies. PMID:22777290

  7. Addictive sexual behavior.

    PubMed

    Myers, W A

    1994-01-01

    Case material is presented from two patients suffering from addictive sexual behavior. The term addiction is used because of the intense, driven quality of the behavior and because of its mood-elevating effects. Psychodynamically, the patients' sexual acts helped to undo feelings of rejection at the hands of their mothers and to enhance feelings of lovability and of self-esteem. The behavior also helped to neutralize powerful feelings of rage toward the mother. In one patient, the acts also helped to ease inner turmoil related to an underlying attention deficit disorder. I speculate that some adults with addictive sexual behavior may have underlying attention deficit disorders. In both my patients, the sexual behaviors served the self-regulatory function of alleviating inner feelings of anhedonia and depression. When they decreased their sexual activities during the course of the treatment, they required adjunctive antidepressant medication. The underlying meaning of the medication and countertransference attitudes toward such patients are explored.

  8. Child Sexual Abuse, Sexual Anxiety, and Sexual Satisfaction: The Role of Self-Capacities.

    PubMed

    Bigras, Noémie; Godbout, Natacha; Briere, John

    2015-01-01

    Research indicates that child sexual abuse produces lasting alterations in interpersonal relatedness, identity, and affect regulation, often referred to as self-capacity disturbance. Child sexual abuse also has been shown to negatively impact sexual functioning. This study examined the role of altered self-capacities in mediating the relationship between child sexual abuse and sexual responses. Path analysis revealed that child sexual abuse was related to sexual anxiety and decreased sexual satisfaction through its association with reduced self-awareness and a propensity to be involved in difficult interpersonal relationships.

  9. Child Sexual Abuse, Sexual Anxiety, and Sexual Satisfaction: The Role of Self-Capacities.

    PubMed

    Bigras, Noémie; Godbout, Natacha; Briere, John

    2015-01-01

    Research indicates that child sexual abuse produces lasting alterations in interpersonal relatedness, identity, and affect regulation, often referred to as self-capacity disturbance. Child sexual abuse also has been shown to negatively impact sexual functioning. This study examined the role of altered self-capacities in mediating the relationship between child sexual abuse and sexual responses. Path analysis revealed that child sexual abuse was related to sexual anxiety and decreased sexual satisfaction through its association with reduced self-awareness and a propensity to be involved in difficult interpersonal relationships. PMID:26301436

  10. Outcome in adulthood of asymptomatic airway hyperresponsiveness in childhood: a longitudinal population study.

    PubMed

    Rasmussen, Finn; Taylor, D Robin; Flannery, Erin M; Cowan, Jan O; Greene, Justina M; Herbison, G Peter; Sears, Malcolm R

    2002-09-01

    The clinical outcome of asymptomatic airway hyperresponsiveness (AHR) first detected in childhood is sparsely reported, with conflicting results. We used a birth cohort of 1,037 children followed to age 26 years to assess the clinical outcome of asymptomatic AHR to methacholine first documented in study members at age 9 years. Of 547 study members who denied wheezing symptoms ever at age 9 years, 41 (7.5%) showed AHR. Forty showed methacholine responsiveness, with a provocation concentration of methacholine that elicited a 20% drop in forced expired volume in 1 sec (PC(20)) < or = 8 mg/mL, and one had baseline airway obstruction with a bronchodilator response exceeding 10%. Of these 41 study members, 18 (44%), 11 (27%), and 4 (10%) maintained AHR in 1, 2, and 3 later assessments, respectively, while 23 (56%) manifested AHR only at age 9. Compared with asymptomatic study members without AHR, those with asymptomatic AHR at age 9 years were more likely to report asthma and wheeze at any subsequent assessment, were more likely to have high IgE levels and eosinophils at ages 11 and 21, and more often demonstrated positive responses to skin allergen testing at ages 13 and 21 years. Persistent AHR at later assessments increased these likelihoods further.In conclusion, asymptomatic children with AHR are more likely to develop asthma and atopy later in life compared with asymptomatic children without AHR. Persistent AHR, even though initially asymptomatic, was associated with an even greater increased risk of development of asthma. We suggest that rather than considering AHR as a marker of asthma, it should be regarded as a parallel pathological process that may lead to subsequent symptoms and clinical evidence of asthma.

  11. Investigation of Gastroduodenal Mucosal Injury in Japanese Asymptomatic Antiplatelet Drug Users.

    PubMed

    Sogabe, Masahiro; Okahisa, Toshiya; Nakasono, Masahiko; Fujino, Yasuteru; Mitsui, Yasuhiro; Takaoka, Yoshihumi; Kimura, Tetsuo; Okamoto, Koichi; Muguruma, Naoki; Takayama, Tetsuji

    2015-07-01

    Antiplatelet drugs are widely used for the prevention of cardiovascular disease and cerebral vascular disorders. Although there have been several studies on gastroduodenal mucosal injury with gastrointestinal (GI) symptoms such as GI bleeding, in antiplatelet drug users (including low-dose aspirin (LDA)), there have been few reports on the association between antiplatelet drug use and gastroduodenal mucosal injury in asymptomatic antiplatelet drug users. This study was a cross-sectional study elucidating the association between antiplatelet drug use and gastroduodenal mucosal injury in asymptomatic antiplatelet drug users.Subjects were 186 asymptomatic Japanese antiplatelet drug users who underwent a regular health checkup. Subjects were divided into those with and without gastroduodenal mucosal injury endoscopically, and the association between gastroduodenal mucosal injury and other data in asymptomatic antiplatelet drug users was investigated.The prevalence of males and drinkers were significantly higher in subjects with gastroduodenal mucosal injury than in those without. In addition, the prevalence of proton pump inhibitor (PPI) users was significantly lower in subjects with gastroduodenal mucosal injury than in subjects without gastroduodenal mucosal injury. Logistic regression analysis showed PPI (odds ratios: 0.116; 95% confidence intervals: 0.021-0.638; P < 0.05) was a significant predictor of a decreased prevalence of gastroduodenal mucosal injury and closed-type (C-type) atrophy (3.172; 1.322-7.609; P < 0.01) was a significant predictor of an increased prevalence of severe gastroduodenal mucosal injury in asymptomatic antiplatelet drug users.Gender and lifestyle, such as drinking, may have an impact on risk of gastroduodenal mucosal injury in asymptomatic subjects taking antiplatelet drugs. Although PPI is a significant predictor of a decreased prevalence of gastroduodenal mucosal injury, including in asymptomatic antiplatelet drug users, status of

  12. Outcomes of Sexual Behaviors among Sexual Minority Youth

    ERIC Educational Resources Information Center

    Morgan, Elizabeth M.

    2014-01-01

    Very little is known about outcomes of sexual behavior for sexual minority youth. In this chapter, I review relevant literature and draw on findings from my own research to initiate an inquiry into this important topic. I begin with a brief overview of the range of sexual behaviors of sexual minority adolescents and young adults. Next, I describe…

  13. Changes in Women's Sexual Behavior Following Sexual Assault

    ERIC Educational Resources Information Center

    Deliramich, Aimee N.; Gray, Matt J.

    2008-01-01

    The present study examines changes in women's sexual activity and behavior following sexual assault and the relationship between alcohol abuse and postassault promiscuity. Although many researchers have focused on avoidance of sexual activity following an assault, some have suggested that women may exhibit an increase in sexual activity…

  14. Sanctification of sexuality: implications for newlyweds' marital and sexual quality.

    PubMed

    Hernandez, Krystal M; Mahoney, Annette; Pargament, Kenneth I

    2011-10-01

    Research on the intersection of sexuality, religion, and spirituality has primarily examined whether global levels of religiousness (e.g., service attendance) deter premarital and extramarital sexual activity. Virtually no empirical work has addressed whether specific spiritual beliefs about sexuality enhance marital sexuality. Using a community sample of 83 individuals married between 4 and 18 months, we found that greater perceptions of sexuality as sanctified predicted greater marital satisfaction, sexual satisfaction, sexual intimacy, and spiritual intimacy beyond global religiousness and demographics. The findings open a new line of research on religion and family life, and extend theories on the possible benefits of the sanctification of intimate relationships.

  15. What is sexual addiction?

    PubMed

    Levine, Stephen B

    2010-01-01

    Married men labeled as sexual addicts seek help after being discovered to have had broken monogamy rules for sexual behavior through their use of masturbation, pornography, cybersex, commercial sex involvement, paraphilic pursuits, or affairs. This study analyzed the sexual patterns and dynamics of 30 men who presented to 1 clinician between 2005 and 2009. Their important differences were captured by a 6-category spectrum: (a) no sexual excess beyond breaking the spouse's restrictive rules (n = 2), (b) discovery of husband's longstanding sexual secrets (n = 5), (c) new discovery of the joys of commercial sex (n = 4), (d) the bizarre or paraphilic (n = 7), (e) alternate concept of normal masculinity (n = 5), and (f) spiraling psychological deterioration (n = 7). Only the men with a spiraling psychological deterioration-about 25% of the sample with sexual issues-could reasonably be described as having a sexual addiction. This group experienced significant psychological failures before the onset of their deterioration. Another 25% were adequately defined as paraphilic. Half of the sample was not adequately described using addiction, compulsivity, impulsivity, and relationship incapacity models. The authors discuss the implications of these findings for DSM-5 and treatment. PMID:20432125

  16. Glutamate and Lipid Metabolic Perturbation in the Hippocampi of Asymptomatic Borna Disease Virus-Infected Horses

    PubMed Central

    Lei, Yang; Wang, Xiao; Liu, Zhao; Li, Dan; Zheng, Peng; Zhang, Lujun; Chen, Shigang; Xie, Peng

    2014-01-01

    Borna disease virus (BDV) is a neurotropic, enveloped, non-segmented, negative-stranded RNA virus that infects a wide variety of vertebrate species from birds to humans across a broad global geographic distribution. Animal symptomatology range from asymptomatic infection to behavioral abnormalities to acute meningoencephalitis. Asymptomatic BDV infection has been shown to be more frequent than conventionally estimated. However, the molecular mechanism(s) underyling asymptomatic BDV infection remain largely unknown. Here, based on real-time quantitative PCR and Western blotting, a total of 18 horse hippocampi were divided into BDV-infected (n = 8) and non-infected control (n = 10) groups. A gas chromatography coupled with mass spectrometry (GC-MS) metabolomic approach, in conjunction with multivariate statistical analysis, was used to characterize the hippocampal metabolic changes associated with asymptomatic BDV infection. Multivariate statistical analysis showed a significant discrimination between the BDV-infected and control groups. BDV-infected hippocampi were characterized by lower levels of D-myo-inositol-1-phosphate, glutamate, phosphoethanolamine, heptadecanoic acid, and linoleic acid in combination with a higher level of ammonia. These differential metabolites are primarily involved in glutamate and lipid metabolism. These finding provide an improved understanding of hippocampal changes associated with asymptomatic BDV infection. PMID:24956478

  17. A new screening pathway for identifying asymptomatic patients using dental panoramic radiographs

    NASA Astrophysics Data System (ADS)

    Hayashi, Tatsuro; Matsumoto, Takuya; Sawagashira, Tsuyoshi; Tagami, Motoki; Katsumata, Akitoshi; Hayashi, Yoshinori; Muramatsu, Chisako; Zhou, Xiangrong; Iida, Yukihiro; Matsuoka, Masato; Katagi, Kiyoji; Fujita, Hiroshi

    2012-03-01

    To identify asymptomatic patients is the challenging task and the essential first step in diagnosis. Findings of dental panoramic radiographs include not only dental conditions but also radiographic signs that are suggestive of possible systemic diseases such as osteoporosis, arteriosclerosis, and maxillary sinusitis. Detection of such signs on panoramic radiographs has a potential to provide supplemental benefits for patients. However, it is not easy for general dental practitioners to pay careful attention to such signs. We addressed the development of a computer-aided detection (CAD) system that detects radiographic signs of pathology on panoramic images, and the design of the framework of new screening pathway by cooperation of dentists and our CAD system. The performance evaluation of our CAD system showed the sensitivity and specificity in the identification of osteoporotic patients were 92.6 % and 100 %, respectively, and those of the maxillary sinus abnormality were 89.6 % and 73.6 %, respectively. The detection rate of carotid artery calcifications that suggests the need for further medical evaluation was approximately 93.6 % with 4.4 false-positives per image. To validate the utility of the new screening pathway, preliminary clinical trials by using our CAD system were conducted. To date, 223 panoramic images were processed and 4 asymptomatic patients with suspected osteoporosis, 7 asymptomatic patients with suspected calcifications, and 40 asymptomatic patients with suspected maxillary sinusitis were detected in our initial trial. It was suggested that our new screening pathway could be useful to identify asymptomatic patients with systemic diseases.

  18. Asymptomatic Malaria and Associated Risk Factors among School Children in Sanja Town, Northwest Ethiopia

    PubMed Central

    Worku, Ligabaw; Damtie, Demekech; Endris, Mengistu; Getie, Sisay

    2014-01-01

    Introduction. Asymptomatic malaria is prevalent in highly endemic areas of Africa and is new challenge for malaria prevention and control strategies. Objective. To determine the prevalence of asymptomatic malaria and associated risk factors among school children in Sanja Town, northwest Ethiopia. Methods. A cross-sectional study was conducted from February to March 2013, on 385 school children selected using stratified proportionate systematic sampling technique. Pretested questionnaire was used to collect sociodemographic data and associated risk factors. Giemsa-stained thin and thick blood films were examined for detection, identification, and quantification of malaria parasites. Data were entered and analyzed using SPSS 20.0 statistical software. Multivariate logistic regression was done for assessing associated risk factors and proportions for categorical variables were compared using chi-square test. P values less than 0.05 were taken as statistically significant. Results. The prevalence of asymptomatic malaria was 6.8% (n = 26). The majority of parasitemic study participants had low parasite density 65.5% (17/26). Level of grade, age, bed net usage, and frequent exposure to malaria infection were associated with risk of asymptomatic malaria. Conclusion. Asymptomatic malaria was low in this study area and is associated with level of grade, age, bed net usage, and frequent exposure to malaria infection. PMID:27355032

  19. Dengue Patients Exhibit Higher Levels of PrM and E Antibodies Than Their Asymptomatic Counterparts

    PubMed Central

    Yeo, Adeline Syin Lian; Manikam, Rishya; Sathar, Jameela; Kumari Natkunam, Santha

    2015-01-01

    Dengue virus infection is a common tropical disease which often occurs without being detected. These asymptomatic cases provide information in relation to the manifestation of immunological aspects. In this study, we developed an ELISA method to compare neutralizing effects of dengue prM and E antibodies between dengue patients and their asymptomatic household members. Recombinant D2 premembrane (prM) was constructed, cloned, and tested for antigenicity. The recombinant protein was purified and tested with controls by using an indirect ELISA method. Positive dengue serum samples with their asymptomatic pair were then carried out onto the developed ELISA. In addition, commercially available recombinant envelope (E) protein was used to develop an ELISA which was tested with the same set of serum samples in the prM ELISA. Asymptomatic individuals showed preexisting heterotypic neutralizing antibodies. The recombinant prM was antigenically reactive in the developed ELISA. Dengue patients had higher prM and E antibodies compared to their household members. Our study highlights the neutralizing antibodies levels with respect to dengue prM and E between dengue patients and asymptomatic individuals. PMID:25815314

  20. A new challenge for malaria control in Brazil: asymptomatic Plasmodium infection--a review.

    PubMed

    Coura, José Rodrigues; Suárez-Mutis, Martha; Ladeia-Andrade, Simone

    2006-05-01

    The evolution of malaria in Brazil, its morbidity, the malaria control programs, and the new challenges for these programs in the light of the emergence of asymptomatic infection in the Amazon region of Brazil were reviewed. At least six Brazilian research groups have demonstrated that asymptomatic infection by Plasmodium is an important impediment to malaria control, among mineral prospectors in Mato Grosso and riverside communities in Rondônia and, in our group, in the middle and upper reaches of the Negro river, in the state of Amazonas. Likewise, other researchers have studied the problem among indigenous communities in the Colombian, Peruvian, and Venezuelan parts of the Amazon basin, adjacent to Brazil. The frequency of positive results from the polymerase chain reaction (PCR) among asymptomatic individuals has ranged from 20.4 to 49.5%, and the presence of Plasmodium in the thick blood smears, from 4.2 to 38.5%. Infection with Anopheles darlingi has also been demonstrated by xenodiagnosis among asymptomatic patients with positive PCR results. If a mean of 25% is taken for the asymptomatic infection caused by Plasmodium sp. in the Amazon region of Brazil, malaria control will be difficult to achieve in that region with the measures currently utilized for such control. PMID:16862314

  1. Dengue patients exhibit higher levels of PrM and E antibodies than their asymptomatic counterparts.

    PubMed

    Yeo, Adeline Syin Lian; Rathakrishnan, Anusyah; Wang, Seok Mui; Ponnampalavanar, Sasheela; Manikam, Rishya; Sathar, Jameela; Kumari Natkunam, Santha; Sekaran, Shamala Devi

    2015-01-01

    Dengue virus infection is a common tropical disease which often occurs without being detected. These asymptomatic cases provide information in relation to the manifestation of immunological aspects. In this study, we developed an ELISA method to compare neutralizing effects of dengue prM and E antibodies between dengue patients and their asymptomatic household members. Recombinant D2 premembrane (prM) was constructed, cloned, and tested for antigenicity. The recombinant protein was purified and tested with controls by using an indirect ELISA method. Positive dengue serum samples with their asymptomatic pair were then carried out onto the developed ELISA. In addition, commercially available recombinant envelope (E) protein was used to develop an ELISA which was tested with the same set of serum samples in the prM ELISA. Asymptomatic individuals showed preexisting heterotypic neutralizing antibodies. The recombinant prM was antigenically reactive in the developed ELISA. Dengue patients had higher prM and E antibodies compared to their household members. Our study highlights the neutralizing antibodies levels with respect to dengue prM and E between dengue patients and asymptomatic individuals. PMID:25815314

  2. Research in Human Sexuality Education

    ERIC Educational Resources Information Center

    Carmichael, Joan; And Others

    1977-01-01

    Medical students' attitudes towards concepts in sexuality before and after a five-day sexuality course were tested at the University of Miami School of Medicine and evaluated with Osgood's Semantic Differential. Concepts rated were "my sexuality,""masturbation,""homosexuality," and "my role in understanding sexual problems." (LBH)

  3. Sexual Harassment in Higher Education.

    ERIC Educational Resources Information Center

    Truax, Anne; And Others

    1989-01-01

    An article and three responses on sexual harassment in higher education are presented: "Sexual Harassment in Higher Education: What We've Learned" (Anne Truax); "Who Is Responsible for Sexual Harassment?" (Barbara G. Taylor); "The Feminist-Unionist Dilemma" (Sherna Berger Gluck); and "Sexual Harassment and Academic Power" (Loralee MacPike). (MLW)

  4. Sexual Health for America's Adolescents.

    ERIC Educational Resources Information Center

    Haffner, Debra W.

    1996-01-01

    The National Commission on Adolescent Sexual Health developed a professional consensus statement about adolescent sexual health. Its report for policymakers recommends that adults face the facts about adolescent sexuality and that public policies on adolescent sexual health be based on appropriate knowledge, accurate data, current theory, ongoing…

  5. Human Sexuality: Responsible Life Choices.

    ERIC Educational Resources Information Center

    Ryder, Verdene; Smith, Peggy B.

    This book provides a complete course in human sexuality. It can also be used to supplement a family living course. Text content provides current information for teaching high school students about sexuality issues. The text offers basic information on growth and development, sexual development, pregnancy, and birth. It explains the sexual decision…

  6. Sexual selection and speciation.

    PubMed

    Panhuis, T M.; Butlin, R; Zuk, M; Tregenza, T

    2001-07-01

    The power of sexual selection to drive changes in mate recognition traits gives it the potential to be a potent force in speciation. Much of the evidence to support this possibility comes from comparative studies that examine differences in the number of species between clades that apparently differ in the intensity of sexual selection. We argue that more detailed studies are needed, examining extinction rates and other sources of variation in species richness. Typically, investigations of extant natural populations have been too indirect to convincingly conclude speciation by sexual selection. Recent empirical work, however, is beginning to take a more direct approach and rule out confounding variables.

  7. Television and adolescent sexuality.

    PubMed

    Brown, J D; Childers, K W; Waszak, C S

    1990-01-01

    Existing studies of the sexual content of television programming and advertising and the effects of this content on adolescent viewers are reviewed. Content studies show that the frequency of sexual references have increased in the past decade and are increasingly explicit. Studies of the effects of this content, while scarce, suggest that adolescents who rely heavily on television for information about sexuality will have high standards of female beauty and will believe that premarital and extramarital intercourse with multiple partners is acceptable. They are unlikely to learn about the need for contraceptives as a form of protection against pregnancy or disease. Suggestions for future research and trends in television programming policies are explored.

  8. [Sexual abuse of minors].

    PubMed

    Hayez, J Y

    1991-01-01

    The author gives a definition of sexual abuse on minors, emphasizing its more frequent occurrence inside the family (incest) than outside. He describes the countertransference reactions induced by this type of abuse, especially in professional teams who tend to put each other in a position of rivalry. Next, he sketches the pathogeny of sexual abuse, the clinical signs and the long term effects. The author deduces what should be the first signs of sexual abuse and proposes a pattern of diagnosis. Finally, he explains a management model, of the crisis and the follow-up of this difficult situation. PMID:1670411

  9. AIDS and human sexuality.

    PubMed

    Smith, L L; Lathrop, L M

    1993-01-01

    The sexual behaviours placing an individual at risk for HIV infection are those also placing him/her at risk for gonorrhoea, syphilis, hepatitis B, chlamydia and unplanned pregnancy. This article proposes that approaches to HIV prevention must be included within a broad context of human sexuality. To address disease prevention in the absence of including people's relationships, social, behavioural and emotional needs is futile. Compartmentalization, denial of risk by various populations, and societal barriers are all factors to be overcome in the fight against HIV transmission. Specific strategies involved in a comprehensive approach are outlined under the categories of predisposing, enabling and reinforcing factors contributing to healthy sexual behaviour. PMID:8481861

  10. [Depression and sexual disorders].

    PubMed

    Ducrocq, F

    1999-01-01

    Nowadays, we talk more and more often about sexual disorders, and depression in one of the possible etiologies of them. Depression could lead to sexual disorders or induce them indirectly. Paradoxically, depression treatments, such as tricyclic antidepressant or SSRI could induce this kind of disorder. Tianeptine, the only molecule representative of this pharmacological class, has proved its good acceptability on the libido, as shown by the results of a meta-analysis. The respect of the sexual function is essential to obtain a good observance of the antidepressant treatment.

  11. AIDS and human sexuality.

    PubMed

    Smith, L L; Lathrop, L M

    1993-01-01

    The sexual behaviours placing an individual at risk for HIV infection are those also placing him/her at risk for gonorrhoea, syphilis, hepatitis B, chlamydia and unplanned pregnancy. This article proposes that approaches to HIV prevention must be included within a broad context of human sexuality. To address disease prevention in the absence of including people's relationships, social, behavioural and emotional needs is futile. Compartmentalization, denial of risk by various populations, and societal barriers are all factors to be overcome in the fight against HIV transmission. Specific strategies involved in a comprehensive approach are outlined under the categories of predisposing, enabling and reinforcing factors contributing to healthy sexual behaviour.

  12. [Sexuality and schizophrenia].

    PubMed

    de Molina Román, M R; Salvador Carulla, L; Foras Eroles, F

    1994-09-01

    The sex behaviour of patients suffering from schizophrenia has been largely overlooked. This study is aimed at describing the pattern of sexual responses and conducts in 113 inpatients with schizophrenia (DSM-III-R). A high rate of sexual dysfunction was found in both males (62.9%) and females (50%). These rates are higher than found in other previous studies. The possible cause factors of sexual dysfunctions in this group of patients and the methodological problems related to this type of study are reviewed.

  13. The evolving sexual health paradigm: transforming definitions into sexual health practices.

    PubMed

    Fortenberry, J Dennis

    2013-10-01

    Sexual health is an evolving paradigm that integrates a positive approach to sexuality with existing public health policy and practice for reducing the burdens of sexually transmitted infections, including those due to HIV. The sexual health paradigm rests in commitment to sexual rights, sexual knowledge, sexual choice, and sexual pleasure, as well as key elements of sexuality addressed by sexual desire, sexual arousal, and sexual function, and sexual behaviors. The sexual health paradigm offers new approaches to supporting general health and well being while reducing the burdens of sexual diseases and their consequences. PMID:24088679

  14. Congenitally corrected transposition of the great arteries in an 83-year-old asymptomatic patient: description and literature review

    PubMed Central

    Placci, Angelo; Lovato, Luigi; Bonvicini, Marco

    2014-01-01

    We describe the case of an 83-year-old asymptomatic man followed in our centre. Transoesophageal echocardiography disclosed congenitally corrected transposition of great arteries (CCTGA) with no associated anomalies and only mild aortic regurgitation. Cardiac MR confirmed the diagnosis and revealed preserved systemic ventricle systolic function with a normal perfusional pathway. This report is a demonstration that CCTGA without associated anomalies can reach older life in an asymptomatic condition. This is the oldest asymptomatic living patient with CCTGA ever described. PMID:25336547

  15. Perceptions of low agency and high sexual openness mediate the relationship between sexualization and sexual aggression.

    PubMed

    Blake, Khandis R; Bastian, Brock; Denson, Thomas F

    2016-09-01

    Researchers have become increasingly interested in the saturation of popular Western culture by female hypersexualization. We provide data showing that men have more sexually aggressive intentions toward women who self-sexualize, and that self-sexualized women are vulnerable to sexual aggression if two qualifying conditions are met. Specifically, if perceivers view self-sexualized women as sexually open and lacking agency (i.e., the ability to influence one's environment), they harbor more sexually aggressive intentions and view women as easier to sexually victimize. In Experiment 1, male participants viewed a photograph of a woman whose self-sexualization was manipulated through revealing versus non-revealing clothing. In subsequent experiments, men and women (Experiment 2) and men only (Experiment 3) viewed a photograph of a woman dressed in non-revealing clothing but depicted as open or closed to sexual activity. Participants rated their perceptions of the woman's agency, then judged how vulnerable she was to sexual aggression (Experiments 1 and 2) or completed a sexually aggressive intentions measure (Experiment 3). Results indicated that both men and women perceived self-sexualized women as more vulnerable to sexual aggression because they assumed those women were highly sexually open and lacked agency. Perceptions of low agency also mediated the relationship between women's perceived sexual openness and men's intentions to sexually aggress. These effects persisted even when we described the self-sexualized woman as possessing highly agentic personality traits and controlled for individual differences related to sexual offending. The current work suggests that perceived agency and sexual openness may inform perpetrator decision-making and that cultural hypersexualization may facilitate sexual aggression. Aggr. Behav. 42:483-497, 2016. © 2016 Wiley Periodicals, Inc. PMID:26848102

  16. Asymptomatic complete atrioventricular block in a 13-year-old girl.

    PubMed

    Sykes, Joseph Anthony; Lubega, Joseph; Ezetendu, Chidibere; Verma, Rajiv; O'Connor, Brian; Kalyanaraman, Meena

    2011-11-01

    Atrioventricular (AV) block is a delay or an interruption in the transmission of an impulse from atria to ventricles due to an anatomic or a functional impairment in the conduction system. Atrioventricular block may be congenital or acquired. Electrocardiographic screening of asymptomatic school-aged children (median, 12.4 years) in Japan found the prevalence of a third-degree AV block to be 2 per 100,000. We report a case of asymptomatic complete AV block of unknown etiology in a 13-year-old child who did not require pacemaker placement. The importance of recognizing an asymptomatic complete AV block in the pediatric population, the classification and controversies of pacemaker placement, and the complications of pacemaker placement are discussed.

  17. A Reservoir of Drug-Resistant Pathogenic Bacteria in Asymptomatic Hosts

    PubMed Central

    Perron, Gabriel G.; Quessy, Sylvain; Bell, Graham

    2008-01-01

    The population genetics of pathogenic bacteria has been intensively studied in order to understand the spread of disease and the evolution of virulence and drug resistance. However, much less attention has been paid to bacterial carriage populations, which inhabit hosts without producing disease. Since new virulent strains that cause disease can be recruited from the carriage population of bacteria, our understanding of infectious disease is seriously incomplete without knowledge on the population structure of pathogenic bacteria living in an asymptomatic host. We report the first extensive survey of the abundance and diversity of a human pathogen in asymptomatic animal hosts. We have found that asymptomatic swine from livestock productions frequently carry populations of Salmonella enterica with a broad range of drug-resistant strains and genetic diversity greatly exceeding that previously described. This study shows how agricultural practice and human intervention may lead and influence the evolution of a hidden reservoir of pathogens, with important implications for human health. PMID:19015729

  18. Asymptomatic severe aortic stenosis with normal left ventricular function - A review.

    PubMed

    Sathyamurthy, I; Jayanthi, K

    2016-01-01

    Aortic stenosis (AS) is one of the commonest forms of acquired valvular heart disease. Aortic valve replacement (AVR) is the treatment of choice for symptomatic severe AS. Conservative management is usually advocated for asymptomatic severe AS. But there are data on predictors to identify subsets of asymptomatic AS patients at high risk of cardiac events in whom early surgical intervention is warranted. Non-invasive tests like exercise stress test, exercise echocardiography will help us to identify those who are at high risk of developing early symptoms due to LV dysfunction and also those at high risk of sudden death. In this article, an attempt is made to review the literature on this subset of asymptomatic severe AS to help clinicians to decide regarding the need for early aortic valve replacement in them. PMID:27543485

  19. Clinical Utility of Serologic Testing for Celiac Disease in Asymptomatic Patients

    PubMed Central

    2011-01-01

    Executive Summary Objective The objective of this evidence-based analysis was to evaluate the clinical utility of serologic testing for celiac disease in asymptomatic individuals presenting with one of the non-gastrointestinal conditions evaluated in this report. The clinical utility was based on the effects of a gluten-free diet (GFD) on outcomes specific to each of these conditions. The prevalence of celiac disease in asymptomatic individuals and one of these non-gastrointestinal conditions was also evaluated. Clinical Need and Target Population Celiac Disease Celiac disease is an autoimmune disease characterized by a chronic inflammatory state of the proximal small bowel mucosa accompanied by structural and functional changes. Technology Under Evaluation Serologic Tests for Celiac Disease There are a number of serologic tests for celiac disease available. Serologic tests are automated with the exception of the anti-endomysial antibody test, which is more time-consuming and operator-dependent than the other tests. Research Questions What is the prevalence of asymptomatic celiac disease in patients presenting with one of the non-gastrointestinal conditions evaluated? What is the effect of the gluten-free diet on condition-specific outcomes in patients with asymptomatic celiac disease presenting with one of the non-gastrointestinal conditions evaluated? What is the clinical utility of serologic testing for celiac disease in asymptomatic patients presenting with one of the non-gastrointestinal conditions evaluated? The clinical utility was defined as the impact of the GFD on disease specific outcomes. What is the risk of all-cause mortality and lymphoma in individuals with asymptomatic celiac disease? What is the budget impact of serologic testing for celiac disease in asymptomatic subjects presenting with one of the non-gastrointestinal conditions evaluated? Research Methods Study Population The study population consisted of individuals with newly diagnosed celiac

  20. Antibody isotypes in urethral swabs of symptomatic and asymptomatic men infected with Trichomonas vaginalis.

    PubMed

    Imam, Naglaa F A; Eassa, Ahmed H A; Shoeib, Eman Y S; Abo-Raia, Gamal Y S

    2007-12-01

    Trichomoniasis may be asymptomatic or symptomatic in both sexes. The outcome of infection depends on the virulence factors of T. vaginalis, but these factors remain unclear. Genetic variability of the isolates and the host's immune response are likely to be key factors in that respect. Symptomatic and asymptomatic males infected with T. vaginalis were compared regarding the differences in antibody subclasses response in the urethral samples. In symptomatic cases there was a significant elevation in IgM, IgG1 & IgG2b levels in urethral samples, and a little, non-significant rise in IgG2a levels. However, there were no statistically significant differences between levels of IgA, IgG3 & IgG4. The results showed that specific IgG1 & IgM and to a lesser extent IgG2 may be involved in established symptomatic trichomoniasis in men, compared to asymptomatic ones. PMID:18383797

  1. MRI of the athletic knee. Findings in asymptomatic professional basketball and collegiate football players.

    PubMed

    Brunner, M C; Flower, S P; Evancho, A M; Allman, F L; Apple, D F; Fajman, W A

    1989-01-01

    For the dedicated athlete in whom minor injuries are frequent and major injuries relatively common, a noninvasive knee assessment could either obviate the need for arthroscopy or focus its direction. The opportunity to study asymptomatic athletes was not feasible before the advent of magnetic resonance imaging (MRI). In this preliminary work, we examined 40 knees in 20 asymptomatic volunteer athletes, including five professional basketball players and 15 collegiate football players. Images were obtained at 0.5 T or 1.5 T. Spin echo sequences were used to obtain 5.0 mm thick coronal and sagittal sections. Fifty percent of asymptomatic athletes (10/20) had significant baseline MRI abnormalities that could have adversely affected scan interpretation in the context of an acute injury. Half of these athletes with MRI abnormalities, or 25% of the total (5/20), had no previous surgery and were unaware of significant injury.

  2. Electrophysiology testing and catheter ablation are helpful when evaluating asymptomatic patients with Wolff-Parkinson-White pattern: the pro perspective.

    PubMed

    Pappone, Carlo; Santinelli, Vincenzo

    2015-09-01

    Important advances in the natural history and diagnosis of, and therapy for, asymptomatic Wolff-Parkinson-White (WPW) syndrome have been made in the last decade by our group. These data have necessitated revisiting current practice guidelines to decide on the optimal management of the asymptomatic WPW population. There has also been an emphasis on identifying initially asymptomatic individuals who are at risk by nationwide screening programs using the electrocardiogram for prophylactic catheter ablation to prevent the lifetime risk of sudden cardiac death, particularly in young asymptomatic people, because only a subgroup of them is at high risk, requiring early catheter ablation.

  3. Sexual Behavior, Sexual Knowledge, and Sexual Attitudes of Emerging Adult Women: Implications for Working with Families

    ERIC Educational Resources Information Center

    Byno, Lucy H.; Mullis, Ronald L.; Mullis, Ann K.

    2009-01-01

    The purpose of this study was twofold: first, to examine the sexual behavior of emerging adult women in relation to their sexual knowledge, sexual attitudes, and perceptions of their parents' sexual attitudes; and second, to discuss the implications of this research in working with young adult women. Three hundred and sixty-four college-age women…

  4. Sexual Scripts and Sexual Risk Behaviors among Black Heterosexual Men: Development of the Sexual Scripts Scale

    PubMed Central

    Bowleg, Lisa; Burkholder, Gary J.; Noar, Seth M.; Teti, Michelle; Malebranche, David J.; Tschann, Jeanne M.

    2014-01-01

    Sexual scripts are widely shared gender and culture-specific guides for sexual behavior with important implications for HIV prevention. Although several qualitative studies document how sexual scripts may influence sexual risk behaviors, quantitative investigations of sexual scripts in the context of sexual risk are rare. This mixed methods study involved the qualitative development and quantitative testing of the Sexual Scripts Scale (SSS). Study 1 included qualitative semi-structured interviews with 30 Black heterosexual men about sexual experiences with main and casual sex partners to develop the SSS. Study 2 included a quantitative test of the SSS with 526 predominantly low-income Black heterosexual men. A factor analysis of the SSS resulted in a 34-item, seven-factor solution that explained 68% of the variance. The subscales and coefficient alphas were: Romantic Intimacy Scripts (α = .86), Condom Scripts (α = .82), Alcohol Scripts (α = .83), Sexual Initiation Scripts (α = .79), Media Sexual Socialization Scripts (α = .84), Marijuana Scripts (α = .85), and Sexual Experimentation Scripts (α = .84). Among men who reported a main partner (n = 401), higher Alcohol Scripts, Media Sexual Socialization Scripts, and Marijuana Scripts scores, and lower Condom Scripts scores were related to more sexual risk behavior. Among men who reported at least one casual partner (n = 238), higher Romantic Intimacy Scripts, Sexual Initiation Scripts, and Media Sexual Socialization Scripts, and lower Condom Scripts scores were related to higher sexual risk. The SSS may have considerable utility for future research on Black heterosexual men’s HIV risk. PMID:24311105

  5. Sexual Counseling and Therapy

    ERIC Educational Resources Information Center

    Hoch, Zwi

    1976-01-01

    The Ob/Gyn Department of Rambam University, Haifa, Israel, recently established a Center for Sexual Counseling, Therapy and Education. The Center's concept and format of therapy, and some preliminary observations, are presented. (Author)

  6. The Sexual Assault Examination

    PubMed Central

    Hargot, L. A.

    1985-01-01

    The sexual assault examination poses many problems for physicians. They must deal not only with the patient's physical and emotional trauma, but also collect forensic evidence, and provide proper treatment and follow-up. Patient management has been simplified and improved in Ontario by a standardized sexual assault examination kit. It has been used at McMaster University's Regional Sexual Assault Centre since its establishment in 1979. The first step in managing victims is ensuring their wellbeing, and treating them sympathetically. The kit provides information on consent, taking the sexual assault history, recording the patient's emotional status, and treatment guidelines. It also contains equipment and instructions on collecting clothing and body evidence, and on the genital and anal examination. The collection of good forensic evidence can decrease the need for doctors and nurses to testify in court. ImagesFig. 1 PMID:21274059

  7. Rape (sexual assault) - overview

    MedlinePlus

    Sex and rape; Date rape; Sexual assault ... Rape may occur between members of the same sex. This is more common in places such as prisons, military settings, and single-sex schools. People with physical or mental disabilities or ...

  8. Theories of Sexual Orientation.

    ERIC Educational Resources Information Center

    Storms, Michael D.

    1980-01-01

    Results indicated homosexuals, heterosexuals, and bisexuals did not differ within each sex on measures of masculinity and femininity. Strong support was obtained for the hypothesis that sexual orientation relates primarily to erotic fantasy orientation. (Author/DB)

  9. [Sexuality and death].

    PubMed

    Sapetti, Adrián

    2006-01-01

    It is intented to show two apparently antithetic poles: Sexuality and Death, in fact interpenetrate themselves, disguising the fear of death, or the desire to die, Eros' world. Different expressions of culture are analyzed, especially the one known as The Profane Time, the time for work, which is characterized by the submission to interdicts (prohibitions) and, on the other hand, the Time for Joy or The Sacred Time, characterized by the transgression of such prohibitions. Its relationship with the interdicts'violations in the sexual as well as in the death arena is analyzed in order to connect the human being's fear in the presence of the unrestraint, the overflow and the abandonment of the time established for work that would imply free sexuality. The latter is connected with some conclusions that could be considered useful in the field of Sexual Therapies, with a certain critical look at the mechanist settlement applied to those treatments.

  10. Understanding Sexual Violence

    MedlinePlus

    ... protective factors. Step 3: Develop and test prevention strategies Using information gathered in research, CDC develops and evaluates strategies ... or technical help so communities can adopt these strategies. For more information on sexual violence prevention activities at CDC, please ...

  11. Child Sexual Abuse

    MedlinePlus

    ... victim of prolonged sexual abuse usually develops low self-esteem, a feeling of worthlessness and an abnormal or ... can help abused children regain a sense of self-esteem, cope with feelings of guilt about the abuse, ...

  12. Sexuality in Older Adults

    MedlinePlus

    ... for your partner. It also benefits your physical health by reducing stress and making you feel good about yourself. As you age, your sexual health will change. But growing older doesn’t have ...

  13. Sexual Orientation (For Parents)

    MedlinePlus

    ... For Kids For Parents MORE ON THIS TOPIC Transgender People Teaching Your Child Tolerance STDs Understanding Early ... and Romance Am I in a Healthy Relationship? Transgender People Sexual Attraction and Orientation Contact Us Print ...

  14. Sexual Abuse of Children.

    ERIC Educational Resources Information Center

    Csapo, Marg

    1988-01-01

    Canadian reports and legislation are reviewed to highlight the school's role in prevention and reporting of suspicions of child sexual abuse. The vulnerability of handicapped children and child pornography are two areas of victimization emphasized. (Author/DB)

  15. The sexual assault examination.

    PubMed

    Hargot, L A

    1985-04-01

    The sexual assault examination poses many problems for physicians. They must deal not only with the patient's physical and emotional trauma, but also collect forensic evidence, and provide proper treatment and follow-up. Patient management has been simplified and improved in Ontario by a standardized sexual assault examination kit. It has been used at McMaster University's Regional Sexual Assault Centre since its establishment in 1979. The first step in managing victims is ensuring their wellbeing, and treating them sympathetically. The kit provides information on consent, taking the sexual assault history, recording the patient's emotional status, and treatment guidelines. It also contains equipment and instructions on collecting clothing and body evidence, and on the genital and anal examination. The collection of good forensic evidence can decrease the need for doctors and nurses to testify in court.

  16. Accurate Risk Assessment of Patients with Asymptomatic Hematuria for the Presence of Bladder Cancer

    PubMed Central

    Cha, Eugene K.; Tirsar, Lenuta-Ancuta; Schwentner, Christian; Hennenlotter, Joerg; Christos, Paul J.; Stenzl, Arnulf; Mian, Christine; Martini, Thomas; Pycha, Armin; Shariat, Shahrokh F.; Schmitz-Dräger, Bernd J.

    2014-01-01

    Purpose Bladder cancer is frequently diagnosed during a workup for hematuria. However, most patients with microscopic hematuria and many with gross hematuria are not appropriately referred to urologists. We hypothesized that in patients presenting with asymptomatic hematuria, the risk of having bladder cancer can be predicted with high accuracy. Towards this end, we analyzed risk factors in patients with asymptomatic hematuria and developed a nomogram for the prediction of bladder cancer presence. Methods Data from 1,182 consecutive subjects without a history of bladder cancer undergoing initial evaluation for asymptomatic hematuria were collected at three centers. Clinical risk factors including age, gender, smoking status, and degree of hematuria were recorded. All subjects underwent standard workup including voided cytology, upper tract imaging, and cystourethroscopy. Factors associated with the presence of bladder cancer were evaluated by univariable and multivariable logistic regression analyses. The multivariable analysis was used to construct a nomogram. Internal validation was performed using 200 bootstrap samples. Results Of the 1,182 subjects who presented with asymptomatic hematuria, 245 (20.7%) had bladder cancer. Increasing age (OR=1.03, p<0.0001), smoking history (OR=3.72, p<0.0001), gross hematuria (OR=1.71, p=0.002), and positive cytology (OR=14.71, p<0.0001) were independent predictors of bladder cancer presence. The multivariable model achieved 83.1% accuracy for predicting the presence of bladder cancer. Conclusions Bladder cancer presence can be predicted with high accuracy in patients who present with asymptomatic hematuria. We developed a nomogram to help optimize referral patterns (i.e., timing and prioritization) of patients with asymptomatic hematuria. PMID:23124847

  17. The nature of iron deposits differs between symptomatic and asymptomatic carotid atherosclerotic plaques

    SciTech Connect

    Kopriva, David; Kisheev, Anastasye; Meena, Deiter; Pelle, Shaneen; Karnitsky, Max; Lavoie, Andrea; Buttigieg, Josef; Hagemeyer, Christoph E.

    2015-11-25

    Iron within atherosclerotic plaque has been implicated as a catalyst of oxidative stress that causes progression of plaque, and plaque rupture. Iron is believed to accumulate within plaque by incorporation of erythrocytes following plaque rupture and hemorrhage. There is only indirect evidence to support this hypothesis. Plaque specimens were obtained from ten symptomatic and fifteen asymptomatic patients undergoing carotid endarterectomy at a single institution. Plaques were sectioned for study using synchrotron radiation induced X-ray fluorescence the study the distribution of zinc, calcium and iron. Histologic staining was carried out with Prussian Blue, and immunohistochemical staining was done to localize macrophages with CD68. Data were compared against patient clinical variables. Ten symptomatic (15 ± 10 days between index symptoms and surgery) and fifteen asymptomatic carotid plaques were studied. Zinc and calcium co-localized in mineralized areas of symptomatic and asymptomatic plaque. Iron was identified away from zinc and calcium in both symptomatic and asymptomatic plaques. Within the symptomatic plaques, iron was found within the thrombus associated with plaque rupture and hemorrhage. It did not stain with Prussian Blue, but was found in association with CD68 positive macrophages. In symptomatic plaques, the abundance of iron showed an association with the source patient’s LDL cholesterol (R2 = 0.39, Significance F = 0.05). Iron in asymptomatic plaque was present as hemosiderin/ferritin that stained positive with Prussian Blue, and was observed in association with CD68 positive macrophages. Iron in acutely symptomatic plaques is found within thrombus, in the presence of macrophages. Moreover, the abundance of iron in symptomatic plaques is associated with the source patient’s LDL cholesterol. Within asymptomatic plaques, iron is found in association with macrophages, as hemosiderin/ferritin.

  18. The nature of iron deposits differs between symptomatic and asymptomatic carotid atherosclerotic plaques

    DOE PAGES

    Kopriva, David; Kisheev, Anastasye; Meena, Deiter; Pelle, Shaneen; Karnitsky, Max; Lavoie, Andrea; Buttigieg, Josef; Hagemeyer, Christoph E.

    2015-11-25

    Iron within atherosclerotic plaque has been implicated as a catalyst of oxidative stress that causes progression of plaque, and plaque rupture. Iron is believed to accumulate within plaque by incorporation of erythrocytes following plaque rupture and hemorrhage. There is only indirect evidence to support this hypothesis. Plaque specimens were obtained from ten symptomatic and fifteen asymptomatic patients undergoing carotid endarterectomy at a single institution. Plaques were sectioned for study using synchrotron radiation induced X-ray fluorescence the study the distribution of zinc, calcium and iron. Histologic staining was carried out with Prussian Blue, and immunohistochemical staining was done to localize macrophagesmore » with CD68. Data were compared against patient clinical variables. Ten symptomatic (15 ± 10 days between index symptoms and surgery) and fifteen asymptomatic carotid plaques were studied. Zinc and calcium co-localized in mineralized areas of symptomatic and asymptomatic plaque. Iron was identified away from zinc and calcium in both symptomatic and asymptomatic plaques. Within the symptomatic plaques, iron was found within the thrombus associated with plaque rupture and hemorrhage. It did not stain with Prussian Blue, but was found in association with CD68 positive macrophages. In symptomatic plaques, the abundance of iron showed an association with the source patient’s LDL cholesterol (R2 = 0.39, Significance F = 0.05). Iron in asymptomatic plaque was present as hemosiderin/ferritin that stained positive with Prussian Blue, and was observed in association with CD68 positive macrophages. Iron in acutely symptomatic plaques is found within thrombus, in the presence of macrophages. Moreover, the abundance of iron in symptomatic plaques is associated with the source patient’s LDL cholesterol. Within asymptomatic plaques, iron is found in association with macrophages, as hemosiderin/ferritin.« less

  19. The Nature of Iron Deposits Differs between Symptomatic and Asymptomatic Carotid Atherosclerotic Plaques

    PubMed Central

    Kopriva, David; Kisheev, Anastasye; Meena, Deiter; Pelle, Shaneen; Karnitsky, Max; Lavoie, Andrea; Buttigieg, Josef

    2015-01-01

    Iron within atherosclerotic plaque has been implicated as a catalyst of oxidative stress that causes progression of plaque, and plaque rupture. Iron is believed to accumulate within plaque by incorporation of erythrocytes following plaque rupture and hemorrhage. There is only indirect evidence to support this hypothesis. Plaque specimens were obtained from ten symptomatic and fifteen asymptomatic patients undergoing carotid endarterectomy at a single institution. Plaques were sectioned for study using synchrotron radiation induced X-ray fluorescence the study the distribution of zinc, calcium and iron. Histologic staining was carried out with Prussian Blue, and immunohistochemical staining was done to localize macrophages with CD68. Data were compared against patient clinical variables. Ten symptomatic (15 ± 10 days between index symptoms and surgery) and fifteen asymptomatic carotid plaques were studied. Zinc and calcium co-localized in mineralized areas of symptomatic and asymptomatic plaque. Iron was identified away from zinc and calcium in both symptomatic and asymptomatic plaques. Within the symptomatic plaques, iron was found within the thrombus associated with plaque rupture and hemorrhage. It did not stain with Prussian Blue, but was found in association with CD68 positive macrophages. In symptomatic plaques, the abundance of iron showed an association with the source patient’s LDL cholesterol (R2 = 0.39, Significance F = 0.05). Iron in asymptomatic plaque was present as hemosiderin/ferritin that stained positive with Prussian Blue, and was observed in association with CD68 positive macrophages. Iron in acutely symptomatic plaques is found within thrombus, in the presence of macrophages. The abundance of iron in symptomatic plaques is associated with the source patient’s LDL cholesterol. Within asymptomatic plaques, iron is found in association with macrophages, as hemosiderin/ferritin. PMID:26606178

  20. Multidimensional characterization of sexual minority adolescents' sexual safety strategies.

    PubMed

    Masters, N Tatiana; Beadnell, Blair; Morrison, Diane M; Hoppe, Marilyn J; Wells, Elizabeth A

    2013-10-01

    Young adults have high rates of sexually transmitted infections (STIs). Sexual minority youths' risk for STIs, including HIV, is as high as or higher than sexual majority peers'. Sexual safety, while often treated as a single behavior such as condom use, can be best conceptualized as the result of multiple factors. We used latent class analysis to identify profiles based on ever-used sexual safety strategies and lifetime number of partners among 425 self-identified LGBTQ youth aged 14-19. Data collection took place anonymously online. We identified four specific subgroup profiles for males and three for females, with each subgroup representing a different level and type of sexual safety. Profiles differed from each other in terms of age and outness for males, and in outness, personal homonegativity, and amount of education received about sexual/romantic relationships for females. Youths' sexual safety profiles have practice implications for sexuality educators, health care professionals, and parents.

  1. Asymptomatic Incidental Ductal Carcinoma in situ in a Male Breast Presenting with Contralateral Gynecomastia

    PubMed Central

    Isley, Laura M.; Leddy, Rebecca J.; Rumboldt, Tihana; Bernard, Jacqueline M.

    2012-01-01

    Ductal carcinoma in situ (DCIS) in males is rare and usually presents with symptoms on the affected side, such as, palpable mass or bloody nipple discharge. Even as DCIS has been reported in conjunction with gynecomastia in the same breast, we report an unusual case of a 62-year-old Caucasian male, with no family history of breast cancer, who presented with symptomatic side gynecomastia, and was incidentally found to have DCIS in a completely asymptomatic left breast. To the best of our knowledge, this case is the first report in literature of asymptomatic, incidentally discovered DCIS in a male patient. PMID:22530182

  2. [Risk factors of asymptomatic hypertension on the territory of Posusje Municipality (Bosnia and Herzegovina)].

    PubMed

    Beslić, Jozo; Pjevac, Neda; Sakić, Vjera; Pjevac, Nada

    2012-05-01

    Arterial hypertension is the leading mortality risk factor. The aim of the study was to assess the rate of asymptomatic hypertension detected in a randomly selected population sample in Posusje Municipality according to the grade of hypertension (mild, moderate or severe) and risk factors. The following risk factors were analyzed: intake of saturated fatty acids, alcohol, tobacco products and black coffee. Asymptomatic hypertension was detected in 532 of 2000 (26.60%) subjects included in the study. In comparison to the rest of the study sample, these 532 subjects reported a statistically significantly higher consumption of saturated fatty acids, alcohol, tobacco products and black coffee.

  3. Asymptomatic inhaled foreign body. A bullet in the lung for 2 years.

    PubMed

    Salim, Muhammad U; Asghar, Asif; Tareen, Irum; Azhar, Muhammad

    2016-10-01

    It is very rare to have a big foreign body in the lungs without any complications or symptoms for 2 years. A 14-year-old male with episodes of minor hemoptysis for 4 weeks had a history of inhalation of a bullet 2 years earlier. He had asymptomatic for lung complications for 2 years. The bullet was removed by right thoracotomy and  non-anatomical wedge stapled resection, and he followed an uneventful recovery. An aspirated foreign body although big can remain asymptomatic for a long time, especially if it has migrated to the periphery. PMID:27652366

  4. Symptomatic and asymptomatic benign prostatic hyperplasia: Molecular differentiation by using microarrays

    NASA Astrophysics Data System (ADS)

    Prakash, Kulkarni; Pirozzi, Gregorio; Elashoff, Michael; Munger, William; Waga, Iwao; Dhir, Rajiv; Kakehi, Yoshiyuki; Getzenberg, Robert H.

    2002-05-01

    Benign prostatic hyperplasia (BPH) is a disease of unknown etiology that significantly affects the quality of life in aging men. Histologic BPH may present itself either as symptomatic or asymptomatic in nature. To elucidate the molecular differences underlying BPH, gene expression profiles from the prostate transition zone tissue have been analyzed by using microarrays. A set of 511 differentially expressed genes distinguished symptomatic and asymptomatic BPH. This genetic signature separates BPH from normal tissue but does not seem to change with age. These data could provide novel approaches for alleviating symptoms and hyperplasia in BPH.

  5. Female sexual dysfunction.

    PubMed

    Aslan, Erdogan; Fynes, Michelle

    2008-02-01

    Female sexual dysfunction is a common problem with detrimental effects on woman's quality of life. It also has an economical and societal impact. It is defined as disorders of sexual desire, arousal, orgasm, and sexual pain, which lead to personal distress. The etiology of sexual dysfunction is frequently multifactorial as it relates to general physical and mental well-being, quality of relationship, past sexual functioning, social class, education, employment, life stressors, personality factors, the presence of a sexual partner, and partner's age and health. It is very important to adopt the most efficient approach to gather information, and this may be achieved via standardized questionnaires or open-ended questions. Therapy should be tailored according to the patient's needs and may involve a multidisciplinary team approach including psychosexual counselor/sexologist/therapist and the physician. There is still more work needed to optimize the care of women with this problem. Priority should be given to international standardization and training of health care professionals.

  6. Activation of Nesfatin-1-Containing Neurones in the Hypothalamus and Brainstem by Peripheral Administration of Anorectic Hormones and Suppression of Feeding via Central Nesfatin-1 in Rats.

    PubMed

    Saito, R; So, M; Motojima, Y; Matsuura, T; Yoshimura, M; Hashimoto, H; Yamamoto, Y; Kusuhara, K; Ueta, Y

    2016-09-01

    Peripheral anorectic hormones, such as glucagon-like peptide (GLP)-1, cholecystokinin (CCK)-8 and leptin, suppress food intake. The newly-identified anorectic neuropeptide, nesfatin-1, is synthesised in both peripheral tissues and the central nervous system, particularly by various nuclei in the hypothalamus and brainstem. In the present study, we examined the effects of i.p. administration of GLP-1 and CCK-8 and co-administrations of GLP-1 and leptin at subthreshold doses as confirmed by measurement of food intake, on nesfatin-1-immunoreactive (-IR) neurones in the hypothalamus and brainstem of rats by Fos immunohistochemistry. Intraperitoneal administration of GLP-1 (100 μg/kg) caused significant increases in the number of nesfatin-1-IR neurones expressing Fos-immunoreactivity in the supraoptic nucleus (SON), the area postrema (AP) and the nucleus tractus solitarii (NTS) but not in the paraventricular nucleus (PVN), the arcuate nucleus (ARC) or the lateral hypothalamic area (LHA). On the other hand, i.p. administration of CCK-8 (50 μg/kg) resulted in marked increases in the number of nesfatin-1-IR neurones expressing Fos-immunoreactivity in the SON, PVN, AP and NTS but not in the ARC or LHA. No differences in the percentage of nesfatin-1-IR neurones expressing Fos-immunoreactivity in the nuclei of the hypothalamus and brainstem were observed between rats treated with saline, GLP-1 (33 μg/kg) or leptin. However, co-administration of GLP-1 (33 μg/kg) and leptin resulted in significant increases in the number of nesfatin-1-IR neurones expressing Fos-immunoreactivity in the AP and the NTS. Furthermore, decreased food intake induced by GLP-1, CCK-8 and leptin was attenuated significantly by pretreatment with i.c.v. administration of antisense nesfatin-1. These results indicate that nesfatin-1-expressing neurones in the brainstem may play an important role in sensing peripheral levels of GLP-1 and leptin in addition to CCK-8, and also suppress food intake in

  7. Association between metabolic syndrome and subclinical coronary atherosclerosis in asymptomatic adults.

    PubMed

    Kullo, Iftikhar J; Cassidy, Andrea E; Peyser, Patricia A; Turner, Stephen T; Sheedy, Patrick F; Bielak, Lawrence F

    2004-12-15

    Metabolic syndrome was associated with the presence and quantity of coronary artery calcium, a marker of subclinical coronary atherosclerosis, in 1,129 asymptomatic adults, ages 20 to 79 years, from a community-based study. The association was independent of 10-year risk of coronary heart disease based on the Framingham risk score.

  8. Discrepancies between Knowledge and Use of Diagnostic Studies in Asymptomatic Patients.

    ERIC Educational Resources Information Center

    Greenland, Philip; And Others

    1979-01-01

    Rochester, New York, physicians and graduate medical students' use of laboratory tests as applied to asymptomatic patients was surveyed and their knowledge of four specific screening procedures was tested. The results reinforce the impression that laboratory ordering practices are dependent in part upon factors other than knowledge of test…

  9. No evidence of asymptomatic variant CJD infection in immunodeficiency patients treated with UK-sourced immunoglobulin.

    PubMed

    Helbert, M R; Bangs, C; Bishop, M; Molesworth, A; Ironside, J

    2016-04-01

    Surveillance of 75 immunodeficiency patients exposed to UK-sourced immunoglobulin, including batches derived from donors who went on to develop vCJD, has not detected any clinical cases of vCJD, or of asymptomatic infection in 15 patients with available tissue samples of sufficient quality for testing. PMID:26529032

  10. Excretion of serotype G1 rotavirus strains by asymptomatic staff: a possible source of nosocomial infection.

    PubMed

    Barnes, Graeme L; Callaghan, Sarah L; Kirkwood, Carl D; Bogdanovic-Sakran, Nada; Johnston, Linda J; Bishop, Ruth F

    2003-06-01

    This study supports the hypothesis that feces from asymptomatic adults may provide a vehicle for the transmission of rotavirus, in addition to aerosols, hands, and fomites. The observed preferential carriage of serotype G1 strains in the adult gastrointestinal tract may explain G1 predominance and persistence in epidemiologic studies worldwide.

  11. Absence of Asymptomatic Malaria Infection in Endemic Area of Bashagard District, Hormozgan Province, Iran

    PubMed Central

    Turki, H; Zoghi, S; Mehrizi, A A; Zakeri, S; Raeisi, A; Khazan, H; Haghdoost, AA

    2012-01-01

    Background A successful malaria elimination program calls for enough attention to parasite carriers, especially asymptomatic malaria, as well as the diagnosis and treatment of clinical cases. Asymptomatic malaria is an infection that patients do not show any symptom; thus, these patients play critical role in the concept of an elimination program. The current investigation was conducted to evaluate the presence of these cases in Bashagard District, formerly a high malaria transmission area in Hormozgan Province, Iran. Methods Blood samples (n = 500) were collected from symptomless individuals residing in Bashagard to evaluate Plasmodium infection by using microscopic, serological and nested-PCR techniques. Results Regarding the microscopic and nested-PCR analysis, no asymptomatic infection was detected among studied individuals. Totally, 1% of the studied population (5 of 500) had anti PvMSP-119-specific IgG antibody; however, only 0.2% (1 of 500) of the individuals was seropositive to recombinant PfMSP-119, using ELISA. Conclusion This study showed no asymptomatic malaria infection in the studied population; hence malaria elimination is feasible and can be successfully carried out in this region. PMID:23133470

  12. Computer-enhanced thallium scintigrams in asymptomatic men with abnormal exercise tests

    SciTech Connect

    Uhl, G.S.; Kay, T.N.; Hickman, J.R. Jr.

    1981-12-01

    The use of treadmill testing in asymptomatic patients and those with an atypical chest pain syndrome is increasing, yet the proportion of false positive stress electrocardiograms increases as the prevalence of disease decreases. To determine the diagnostic accuracy of computer-enhanced thallium perfusion scintigraphy in this subgroup of patients, multigated thallium scans were obtained after peak exercise and 3 or 4 hours after exercise and the raw images enhanced by a computer before interpretations were made. The patient group consisted of 191 asymptomatic U.S. Air force aircrewmen who had an abnormal exercise electrocardiogram. Of these, 135 had normal coronary angiographic findings, 15 had subcritical coronary stenosis (less than 50 percent diameter narrowing) and 41 had significant coronary artery disease. Use of computer enhancement resulted in only four false positive and two false negative scintigrams. The small subgroup with subcritical coronary disease had equivocal results on thallium scintigraphy, 10 men having abnormal scans and 5 showing no defects. The clinical significance of such subcritical disease in unclear, but it can be detected with thallium scintigraphy. Thallium scintigrams that have been enhanced by readily available computer techniques are an accurate diagnostic tool even in asymptomatic patients with an easily interpretable abnormal maximal stress electrocardiogram. Thallium scans can be effectively used in counseling asymptomatic patients on the likelihood of their having coronary artery disease.

  13. Can repeated plasma donation by asymptomatic HIV-infected individuals delay the onset of AIDS?

    PubMed Central

    Bainbridge, D R; Lowdell, M W; Hannet, I M; Strauss, K W; Karpas, A

    1997-01-01

    Healthy HIV-positive regular donors of plasma in a programme of passive immunotherapy for AIDS patients were studied over a period of about two years. None developed symptoms of clinical progression; most seemed to make substantial gains of CD4 cells by comparison with asymptomatic individuals who were not donating. The effects of donation did not seem to diminish with repetition, and donor CD4 counts tended towards stabilizing within normal limits. Asymptomatic HIV-positive individuals were compared immunologically with 'normals' and people with AIDS, using a battery of 25 measurements on peripheral blood. The immunological profiles of donor and non-donor asymptomatics, indistinguishable at the start, became dissimilar: donors' profiles resembled AIDS less, non-donors became less like 'normal' and a few non-donor results could not be distinguished from AIDS. Improvement in the CD4 counts and amelioration of the immunological profile in donors provide prima facie evidence that plasmapheresis may be therapeutic for asymptomatic HIV-positive people. Further studies are justified. PMID:9279896

  14. Prevalence and genotype distribution of human papillomavirus infection in asymptomatic women in Liaoning province, China.

    PubMed

    Xue, Hui; Lin, Xuyong; Li, Tianren; Yan, Xiaoxia; Guo, Kejun; Zhang, Yi

    2015-07-01

    Infection by human papillomavirus (HPV) is a necessary cause of cervical cancer. The purpose of this study was to investigate the prevalence and genotype distribution of HPV infection in Chinese women who were asymptomatic for cervical diseases. Cervical cytology samples were collected from 6479 asymptomatic Chinese women of Liaoning province, and tested for various HPV genotypes using a chip hybridization assay. HPV was found in 10.3% of all the asymptomatic women studied, with the prevalence of high risk HPV (HR HPV) and low risk HPV (LR HPV) being 9.5% and 1.1%, respectively. HPV genotypes 16, 52, and 58 were found the most frequently genotypes in the HR HPV positive women, and were present in 26.2%, 19.4% and 13.8%, respectively. A graph of HR HPV positive infection rates as a function of age is U-shaped, with a peak in women less than 30 years old and a second peak among women older than 50 years. Nearly half of the women infected with either HR HPV or LR HPV presented a normal looking cervix upon visual examination. The current study demonstrates that the epidemiology of HPV infection in asymptomatic Chinese women in Liaoning province is different from that in women from other regions, even from patients with cervical lesions in the same region. These findings could be used to guide the generation and design of an HPV vaccine for this population.

  15. Risk factors for symptomatic and asymptomatic norovirus infection in the community.

    PubMed

    Phillips, G; Tam, C C; Rodrigues, L C; Lopman, B

    2011-11-01

    The objective of this study was to investigate risk factors for norovirus-associated infectious intestinal disease (IID) and asymptomatic norovirus infection. Individuals with IID and healthy controls were recruited in a community-based study in England (1993-1996). This is the first risk-factor study to use viral load measurements, generated by real-time RT-PCR, to identify cases of norovirus-associated IID and asymptomatic infections. Using multivariable logistic regression the main risk factor identified for norovirus-associated IID was contact with a person with IID symptoms. Infectious contacts accounted for 54% of norovirus cases in young children and 39% of norovirus cases in older children and adults. For young children, contacts outside the household presented the highest risk; for older children and adults, the highest risk was associated with child contacts inside the household. Foreign travel and consumption of shellfish increased the risk of norovirus-associated IID. Lifestyle and dietary factors were associated with a decreased risk of both norovirus-associated IID and asymptomatic infection. No risk factors were identified for asymptomatic norovirus infection.

  16. Asymptomatic Plasmodium Infections in Children in Low Malaria Transmission Setting, Southwestern Uganda1

    PubMed Central

    Roh, Michelle E.; Oyet, Caesar; Orikiriza, Patrick; Wade, Martina; Kiwanuka, Gertrude N.; Mwanga-Amumpaire, Juliet; Boum, Yap

    2016-01-01

    A survey of asymptomatic children in Uganda showed Plasmodium malariae and P. falciparum parasites in 45% and 55% of microscopy-positive samples, respectively. Although 36% of microscopy-positive samples were negative by rapid diagnostic test, 75% showed P. malariae or P. ovale parasites by PCR, indicating that routine diagnostic testing misses many non–P. falciparum malarial infections. PMID:27434741

  17. Asymptomatic Plasmodium Infections in Children in Low Malaria Transmission Setting, Southwestern Uganda(1).

    PubMed

    Roh, Michelle E; Oyet, Caesar; Orikiriza, Patrick; Wade, Martina; Kiwanuka, Gertrude N; Mwanga-Amumpaire, Juliet; Parikh, Sunil; Boum, Yap

    2016-08-01

    A survey of asymptomatic children in Uganda showed Plasmodium malariae and P. falciparum parasites in 45% and 55% of microscopy-positive samples, respectively. Although 36% of microscopy-positive samples were negative by rapid diagnostic test, 75% showed P. malariae or P. ovale parasites by PCR, indicating that routine diagnostic testing misses many non-P. falciparum malarial infections. PMID:27434741

  18. Cardiovascular risk evaluation and prevalence of silent myocardial ischemia in subjects with asymptomatic carotid artery disease

    PubMed Central

    Ciccone, Marco Matteo; Niccoli-Asabella, Artor; Scicchitano, Pietro; Gesualdo, Michele; Notaristefano, Antonio; Chieppa, Domenico; Carbonara, Santa; Ricci, Gabriella; Sassara, Marco; Altini, Corinna; Quistelli, Giovanni; Lepera, Mario Erminio; Favale, Stefano; Rubini, Giuseppe

    2011-01-01

    Introduction: Silent ischemia is an asymptomatic form of myocardial ischemia, not associated with angina or anginal equivalent symptoms, which can be demonstrated by changes in ECG, left ventricular function, myocardial perfusion, and metabolism. The aim of this study was to evaluate the prevalence of silent myocardial ischemia in a group of patients with asymptomatic carotid stenosis. Methods: A total of 37 patients with asymptomatic carotid plaques, without chest pain or dyspnea, was investigated. These patients were studied for age, sex, hypertension, diabetes, dyslipidemia, smoking, and family history of cardiac disease, and underwent technetium-99 m sestamibi myocardial stress-rest scintigraphy and echo-color Doppler examination of carotid arteries. Results: A statistically significant relationship (P = 0.023) was shown between positive responders and negative responders to scintigraphy test when both were tested for degree of stenosis. This relationship is surprising in view of the small number of patients in our sample. Individuals who had a positive scintigraphy test had a mean stenosis degree of 35% ± 7% compared with a mean of 44% ± 13% for those with a negative test. Specificity of our detection was 81%, with positive and negative predictive values of 60% and 63%, respectively. Conclusion: The present study confirms that carotid atherosclerosis is associated with coronary atherosclerosis and highlights the importance of screening for ischemic heart disease in patients with asymptomatic carotid plaques, considering eventually plaque morphology (symmetry, composition, eccentricity or concentricity of the plaque, etc) for patient stratification. PMID:21468172

  19. Aceruloplasminemia in an asymptomatic patient with a new mutation. Diagnosis and family genetic analysis.

    PubMed

    Pérez-Aguilar, Fernando; Burguera, Juan A; Benlloch, Salvador; Berenguer, Marina; Rayón, Jose M

    2005-06-01

    A 39-year-old asymptomatic man showed elevated serum ferritin levels, mild hypertransaminasemia and serum ceruloplasmin almost undetectable. There was histological iron accumulation within the hepatocytes and also in the central nervous system (MRI). A genetic analysis revealed a new missense mutation in the ceruloplasmin gene. Two of the other four siblings were also affected by this mutation.

  20. Risk stratifying asymptomatic aortic stenosis: role of the resting 12-lead ECG.

    PubMed

    Greve, Anders M

    2014-02-01

    Despite being routinely performed in the clinical follow-up of asymptomatic AS patients, little or no evidence describes the prognostic value of ECG findings in asymptomatic AS populations. This PhD thesis examined the correlates of resting 12-lead ECG variables with echocardiographic measures of AS severity and cardiovascular outcomes in the till date largest cohort (n=1,563) of asymptomatic patients with mild-to-moderate AS. Most importantly, this PhD thesis demonstrated that QRS-duration adds independent predictive value of sudden cardiac death and that the additional presence of ECG LVH/strain for fixed AS severity represents a lethal risk attribute. Finally, ECG abnormalities displayed low/moderate concordance with echocardiographic parameters. This argues that the ECG should be regarded as a separate tool for obtaining prognostically important information. Treatment was not randomized by ECG findings, future studies should therefore examine if and which ECG variables should elicit closer follow-up and/or earlier intervention to improve prognosis in asymptomatic AS populations. PMID:24495893

  1. The impact of sexual trauma on sexual desire and function.

    PubMed

    McCarthy, Barry; Farr, Emily

    2011-01-01

    The field of sexual trauma is one of the most controversial and value-laden in mental health. The three factors which most affect adult sexual desire and function are the type of sexual trauma, how the sexual incidents were dealt with at the time and, most important, whether the person views her/himself as a survivor or victim. The assessment and treatment program described focuses on couple sex therapy with a special focus on processing the sexual trauma, honoring the person's veto and being 'partners in healing'. The core therapeutic theme is valuing intimate, erotic sexuality, which reinforces being a proud survivor rather than a shameful, anxious or angry victim. It is crucial to create a relapse prevention program to ensure that the person with the sexual trauma history continues to experience the positive roles of adult couple sexuality. PMID:22005207

  2. Sexual abuse in children - what to know

    MedlinePlus

    Sexual abuse - children ... are sexually abused before they turn 18. Sexual abuse of children is any activity that the abuser ... or vagina Tongue kissing Oral sex Intercourse Sexual abuse can also happen without physical contact, such as: ...

  3. Early adolescents' sexual behaviors.

    PubMed

    Porter, C P; Ronis, D L; Oakley, D J; Guthrie, B J; Killion, C

    1999-01-01

    The purpose of this study was to analyze changes in early adolescents' intimate behaviors and the initiation of sexual intercourse over a one-year time period. The changes are interpreted within the context of recent progress in understanding the development of early adolescents. Public school students in sixth and ninth grades of selected schools in a midwestern industrial city were studied in two waves of data collection. A total of 106 students provided data for the second year, allowing comparisons of their Time 2 with their Time 1 responses. Five of eight intimate behaviors studied increased in frequency during the year. Also, the adolescents' perceived benefits of having sexual intercourse increased and perceived costs decreased during the follow-up year. Increases in the frequency of intimate behaviors but not changes in their perceptions of the benefits and costs predicted whether or not students had initiated sexual intercourse during the follow-up period. These findings support current understanding of early adolescence as a time of incremental learning about intimacy and about sexual relationships. The findings suggest that preventing early sexual intercourse may require understanding the specific behavioral competencies related to healthful development of intimacy. Pediatric nurses can be leaders in providing the necessary counseling and education to young adolescents, their families, and their communities.

  4. The Impact of Sexual Orientation on Sexuality and Sexual Practices in North American Medical Students

    PubMed Central

    Breyer, Benjamin N.; Smith, James F.; Eisenberg, Michael L.; Ando, Kathryn A.; Rowen, Tami S.; Shindel, Alan W.

    2013-01-01

    Introduction There has been limited investigation of the sexuality and sexual dysfunction in non-heterosexual subjects by the sexual medicine community. Additional research in these populations is needed. Aims To investigate and compare sexuality and sexual function in students of varying sexual orientations. Methods An internet-based survey on sexuality was administered to medical students in North American between the months of February and July of 2008. Main Outcome Measures All subjects provided information on their ethnodemographic characteristics, sexual orientation, and sexual history. Subjects also completed a series of widely-utilized instruments for the assessment of human sexuality (International Index of Erectile Function [IIEF], Female Sexual Function Index [FSFI], Premature Ejaculation Diagnostic Tool [PEDT], Index of Sex Life [ISL]). Results There were 2,276 completed responses to the question on sexual orientation. 13.2% of male respondents and 4.7% of female respondents reported a homosexual orientation; 2.5% of male and 5.7% of female respondents reported a bisexual orientation. Many heterosexual males and females reported same-sex sexual experiences (4% and 10%, respectively). Opposite-sex experiences were very common in the male and female homosexual population (37% and 44%, respectively). The prevalence of premature ejaculation (PEDT > 8) was similar among heterosexual and homosexual men (16% and 17%, P = 0.7, respectively). Erectile dysfunction (IIEF-EF < 26) was more common in homosexual men relative to heterosexual men (24% vs. 12%, P = 0.02). High risk for female sexual dysfunction (FSFI < 26.55) was more common in heterosexual and bisexual women compared with lesbians (51%, 45%, and 29%, respectively, P = 0.005). Conclusion In this survey of highly educated young professionals, numerous similarities and some important differences in sexuality and sexual function were noted based on sexual orientation. It is unclear whether the

  5. Psychiatric disorders and sexual dysfunction.

    PubMed

    Waldinger, Marcel D

    2015-01-01

    Sexual problems are highly prevalent among patients with psychiatric disorders. They may be caused by the psychopathology of the psychiatric disorder but also by its pharmacotherapy. Both positive symptoms (e.g., psychosis, hallucinations) as well as negative symptoms (e.g., anhedonia) of schizophrenia may negatively interfere with interpersonal and sexual relationships. Atypical antipsychotics have fewer sexual side-effects than the classic antipsychotics. Mood disorders may affect libido, sexual arousal, orgasm, and erectile function. With the exception of bupropion, agomelatine, mirtazapine, vortioxetine, amineptine, and moclobemide, all antidepressants cause sexual side-effects. Selective serotonin reuptake inhibitors (SSRIs) may particularly delay ejaculation and female orgasm, but also can cause decreased libido and erectile difficulties. SSRI-induced sexual side-effects are dose-dependent and reversible. Very rarely, their sexual side-effects persist after SSRI discontinuation. This is often preceded by genital anesthesia. Some personality characteristics are a risk factor for sexual dysfunction. Also patients with eating disorders may suffer from sexual difficulties. So far, research into psychotropic-induced sexual side-effects suffers from substantial methodologic limitations. Patients tend not to talk with their clinician about their sexual life. Psychiatrists and other doctors need to take the initiative to talk about the patient's sexual life in order to become informed about potential medication-induced sexual difficulties. PMID:26003261

  6. Chlamydia trachomatis infection and sexual behaviour among female students attending higher education in the Republic of Ireland

    PubMed Central

    O'Connell, Emer; Brennan, Wendy; Cormican, Martin; Glacken, Marita; O'Donovan, Diarmuid; Vellinga, Akke; Cahill, Niall; Lysaght, Fionnguala; O'Donnell, Joan

    2009-01-01

    Background There are no prevalence data on Chlamydia trachomatis relating to female students attending higher education available for the Republic of Ireland. This information is required to guide on the necessity for Chlamydia screening programmes in higher education settings. This research aimed to determine the prevalence of and predictive risk factors for Chlamydia trachomatis genital infection among female higher education students in Ireland. Methods All females presenting during one-day periods at Student Health Units in three higher education institutions in two cities in the Republic of Ireland were invited to participate. Participants completed a questionnaire on lifestyle and socio-demographic factors and provided a urine sample. Samples were tested for C. trachomatis DNA by a PCR based technique (Cobas Amplicor, Roche). To examine possible associations between a positive test and demographic and lifestyle risk factors, a univariate analysis was performed. All associations with a p value < 0.05 were included in a multivariate logistic regression analysis. Results Of the 460 sexually active participants 22 tested positive (prevalence 4.8%; 95% CI 3.0 to 7.1%). Variables associated with significantly increased risk were current suggestive symptoms, two or more one-night stands and three or more lifetime sexual partners. The students displayed high-risk sexual behaviour. Conclusion The prevalence of C. trachomatis infection and the lack of awareness of the significance of suggestive symptoms among sexually experienced female students demonstrate the need for a programme to test asymptomatic or non-presenting higher education students. The risk factors identified by multivariate analysis may be useful in identifying those who are most likely to benefit from screening. Alcohol abuse, condom use, sexual behaviour (at home and abroad) and, knowledge of sexually transmitted infections (STIs) (including asymptomatic nature or relevant symptoms) were identified as

  7. Should We Screen for Coronary Heart Disease in Asymptomatic Persons?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center.

    PubMed

    Smetana, Gerald W; Cutlip, Donald E; Pinto, Duane S

    2016-04-01

    In March 2015, the American College of Physicians (ACP) released a clinical guideline on the value of screening for coronary heart disease (CHD) in asymptomatic persons. The guideline authors found that results of screening studies are unlikely to change patient management or the intensity of risk factor reduction strategies. Most events occur in patients who are at low to intermediate risk for CHD; and in low-risk asymptomatic patients, percutaneous coronary intervention in "screen-positive" patients does not improve outcomes and creates unnecessary risks. As a result, the ACP recommended against screening for asymptomatic patients who are at low risk for CHD. Instead, it recommended a focus on proven strategies, such as treatment of hypertension and hypercholesterolemia, to reduce risk in appropriately selected asymptomatic persons. Two discussants weigh the evidence for and against screening for CHD in asymptomatic patients with varying degrees of risk and provide recommendations for a specific patient who is uncertain whether to proceed to screening. PMID:27043981

  8. [How could self help support patients and families with anorectal malformations?--Psychosocial help offers of SoMA eV].

    PubMed

    Schwarzer, Nicole

    2010-01-01

    To be born with an anorectal malformation means to suffer from a rare disease. The afflicted viscera and the consequences e. g. incontinence border on a taboo. In most instances it is necessary to have an interdisciplinary and long-term follow up of the patients. Involved children and their families benefit in a special way from the offers of a self-help organization. The feeling not to be alone helps to cope with the strain situation, as do the presented projects and offers which come up with the special needs of the patients. The everyday experience and capacity of the patients can be used to solve problems. On the one hand, self-help represents a pool of knowledge on the other hand it shows to the attending physician or therapist the long-term results achieved. Here a network of the different specialties is crucial. Especially in the psychosocial field where self-help organizations have reached their limits--there is a need for more psychotherapeutical support.

  9. Molecular genetic analysis of a de novo balanced translocation t(6;17)(p21.31;q11.2) associated with hypospadias and anorectal malformation.

    PubMed

    Mansouri, Mahmoud Reza; Carlsson, Birgit; Davey, Edward; Nordenskjöld, Agneta; Wester, Tomas; Annerén, Göran; Läckgren, Göran; Dahl, Niklas

    2006-03-01

    We report a young boy with penoscrotal hypospadias, anal atresia (AA) with a recto-urethral fistula, a hypoplastic kidney and a balanced translocation t(6;17)(p21.31;q11.2). Physical mapping of the breakpoints localized the chromosome 6 breakpoint within an intron of the gene lipoma HMGIC fusion partner-like 5 (LHFPL5) whereas the chromosome 17 breakpoint was mapped to the first intron of the 182-FIP gene encoding the Fragile X Mental Retardation Protein Interacting Protein. Sequence analysis across the breakpoints revealed an almost perfectly balanced translocation with a 2 bp deletion on the derivative chromosome 6 and a 7 bp duplication on the derivative chromosome 17. We identified a fusion transcript consisting of the first exon of 182-FIP and the last exon of LHFPL5 in patient-derived cells. Quantitative expression analysis of the genes flanking the breakpoints, revealed increased transcript levels for SFRS protein kinase 1 (SRPK1) and TAO kinase 1 (TAOK1) which suggests a positional effect due to the translocation. We hypothesize that the urogenital and anorectal malformations in the patient result from one or several mechanisms including disruption of the genes 182-FIP and LHFPL5, altered expression of the genes flanking the translocation breakpoints and, a gain of function mechanism mediated by the 182-FIP-LHFPL5 fusion transcript. PMID:16395596

  10. Identification of Bacteriology and Risk Factor Analysis of Asymptomatic Bacterial Colonization in Pacemaker Replacement Patients

    PubMed Central

    Chu, Xian-Ming; Yu, Hua; Sun, Xue-Xia; An, Yi; Li, Bing; Li, Xue-Bin

    2015-01-01

    Background Recent researches revealed that asymptomatic bacterial colonization on PMs might be ubiquitous and increase the risk of clinical PM infection. Early diagnosis of patients with asymptomatic bacterial colonization could provide opportunity for targeted preventive measures. Objective The present study explores the incidence of bacterial colonization of generator pockets in pacemaker replacement patients without signs of infection, and to analyze risk factors for asymptomatic bacterial colonization. Methods From June 2011 to December 2013, 118 patients underwent pacemaker replacement or upgrade. Identification of bacteria was carried out by bacterial culture and 16S rRNA sequencing. Clinical risk characteristics were analyzed. Results The total bacterial positive rate was 37.3% (44 cases), and the coagulase-negative Staphylococcus aureus detection rate was the highest. Twenty two (18.6%) patients had positive bacterial culture results, of which 50% had coagulase-negative staphylococcus. The bacterial DNA detection rate was 36.4 % (43 cases). Positive bacterial DNA results from pocket tissues and the surface of the devices were 22.0% and 29.7%, respectively. During follow-up (median, 27.0 months), three patients (6.8%, 3/44) became symptomatic with the same genus of microorganism, S. aureus (n=2) and S. epidermidis (n=1). Multivariable logistic regression analysis showed that history of bacterial infection, use of antibiotics, application of antiplatelet drugs, replacement frequency were independent risk factors for asymptomatic bacterial colonization. Conclusion There was a high incidence of asymptomatic bacterial colonization in pacemaker patients with independent risk factors. Bacterial culture combined genetic testing could improve the detection rate. PMID:25768661

  11. Accurate Serodetection of Asymptomatic Leishmania donovani Infection by Use of Defined Antigens

    PubMed Central

    Vallur, Aarthy C.; Reinhart, Caroline; Mohamath, Raodoh; Goto, Yasuyuki; Ghosh, Prakash; Mondal, Dinesh; Duthie, Malcolm S.

    2016-01-01

    Infection with Leishmania donovani is typically asymptomatic, but a significant number of individuals may progress to visceral leishmaniasis (VL), a deadly disease that threatens 200 million people in areas where it is endemic. While diagnosis of acute VL has been simplified by the use of cost-effective confirmatory serological tests, similar standardized tools are not widely available for detecting asymptomatic infection, which can be 4 to 20 times more prevalent than active disease. A simple and accurate serological test that is capable of detecting asymptomatic L. donovani infection will be useful for surveillance programs targeting VL control and elimination. To address this unmet need, we evaluated recombinant antigens for their ability to detect serum antibodies in 104 asymptomatic L. donovani-infected individuals (qualified as positive for L. donovani-specific antibodies by direct agglutination test [DAT]) from the Mymensingh district of Bangladesh where VL is hyperendemic. The novel proteins rKR95 and rTR18 possessed the greatest potential and detected 69% of DAT-positive individuals, with rKR95 being more robust in reactivity. Agreement in results for individuals with high DAT responses, who are more likely to progress to VL disease, was 74%. When considered along with rK39, a gold standard antigen that is used to confirm clinical diagnosis of VL but that is now becoming widely used for surveillance, rKR95 and rTR18 conferred a sensitivity of 84% based on a theoretical combined estimate. Our data indicate that incorporating rKR95 and rTR18 with rK39 in serological tests amenable to rapid or high-throughput screening may enable simple and accurate detection of asymptomatic infection. Such tests will be important tools to measure L. donovani infection rates, a primary goal in surveillance and a critical measurement with which to assess elimination programs. PMID:26842701

  12. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations

    PubMed Central

    Brinjikji, W.; Luetmer, P.H.; Comstock, B.; Bresnahan, B.W.; Chen, L.E.; Deyo, R.A.; Halabi, S.; Turner, J.A.; Avins, A.L.; James, K.; Wald, J.T.; Kallmes, D.F.; Jarvik, J.G.

    2015-01-01

    BACKGROUND AND PURPOSE Degenerative changes are commonly found in spine imaging but often occur in pain-free individuals as well as those with back pain. We sought to estimate the prevalence, by age, of common degenerative spine conditions by performing a systematic review studying the prevalence of spine degeneration on imaging in asymptomatic individuals. MATERIALS AND METHODS We performed a systematic review of articles reporting the prevalence of imaging findings (CT or MR imaging) in asymptomatic individuals from published English literature through April 2014. Two reviewers evaluated each manuscript. We selected age groupings by decade (20, 30, 40, 50, 60, 70, 80 years), determining age-specific prevalence estimates. For each imaging finding, we fit a generalized linear mixed-effects model for the age-specific prevalence estimate clustering in the study, adjusting for the midpoint of the reported age interval. RESULTS Thirty-three articles reporting imaging findings for 3110 asymptomatic individuals met our study inclusion criteria. The prevalence of disk degeneration in asymptomatic individuals increased from 37% of 20-year-old individuals to 96% of 80-year-old individuals. Disk bulge prevalence increased from 30% of those 20 years of age to 84% of those 80 years of age. Disk protrusion prevalence increased from 29% of those 20 years of age to 43% of those 80 years of age. The prevalence of annular fissure increased from 19% of those 20 years of age to 29% of those 80 years of age. CONCLUSIONS Imaging findings of spine degeneration are present in high proportions of asymptomatic individuals, increasing with age. Many imaging-based degenerative features are likely part of normal aging and unassociated with pain. These imaging findings must be interpreted in the context of the patient’s clinical condition. PMID:25430861

  13. Evaluation of Paraoxonase, Malondialdehyde, and Lipoprotein Levels in Patients with Asymptomatic Cholelithiasis

    PubMed Central

    Atamer, Aytac; Kurdas-Ovunc, Ayse O.; Yesil, Atakan; Atamer, Yildiz

    2014-01-01

    Background/Aim: To compare lipoprotein and malondialdehyde levels and paraoxonase-1 activity between subjects with asymptomatic cholelithiasis and controls. Patients and Methods: Eighty subjects with asymptomatic cholelithiasis (55 women, 25 men, mean age: 51, SD 14 years) and 40 control subjects without cholelithiasis (25 women, 25 men, mean age: 51, SD 12 years) were enrolled to the study. Serum paraoxonase activity, lipoproteins, and malondialdehyde were measured. Results: In the cholelithiasis group, serum total cholesterol, low-density lipoprotein cholesterol, and malondialdehyde were significantly higher and high-density lipoprotein cholesterol (HDL-C) and paraoxonase-1 were significantly lower than the controls. In cholelithiasis patients with serum glucose level > 100 mg/dL, body mass index, serum total cholesterol, triglyceride (TG), and malondialdehyde levels were significantly higher than cholelithiasis patients with serum glucose level < 100 mg/dL. Paraoxonase-1 activity was significantly lower in patients with serum glucose level > 100 mg/dL. In cholelithiasis patients with TG > 150 mg/dL, mean age, body mass index, glucose, total cholesterol, and malondialdehyde were significantly higher than in cholelithiasis patients with TG < 150 mg/dL. In cholelithiasis subgroup with TG > 150 mg/dL, HDL-C level and paraoxonase-1 activity were lower than in the cholelithiasis subgroup with TG < 150 mg/dL. All of the above comparisons were statistically significant (P < 0.05). Conclusions: Patients with asymptomatic cholelithiasis have evidence of increased lipid peroxidation and decreased antioxidant capacity. Patients with asymptomatic cholelithiasis with components of the metabolic syndrome have more lipid peroxidation and less antioxidant capacity than patients with asymptomatic cholelithiasis but without the components of the metabolic syndrome. PMID:24496161

  14. Asymptomatic Peripheral Arterial Disease Is Associated With More Adverse Lower Extremity Characteristics Than Intermittent Claudication

    PubMed Central

    McDermott, Mary M.; Guralnik, Jack M.; Ferrucci, Luigi; Tian, Lu; Liu, Kiang; Liao, Yihua; Green, David; Sufit, Robert; Hoff, Frederick; Nishida, Takashi; Sharma, Leena; Pearce, William H.; Schneider, Joseph R.; Criqui, Michael H.

    2016-01-01

    Background This study assessed functional performance, calf muscle characteristics, peripheral nerve function, and quality of life in asymptomatic persons with peripheral arterial disease (PAD). Methods and Results PAD participants (n=465) had an ankle brachial index <0.90. Non-PAD participants (n=292) had an ankle brachial index of 0.90 to 1.30. PAD participants were categorized into leg symptom groups including intermittent claudication (n=215) and always asymptomatic (participants who never experienced exertional leg pain, even during the 6-minute walk; n=72). Calf muscle was measured with computed tomography. Analyses were adjusted for age, sex, race, ankle brachial index, comorbidities, and other confounders. Compared with participants with intermittent claudication, always asymptomatic PAD participants had smaller calf muscle area (4935 versus 5592 mm2; P<0.001), higher calf muscle percent fat (16.10% versus 9.45%; P<0.001), poorer 6-minute walk performance (966 versus 1129 ft; P=0.0002), slower usual-paced walking speed (P=0.0019), slower fast-paced walking speed (P<0.001), and a poorer Short-Form 36 Physical Functioning score (P=0.016). Compared with an age-matched, sedentary, non-PAD cohort, always asymptomatic PAD participants had smaller calf muscle area (5061 versus 5895 mm2; P=0.009), poorer 6-minute walk performance (1126 versus 1452 ft; P<0.001), and poorer Walking Impairment Questionnaire speed scores (40.87 versus 57.78; P=0.001). Conclusions Persons with PAD who never experience exertional leg symptoms have poorer functional performance, poorer quality of life, and more adverse calf muscle characteristics compared with persons with intermittent claudication and a sedentary, asymptomatic, age-matched group of non-PAD persons. PMID:18458172

  15. Sexual compulsion – Relationship with sex, attachment and sexual orientation

    PubMed Central

    KATZ, LICHEN; EBERHARDT, HILA; COHEN, KOBY; LEJOYEUX, MICHEL

    2015-01-01

    Background and aims Sexual addiction, also known as hypersexual disorder, is associated with serious psychosocial problems for many people. Methods This study used questionnaires to investigate the effects of gender, sexual orientation and attachment (avoidance and anxiety) on sexual compulsion among 100 heterosexual and homosexual men and women. Results A positive correlation was found between anxious attachment and sexual compulsivity (r = 0.46; p < 0.01) and a positive correlation between avoidant attachment and sexual compulsivity (r = 0.39; p ≤ 0.01) in all participants. Secondly, an analysis of covariance showed a gender by sexual orientation interaction effect [F(1, 103) = 6.39, p < 0.01] but no attachment effect on sexual compulsivity. A follow-up comparison showed that lesbian women had higher rates of sexual compulsivity than heterosexual women [t (2, 50) = 5.08, p < 0.001] whereas there was non-significant difference in sexual compulsivity between homosexual and heterosexual men [t (2, 50) = 1.30, p = N.S.]. Discussion The results provide preliminary evidence for an association between attachment and sexual compulsivity and the effects of gender and sexual orientation on sexual compulsivity. PMID:25786496

  16. Sexual Identity Development among Ethnic Sexual-Minority Male Youths.

    ERIC Educational Resources Information Center

    Dube, Eric M.; Savin-Williams, Ritch C.

    1999-01-01

    This study explored how ethnicity influenced sexual identity development in 139 sexual-minority males. Findings demonstrated that participants, regardless of ethnicity, experienced most identity milestones at developmentally appropriate ages, had moderately low internalized homophobia, and became romantically and sexually involved with other males…

  17. The Role of Sexual Precedence in Verbal Sexual Coercion

    ERIC Educational Resources Information Center

    Livingston, Jennifer A.; Buddie, Amy M.; Testa, Maria; VanZile-Tamsen, Carol

    2004-01-01

    Experiences of verbal sexual coercion are common and have potential for negative consequences, yet are not well understood. This study used qualitative and descriptive statistics to examine verbal sexual coercion experiences among a community sample of 114 women and explored the role of sexual precedence in these experiences. Analyses revealed…

  18. Association of Sexual Revictimization with Sexuality and Psychological Function

    ERIC Educational Resources Information Center

    Miner, Michael H.; Flitter, Jill M. Klotz; Robinson, Beatrice E.

    2006-01-01

    This study explores the associations of sexual revictimization (experiencing sexual abuse in childhood and adulthood) in a sample of 230 African American women who are low-income. Data indicate that women who experience sexual revictimization are more at risk for emotional stress and psychological pathology than women with no history of abuse. In…

  19. Weighing the shift from sexual identity to sexual relationships.

    PubMed

    Bullough, V L

    1984-01-01

    The shift in inquiry from sexual identity to a conceptualization of sexual relationship, as proposed by De Cecco and Shively (1983/1984), has advantages for research on sexuality, but psychological and political disadvantages for homosexuals, which are briefly summarized in this analysis.

  20. Adolescent sexuality and public policy.

    PubMed

    Olsen, J A; Jensen, L C; Greaves, P M

    1991-01-01

    In recent decades, various attempts have been made to determine the level of sexual activity among adolescents. This information has been used in the planning and evaluation of sex-related programs. However, there is a flaw in using only the initial estimates of the behavior--that a sexually active person is defined as one who has had sexual intercourse. This narrow definition distorts the perception of adolescent sexual behavior. Sexual activity can more accurately be designated by focusing on the actual frequency with which teenagers have sex. In this research report, adolescents were considered sexually active if they had had sex within the last four weeks. Using this definition, adolescents were found to be substantially less sexually active than has been previously reported. This finding was then used to look at various policy decisions in the areas of sex education, family planning, and sexually transmitted disease prevention. PMID:1927672

  1. Associations between youth homelessness, sexual offenses, sexual victimization, and sexual risk behaviors: a systematic literature review.

    PubMed

    Heerde, Jessica A; Scholes-Balog, Kirsty E; Hemphill, Sheryl A

    2015-01-01

    Homeless youth commonly report engaging in sexual risk behaviors. These vulnerable young people also frequently report being sexually victimized. This systematic review collates, summarizes, and appraises published studies of youth investigating relationships between homelessness, perpetration of sexual offenses, experience of sexual victimization, and engagement in sexual risk behavior. A systematic search of seventeen psychology, health, and social science electronic databases was conducted. Search terms included "homeless*," "youth," "offend*," "victimization," "crime," "rape," "victim*," and "sex crimes." Thirty-eight studies were identified that met the inclusion criteria. Findings showed homeless youth commonly report being raped and sexually assaulted, fear being sexually victimized, and engage in street prostitution and survival sex. Rates of victimization and sexual risk behavior were generally higher for females. Given the paucity of longitudinal studies and limitations of current studies, it is unclear whether homelessness is prospectively associated with sexual victimization or engagement in sexual risk behavior, and whether such associations vary cross nationally and as a function of time and place. Future prospective research examining the influence of the situational context of homelessness is necessary to develop a better understanding of how homelessness influences the perpetration of sexual offenses, experience of sexual victimization, and engagement in sexual risk behavior among homeless youth.

  2. Beyond Sexual Orientation: Integrating Gender/Sex and Diverse Sexualities via Sexual Configurations Theory.

    PubMed

    van Anders, Sari M

    2015-07-01

    Sexual orientation typically describes people's sexual attractions or desires based on their sex relative to that of a target. Despite its utility, it has been critiqued in part because it fails to account for non-biological gender-related factors, partnered sexualities unrelated to gender or sex, or potential divergences between love and lust. In this article, I propose Sexual Configurations Theory (SCT) as a testable, empirically grounded framework for understanding diverse partnered sexualities, separate from solitary sexualities. I focus on and provide models of two parameters of partnered sexuality--gender/sex and partner number. SCT also delineates individual gender/sex. I discuss a sexual diversity lens as a way to study the particularities and generalities of diverse sexualities without privileging either. I also discuss how sexual identities, orientations, and statuses that are typically seen as misaligned or aligned are more meaningfully conceptualized as branched or co-incident. I map out some existing identities using SCT and detail its applied implications for health and counseling work. I highlight its importance for sexuality in terms of measurement and social neuroendocrinology, and the ways it may be useful for self-knowledge and feminist and queer empowerment and alliance building. I also make a case that SCT changes existing understandings and conceptualizations of sexuality in constructive and generative ways informed by both biology and culture, and that it is a potential starting point for sexual diversity studies and research.

  3. [Sexuality in Ancient Egypt].

    PubMed

    Androutsos, G; Marketos, S

    1994-10-01

    The present article explores the sexuality in ancient Egypt. In particular in this article are presented the ways of concubinage (marriage, concubinage, adultery), the incest, loves of the pharaohs and of the common people, the freedom of choice in garments, the status of the hetairas and of the whores, the sexual perversions (male and female homosexuality, necrophilia, sodomism, bestiality, rape, masturbation, exhibitionism), the operations of the genitals (circumcision, excision, castration) and finally the level of knowledge in gynaecology, fertility, contraception and obstetrics that even today demands our admiration.

  4. [Migrant adolescents and sexuality].

    PubMed

    Renteria, Saira-Christine

    2012-06-13

    Besides its emotional, hormonal and physical components, sexuality has also an important social function. Analyzing these interactions in immigrant adolescents who are challenged at the same time by developmental changes and modified cultural and social rules--especially if they differ from the rules assimilated during childhood--might help professionals to access better comprehension. Personal experience, individual and external resources, whether they are family oriented or professional, are prone to influence on behavior, perception and outcome related to sexual health. The subject is discussed on the base of scientific literature and medical practice.

  5. [Physiology and physiopathology of sexuality].

    PubMed

    Cuzin, Béatrice

    2016-01-01

    From desire to orgasm, sexuality, in women and men, is underpinned by a complex organic, psychological and emotional function. Sexual dysfunction encompasses diverse aetiologies, including chronic diseases and iatrogenesis resulting from medication or surgery. The effects of a chronic disease can have an impact on all phases of the sexual response. PMID:27317816

  6. The "Right" Sexuality for Girls

    ERIC Educational Resources Information Center

    Lamb, Sharon

    2008-01-01

    Feminist researchers in psychology and education have been theorizing about the kind of sexuality girls ought to have. They are not afraid to investigate morality and what makes a good life. While they explore the meaning and cultural context of girls' sexual development, the good sexual life they describe may be an elusive ideal that, in the end,…

  7. Organizational Costs of Sexual Harassment.

    ERIC Educational Resources Information Center

    Terpstra, David E.

    1986-01-01

    Working women were surveyed regarding their probable initial reactions to different forms of sexual harassment. Many indicated they would either quit their jobs or report sexual harassment to external authorities. Discusses organizational costs of sexual harassment, ways of preventing such costs, and implications for employment counselors.…

  8. Sexuality Education as a Ministry

    ERIC Educational Resources Information Center

    Davis, Melanie J.

    2011-01-01

    The author describes her development from being her religious congregation's sexuality educator to completing doctoral studies and finding her place in the professional sexuality education community. She equates sexuality education to a ministry that reaches out to those in need of knowledge.

  9. Sexual Trauma, Spirituality, and Psychopathology

    ERIC Educational Resources Information Center

    Krejci, Mark J.; Thompson, Kevin M.; Simonich, Heather; Crosby, Ross D.; Donaldson, Mary Ann; Wonderlich, Stephen A.; Mitchell, James E.

    2004-01-01

    This study assessed the association between spirituality and psychopathology in a group of sexual abuse victims and controls with a focus on whether spirituality moderated the association between sexual trauma and psychopathology. Seventy-one sexual trauma victims were compared to 25 control subjects on spiritual well-being, the Eating Disorder…

  10. Sexual Interaction in Nonclinical Couples.

    ERIC Educational Resources Information Center

    Woody, Jane D.; D'Souza, Henry J.

    1997-01-01

    Reports on the sexual functioning and interaction of 58 nonclinical heterosexual couples as measured by the Sexual Interaction System Scale (SISS). On all five SISS factors, the nonclinical sample scored significantly better than persons in therapy for sexual dysfunction; they also reported satisfactory relationship adjustment and high levels of…

  11. When Caregivers Sexually Abuse Children.

    ERIC Educational Resources Information Center

    Tully, Fred

    1998-01-01

    A veteran child therapist reflects on the distressing problem of adults who sexually violate children and youth in their care. Discusses changes in society that may be the cause of increased child sexual abuse. Offers three "truths" concerning child sexual abuse. Presents the account of an abuser and discusses what happens when an abuser is…

  12. Sexual Health in Prime Time

    ERIC Educational Resources Information Center

    Taverner, William J.

    2006-01-01

    The term "sexual health" is often used in sexuality education without any concrete, operational definition, and students are left to ascertain the meaning for themselves. In the absence of a clear definition, students may adopt diverse or narrow understandings of this vague term, without learning the full scope of everything that sexual health…

  13. Sexual behaviour and condom use among individuals with a history of symptomatic genital herpes

    PubMed Central

    Rana, R K; Pimenta, J M; Rosenberg, D M; Warren, T; Sekhin, S; Cook, S F; Robinson, N J

    2006-01-01

    Objectives This study describes the differences in sexual behaviour in individuals with genital herpes (GH) during “symptomatic” and “asymptomatic” periods of the disease. Methods A cross sectional questionnaire was undertaken by 1193 individuals attending clinics between 1998 and 2001. All participants in this analysis were in heterosexual, monogamous partnerships, self identified with a history of symptomatic GH and with confirmed HSV‐2 infection. Results Sexual activity reported during asymptomatic v symptomatic periods of GH was 98% v 40% (p<0.001), 76% v 29% (p<0.001), and 25% v 11% (p<0.001) for vaginal, oral, and anal intercourse, respectively, while “always” condom use during asymptomatic and symptomatic periods was 20% v 35% (p<0.001), 2% v 7% (p<0.001), and 10% v 15% (p = 0.131), respectively. The proportion of individuals who either abstained from vaginal intercourse or “always” used condoms was 21% v 74% (p<0.001), for asymptomatic v symptomatic periods. Multivariable analyses indicated that factors associated with engaging in intercourse during symptomatic periods of GH included current intrauterine device use (adjusted odds ratio (aOR) = 2.96, 95% confidence interval (CI) = 1.46 to 6.02); living in Latin America (aOR = 2.16, CI = 1.19 to 3.91) or Europe (aOR = 1.67, CI = 1.21 to 2.28), compared with North America; previous sexually transmitted disease (aOR = 1.42, CI = 1.08 to 1.89); a higher number of sexual acts per month (aOR = 1.09, CI = 1.06 to 1.11); and a higher number of GH recurrences per year (aOR = 1.08, CI = 1.03 to 1.12). Conclusions These data indicate that the majority of people with GH either abstained from intercourse or “always” used condoms during symptomatic periods of GH. However, condom use was relatively low during asymptomatic periods in comparison with symptomatic periods. These results highlight that further education on GH prevention is warranted

  14. Herpes Genitalis in Patients Attending a Clinic for Sexually Transmitted Diseases

    PubMed Central

    Lawee, David; Gutman, Mory; Hrytzay, Millie; McLachlin, Jeanette

    1983-01-01

    In a prospective study of 210 patients attending a hospital-based sexually transmitted disease clinic, we documented the prevalence of genital herpes infection (GHI) and its association with gonococcal infection (GI). Herpes simplex virus type 2 was cultured from 58% of symptomatic patients and 0.5% of asymptomatic patients. The ratio of GI to GHI was 41:31 by clinical criteria. The laboratory-confirmed ratio was 41:18. These ratios are much higher than those normally used to estimate the caseload of GHI. PMID:21283317

  15. The sexual habitus of transgender men: negotiating sexuality through gender.

    PubMed

    Schilt, Kristen; Windsor, Elroi

    2014-01-01

    In this article, the authors consider how trans men's decisions about physical body modifications impact their sense of themselves as gendered and sexual actors. Based on interviews with 74 trans men, the authors explore how their embodiment, gender identity, erotic ideation, lifetime of sexual practices, and domain of potential partners-what the authors term "sexual habitus"-can be affirmed, transformed, or challenged as their embodiment changes. These changes underscore the dynamic relationship between gender and sexuality and illustrate how bodies matter in sexual trajectories across the life course.

  16. Sexual Abuse and Sexual Functioning in a Chronic Pelvic Pain Sample

    ERIC Educational Resources Information Center

    Randolph, Mary E.; Reddy, Diane M.

    2006-01-01

    Sexual abuse, particularly childhood sexual abuse, has been linked to chronic pelvic pain and to sexual dysfunction, though the sexual functioning of survivors of sexual abuse has not been studied in a chronic pain population. Sixty-three women with chronic pelvic pain completed measures of sexual function, sexual abuse, and pain. Using an index…

  17. Sexual education, gender ideology, and youth sexual empowerment.

    PubMed

    Grose, Rose Grace; Grabe, Shelly; Kohfeldt, Danielle

    2014-01-01

    Sexual education plays an essential role in preventing unplanned pregnancy and the transmission of sexually transmitted infections (STIs). School-based sexual education programs, in particular, may be well positioned to address social factors that are empirically linked to negative sexual health outcomes, such as traditional social norms surrounding gender and sexuality. However, youth are seldom granted access to sexual education programs that explicitly address these issues. This study presents findings from a pretest-posttest survey of a sexual education program that did. It was designed for eighth graders (N=95) in the context of a school-community collaboration. The study assessed the links between several components of sexual empowerment, including gender ideology, sexual knowledge, and contraceptive beliefs. Findings link participation in the sexual education program to more progressive attitudes toward girls and women, less agreement with hegemonic masculinity ideology, and increases in sexual health and resource knowledge. Structural equation models suggest that traditional attitudes toward women were significantly related to hegemonic masculinity ideology among both boys and girls, which was in turn negatively related to safer contraceptive beliefs.

  18. The relationship between sexual selection and sexual conflict.

    PubMed

    Kokko, Hanna; Jennions, Michael D

    2014-07-18

    Evolutionary conflicts of interest arise whenever genetically different individuals interact and their routes to fitness maximization differ. Sexual selection favors traits that increase an individual's competitiveness to acquire mates and fertilizations. Sexual conflict occurs if an individual of sex A's relative fitness would increase if it had a "tool" that could alter what an individual of sex B does (including the parental genes transferred), at a cost to B's fitness. This definition clarifies several issues: Conflict is very common and, although it extends outside traits under sexual selection, sexual selection is a ready source of sexual conflict. Sexual conflict and sexual selection should not be presented as alternative explanations for trait evolution. Conflict is closely linked to the concept of a lag load, which is context-dependent and sex-specific. This makes it possible to ask if one sex can "win." We expect higher population fitness if females win.

  19. The relationship between sexual selection and sexual conflict.

    PubMed

    Kokko, Hanna; Jennions, Michael D

    2014-09-01

    Evolutionary conflicts of interest arise whenever genetically different individuals interact and their routes to fitness maximization differ. Sexual selection favors traits that increase an individual's competitiveness to acquire mates and fertilizations. Sexual conflict occurs if an individual of sex A's relative fitness would increase if it had a "tool" that could alter what an individual of sex B does (including the parental genes transferred), at a cost to B's fitness. This definition clarifies several issues: Conflict is very common and, although it extends outside traits under sexual selection, sexual selection is a ready source of sexual conflict. Sexual conflict and sexual selection should not be presented as alternative explanations for trait evolution. Conflict is closely linked to the concept of a lag load, which is context-dependent and sex-specific. This makes it possible to ask if one sex can "win." We expect higher population fitness if females win. PMID:25038050

  20. Televised sexual content and parental mediation: Influences on adolescent sexuality

    PubMed Central

    Fisher, Deborah A.; Hill, Douglas L.; Grube, Joel W.; Bersamin, Melina M.; Walker, Samantha; Gruber, Enid L.

    2011-01-01

    Little research has been conducted to examine the influence of exposure to televised sexual content on adolescent sexuality or how parental intervention may reduce negative effects of viewing such content. This study uses self-report data from 1,012 adolescents to investigate the relations among exposure to sexually suggestive programming, parental mediation strategies, and three types of adolescent sexuality outcomes: participation in oral sex and sexual intercourse, future intentions to engage in these behaviors, and sex expectancies. As predicted, exposure to sexual content was associated with an increased likelihood of engaging in sexual behaviors, increased intentions to do so in the future, and more positive sex expectancies. Often, parental mediation strategies were a significant factor in moderating these potential media influences. PMID:21546986