ompared with no therapy. Further study is needed to determine if these AT-III effects on neuroinflammation affect longer-term neurocognitive recovery after TBI.

While sexual dysfunction (SD) in men following traumatic pelvic fracture is common, little is known of how men experience changes in their sexual health after injury. The aims of the present study were to explore the personal and interpersonal impacts of SD in men after pelvic injury and to understood how interactions with the health care system can be optimized to improve patient-centered trauma survivorship care.

Fifteen semistructured interviews were conducted with men who had a history of traumatic pelvic fracture and self-reported SD. Interviews were audio recorded, transcribed, and uploaded to a web-based qualitative analysis platform. A codebook was developed, and intercoder reliability was verified. Inductive thematic analysis was performed to identify notable themes related to patient postinjury sexual health experiences.

Median age of interviewees was 46 years (interquartile range, 44-54 years), with a median time since injury of 41 months (interquartile range, 22-55 months). see more Five primary themes were identified from the analysis (1) effects on self-image and romantic relationships, (2) unknown care pathways and lack of communication, (3) inconsistencies with health care provider priorities, (4) provision of sexual health information and resources, and (5) the importance of setting expectations. Interviewees suggested that improved communication, provision of information related to possible adverse effects of their injuries, and expectation setting would improve posttrauma experiences.

Men’s experiences with SD after pelvic trauma can be heavily influenced by their interactions with health care providers and the value that is placed on sexual health as a component of survivorship. Incorporating these findings into a patient-centered trauma survivorship program may improve patient experiences.

Therapeutic, level V.

Therapeutic, level V.

Multiply injured patients (MIPs) are at risk of complications including infections, and acute and prolonged organ dysfunction. The immunologic response to injury has been shown to affect outcomes. Recent advances in computational capabilities have shown that early dynamic coordination of the immunologic response is associated with improved outcomes after trauma. We hypothesized that patients who were sensitive or tolerant of hemorrhage would demonstrate differences in dynamic immunologic orchestration within hours of injury.

We identified two groups of MIPs who demonstrated distinct clinical tolerance to hemorrhage (n = 10) or distinct clinical sensitivity to hemorrhage (n = 9) from a consecutive cohort of 100 MIPs. Hemorrhage was quantified by integrating elevated shock index values for 24 hours after injury (shock volume). Clinical outcomes were quantified by average Marshall Organ Dysfunction Scores from days 2 to 5 after injury. Shock-sensitive patients had high cumulative organ dysfunction after lowers was amplified in shock-tolerant patients.

Prospective clinical outcomes study, level III.

Prospective clinical outcomes study, level III.An investigation of unexpected positive test results for Chlamydia trachomatis at a women’s health clinic in Sweden revealed that samples were contaminated by RNA in clinic. The risk for RNA contamination at clinic has been postulated previously. We are, however, not aware that this has actually been demonstrated in practice.No clear guidelines are available for the management of pregnant women with condyloma acuminata, a human papilloma virus-associated benign neoplasm that develops in the genital tract. We performed a systematic review to gain a better understanding of the management of condyloma acuminata during pregnancy. In this review, we mainly focused on treatments. We searched PubMed, Google Scholar, and Web of Science to identify studies on the treatment of condyloma acuminata during pregnancy. Thirty articles met the inclusion criteria. The treatment methods described in the literature were laser therapy, cryotherapy, imiquimod, photodynamic therapy, trichloroacetic acid, and local hyperthermia. The most effective treatment remains unclear. Various factors must be considered when deciding how to treat. Based on our assessment of the literature, we recommend cryotherapy as the first-choice treatment and laser therapy as the second-choice treatment. Imiquimod can be considered in cases such as extensive condyloma acuminata that is not easily treated by cryotherapy or laser therapy. In such cases, sufficient informed consent must be obtained from the patient. Cryotherapy, laser therapy, and imiquimod have been administered during all three trimesters with no severe adverse effects, but we cautiously recommend reserving laser therapy until the third trimester because of the lower risk of recurrence prior to delivery. There are still many unclear points regarding the management of condyloma in pregnancy, and further research is needed.

We conducted an observational study to determine whether syphilis patients who do not demonstrate serological cure or lack of seroreversion in nontreponemal (NT) antibody titers after initial therapy benefit from re-treatment and cerebrospinal fluid (CSF) analysis.

We enrolled syphilis patients from STD clinics in Guangzhou, China who had persistent NT titers after therapy. Serological non-response was defined as < 4-fold decline in baseline NT titers after therapy. Lack of seroreversion was defined as demonstrating a > 4-fold NT titer decline but without seroreversion to negative, or having persistent low-level titers (i.e. 11-12) after therapy. Following consent, we abstracted medical record data regarding syphilis diagnoses, initial and re-treatment regimens, and serological outcomes. NT titers were obtained from participants at enrollment and follow-up. We evaluated CSF findings among a subgroup of participants relative to re-treatment.

From March 2012 – February 2016, we enrolled 135 HIV-negative syphilis patients with persistent NT titers after initial therapy. Among 116 participants with > 12 months of follow-up, 60 (52%) received re-treatment for syphilis. Overall, there were no significant differences in serological response between those who were retreated versus not among serological non-responders (29% vs 27%; p=1.0) or among participants without seroconversion (41% vs 37%; p=0.8). Of 60 participants who underwent CSF analyses, eight (13%) had CSF abnormalities, but only two (3%) met neurosyphilis criteria after re-treatment.

Most HIV-negative syphilis patients who have serological non-response or lack of seroreversion following therapy do not benefit from re-treatment in the short-term, and neurosyphilis is uncommon.

Most HIV-negative syphilis patients who have serological non-response or lack of seroreversion following therapy do not benefit from re-treatment in the short-term, and neurosyphilis is uncommon.