Communicable Diseases, Emerging ; Communication ; Dengue ; prevention & control ; Dengue Vaccines ; therapeutic use ; HIV Infections ; prevention & control ; Health Education ; Health Policy ; Humans ; Mosquito Control ; Obesity ; prevention & control ; therapy ; Public Health ; Public Health Practice ; Risk ; Risk Reduction Behavior ; Sexually Transmitted Diseases ; prevention & control ; Singapore ; Tobacco Use ; prevention & control ; therapy

Clinical practice guidelines (CPG) are one of the most effective ways to translate evidence of medical improvement into everyday practice. This study evaluated the dissemination and implementation of the Sexually Transmitted Infections-Korean Guidelines (STIKG) by applying the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework. A survey questionnaire was administered to clinicians via the internet. Among the 332 respondents, 190 (57.2%) stated that they were aware of STIKG and 107 (33.2%) implemented STIKG in their practice. The odds that a physician was exposed to STIKG (dissemination) were 2.61 times greater among physicians with previous training or education for any CPG than those who did not. Clinicians who indicated that STIKG were easy to understand were 4.88 times more likely to implement STIKG in their practice than those who found them not so easy. When a clinician's workplace had a supporting system for CPG use, the odds of implementation was 3.76 times higher. Perceived level of effectiveness of STIKG did not significantly influence their implementation. The findings of this study suggest that, ultimately, knowing how to engage clinicians in CPG implementation is as important as how to disseminate such guidelines; moreover, easy-to-use guidelines and institutional support are key factors.
Adult ; Female ; Guideline Adherence/*statistics & numerical data ; *Health Knowledge, Attitudes, Practice ; *Health Plan Implementation ; Humans ; *Information Dissemination ; Male ; Middle Aged ; Physicians ; Practice Patterns, Physicians' ; Public Health Surveillance ; Quality of Health Care ; Sexually Transmitted Diseases/*therapy ; Surveys and Questionnaires

The optimal and alternative antimicrobial regimens to treat neurosyphilis in human immunodeficiency virus (HIV) infected patients remain controversial. Little is known concerning the efficacy of ceftriaxone. A 75-year-old heterosexual man visited an outpatient clinic due to incidentally detected positive serum Venereal disease research laboratory (VDRL) and Fluorescent treponemal antibody absorbed tests in routine preoperative checkup. Because of benzathine penicillin was unavailable to use, 4-week regimen with doxycycline was started. After 2 weeks doxycycline treatment, a severe headache suddenly occurred. Cerebrospinal fluid (CSF) analysis showed mild lymphocyte-dominant pleocytosis, increased protein, and weakly reactive VDRL test. ELISA for HIV antibody and Western blot assay revealed he is infected with HIV. Initial CD4+ T cell count was 220/mm3 and the load of HIV RNA was 5,200 copies/mL. The most probable diagnosis was deemed to be neurosyphilis, considering the possibilities of Jarisch-Herxheimer reaction or doxycycline-induced pseudotumor cerebri. In the absence of procaine penicillin G in our hospital, intravenous ceftriaxone was administered and highly active antiretroviral therapy was started. After 14days of treatment, the patient no longer had a headache and the CSF profile was improved. Additional follow-up CSF analysis was done 3months after treatment. CSF pleocytosis and protein level were decreased and the CSF VDRL was converted to negative. Ceftriaxone may be a good alternative in the treatment of neurosyphilis in HIV infected patient.
Aged ; Ambulatory Care Facilities ; Antiretroviral Therapy, Highly Active ; Blotting, Western ; Ceftriaxone ; Cell Count ; Doxycycline ; Enzyme-Linked Immunosorbent Assay ; Ethylenediamines ; Follow-Up Studies ; Headache ; Heterosexuality ; HIV ; Humans ; Leukocytosis ; Neurosyphilis ; Penicillin G Benzathine ; Penicillin G Procaine ; Pseudotumor Cerebri ; RNA ; Sexually Transmitted Diseases

Administration, Intravaginal ; Administration, Rectal ; Anti-Infective Agents ; administration & dosage ; Female ; HIV Infections ; drug therapy ; prevention & control ; psychology ; Humans ; Male ; Patient Acceptance of Health Care ; Sexually Transmitted Diseases ; drug therapy ; prevention & control ; psychology

Sexually transmitted diseases (STDs) are not rare during pregnancy; however, they are usually asymptomatic and may be unrecognized. STDs in pregnancy can cause serious complications to both pregnant women and fetuses. Screening tests are recommended, because the treatment of these diseases can be curative in most cases, or at least effective in reducing complications. In this point of view, the Centers for Disease Control and Prevention recommends screening of all pregnant women for several STDs including human immunodeficiency virus (HIV) infection, hepatitis B, and syphilis, and screening selectively in high risk women for gonorrhea and hepatitis C. To reduce vertical transmissions, highly active antiretroviral therapy and timed Cesarean delivery is recommended in HIV-infected pregnant women. Penicillin is still a drug of choice for syphilis in pregnancy. In women who have active genital herpetic lesions at the time of labor, Cesarean delivery is indicated to protect neonates from perinatal transmissions. However, in women who have genital warts with human papilloma virus infection, Cesarean delivery is not recommended to prevent neonatal laryngeal papillomatosis. In women infected with gonorrhea, Chlamydia or Trichomonas, tests for HIV infection are recommended because of high prevalence of concomitant infections.
Antiretroviral Therapy, Highly Active ; Centers for Disease Control and Prevention (U.S.) ; Chlamydia ; Condylomata Acuminata ; Female ; Fetus ; Gonorrhea ; Hepatitis B ; Hepatitis C ; HIV ; HIV Infections ; Humans ; Infant, Newborn ; Laryngeal Neoplasms ; Mass Screening ; Papilloma ; Penicillins ; Pregnancy ; Pregnant Women ; Prevalence ; Sexually Transmitted Diseases ; Syphilis ; Trichomonas ; Viruses

Department of Medical History, College of Medicine, Yonsei University, Korea.
China ; Communicable Disease Control/*history ; Female ; History, 20th Century ; Humans ; Male ; Pregnancy ; Sexually Transmitted Diseases/*history/prevention & control/therapy ; Social Control, Formal

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Genital Diseases, Female ; drug therapy ; microbiology ; Humans ; Phytotherapy ; Pregnancy ; Pregnancy Complications, Infectious ; drug therapy ; Sexually Transmitted Diseases, Bacterial ; drug therapy ; Ureaplasma Infections ; drug therapy ; Ureaplasma urealyticum

OBJECTIVETo study the therapeutic effect of Linbiqing decoction on chronic prostatitis following sexually transmitted disease (CPFSTD).

METHODSLinbiqing decotion was given orally to 36 patients with CPFSTD, and the therapeutic effet was assessed by observing the clinical symptoms and measuring the objective indexes before and after the treatment.

RESULTSFour to eight weeks after the drug administration, the overall effectivity rate was 72.22%, and the scores of NIH-CPSI were decreased significantly.

CONCLUSIONLinbiqing decoction has definite therapeutic effect on CPFSTD, and can be considered as an effective means for the treatment of the disease.

Adult ; Chronic Disease ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Middle Aged ; Phytotherapy ; Prostatitis ; drug therapy ; Sexually Transmitted Diseases ; complications

PURPOSE: Condyloma acuminatum is a common sexually transmitted disease of the external genitalia and anus. Approximately 5% of patients demonstrate urethral involvement. Electrical fulguration or excision using a pediatric resectoscope has been used in the management of such lesions. Holmium(Ho):YAG laser, 5-FU(fluorouracil), or interferon may be helpful in eradicating them. We reviewed the results of intraurethral condyloma acuminatum treatment with Ho:YAG laser and 5-FU solution. MATERIALS AND METHODS: From January 2001 to July 2002, seven patients with intraurethral condylomata acuminata were enrolled in the study. The mean age of the subjects was 19.5(range 25~43) years. Under local anesthesia with 10% lidocaine spray and jelly, all of the intraurethral lesions were removed with the Ho:YAG laser followed by coverage with 10mL of 5% 5-FU solution. Intraurethral injection of 5-FU was performed weekly up to six times. Urethroscopy for detection of recurrence was done 3 months after initial laser therapy. RESULTS: Most patients had multiple intraurethral lesions. Six patients (86%) responded to initial therapy without local recurrence with a mean follow-up of 15.8 (range 9.1-23.2) months. One patient had a recurrence at 2 months. CONCLUSIONS: We believe that the Ho:YAG laser plus 5% 5-FU solution is a useful option for the treatment of intraurethral condyloma acuminatum.
Anal Canal ; Anesthesia, Local ; Condylomata Acuminata ; Fluorouracil* ; Follow-Up Studies ; Genitalia ; Holmium* ; Humans ; Interferons ; Laser Therapy ; Lasers, Solid-State* ; Lidocaine ; Recurrence ; Sexually Transmitted Diseases

OBJECTIVETo explore the etiologic relationship between sexually transmitted diseases(STDs) and chronic prostatitis (CP), and to evaluate the effect of multiple treatment on CP following STDs.

METHODSSeventy-two cases of CP after STDs were randomly divided into three groups: Group A (treated with levefloxatin), Group B (treated with Levofloxacin, terazosin and microwave), and Group C (treated with levofloxacin, Chinese traditional medicine and microwave), all treated for thirty days. The pathogens related to STDs in the prostatic fluid of all the patients had been examined before treatment. The efficacy was evaluated among the three groups by comparing the count of leukocytes and the scores of NIH-CPSI before and after treatment.

RESULTSThe pathogens related to STDs were found in the prostatic fluid of 7 patients. The count of leukocytes and the scores of NIH-CPSI decreased after treatment in the three groups, more markedly in Groups B and C than in Group A.

CONCLUSIONThere is no strict etiological causality between STDs and CP. Multiple treatments are superior to single antibiotic treatment.

Adult ; Chronic Disease ; Drug Therapy, Combination ; Humans ; Leukocyte Count ; Male ; Microwaves ; therapeutic use ; Middle Aged ; Prostatitis ; blood ; etiology ; therapy ; Sexually Transmitted Diseases ; complications