M. Gomberg - Academia.edu (original) (raw)
Papers by M. Gomberg
Sexually Transmitted Infections, 2013
Poster presentations Background In HIV-positive individuals clinicians observe a broad range of s... more Poster presentations Background In HIV-positive individuals clinicians observe a broad range of skin conditions like xerosis, tumours, rash and drug-induced exanthema as well as common skin infections caused by bacteria, fungi and viruses. Beyond this, some reports point out a higher incidence on atopic conditions like atopic dermatitis (AD), sinusitis, asthma and laboratory findings like hypereosinophilia and Hyper IgE. Methods Between May and November 2006, 196 patients of the HIV outpatient department of the Clinic for Dermatology, Venerology and Allergology at the Ruhr University Bochum underwent a dermatological examination. Skin conditions focusing on AD were measured by SCORAD (SCORing Atopic Dermatitis) and Erlanger atopy score. Results In general, 36 patients (18.4%) out of 196 participants suffered from clinically from AD. Median count at "Erlanger Atopy Score" was 12.8 (median 11.5). Verification by SCORAD showed 55.6% (20/36) with mild, 36.1% (13/36) with moderate and 8.3% (3/36) with severe AD. Neither with pruritus and viral load nor with CDC Category a correlation was found. Exclusively CD4 counts were negative correlated with higher Visual analogue scale for prutitus (p = 0.0306). Xerosis was diagnosed in more than 53.6% of the 196 patients and thus was the leading diagnosis, although there was no correlation with the CD4 count, viral load or CDC Category. Furthermore, a negative correlation was found (p = 0.0214) between IgE and CD4 and a p-value of 0.0111 between IgE and the CDC Category (higher IgE, higher CDC Category) was demonstrated as well. Conclusion In our sample xerosis cutis was the leading diagnosis. Furthermore, compared to pre-existing literature for the first time standardised diagnostic tools for AD, the SCORAD and the Erlanger Atopy Score, were used to examine HIV-positive individuals. Diagnostic tools help to identify the origin of dry skin in HIV-infected patients and to initiate adequate treatment. Azithromycin PhArmAcokinetics After intrAvenous infusion in Women With And Without Pelvic inflAmmAtory diseAses
International Journal of STD & AIDS, 2020
Gonorrhoea is a major public health concern globally. Increasing incidence and sporadic ceftriaxo... more Gonorrhoea is a major public health concern globally. Increasing incidence and sporadic ceftriaxone-resistant cases, including treatment failures, are growing concerns. The 2020 European gonorrhoea guideline provides up-to-date evidence-based guidance regarding the diagnosis and treatment of gonorrhoea. The updates and recommendations emphasize significantly increasing gonorrhoea incidence; broad indications for increased testing with validated and quality-assured nucleic acid amplification tests (NAATs) and culture; dual antimicrobial therapy including high-dose ceftriaxone and azithromycin (ceftriaxone 1 g plus azithromycin 2 g) OR ceftriaxone 1 g monotherapy (ONLY in well-controlled settings, see guideline for details) for uncomplicated gonorrhoea when the antimicrobial susceptibility is unknown; recommendation of test of cure (TOC) in all gonorrhoea cases to ensure eradication of infection and identify resistance; and enhanced surveillance of treatment failures when recommended ...
Journal of the European Academy of Dermatology and Venereology, 2016
Mycoplasma genitalium is a cause of 10-35% of non-chlamydial non-gonococcal urethritis in men and... more Mycoplasma genitalium is a cause of 10-35% of non-chlamydial non-gonococcal urethritis in men and in women, and is associated with cervicitis and pelvic inflammatory disease (PID). Transmission of M. genitalium occurs through direct mucosal contact. In women, symptoms include vaginal discharge, dysuria or symptoms of PIDabdominal pain and dyspareunia. In men, urethritis, dysuria and discharge predominates. Asymptomatic infections are frequent. In this review, we present the evidence base for the recommendations in the 2016 European guideline on M. genitalium infections and describe indications for testing, recommended diagnostic methods, treatment and patient management. The guideline was prepared on behalf of the European branch of The International Union against Sexually Transmitted Infections; the European Academy of Dermatology and Venereology; the European Dermatology Forum; the European Society of Clinical Microbiology and Infectious Diseases; the Union of European Medical Specialists. The European Centre for Disease Prevention and Control and the European Office of the World Health Organisation also contributed to their development.
Journal of the European Academy of Dermatology and Venereology, 2016
Mycoplasma genitalium infection contributes to 10-35% of non-chlamydial non-gonococcal urethritis... more Mycoplasma genitalium infection contributes to 10-35% of non-chlamydial non-gonococcal urethritis in men. In women, M. genitalium is associated with cervicitis and pelvic inflammatory disease (PID). Transmission of M. genitalium occurs through direct mucosal contact. Asymptomatic infections are frequent. In women, symptoms include vaginal discharge, dysuria or symptoms of PIDabdominal pain and dyspareunia. In men, urethritis, dysuria and discharge predominates. Besides symptoms, indication for laboratory test is a high-risk sexual behaviour. Diagnosis is achievable only through nucleic acid amplification testing (NAAT). If available, NAAT diagnosis should be followed with an assay for macrolide resistance. Therapy for M. genitalium is indicated if M. genitalium is detected or on an epidemiological basis. Doxycycline has a low cure rate of 30-40%, but does not increase resistance. Azithromycin has a cure rate of 85-95% in macrolide susceptible infections. An extended course appears to have a higher cure rate. An increasing prevalence of macrolide resistance, most likely due to widespread use of azithromycin 1 g single dose without test of cure, is drastically decreasing the cure rate. Moxifloxacin can be used as second-line therapy, but resistance is increasing. Uncomplicated M. genitalium infection should be treated with azithromycin 500 mg on day one, then 250 mg on days 2-5 (oral), or josamycin 500 mg three times daily for 10 days (oral). Second line treatment and treatment for uncomplicated macrolide resistant M. genitalium infection is moxifloxacin 400 mg od for 7-10 days (oral). For third line treatment of persistent M. genitalium infection after azithromycin and moxifloxacin doxycycline 100 mg two times daily for 14 days can be tried and may cure 30%. Pristinamycin 1 g four times daily for 10 days (oral) has a cure rate of app. 90%. Complicated M. genitalium infection (PID, epididymitis) is treated with moxifloxacin 400 mg od for 14 days.
Antibiotiki i khimioterapii͡a = Antibiotics and chemoterapy [sic] / Ministerstvo meditsinskoĭ i mikrobiologicheskoĭ promyshlennosti SSSR, 2013
The vaginal discharge is one of the most frequent symptoms requiring medical advise. Vaginal disc... more The vaginal discharge is one of the most frequent symptoms requiring medical advise. Vaginal discharges are mainly associated with three diseases: bacterial vaginosis, trichomononiasis and candidiasis. The review is concerned with up-to-date approaches to the treatment of females with bacterial vaginosis and trichomononiasis, diseases different by the etiology and pathogenesis, but at the same time similar with respect to the treatment. The analysis is in compliance with the principles of the two fundamental world guidelines.
Sexually Transmitted Diseases, 2000
This chapter discusses the changing epidemiology of sexually transmitted diseases (STDs), focusin... more This chapter discusses the changing epidemiology of sexually transmitted diseases (STDs), focusing on the Russian experience. A highly regimented society with widely accessible health care and strict penalizing policies regarding STDs helped maintain a low incidence of these diseases in Soviet Russia. The political, social, and economic upheaval that occurred in the late 1980s and early 1990s has resulted in a more open society but with increased unemployment, poverty, drug use, prostitution, and tourism. These changes have contributed to a wide increase in STDs, particularly syphilis. There are about 300 Departments of Anonymous Testing and Treatment (DATTs) in Russia, which provide qualified medical care for patients willing to pay. Although these departments add only about 10% of all cases, mostly these patients do not come to the dispensary on their own. Strategic changes are occurring in the field of dermatovenereology to effectively deal with STDs in post-Soviet Russia.
Journal of the European Academy of Dermatology and Venereology, 2001
Chlamydia trachomatis infections of the female and male genital tracts are often asymptomatic and... more Chlamydia trachomatis infections of the female and male genital tracts are often asymptomatic and, thus, tend to become persistent. In the persistent state the typical Chlamydia life cycle is arrested and standard antibiotic regimens do not always eradicate this infection. We sought to relate treatment failures in men and women with persistent chlamydial genital tract infections to electron microscopic evidence of chlamydial persistence and with atypical morphological forms of the organism. Of 16 patients with chlamydial persistence following azithromycin treatment, morphological variants of this organism were observed by electron microscopy from one endocervical sample and one male urethral sample. We document the presence of intracellular inclusions containing only reticulate bodies, extracellular monomembrane and polymembrane phagosomes containing elementary bodies and reticulate bodies with abnormal outer membranes in the process of dividing extracellularly. These observations parallel previous in vitro studies of chlamydial persistence under adverse conditions. This capacity of C. trachomatis to undergo atypical morphological alterations in vivo may contribute to its persistence and relative resistance to antibiotics.
Journal of the European Academy of Dermatology and Venereology, 1997
International Journal of STD & AIDS, 2002
It is generally understood that hepatitis B and hepatitis C may be sexually transmitted. During t... more It is generally understood that hepatitis B and hepatitis C may be sexually transmitted. During the last decade there was a sharp growth of hepatitis B and C in Russia. In comparison to 1992 the incidence of hepatitis B in Russia rose two-fold and in 1999 there were 43.31 cases per 100,000 of population (in some cities up to 150/100,000 and even more). The incidence of hepatitis C in 1999 (19.31 per 100,000 of population) rose to six times more than in 1994. At the same time there was a dramatic growth in syphilis and other sexually transmitted infections in Russia. The proportion of sexual transmission of hepatitis B virus (HBV) and hepatitis C virus (HCV) compared with other routes of transmission increased. According to the data from Moscow City Centre of Epidemiology during the last two years, up to 40% cases of HCV and HBV were sexually transmitted. The most dramatic growth of registered cases of hepatitis was seen among the sexually active population aged 14-29. Confirmation o...
International Journal of STD & AIDS, 2013
Gonorrhoea is a major public health concern globally. Of particularly grave concern is that resis... more Gonorrhoea is a major public health concern globally. Of particularly grave concern is that resistance to the extended-spectrum cephalosporins has emerged during the most recent years. This guideline provides recommendations regarding the diagnosis and treatment of gonorrhoea in Europe. Compared to the outdated 2009 European gonorrhoea guideline, this 2012 European gonorrhoea guideline provides up-to-date guidance on, broader indications for testing and treatment of gonorrhoea; the introduction of dual antimicrobial therapy (ceftriaxone 500 mg and azithromycin 2 g) for uncomplicated gonorrhoea when the antimicrobial sensitivity is unknown; recommendation of test of cure in all gonorrhoea cases to ensure eradication of infection and identify emerging resistance; and recommendations to identify, verify and report failures with recommended treatment regimens. Optimisations of the testing, diagnostics, antimicrobial treatment and follow-up of gonorrhoea patients are crucial in controlli...
International Journal of STD & AIDS, 2020
Gonorrhoea is a major public health concern globally. Increasing incidence and sporadic ceftriaxo... more Gonorrhoea is a major public health concern globally. Increasing incidence and sporadic ceftriaxone-resistant cases, including treatment failures, are growing concerns. The 2020 European gonorrhoea guideline provides up-to-date evidence-based guidance regarding the diagnosis and treatment of gonorrhoea. The updates and recommendations emphasize significantly increasing gonorrhoea incidence; broad indications for increased testing with validated and quality-assured nucleic acid amplification tests and culture; dual antimicrobial therapy including high-dose ceftriaxone and azithromycin (ceftriaxone 1 g plus azithromycin 2 g) OR ceftriaxone 1 g monotherapy (ONLY in well-controlled settings, see guideline for details) for uncomplicated gonorrhoea when the antimicrobial susceptibility is unknown; recommendation of test of cure (TOC) in all gonorrhoea cases to ensure eradication of infection and identify resistance; and enhanced surveillance of treatment failures when recommended treatmen...
Journal of the European Academy of Dermatology and Venereology, 2015
Background Partner management is the process of identifying the contacts of a person infected by ... more Background Partner management is the process of identifying the contacts of a person infected by a sexually transmitted infection (STI) and referral to a health care provider for appropriate management. It represents a public health activity. Methods This guideline is produced by the IUSTI European Guideline Editorial Board and EDF Guideline Committee. Results It provides recommendations concerning the infections that require partner management, the lookback periods for this STI and the main steps to follow for partner management (offering support to patients, notifying partners, identification of contacts). Partner management is voluntary and needs to be performed with respect to human rights, social, cultural and religious behaviours. Conclusions In European countries, there are different approaches to the partner management; some common type of actions can enhance the fight against STI.
Journal of the European Academy of Dermatology and Venereology, 2018
Should we be testing for urogenital Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyti... more Should we be testing for urogenital Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum in men and women?-a position statement from the European STI Guidelines Editorial Board.
Journal of the European Academy of Dermatology and Venereology, 2019
International Journal of STD & AIDS, 2009
† Gummatous syphilis: 22 typical nodules/plaques or ulcers; † Neurosyphilis: ocular, auricular, m... more † Gummatous syphilis: 22 typical nodules/plaques or ulcers; † Neurosyphilis: ocular, auricular, meningovascular, parenchymatous (general paresis, tabes dorsalis); asymptomatic (abnormal cerebrospinal fluid [CSF]); † Cardiovascular syphilis: aortitis-asymptomatic, angina, aortic regurgitation, stenosis of coronary ostia, aortic aneurysm (mainly thoracic). Epidemiological monitoring of infectious syphilis: all patients with primary, secondary and early latent syphilis should be reported to their National Syphilis Surveillance System and these national programmes should report to the European Surveillance of STI (ESSTI) network of the ECDC, if they are within the European Union. 1
Sexually Transmitted Infections, 2015
Sexually Transmitted Infections, 2013
Poster presentations Results Of the 156 specimens, 83 N. gonorrhoeae strains were tested for anti... more Poster presentations Results Of the 156 specimens, 83 N. gonorrhoeae strains were tested for antimicrobial susceptibilities to 18 agents. The prevalence of β-lactamase producing strains and chromosomally-mediated resistant strains were 7.2% and 16.5%, respectively. Against cepharosporins, one strain was resistant to cefixime with MIC 0.5 μg/ml. There was not resistant strain to ceftriaxone, but the 7 strains (8.4%) had MIC 0.125 μg/ml. The MIC of fluoroquinolones to all strains showed a bimodal distribution. The values of MIC90 of ciprofloxacin and levofloxacin were 16 and 8 μg/ml, respectively. Sitafloxacin, one of fluoroquinolones had strong activity to N. gonorrhoeae strains and the value of MIC90 was 0.25 μg/ml. The MIC of azithromycin in 2 strains was 2 μg/ml, but no high-level resistance to macrolides was detected. Conclusion The first national surveillance for antimicrobial susceptibilities of N. gonorrhoeae was performed. Fluoroquinolone-resistance N. gonorrhoeae strains were spread in Japan. The resistant rate of azithromycin resistant was 2.4%. Post-treatment Detection of azithromycin in high-Vaginal swabs Using liqUiD chromatograPhy anD tanDem mass sPectrometry (lc-ms/ms)
Andrology, 2014
Acute and chronic infections of the seminal tract are among the most common causes of male infert... more Acute and chronic infections of the seminal tract are among the most common causes of male infertility. As at least half of male infertility cases are classified as idiopathic, some of these cases might be attributed to asymptomatic infection. The detection and quantification of Epstein-Barr virus (EBV), cytomegalovirus (CMV) and human herpes virus type 6 (HHV-6) DNA in semen samples were performed. A total of 232 patients were divided into five groups: (i) infertile men with varicocoele; (ii) men with idiopathic infertility; (iii) infertile men with chronic inflammatory urogenital tract diseases (IUTD); (iv) fertile men with IUTD and (v) men whose partners had a history of pregnancy loss. In the study population, the prevalence of viral DNA was 17.7, 3.4% for EBV, 5.2% for CMV, 6.5% for HHV-6, 0.43% for EBV + CMV, 0.87% for EBV + HHV-6 and 1.3% for CMV + HHV-6. The median viral loads for EBV, CMV and HHV-6 were 500, 2250 and 250 copies/mL respectively. Of the sperm cell fractions, derived from infected samples 87.5% contained viral DNA. No association between EBV and fertility disorders or IUTD was found. CMV detection was much higher in the group of patients with infertility and concomitant IUTD compared with the other groups combined (18.5% vs. 5.4%, p = 0.03) and associated with reduced sperm cell count (39.5 × 10(6) /mL vs. 72.5 × 10(6) /mL, p = 0.036). Immunostaining of spermatozoa from infected samples and in vitro-infected cells detected CMV in sperm heads, tails and connecting pieces and revealed attachment to sperm membrane and intracellular localization. HHV-6 was the more common in fertile men with chronic IUTD than in the other groups combined (19% vs. 6.3%, p = 0.018) and had no effect on sperm parameters. The results suggest that both CMV and HHV-6 may contribute to the aetiology of IUTD and, moreover, CMV-associated IUTD can lead to male sterility.
Science, 1924
... Bancroft,; BB Boltwood,; JC Booth,; CF Chandler,; Russell H. Chittenden,; FW Clarke,; FG Cott... more ... Bancroft,; BB Boltwood,; JC Booth,; CF Chandler,; Russell H. Chittenden,; FW Clarke,; FG Cottrell,; Josiah P. Cooke,; EC Franklin,; J. Willard Gibbs,; Wolcott Gibbs,; Moses Gomberg,; Robert Hare,; WF Hillebrand,; T. Sterry Hunt,; Irving ...
Sexually Transmitted Infections, 2013
Poster presentations Background In HIV-positive individuals clinicians observe a broad range of s... more Poster presentations Background In HIV-positive individuals clinicians observe a broad range of skin conditions like xerosis, tumours, rash and drug-induced exanthema as well as common skin infections caused by bacteria, fungi and viruses. Beyond this, some reports point out a higher incidence on atopic conditions like atopic dermatitis (AD), sinusitis, asthma and laboratory findings like hypereosinophilia and Hyper IgE. Methods Between May and November 2006, 196 patients of the HIV outpatient department of the Clinic for Dermatology, Venerology and Allergology at the Ruhr University Bochum underwent a dermatological examination. Skin conditions focusing on AD were measured by SCORAD (SCORing Atopic Dermatitis) and Erlanger atopy score. Results In general, 36 patients (18.4%) out of 196 participants suffered from clinically from AD. Median count at "Erlanger Atopy Score" was 12.8 (median 11.5). Verification by SCORAD showed 55.6% (20/36) with mild, 36.1% (13/36) with moderate and 8.3% (3/36) with severe AD. Neither with pruritus and viral load nor with CDC Category a correlation was found. Exclusively CD4 counts were negative correlated with higher Visual analogue scale for prutitus (p = 0.0306). Xerosis was diagnosed in more than 53.6% of the 196 patients and thus was the leading diagnosis, although there was no correlation with the CD4 count, viral load or CDC Category. Furthermore, a negative correlation was found (p = 0.0214) between IgE and CD4 and a p-value of 0.0111 between IgE and the CDC Category (higher IgE, higher CDC Category) was demonstrated as well. Conclusion In our sample xerosis cutis was the leading diagnosis. Furthermore, compared to pre-existing literature for the first time standardised diagnostic tools for AD, the SCORAD and the Erlanger Atopy Score, were used to examine HIV-positive individuals. Diagnostic tools help to identify the origin of dry skin in HIV-infected patients and to initiate adequate treatment. Azithromycin PhArmAcokinetics After intrAvenous infusion in Women With And Without Pelvic inflAmmAtory diseAses
International Journal of STD & AIDS, 2020
Gonorrhoea is a major public health concern globally. Increasing incidence and sporadic ceftriaxo... more Gonorrhoea is a major public health concern globally. Increasing incidence and sporadic ceftriaxone-resistant cases, including treatment failures, are growing concerns. The 2020 European gonorrhoea guideline provides up-to-date evidence-based guidance regarding the diagnosis and treatment of gonorrhoea. The updates and recommendations emphasize significantly increasing gonorrhoea incidence; broad indications for increased testing with validated and quality-assured nucleic acid amplification tests (NAATs) and culture; dual antimicrobial therapy including high-dose ceftriaxone and azithromycin (ceftriaxone 1 g plus azithromycin 2 g) OR ceftriaxone 1 g monotherapy (ONLY in well-controlled settings, see guideline for details) for uncomplicated gonorrhoea when the antimicrobial susceptibility is unknown; recommendation of test of cure (TOC) in all gonorrhoea cases to ensure eradication of infection and identify resistance; and enhanced surveillance of treatment failures when recommended ...
Journal of the European Academy of Dermatology and Venereology, 2016
Mycoplasma genitalium is a cause of 10-35% of non-chlamydial non-gonococcal urethritis in men and... more Mycoplasma genitalium is a cause of 10-35% of non-chlamydial non-gonococcal urethritis in men and in women, and is associated with cervicitis and pelvic inflammatory disease (PID). Transmission of M. genitalium occurs through direct mucosal contact. In women, symptoms include vaginal discharge, dysuria or symptoms of PIDabdominal pain and dyspareunia. In men, urethritis, dysuria and discharge predominates. Asymptomatic infections are frequent. In this review, we present the evidence base for the recommendations in the 2016 European guideline on M. genitalium infections and describe indications for testing, recommended diagnostic methods, treatment and patient management. The guideline was prepared on behalf of the European branch of The International Union against Sexually Transmitted Infections; the European Academy of Dermatology and Venereology; the European Dermatology Forum; the European Society of Clinical Microbiology and Infectious Diseases; the Union of European Medical Specialists. The European Centre for Disease Prevention and Control and the European Office of the World Health Organisation also contributed to their development.
Journal of the European Academy of Dermatology and Venereology, 2016
Mycoplasma genitalium infection contributes to 10-35% of non-chlamydial non-gonococcal urethritis... more Mycoplasma genitalium infection contributes to 10-35% of non-chlamydial non-gonococcal urethritis in men. In women, M. genitalium is associated with cervicitis and pelvic inflammatory disease (PID). Transmission of M. genitalium occurs through direct mucosal contact. Asymptomatic infections are frequent. In women, symptoms include vaginal discharge, dysuria or symptoms of PIDabdominal pain and dyspareunia. In men, urethritis, dysuria and discharge predominates. Besides symptoms, indication for laboratory test is a high-risk sexual behaviour. Diagnosis is achievable only through nucleic acid amplification testing (NAAT). If available, NAAT diagnosis should be followed with an assay for macrolide resistance. Therapy for M. genitalium is indicated if M. genitalium is detected or on an epidemiological basis. Doxycycline has a low cure rate of 30-40%, but does not increase resistance. Azithromycin has a cure rate of 85-95% in macrolide susceptible infections. An extended course appears to have a higher cure rate. An increasing prevalence of macrolide resistance, most likely due to widespread use of azithromycin 1 g single dose without test of cure, is drastically decreasing the cure rate. Moxifloxacin can be used as second-line therapy, but resistance is increasing. Uncomplicated M. genitalium infection should be treated with azithromycin 500 mg on day one, then 250 mg on days 2-5 (oral), or josamycin 500 mg three times daily for 10 days (oral). Second line treatment and treatment for uncomplicated macrolide resistant M. genitalium infection is moxifloxacin 400 mg od for 7-10 days (oral). For third line treatment of persistent M. genitalium infection after azithromycin and moxifloxacin doxycycline 100 mg two times daily for 14 days can be tried and may cure 30%. Pristinamycin 1 g four times daily for 10 days (oral) has a cure rate of app. 90%. Complicated M. genitalium infection (PID, epididymitis) is treated with moxifloxacin 400 mg od for 14 days.
Antibiotiki i khimioterapii͡a = Antibiotics and chemoterapy [sic] / Ministerstvo meditsinskoĭ i mikrobiologicheskoĭ promyshlennosti SSSR, 2013
The vaginal discharge is one of the most frequent symptoms requiring medical advise. Vaginal disc... more The vaginal discharge is one of the most frequent symptoms requiring medical advise. Vaginal discharges are mainly associated with three diseases: bacterial vaginosis, trichomononiasis and candidiasis. The review is concerned with up-to-date approaches to the treatment of females with bacterial vaginosis and trichomononiasis, diseases different by the etiology and pathogenesis, but at the same time similar with respect to the treatment. The analysis is in compliance with the principles of the two fundamental world guidelines.
Sexually Transmitted Diseases, 2000
This chapter discusses the changing epidemiology of sexually transmitted diseases (STDs), focusin... more This chapter discusses the changing epidemiology of sexually transmitted diseases (STDs), focusing on the Russian experience. A highly regimented society with widely accessible health care and strict penalizing policies regarding STDs helped maintain a low incidence of these diseases in Soviet Russia. The political, social, and economic upheaval that occurred in the late 1980s and early 1990s has resulted in a more open society but with increased unemployment, poverty, drug use, prostitution, and tourism. These changes have contributed to a wide increase in STDs, particularly syphilis. There are about 300 Departments of Anonymous Testing and Treatment (DATTs) in Russia, which provide qualified medical care for patients willing to pay. Although these departments add only about 10% of all cases, mostly these patients do not come to the dispensary on their own. Strategic changes are occurring in the field of dermatovenereology to effectively deal with STDs in post-Soviet Russia.
Journal of the European Academy of Dermatology and Venereology, 2001
Chlamydia trachomatis infections of the female and male genital tracts are often asymptomatic and... more Chlamydia trachomatis infections of the female and male genital tracts are often asymptomatic and, thus, tend to become persistent. In the persistent state the typical Chlamydia life cycle is arrested and standard antibiotic regimens do not always eradicate this infection. We sought to relate treatment failures in men and women with persistent chlamydial genital tract infections to electron microscopic evidence of chlamydial persistence and with atypical morphological forms of the organism. Of 16 patients with chlamydial persistence following azithromycin treatment, morphological variants of this organism were observed by electron microscopy from one endocervical sample and one male urethral sample. We document the presence of intracellular inclusions containing only reticulate bodies, extracellular monomembrane and polymembrane phagosomes containing elementary bodies and reticulate bodies with abnormal outer membranes in the process of dividing extracellularly. These observations parallel previous in vitro studies of chlamydial persistence under adverse conditions. This capacity of C. trachomatis to undergo atypical morphological alterations in vivo may contribute to its persistence and relative resistance to antibiotics.
Journal of the European Academy of Dermatology and Venereology, 1997
International Journal of STD & AIDS, 2002
It is generally understood that hepatitis B and hepatitis C may be sexually transmitted. During t... more It is generally understood that hepatitis B and hepatitis C may be sexually transmitted. During the last decade there was a sharp growth of hepatitis B and C in Russia. In comparison to 1992 the incidence of hepatitis B in Russia rose two-fold and in 1999 there were 43.31 cases per 100,000 of population (in some cities up to 150/100,000 and even more). The incidence of hepatitis C in 1999 (19.31 per 100,000 of population) rose to six times more than in 1994. At the same time there was a dramatic growth in syphilis and other sexually transmitted infections in Russia. The proportion of sexual transmission of hepatitis B virus (HBV) and hepatitis C virus (HCV) compared with other routes of transmission increased. According to the data from Moscow City Centre of Epidemiology during the last two years, up to 40% cases of HCV and HBV were sexually transmitted. The most dramatic growth of registered cases of hepatitis was seen among the sexually active population aged 14-29. Confirmation o...
International Journal of STD & AIDS, 2013
Gonorrhoea is a major public health concern globally. Of particularly grave concern is that resis... more Gonorrhoea is a major public health concern globally. Of particularly grave concern is that resistance to the extended-spectrum cephalosporins has emerged during the most recent years. This guideline provides recommendations regarding the diagnosis and treatment of gonorrhoea in Europe. Compared to the outdated 2009 European gonorrhoea guideline, this 2012 European gonorrhoea guideline provides up-to-date guidance on, broader indications for testing and treatment of gonorrhoea; the introduction of dual antimicrobial therapy (ceftriaxone 500 mg and azithromycin 2 g) for uncomplicated gonorrhoea when the antimicrobial sensitivity is unknown; recommendation of test of cure in all gonorrhoea cases to ensure eradication of infection and identify emerging resistance; and recommendations to identify, verify and report failures with recommended treatment regimens. Optimisations of the testing, diagnostics, antimicrobial treatment and follow-up of gonorrhoea patients are crucial in controlli...
International Journal of STD & AIDS, 2020
Gonorrhoea is a major public health concern globally. Increasing incidence and sporadic ceftriaxo... more Gonorrhoea is a major public health concern globally. Increasing incidence and sporadic ceftriaxone-resistant cases, including treatment failures, are growing concerns. The 2020 European gonorrhoea guideline provides up-to-date evidence-based guidance regarding the diagnosis and treatment of gonorrhoea. The updates and recommendations emphasize significantly increasing gonorrhoea incidence; broad indications for increased testing with validated and quality-assured nucleic acid amplification tests and culture; dual antimicrobial therapy including high-dose ceftriaxone and azithromycin (ceftriaxone 1 g plus azithromycin 2 g) OR ceftriaxone 1 g monotherapy (ONLY in well-controlled settings, see guideline for details) for uncomplicated gonorrhoea when the antimicrobial susceptibility is unknown; recommendation of test of cure (TOC) in all gonorrhoea cases to ensure eradication of infection and identify resistance; and enhanced surveillance of treatment failures when recommended treatmen...
Journal of the European Academy of Dermatology and Venereology, 2015
Background Partner management is the process of identifying the contacts of a person infected by ... more Background Partner management is the process of identifying the contacts of a person infected by a sexually transmitted infection (STI) and referral to a health care provider for appropriate management. It represents a public health activity. Methods This guideline is produced by the IUSTI European Guideline Editorial Board and EDF Guideline Committee. Results It provides recommendations concerning the infections that require partner management, the lookback periods for this STI and the main steps to follow for partner management (offering support to patients, notifying partners, identification of contacts). Partner management is voluntary and needs to be performed with respect to human rights, social, cultural and religious behaviours. Conclusions In European countries, there are different approaches to the partner management; some common type of actions can enhance the fight against STI.
Journal of the European Academy of Dermatology and Venereology, 2018
Should we be testing for urogenital Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyti... more Should we be testing for urogenital Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum in men and women?-a position statement from the European STI Guidelines Editorial Board.
Journal of the European Academy of Dermatology and Venereology, 2019
International Journal of STD & AIDS, 2009
† Gummatous syphilis: 22 typical nodules/plaques or ulcers; † Neurosyphilis: ocular, auricular, m... more † Gummatous syphilis: 22 typical nodules/plaques or ulcers; † Neurosyphilis: ocular, auricular, meningovascular, parenchymatous (general paresis, tabes dorsalis); asymptomatic (abnormal cerebrospinal fluid [CSF]); † Cardiovascular syphilis: aortitis-asymptomatic, angina, aortic regurgitation, stenosis of coronary ostia, aortic aneurysm (mainly thoracic). Epidemiological monitoring of infectious syphilis: all patients with primary, secondary and early latent syphilis should be reported to their National Syphilis Surveillance System and these national programmes should report to the European Surveillance of STI (ESSTI) network of the ECDC, if they are within the European Union. 1
Sexually Transmitted Infections, 2015
Sexually Transmitted Infections, 2013
Poster presentations Results Of the 156 specimens, 83 N. gonorrhoeae strains were tested for anti... more Poster presentations Results Of the 156 specimens, 83 N. gonorrhoeae strains were tested for antimicrobial susceptibilities to 18 agents. The prevalence of β-lactamase producing strains and chromosomally-mediated resistant strains were 7.2% and 16.5%, respectively. Against cepharosporins, one strain was resistant to cefixime with MIC 0.5 μg/ml. There was not resistant strain to ceftriaxone, but the 7 strains (8.4%) had MIC 0.125 μg/ml. The MIC of fluoroquinolones to all strains showed a bimodal distribution. The values of MIC90 of ciprofloxacin and levofloxacin were 16 and 8 μg/ml, respectively. Sitafloxacin, one of fluoroquinolones had strong activity to N. gonorrhoeae strains and the value of MIC90 was 0.25 μg/ml. The MIC of azithromycin in 2 strains was 2 μg/ml, but no high-level resistance to macrolides was detected. Conclusion The first national surveillance for antimicrobial susceptibilities of N. gonorrhoeae was performed. Fluoroquinolone-resistance N. gonorrhoeae strains were spread in Japan. The resistant rate of azithromycin resistant was 2.4%. Post-treatment Detection of azithromycin in high-Vaginal swabs Using liqUiD chromatograPhy anD tanDem mass sPectrometry (lc-ms/ms)
Andrology, 2014
Acute and chronic infections of the seminal tract are among the most common causes of male infert... more Acute and chronic infections of the seminal tract are among the most common causes of male infertility. As at least half of male infertility cases are classified as idiopathic, some of these cases might be attributed to asymptomatic infection. The detection and quantification of Epstein-Barr virus (EBV), cytomegalovirus (CMV) and human herpes virus type 6 (HHV-6) DNA in semen samples were performed. A total of 232 patients were divided into five groups: (i) infertile men with varicocoele; (ii) men with idiopathic infertility; (iii) infertile men with chronic inflammatory urogenital tract diseases (IUTD); (iv) fertile men with IUTD and (v) men whose partners had a history of pregnancy loss. In the study population, the prevalence of viral DNA was 17.7, 3.4% for EBV, 5.2% for CMV, 6.5% for HHV-6, 0.43% for EBV + CMV, 0.87% for EBV + HHV-6 and 1.3% for CMV + HHV-6. The median viral loads for EBV, CMV and HHV-6 were 500, 2250 and 250 copies/mL respectively. Of the sperm cell fractions, derived from infected samples 87.5% contained viral DNA. No association between EBV and fertility disorders or IUTD was found. CMV detection was much higher in the group of patients with infertility and concomitant IUTD compared with the other groups combined (18.5% vs. 5.4%, p = 0.03) and associated with reduced sperm cell count (39.5 × 10(6) /mL vs. 72.5 × 10(6) /mL, p = 0.036). Immunostaining of spermatozoa from infected samples and in vitro-infected cells detected CMV in sperm heads, tails and connecting pieces and revealed attachment to sperm membrane and intracellular localization. HHV-6 was the more common in fertile men with chronic IUTD than in the other groups combined (19% vs. 6.3%, p = 0.018) and had no effect on sperm parameters. The results suggest that both CMV and HHV-6 may contribute to the aetiology of IUTD and, moreover, CMV-associated IUTD can lead to male sterility.
Science, 1924
... Bancroft,; BB Boltwood,; JC Booth,; CF Chandler,; Russell H. Chittenden,; FW Clarke,; FG Cott... more ... Bancroft,; BB Boltwood,; JC Booth,; CF Chandler,; Russell H. Chittenden,; FW Clarke,; FG Cottrell,; Josiah P. Cooke,; EC Franklin,; J. Willard Gibbs,; Wolcott Gibbs,; Moses Gomberg,; Robert Hare,; WF Hillebrand,; T. Sterry Hunt,; Irving ...