Notes

Adjusting clinical testing by way of home brew in the COVID-19 outbreak.
Medication abortion, also referred to as medical abortion, is a safe and effective method of providing abortion. Medication abortion involves the use of medicines rather than uterine aspiration to induce an abortion. The U.S. Food and Drug Administration (FDA)-approved medication abortion regimen includes mifepristone and misoprostol. The purpose of this document is to provide updated evidence-based guidance on the provision of medication abortion up to 70 days (or 10 weeks) of gestation. Information about medication abortion after 70 days of gestation is provided in other ACOG publications ().
Hepatocyte transplantation has been extensively investigated as an alternative to orthotopic liver transplantation. However, its application in routine clinical practice has been restricted because of low initial engraftment and subsequent repopulation.

Using mice as a model, we have developed a minimally invasive and nontoxic pre-conditioning strategy based on pre-administration of antibodies against hepsin to increase donor hepatocyte retention and engraftment rate.

Liver sinusoid diameters decreased significantly with anti-hepsin pretreatment, and graft cell numbers increased nearly twofold in the recipients' liver parenchyma for 20 days after hepatocyte transplantation. Postoperative complications such as hepatic ischemia injury or apparent immune cell accumulation were not observed in recipients. In a hemophilia B mouse model, anti-hepsin pre-conditioning enhanced the expression and clotting activity of coagulation factor IX (FIX) to nearly twofold that of IgG-treated controls and maintained higherst that pre-conditioning with anti-hepsin may have clinical applications for liver cell therapy.
Ex vivo lung perfusion (EVLP) is used to evaluate and recondition extended criteria donor lungs for transplantation. Interleukin-1β (IL-1β) has been identified as a prognostic indicator of nonrecovery during EVLP. This may be an effect of inflammasome activation or cellular necrosis following donation and graft preservation. Delineating the mechanism of IL-1β release is required.

The inactive intracellular precursor molecule, pro-IL-1β, was characterised along with the pro-IL-1β processing enzyme, caspase-1, in the perfusate of n=20 human lungs that had undergone EVLP (n=10 lungs that failed to recover and were discarded vs n=10 lungs that reconditioned and were transplanted). In an experimental porcine model, n=8 lungs underwent EVLP and were randomised to receive either a specific NLRP3 inflammasome inhibitor or control.

Significant increases in pro-IL-1β and caspase-1 were observed in the perfusate from human lungs that did not recondition during EVLP compared to those that successfully reconditioned and were used for transplantation. Within the porcine EVLP, NLRP3 inflammasome inhibition reduced IL-1β within the perfusate compared to controls, but this had no impact on lung function, hemodynamics, or inflammation.

Our data suggest that pro-IL-1β is passively released following cellular necrosis of the donor lung.
Our data suggest that pro-IL-1β is passively released following cellular necrosis of the donor lung.
In this study, we report the epidemiology of COVID-19 among recipients of organ transplantation and evaluate associated factors with death.

We screened 6969 patients who had organ transplantations in our center for COVID-19. Specific data on presentation, clinical course, treatment, and prognosis were acquired.

We found 85 patients (66 liver, 16 kidney, 2 kidney-pancreas, and 1 liver-kidney recipient) who acquired COVID-19. Most common symptoms included fever (48.2%), cough (41.2%), myalgia (41.2%), and fatigue (40%). Dyspnea developed in 33% of patients. Overall, one-third of patients had an oxygen saturation of below 90% on admission. Patients were hospitalized for a median (interquartile range) of 9 (5, 13.7) days and had a 33.9% intensive care unit admission rate. Overall, 17 patients (20%) died, which included 31.3% of patients with kidney transplantations and 18.2% of patients with liver transplantations. All 4 pediatric patients in our series died. In our univariate analysis among adults, rates oof death due COVID-19.
Many US health departments now integrate HIV-related outcomes (e.g., relinkage to HIV care and preexposure prophylaxis [PrEP]) into sexually transmitted disease (STD) partner services (PS) programs. We sought to determine the barriers, facilitators, and cost of integrating these activities into PS.

From 2016 to 2018, the Mississippi State Department of Health integrated 3 new activities into STD PS HIV testing for partners of HIV-negative men who have sex with men with gonorrhea/chlamydia, relinkage to HIV care for STD PS recipients previously diagnosed with HIV, and PrEP referrals. We conducted direct observations and interviews with disease intervention specialists (DIS) in Jackson to assess barriers and facilitators to implementing these activities. We completed time and motion studies with 8 DIS and case tracking forms for 90 unique cases to estimate the incremental staff time and associated personnel cost of added services compared with a standard PS case.

Disease intervention specialists were optiritization of partner services activities.
Evidence-based interventions are needed to stem sexually transmitted infections (STIs). Clinic-delivered counseling remains an important avenue for effective STI prevention.

A 3-arm randomized clinical trial compared (a) STI health education control condition, (b) risk reduction counseling, and (c) enhanced partner notification counseling. Men and women (n = 1050) were recruited from an STI clinic in Cape Town, South Africa. After baseline assessments, participants were randomly allocated to receive 1 of the 3 single-session counseling interventions and were followed up for 9 months of behavioral assessments and 12 months of electronic medical records abstraction for STI clinic services.

Sexual risk reduction counseling reported greater condom use than did the other 2 conditions during the 3 and 6 months follow-ups. In addition, women receiving risk reduction counseling were significantly less likely to have returned for STI clinic services but did not differ in the number of STI clinic visits over the year.

Brief single-session STI prevention counseling demonstrates significant targeted outcomes. The findings suggest that counseling approaches to both increase condom use and enhance partner notification may offer more robust and sustained outcomes and should be tested in future research.
Brief single-session STI prevention counseling demonstrates significant targeted outcomes. The findings suggest that counseling approaches to both increase condom use and enhance partner notification may offer more robust and sustained outcomes and should be tested in future research.
Youth with perinatally acquired HIV (YPHIV) are at higher risk for anogenital human papillomavirus (HPV) infection.

We enrolled a cohort of YPHIV and HIV-negative youth in Thailand and Vietnam, matched by age and lifetime sex partners, and followed them up for 144 weeks (to 2017). Participants had annual pelvic examinations with samples taken for HPV genotyping. Concordant infection was simultaneous HPV detection in multiple anogenital compartments (cervical, vaginal, anal); sequential infection was when the same type was found in successive compartments (cervicovaginal to/from anal). Generalized estimating equations were used to assess factors associated with concordant infection, and Cox regression was used to assess factors associated with sequential infection.

A total of 93 YPHIV and 99 HIV-negative women were enrolled, with a median age of 19 years (interquartile range, 18-20 years). High-risk anogenital HPV infection was ever detected in 76 (82%) YPHIV and 66 (67%) HIV-negative youth during follow-up. Concordant anogenital high-risk HPV infection was found in 62 (66%) YPHIV versus 44 (34%) HIV-negative youth. Sequential cervicovaginal to anal high-risk HPV infection occurred in 20 YPHIV versus 5 HIV-negative youth, with an incidence rate of 9.76 (6.30-15.13) versus 2.24 (0.93-5.38) per 100 person-years. Anal to cervicovaginal infection occurred in 4 YPHIV versus 0 HIV-negative women, with an incidence rate of 1.78 (0.67-4.75) per 100 person-years. Perinatally acquired HIV was the one factor independently associated with both concordant and sequential high-risk HPV infection.

Children and adolescents with perinatally acquired HIV should be prioritized for HPV vaccination, and cervical cancer screening should be part of routine HIV care for sexually active YPHIV.
Children and adolescents with perinatally acquired HIV should be prioritized for HPV vaccination, and cervical cancer screening should be part of routine HIV care for sexually active YPHIV.We identified and characterized the first two Neisseria gonorrhoeae strains with high-level azithromycin resistance isolated in Japan. These were in the clade of ceftriaxone- and azithromycin-resistant strains isolated in Australia and the UK. The MLST, NG-MAST and NG-STAR types of these strains were found in gonococci from eastern Asia.
Given its high cost, governmental financing is essential for promoting HIV preexposure prophylaxis (PrEP). The study investigated levels and associated factors of the general public's support toward governmental provision of free or subsidized PrEP to Chinese people at high risk of HIV.

A population-based random telephone survey was conducted among 300 residents in Hong Kong, China, from June to July, 2019. Descriptive analyses and logistic regression were performed.

The prevalence rates of supportive attitude for free and subsidized PrEP were 30.0% and 30.3%, respectively; opinions were split, as similar proportions showed oppositional attitude. Those who were older, had less education, did not have a full-time job, or reported a lower household income were less likely to support free or subsidized PrEP. Stigmatizing attitudes against homosexuals (adjusted odds ratio [AOR], 0.81; 95% CI, 0.73-0.89) and perceived negative societal impacts of free PrEP (AOR, 0.78; 95% CI, 0.70-0.87) were negatively associated with the support for free PrEP. Compassion to others (AOR, 1.10; 95% CI, 1.01-1.21), perceived positive societal impacts of free PrEP (AOR, 1.86; 95% CI, 1.43-2.44), and the belief that the positive impacts would overweigh the negative impacts (AOR, 26.97; 95% CI, 10.66-68.24) were positively associated with the support for free PrEP. Similar associations were observed for the support toward subsidized PrEP.

The Hong Kong general public's support for government financial assistance of PrEP for people at high risk of HIV was low. Preexposure prophylaxis advocacy campaigns are warranted and suggested to incorporate components that address the associated factors.
The Hong Kong general public's support for government financial assistance of PrEP for people at high risk of HIV was low. Preexposure prophylaxis advocacy campaigns are warranted and suggested to incorporate components that address the associated factors.Using 2013-2017 National Survey of Family Growth (NSFG), 37.6% of women with ≥1 anal sex partner in the last 12 months reported chlamydia testing at unspecified anatomic sites in the past 12 months. Resveratrol Women whose medical provider asked about type of sex (i.e. vaginal, oral, anal), compared to those whose provider did not, reported higher chlamydia testing.
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