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Carlos F Cáceres, Annick Borquez, Jeffrey D Klausner, Rachel Baggaley, Chris Beyrer
BACKGROUND: In this article, we present recent evidence from studies focused on the implementation, effectiveness and cost-effectiveness of pre-exposure prophylaxis (PrEP) for HIV infection; discuss PrEP scale-up to date, including the observed levels of access and policy development; and elaborate on key emerging policy and research issues to consider for further scale-up, with a special focus on lower-middle income countries. DISCUSSION: The 2015 WHO Early Release Guidelines for HIV Treatment and Prevention reflect both scientific evidence and new policy perspectives...
2016: Journal of the International AIDS Society
Joshua D Billings, Dvora L Joseph Davey, Kelika A Konda, Claire C Bristow, Jeremy Chow, Jeffrey D Klausner, Carlos F Cáceres
The aim of the study was to identify factors associated with undiagnosed human immunodeficiency virus (HIV) infection among men who have sex with men (MSM) and male-to-female transgender women in Lima, Peru.We analyzed characteristics of 378 MSM and transgender women recruited from 2 sexually transmitted infection (STI) clinics in Lima, Peru. Descriptive analyses compared: (A) HIV-uninfected, (B) previously undiagnosed HIV-infected, and (C) previously diagnosed HIV-infected participants. Multivariable logistic regression models identified: (1) correlates of previously undiagnosed HIV-infection among participants thought to be HIV-uninfected (B vs A); and (2) correlates of previously undiagnosed HIV-infection among HIV-infected participants (B vs C)...
October 2016: Medicine (Baltimore)
Brian J Morris, Jeffrey D Klausner, John N Krieger, Bradley J Willcox, Pierre D Crouse, Neil Pollock
INTRODUCTION: The Canadian Pediatrics Society (CPS) recently released a position statement on early infant (newborn) male circumcision (EIMC). It concluded that since benefits do not exceed risks, circumcision should only be performed on boys in high-risk populations or circumstances. This contradicts recommendations by the American Academy of Pediatrics and the Centers for Disease Control and Prevention (CDC) whose policies each support more widespread implementation of EIMC. Here we review the CPS statement, particularly its risk-benefit analysis, to determine the basis for this disparity...
October 2016: Canadian Journal of Urology
D Joseph Davey, M Alexandra, J D Klausner
No abstract text is available yet for this article.
October 2016: International Journal of STD & AIDS
G Lahat, N Lubezky, F Gerstenhaber, E Nizri, M Gysi, M Rozenek, Y Goichman, I Nachmany, R Nakache, I Wolf, J M Klausner
BACKGROUND: We evaluated the prognostic significance and universal validity of the total number of evaluated lymph nodes (ELN), number of positive lymph nodes (PLN), lymph node ratio (LNR), and log odds of positive lymph nodes (LODDS) in a relatively large and homogenous cohort of surgically treated pancreatic ductal adenocarcinoma (PDAC) patients. METHODS: Prospectively accrued data were retrospectively analyzed for 282 PDAC patients who had pancreaticoduodenectomy (PD) at our institution...
September 29, 2016: World Journal of Surgical Oncology
Like Li, Nick AuYeung, Renwei Mei, James F Klausner
We present a systematic study on the effects of tangential-type boundary condition discontinuities on the accuracy of the lattice Boltzmann equation (LBE) method for Dirichlet and Neumann problems in heat and mass transfer modeling. The second-order accurate boundary condition treatments for continuous Dirichlet and Neumann problems are directly implemented for the corresponding discontinuous boundary conditions. Results from three numerical tests, including both straight and curved boundaries, are presented to show the accuracy and order of convergence of the LBE computations...
August 2016: Physical Review. E
Chelsea P Roberts, Jeffrey D Klausner
Syphilis and human immunodeficiency virus (HIV) coinfection disproportionately affects men who have sex with men (MSM), and the rate of coinfection has been increasing over the last decade. HIV and syphilis coinfection is particularly challenging because the infections interact synergistically thereby increasing the risk of acquisition and transmission as well as accelerating disease progression. Areas covered: This paper reviews and summarizes the epidemiology, pathogenesis, diagnosis, clinical management and prevention of HIV and syphilis coinfection among MSM...
November 2016: Expert Review of Anti-infective Therapy
Shelly Loewenstein, Nir Lubezky, Eran Nizri, Meir Zemel, Yishai Levin, Alon Savidor, Osnat Sher, Joseph M Klausner, Guy Lahat
: Previous data demonstrated that high retroperitoneal visceral fat (VF) content increases retroperitoneal soft-tissue sarcoma (RSTS) local recurrence and patients mortality. Most RSTS tumors initiate and recur within VF. The objective of the current study was to evaluate potential paracrine effects of VF on RSTS. A xenograft model was used to evaluate in vivo effects of human VF on STS growth. Tissue explants were prepared from VF, and their conditioned medium (CM) was utilized for various in vitro experiments designed to evaluate growth, survival, migration and invasion of STS and endothelial cells...
September 12, 2016: Molecular Cancer Research: MCR
Brian J Morris, John N Krieger, Jeffrey D Klausner
We evaluate recent claims opposing infant male circumcision, a procedure now supported by the evidence-based policy of the American Academy of Pediatrics. We find those criticisms depend on speculative claims about the foreskin and obfuscation of the strong scientific evidence supporting pediatric policy development. An argument that circumcision should be delayed to allow a boy to make up his own mind as an adult fails to appreciate the psychological, scheduling and financial burdens later circumcision entails, so reducing the likelihood that it will occur...
August 8, 2016: World Journal of Clinical Pediatrics
Hayoung Park, Kelika A Konda, Chelsea P Roberts, Jorge L Maguiña, Segundo R Leon, Jesse L Clark, Thomas J Coates, Carlos F Caceres, Jeffrey D Klausner
BACKGROUND: Syphilis is concentrated among high-risk groups, but the epidemiology of syphilis reinfection is poorly understood. We characterized factors associated with syphilis incidence, including reinfection, in a high-risk cohort in Peru. METHODS: Participants in the NIMH CPOL trial were assessed at baseline and 2 annual visits with HIV/STI testing and behavioral surveys. Participants diagnosed with syphilis also attended 4- and 9-month visits. All participants underwent syphilis testing with RPR screening and TPPA confirmation...
2016: PloS One
Sarah C Krzastek, William M Bruch, Samuel P Robinson, Harold F Young, Adam P Klausner
AIMS: The purpose of this study was to evaluate lower urinary tract symptoms (LUTS) in idiopathic normal pressure hydrocephalus (iNPH). METHODS: Patients with new-onset iNPH were prospectively evaluated for LUTS via detailed history and physical, and administration of questionnaires from the International Consultation on Incontinence to assess incontinence (ICIq-UI), overactive bladder (ICIq-OAB), and quality of life (ICIq-LUTqol), as well as the American Urological Association Symptom Score bother scale...
August 4, 2016: Neurourology and Urodynamics
Ravit Geva, Herman Davidovics, Slava Soyfer, Sharon Pelles-Avraham, Joseph M Klausner, Moshe Inbar, Hagit Tulchinsky
AIM: This study aimed to assess the progression-free and overall survival of patients with residual microscopic disease following neoadjuvant chemoradiation and rectal resection for locally advanced rectal cancer. METHODS: Two-hundred and thirty-four consecutive rectal cancer patients who had neoadjuvant chemoradiotherapy followed by radical resection (5/2000-4/2012) were divided according to pathologic tumor response: residual microscopic disease (MIC), complete response (pCR), and partial/no response (nonCR)...
July 30, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Oliver N Refugio, Chelsea Roberts, Richard West, Jeffrey D Klausner
The resurgence of sexually transmissible infections among men who have sex with men is a concern for sexual health. Traditional strategies have relied on the promotion of condom use, regular testing, treatment, and partner management. Future sexually transmissible infection control programs must combine current prevention methods with novel approaches that target the providers, patients, and mechanisms of health care delivery.
July 22, 2016: Sexual Health
Alexandra Medline, Dvora Joseph Davey, Jeffrey D Klausner
Unfavorable pregnancy outcomes caused by Chlamydia trachomatis or Neisseria gonorrhoeae infection are well known. The first step in addressing antenatal C. trachomatis and N. gonorrhoeae infection is a national policy to screen all pregnant women for C. trachomatis and N. gonorrhoeae, regardless of symptoms. The aim of this study was to inform policy makers on the presence of antenatal screening recommendations for C. trachomatis and N. gonorrhoeae infection. We conducted a three-part study from June 2015 to February 2016...
July 20, 2016: International Journal of STD & AIDS
Emily Huang, Robert W Marlin, Sean D Young, Alex Medline, Jeffrey D Klausner
In Los Angeles County, about 25% of men who have sex with men (MSM) are HIV-positive but unaware of their status. An advertisement publicizing free HIV self-tests was placed on Grindr, a smartphone social-networking application, from April 17 to May 29, 2014. Users were linked to to choose a self-test delivery method: U.S. mail, a Walgreens voucher, or from a vending machine. Black or Latino MSM ≥ 18 years old were invited to take a testing experiences survey. During the campaign, the website received 11,939 unique visitors (average: 284 per day) and 334 self-test requests...
August 2016: AIDS Education and Prevention: Official Publication of the International Society for AIDS Education
Tracy P Trang, Betty J Dong, Noah Kojima, Jeffrey D Klausner
INTRODUCTION: Tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) are nucleoside reverse transcriptase inhibitors approved as pre-exposure prophylaxis (PrEP) against human immunodeficiency virus (HIV). Prophylactic TDF-based regimens have been shown to reduce the risk of HIV infection by 74 to 92% among participants with detectable drug levels. Adverse events observed in clinical trials include nausea, elevated creatinine and liver enzymes, and decreased bone mineral density. AREAS COVERED: This article reviews the pharmacology, pharmacokinetics, and the safety profile of TDF and FTC used as PrEP for HIV infection...
September 2016: Expert Opinion on Drug Safety
Nicole E Tuong, Adam P Klausner, Lance J Hampton
INTRODUCTION: Cerebrovascular accidents, or strokes, are a common cause of morbidity and mortality in the United States. Urinary incontinence is a prevalent morbidity experienced by post-stroke patients that is associated with long term disability and institutionalization effects on these patients. MATERIALS AND METHODS: An extensive literature review was conducted using multiple academic search engines using the keywords: 'stroke,' 'CVA,' 'urinary incontinence,' 'urodynamics,' 'pharmacologic treatments,' and 'conservative treatments...
June 2016: Canadian Journal of Urology
D L Joseph Davey, H I Shull, J D Billings, D Wang, K Adachi, J D Klausner
BACKGROUND: Current literature comparing the prevalence rates of curable sexually transmitted infections (STIs) in pregnant women in various global regions is limited. As a result, antenatal screening practices for curable STIs in pregnant women, specifically Treponema pallidum (syphilis), Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), and Trichomonas vaginalis (TV) vary around the world, differing by country and particular STI. METHODS: We conducted a systematic review of publications on STI prevalence among pregnant women in 30 different low- and middle-income countries...
July 2016: Sexually Transmitted Diseases
Claire C Bristow, Linda Severe, Jean William Pape, Marjan Javanbakht, Sung-Jae Lee, Warren Scott Comulada, Jeffrey D Klausner
BACKGROUND: Dual rapid tests for HIV and syphilis infections allow for detection of HIV infection and syphilis at the point-of-care. Those tests have been evaluated in laboratory settings and show excellent performance but have not been evaluated in the field. We evaluated the field performance of the SD BIOLINE HIV/Syphilis Duo test in Port-au-Prince, Haiti using whole blood fingerprick specimens. METHODS: GHESKIO (Haitian Study Group for Kaposi's Sarcoma and Opportunistic Infections) clinic attendees 18 years of age or older were invited to participate...
2016: BMC Infectious Diseases
Noah Kojima, Dvora Joseph Davey, Jeffrey D Klausner
We conducted a meta-analysis to summarize rates of sexually transmitted infections among men who have sex with men (MSM) on pre-exposure prophylaxis (PrEP) for HIV versus MSM not using PrEP. Incidence rate ratios showed that MSM using PrEP were 25.3 times more likely to acquire a Neisseria gonorrhoeae infection, 11.2 times more likely to acquire a Chlamydia trachomatis infection, and 44.6 times more likely to acquire a syphilis infection versus MSM not using PrEP.
September 10, 2016: AIDS
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