2020 European guideline on the management of genital molluscum contagiosum

Molluscum contagiosum is a benign viral epidermal infection associated with high risk of transmission. The guideline is focused on the sexually transmitted molluscum contagiosum. The diagnosis is clinical with characteristic individual lesions, termed ‘mollusca’, seen as dome‐shaped, smooth‐surfaced, pearly, firm, skin‐coloured, pink, yellow or white papules, 2 ‐ 5 mm in diameter with central umbilication. Dermoscopy may facilitate diagnosis. Therapeutic options are numerous, including physical treatments (cautery, curettage and cryotherapy), topical chemical treatments (e.g. podophyllotoxin and imiquimod) or waiting for spontaneous resolution in immunocompetent patients. In pregnancy, it is safe to use physical procedures (e.g. cryotherapy). Immunosuppressed patients develop severe and recalcitrant molluscum lesions that may require treatment with cidofovir, imiquimod or interferon. Patients with molluscum contagiosum infection should be offered to be screened for other sexually transmitted infections.     

Staphylococcus aureus versus Staphylococcus epidermidis in periprosthetic joint infection—Outcome analysis of methicillin-resistant versus methicillin-susceptible strains

Periprosthetic joint infections (PJIs) are a major complication in total joint arthroplasty. Staphylococcus aureus and coagulase-negative staphylococci are known to cause the majority of all PJIs. This study aimed to analyze the eradication rates of S. aureus and S. epidermidis with methicillin susceptibility and methicillin resistance in a 2-stage therapy algorithm. Seventy-four patients with PJI caused by methicillin-resistant S. aureus (MRSA), methicillin-resistant coagulase-negative staphylococci (MRSE), methicillin-susceptible S. aureus (MSSA), and methicillin-susceptible coagulase-negative staphylococci (MSSE) were included, and the outcome was analyzed retrospectively. After a minimal follow-up of 2?years, n?=?56 patients (75.7%) were definitively free of infection. The analysis revealed significant differences between the groups, with eradication rates as follows: MSSA (92.6%), MSSE (95.2%), MRSA (80%), and MRSE (54.2%). MRSE showed a significantly lower rate of patients graded as “definitively free of infection” as compared to patients with infections caused by MSSA, MSSE, and MRSA.     

Ethical Challenges in Promoting the Implementation of Preventive Interventions: Report of the SPR Task Force

Prevention science researchers and practitioners are increasingly engaged in a wide range of activities and roles to promote evidence-based prevention practices in the community. Ethical concerns invariably arise in these activities and roles that may not be explicitly addressed by university or professional guidelines for ethical conduct. In 2015, the Society for Prevention Research (SPR) Board of Directors commissioned Irwin Sandler and Tom Dishion to organize a series of roundtables and establish a task force to identify salient ethical issues encountered by prevention scientists and community-based practitioners as they collaborate to implement evidence-based prevention practices. This article documents the process and findings of the SPR Ethics Task Force and aims to inform continued efforts to articulate ethical practice. Specifically, the SPR membership and task force identified prevention activities that commonly stemmed from implementation and scale-up efforts. This article presents examples that illustrate typical ethical dilemmas. We present principles and concepts that can be used to frame the discussion of ethical concerns that may be encountered in implementation and scale-up efforts. We summarize value statements that stemmed from our discussion. We also conclude that the field of prevention science in general would benefit from standards and guidelines to promote ethical behavior and social justice in the process of implementing evidence-based prevention practices in community settings. It is our hope that this article serves as an educational resource for students, investigators, and Human Subjects Review Board members regarding some of the complexity of issues of fairness, equality, diversity, and personal rights for implementation of preventive interventions.     

Nonverbal Response Cards Reduce Socially Desirable Reporting of Violence Among Adolescents in Rural Burkina Faso: A Randomized Controlled Trial

PurposeAccurate measures of violence are difficult to obtain from self-reported data because of stigmatization and social undesirability of the topic. Most methods that attempt to reduce such biases require literacy and either remove the benefits of interviewer guidance or do not give individual-level results. We tested a low-tech nonverbal response card that avoids revealing interviewees' responses to interviewers while retaining interviewer support among adolescents in communities with very low educational attainment.MethodsAs part of a broader health questionnaire, we asked a sample of 1,644 adolescents, aged 12–20 years, in northwestern Burkina Faso about their experiences of physical and sexual violence. We randomized participants to either a conventional verbal response arm or a nonverbal response card arm where respondents' answers were unspoken and not displayed to interviewers. We first evaluated response validity and reliability in each arm, then compared prevalence rates across arms and evaluated whether any differences varied by respondent characteristics using regression models.ResultsThe level of internal reliability of responses among nonverbal respondents was similar to or greater than that of verbal respondents. Nonverbal respondents reported similar patterns of physical assault and sexual debut as verbal respondents but significantly higher levels of sexual assault and forced sex. These differences were broadly similar across sample subgroups defined by age, gender, proneness to social desirability, and mental health.ConclusionsNonverbal response cards offer a practical and beneficial method for reducing underreporting of stigmatized and traumatic experiences while maintaining data quality in low-literacy populations.     

Comparison of caregiver otitis media risk factor knowledge in suburban and urban primary care environments

OBJECTIVE: There are many risk factors for otitis media. Some of these, such as passive tobacco smoke exposure and childcare arrangements; have the potential to be modified. The purpose of this study is to assess caregiver knowledge deficits about risk factors associated with otitis media and their willingness to modify behaviors associated with those risks. RESEARCH DESIGN AND METHODS: This study is a prospective survey study investigating knowledge deficits of parents or guardians of children ages 6-36 months about the risk factors of otitis media. The patients were consecutively drawn from a suburban and an urban pediatric practice. Any difference in survey results between these two groups was also assessed. Participants completed a survey of 21 questions with content including demographic and OM risk factor data. RESULTS: A total of 401 caregivers completed surveys, with 213 from an urban pediatric practice and 188 from a suburban practice. There was a significant difference in the ethnic distributions of the two populations. The suburban population had a significantly greater family history of ear infections, number of ear infections in the past 12 months, and number of previous ventilation tubes placed. The urban population had a significantly greater number of smokers in the household and decreased knowledge about day care as a risk for OM. The urban population's question responses suggested a greater willingness to change day care arrangements to reduce the risk of otitis media. CONCLUSIONS: Both populations demonstrated knowledge deficits regarding risk factors associated with OM and both populations exhibited willingness to modify behaviors to reduce risk. These findings demonstrate that there are opportunities for improving education regarding OM risk factors and that this education could potentially reduce risk for OM and in turn reduce the incidence of OM in children.     

Partial anomalous pulmonary venous drainage of the right lower lobe shown by CT scans

A case is reported in which the diagnosis of partial anomalous pulmonary venous return was first suggested on computed tomographic (CT) scans. Abnormal pulmonary vessels could be seen on serial CT sections to drain into the superior vena cava. The diagnosis was confirmed at angiographic study.     

Tracheobronchial tree: expandable metallic stents used in experimental and clinical applications. Work in progress

An expandable stainless steel stent was formulated for use in the treatment of tracheobronchial stenosis, tracheomalacia, and airway collapse following tracheal reconstruction. The stents were placed through an endotracheal tube into the trachea and bronchi of 11 healthy dogs. The stents expanded over time, substantially increasing the diameter of the lumen. Slight migration occasionally occurred, while an inflammatory reaction was noted in each animal. The stents were successfully used in the treatment of two cancer patients to dilate a postoperative bronchial stenosis that caused pneumonia and to support a tracheal graft that collapsed with respiration. Because of the stent migration in experimental studies, designs are being tested to develop stents with greater stability. These stents may be effective in overcoming stenosis caused by scarring, extrinsic compression, and collapse of reconstructed tracheobronchial structures.