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Morris BJ, Moreton S, Krieger JN, Klausner JD. Infant Circumcision for Sexually Transmitted Infection Risk Reduction Globally. GLOBAL HEALTH: SCIENCE AND PRACTICE 2022; 10:GHSP-D-21-00811. [PMID: 36041835 PMCID: PMC9426975 DOI: 10.9745/ghsp-d-21-00811] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 06/21/2022] [Indexed: 12/26/2022]
Abstract
Population-based studies in high-income countries have failed to find that male circumcision protects against sexually transmitted infections. Using evidence from several sources, we show that male circumcision does protect against HIV during insertive intercourse for men who have sex with men.
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Affiliation(s)
- Brian J Morris
- School of Medical Sciences, University of Sydney, Sydney, Australia.
| | | | - John N Krieger
- Department of Urology, University of Washington School of Medicine, Seattle, WA, USA
| | - Jeffrey D Klausner
- Department of Medicine, Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
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2
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Bhambhani D, Bhambhani S, Pandya NK. Penile Lichen Sclerosis: A Surgical Perspective of its Aetiology and Treatment. Cureus 2022; 14:e28418. [PMID: 36176860 PMCID: PMC9509524 DOI: 10.7759/cureus.28418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 08/25/2022] [Indexed: 11/25/2022] Open
Abstract
Penile lichen sclerosis is a longstanding inflammatory disease of the skin with a controversial aetiology. Penile lichen sclerosis (PLS) is a growing, inflammatory dermatitis of the anogenital region, which involves the meatus, prepuce, penile shaft, and glans penis. Although the accurate aetiology of PLS is contentious, multiple factors including genetics, autoimmunity, infections of human papillomavirus, hepatitis C, Epstein-Barr virus, risk factors (hormonal and trauma), etc., can be considered to be a part of the etiopathogenesis of PLS. The initial clinical presentations of penile lichen sclerosis are white plaques, atrophied skin, erythema, erosions, and sclerosis in the anogenital region. When the disease advances, the following can occur, including meatal constraints, telangiectasia, petechiae, soreness, papular lesions, tightness of the foreskin, difficulties in passing urine, itching, tenderness on erections, pain, cracking, bleeding, redness, rashes, tightness at frenulum, and dysuria. This disease has a dangerous course of action and if untreated it may be linked with severe urologic and sexual morbidities. PLS is usually treated with medical and surgical interventions like topical or intralesional steroids and circumcision. The role of circumcision is very critical in the course of action and prognosis of PLS, and its treatment is dependent on the stage of the disease. This review brings up the knowledge regarding epidemiology, etiopathology, clinical presentation, and management of PLS with an emphasis on the role of circumcision.
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Wang J, Cao Y, Zhang L, Liu G, Li C. Pathogen distribution and risk factors for urinary tract infection in infants and young children with retained double-J catheters. J Int Med Res 2021; 49:3000605211012379. [PMID: 33947257 PMCID: PMC8113964 DOI: 10.1177/03000605211012379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Objectives To investigate the pathogens and potential risk factors for urinary tract
infection (UTI) in patients with retained double-J catheters (DJCs). Methods In total, 107 infants and young children with DJCs were included in this
retrospective analysis. Patients were included in the infection group
(n = 30) or non-infection group (n = 77), according to UTI presence or
absence. The species and characteristics of pathogens were investigated, and
the clinical features of the patients were recorded for further
analysis. Results Gram-negative bacilli were the most common causative pathogens (69.2%), among
which Escherichia coli was most frequent (38.5%). The
second most common causative pathogens were Gram-positive cocci (28.2%),
among which Enterococcus faecalis was most frequent
(10.3%). UTIs among patients in this study were associated with the
following factors: catheter retention (long-term) (odds ratio [OR] = 2.514,
95% confidence interval [CI] = 1.176–5.373), sex (male) (OR = 2.966, 95%
CI = 1.032–8.529), DJC retention (long-term) (OR = 1.869, 95%
CI = 1.194–2.926), and DJC number (unilateral) (OR = 0.309, 95%
CI = 0.103–0.922). Conclusions Infants and young children with DJCs were likely to experience UTIs, mainly
caused by Gram-negative bacilli. Long-term catheter retention or DJC
retention, male sex, and bilateral DJC retention were risk factors for
UTI.
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Affiliation(s)
- Jianfeng Wang
- Affiliated Foshan Maternal and Child Healthcare Hospital, Southern Medical University, Foshan, China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yu Cao
- Ningxiang Hospital, Hunan University of Traditional Chinese Medicine, Ningxiang, China
| | - Li Zhang
- Affiliated Foshan Maternal and Child Healthcare Hospital, Southern Medical University, Foshan, China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Guoqing Liu
- Affiliated Foshan Maternal and Child Healthcare Hospital, Southern Medical University, Foshan, China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Chunjing Li
- Affiliated Foshan Maternal and Child Healthcare Hospital, Southern Medical University, Foshan, China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
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Urinary Tract Infection After Robot-assisted Laparoscopic Pyeloplasty: Are Urine Cultures and Antibiotics Helpful? Urology 2020; 148:235-242. [PMID: 33248143 DOI: 10.1016/j.urology.2020.09.054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/01/2020] [Accepted: 09/07/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate how variations in peri-operative urine culture (UCx) and antibiotic prophylaxis utilization following robot assisted laparoscopic pyeloplasty (RALP) affect post-RALP urinary tract infection (UTI) rates in children, then use data to generate a standardized care pathway. METHODS Patients undergoing RALP at a single institution from January 2014 to October 2018 were retrospectively reviewed. Patients with vesicoureteral reflux, neurogenic bladder, intermittent catheterization, <=2 months follow-up after stent removal, or age >=18 years were excluded. UCx use, UCx results, and pre- and post-RALP antibiotic use were recorded. The primary outcome was symptomatic UTI, tracked until 60 days after stent removal. UTI was defined as presence of fever or urinary symptoms, a positive UCx with >=10,000 colony forming units of one uropathogen, and a positive urinalysis. RESULTS A total of 152 patients were included (72% male [73% circumcised], 61% white, and 23% Hispanic). One underwent a re-operative pyeloplasty, yielding 153 encounters. Eight patients (5.2%; 95% CI 1.7-8.7%) developed post-RALP UTI. Uncircumcised status and use of pre-operative prophylactic antibiotics were associated with post-RALP UTI (P = .03 and P < .01, respectively). Use of post-RALP antibiotics, whether prophylactic or therapeutic, was not associated with lower UTI rates (P = .92). Positive pre-RALP UCx and positive intra-operative stent removal UCx were associated with higher UTI rates (P = .03 and P < .01, respectively). CONCLUSION UTI occurred in 5.2% of our cohort of >150 patients. As post-RALP antibiotic use was not associated with lower UTI rates, prophylactic antibiotics may be reserved for patients with risk factors. A standardized care pathway could safely reduce unnecessary utilization of UA/UCx and antibiotics.
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Morris BJ, Moreton S, Krieger JN. Critical evaluation of arguments opposing male circumcision: A systematic review. J Evid Based Med 2019; 12:263-290. [PMID: 31496128 PMCID: PMC6899915 DOI: 10.1111/jebm.12361] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/03/2019] [Accepted: 05/12/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To systematically evaluate evidence against male circumcision (MC). METHODS We searched PubMed, Google Scholar, EMBASE and Cochrane databases. RESULTS Database searches retrieved 297 publications for inclusion. Bibliographies of these yielded 101 more. After evaluation we found: Claims that MC carries high risk were contradicted by low frequency of adverse events that were virtually all minor and easily treated with complete resolution. Claims that MC causes psychological harm were contradicted by studies finding no such harm. Claims that MC impairs sexual function and pleasure were contradicted by high-quality studies finding no adverse effect. Claims disputing the medical benefits of MC were contradicted by a large body of high-quality evidence indicating protection against a wide range of infections, dermatological conditions, and genital cancers in males and the female sexual partners of men. Risk-benefit analyses reported that benefits exceed risks by 100-200 to 1. To maximize benefits and minimize risks, the evidence supported early infant MC rather than arguments that the procedure should be delayed until males are old enough to decide for themselves. Claims that MC of minors is unethical were contradicted by balanced evaluations of ethical issues supporting the rights of children to be provided with low-risk, high-benefit interventions such as MC for better health. Expert evaluations of case-law supported the legality of MC of minors. Other data demonstrated that early infant MC is cost-saving to health systems. CONCLUSIONS Arguments opposing MC are supported mostly by low-quality evidence and opinion, and are contradicted by strong scientific evidence.
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Affiliation(s)
- Brian J Morris
- School of Medical SciencesUniversity of SydneySydneyNew South WalesAustralia
| | | | - John N Krieger
- Department of UrologyUniversity of Washington School of MedicineSeattleWashington
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Chung JM, Park CS, Lee SD. Microbiology of smegma: Prospective comparative control study. Investig Clin Urol 2019; 60:127-132. [PMID: 30838346 PMCID: PMC6397923 DOI: 10.4111/icu.2019.60.2.127] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 01/30/2019] [Indexed: 01/12/2023] Open
Abstract
Purpose The aim of the study was to investigate the common bacteria found in the smegma in the subpreputial space of asymptomatic boys prospectively, and to determine the difference of those bacteria according to the presence of smegma. Materials and Methods In our institution, 40 boys who performed penoplasty were recruited into the study. Swab was done using aseptic techniques on smegma and glans in the operation room. According to the presence of smegma in the subpreputial space, we classified glans as a group S (with smegma, n=20) and group C (without smegma, n=20). The swabs were immediately sent to microbiology laboratory for microscopy, culture, and sensitivity tests. Results The mean age was 30.4±26.4 months. Thirty-one bacteria were isolated from smegma, comprising 15 gram-positive species (48.4%) and 16 gram-negative species (51.6%). The most commonly isolated gram-negative bacterium was Escherichia coli (25.8%), while the commonly isolated gram-positive bacteria were Enterococcus faecalis (19.4%) and Enterococcus avium (12.9%). Most of the bacterial isolates were multi-drug-resistant (61.3%). In group S, 12 boys had 22 bacterial isolates in the glans. The commonly isolated bacteria were E. coli (27.3%), E. avium (22.7%) and E. faecalis (18.2%). In group C, 13 boys had 21 bacterial isolates in the glans. The most commonly isolated bacterium was E. faecalis (28.6%). Conclusions Smegma in the subpreputial space of children was colonized by many kinds of uropathogen.
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Affiliation(s)
- Jae Min Chung
- Department of Urology, Pusan National University School of Medicine, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Chang Soo Park
- Department of Urology, Pusan National University School of Medicine, Yangsan, Korea
| | - Sang Don Lee
- Department of Urology, Pusan National University School of Medicine, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
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Morris BJ, Krieger JN. Penile Inflammatory Skin Disorders and the Preventive Role of Circumcision. Int J Prev Med 2017; 8:32. [PMID: 28567234 PMCID: PMC5439293 DOI: 10.4103/ijpvm.ijpvm_377_16] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 02/07/2017] [Indexed: 01/12/2023] Open
Abstract
Penile inflammatory skin conditions such as balanitis and posthitis are common, especially in uncircumcised males, and feature prominently in medical consultations. We conducted a systematic review of the medical literature on PubMed, EMBASE, and Cohrane databases using keywords "balanitis," "posthitis," "balanoposthitis," "lichen sclerosus," "penile inflammation," and "inflammation penis," along with "circumcision," "circumcised," and "uncircumcised." Balanitis is the most common inflammatory disease of the penis. The accumulation of yeasts and other microorganisms under the foreskin contributes to inflammation of the surrounding penile tissue. The clinical presentation of inflammatory penile conditions includes itching, tenderness, and pain. Penile inflammation is responsible for significant morbidity, including acquired phimosis, balanoposthitis, and lichen sclerosus. Medical treatment can be challenging and a cost burden to the health system. Reducing prevalence is therefore important. While topical antifungal creams can be used, usually accompanied by advice on hygiene, the definitive treatment is circumcision. Data from meta-analyses showed that circumcised males have a 68% lower prevalence of balanitis than uncircumcised males and that balanitis is accompanied by a 3.8-fold increase in risk of penile cancer. Because of the high prevalence and morbidity of penile inflammation, especially in immunocompromised and diabetic patients, circumcision should be more widely adopted globally and is best performed early in infancy.
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Affiliation(s)
- Brian J. Morris
- Department of Physiology, School of Medical Sciences and Bosch Institute, University of Sydney, New South Wales 2006, Australia
| | - John N. Krieger
- Department of Medicine, University of Washington School of Medicine, VA Puget Sound Health Care System, Section of Urology, Seattle, Washington 98108, USA
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Morris BJ, Kennedy SE, Wodak AD, Mindel A, Golovsky D, Schrieber L, Lumbers ER, Handelsman DJ, Ziegler JB. Early infant male circumcision: Systematic review, risk-benefit analysis, and progress in policy. World J Clin Pediatr 2017; 6:89-102. [PMID: 28224100 PMCID: PMC5296634 DOI: 10.5409/wjcp.v6.i1.89] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 11/17/2016] [Accepted: 12/27/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To determine whether recent evidence-based United States policies on male circumcision (MC) apply to comparable Anglophone countries, Australia and New Zealand. METHODS Articles in 2005 through 2015 were retrieved from PubMed using the keyword "circumcision" together with 36 relevant subtopics. A further PubMed search was performed for articles published in 2016. Searches of the EMBASE and Cochrane databases did not yield additional citable articles. Articles were assessed for quality and those rated 2+ and above according to the Scottish Intercollegiate Grading System were studied further. The most relevant and representative of the topic were included. Bibliographies were examined to retrieve further key references. Randomized controlled trials, recent high quality systematic reviews or meta-analyses (level 1++ or 1+ evidence) were prioritized for inclusion. A risk-benefit analysis of articles rated for quality was performed. For efficiency and reliability, recent randomized controlled trials, meta-analyses, high quality systematic reviews and large well-designed studies were used if available. Internet searches were conducted for other relevant information, including policies and Australian data on claims under Medicare for MC. RESULTS Evidence-based policy statements by the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) support infant and later age male circumcision (MC) as a desirable public health measure. Our systematic review of relevant literature over the past decade yielded 140 journal articles that met our inclusion criteria. Together, these showed that early infant MC confers immediate and lifelong benefits by protecting against urinary tract infections having potential adverse long-term renal effects, phimosis that causes difficult and painful erections and "ballooning" during urination, inflammatory skin conditions, inferior penile hygiene, candidiasis, various sexually transmissible infections in both sexes, genital ulcers, and penile, prostate and cervical cancer. Our risk-benefit analysis showed that benefits exceeded procedural risks, which are predominantly minor, by up to 200 to 1. We estimated that more than 1 in 2 uncircumcised males will experience an adverse foreskin-related medical condition over their lifetime. Wide-ranging evidence from surveys, physiological measurements, and the anatomical location of penile sensory receptors responsible for sexual sensation strongly and consistently suggested that MC has no detrimental effect on sexual function, sensitivity or pleasure. United States studies showed that early infant MC is cost saving. The evidence supporting early infant MC has further strengthened since the positive AAP and CDC reviews. CONCLUSION Affirmative MC policies are needed in Australia and New Zealand. Routine provision of accurate, unbiased education, and access in public hospitals, will maximize health and financial benefits.
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Affiliation(s)
- Brian J Morris
- School of Medical Sciences and Bosch Institute, University of Sydney, Sydney, NSW 2006, Australia
- School of Medical Sciences and Bosch Institute, University of Sydney, Sydney, NSW 2006, Australia
| | - Sean E Kennedy
- School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Alex D Wodak
- St Vincent’s Hospital and Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, NSW 2010, Australia
| | - Adrian Mindel
- School of Medical Sciences and Bosch Institute, University of Sydney, Sydney, NSW 2006, Australia
| | | | - Leslie Schrieber
- Department of Medicine, Sydney Medical School, Royal North Shore Hospital, Sydney, NSW 2060, Australia
| | - Eugenie R Lumbers
- School of Biomedical Sciences and Pharmacy, Mothers and Babies Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW 2305, Australia
| | - David J Handelsman
- Department of Medicine and ANZAC Research Institute, Concord Hospital, Sydney, NSW 2139, Australia
| | - John B Ziegler
- Department of Immunology and Infectious Diseases, Sydney Children’s Hospital, Randwick, Sydney, NSW 2031, Australia
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Abstract
Deposition of smegma in the subpreputial region is common in young uncircumcised boys. Although the term "smegma pearls" has been used colloquially for this entity, there is an apparent lack of reference to smegma pearls and their characteristics in the extant scientific literature. We present a series of six Indian boys with smegma pearls and discuss their possible origin, course, and management.
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Affiliation(s)
| | - Archana Singal
- Department of Dermatology and Sexually Transmitted Disease, University College of Medical Sciences and GTB Hospital, University of Delhi, Delhi, India
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Balci M, Tuncel A, Baran I, Guzel O, Keten T, Aksu N, Atan A. High-risk Oncogenic Human Papilloma Virus Infection of the Foreskin and Microbiology of Smegma in Prepubertal Boys. Urology 2015. [PMID: 26199167 DOI: 10.1016/j.urology.2015.04.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate the prevalence and genotypes of human papillomavirus (HPV) infection and microbiological status of the foreskin in asymptomatic prepubertal boys. METHODS A total of 100 prepubertal healthy boys who underwent a standard circumcision procedure were included in the study. High-risk HPV status was determined by real-time polymerase chain reaction for the genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68. The swabs were immediately sent to microbiology laboratory for culture and sensitivity tests. RESULTS The median age at the time of surgery was 5.7 years (range, 2 months-9 years). High-risk HPV was detected in 9 foreskins (9%). Positive samples showed are HPV16 (n = 3), 31 (n = 2), 39 (n = 3), and 51 (n = 1). There were a total of 72 organism isolates: 54 gram-positive (75%) and 17 gram-negative (23.6%) bacteria and 1 (1.4%) Candida. The most commonly isolated gram-negative bacterium was Escherichia coli (41.2%), whereas the commonly isolated gram-positive bacterium was Enterecoccus sp. (57.4%). CONCLUSION Our results showed that subclinical high-risk HPV infections are found in the foreskin, which could be a reservoir for HPV-associated diseases, and smegma seems not to be a risk factor for drug-resistant infection in children.
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Affiliation(s)
- Melih Balci
- Third Department of Urology, Ankara Numune Research and Training Hospital, Ministry of Health, Ankara, Turkey
| | - Altug Tuncel
- Third Department of Urology, Ankara Numune Research and Training Hospital, Ministry of Health, Ankara, Turkey.
| | - Irmak Baran
- Department of Clinical Microbiology, Ankara Numune Research and Training Hospital, Ministry of Health, Ankara, Turkey
| | - Ozer Guzel
- Third Department of Urology, Ankara Numune Research and Training Hospital, Ministry of Health, Ankara, Turkey
| | - Tanju Keten
- Third Department of Urology, Ankara Numune Research and Training Hospital, Ministry of Health, Ankara, Turkey
| | - Neriman Aksu
- Department of Clinical Microbiology, Ankara Numune Research and Training Hospital, Ministry of Health, Ankara, Turkey
| | - Ali Atan
- Third Department of Urology, Ankara Numune Research and Training Hospital, Ministry of Health, Ankara, Turkey
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Wei J, Luo J, Wang X, Chen G, Wang X, Wang J. Clinical features of patients of different ages with postoperative multi-space maxillofacial infection. Cell Biochem Biophys 2015; 70:1779-82. [PMID: 25033797 DOI: 10.1007/s12013-014-0128-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
To investigate the clinical features of patients of different ages with multi-space infection after maxillofacial surgery. Three hundred and seven patients with infections in multiple spaces were enrolled in the study. They were classified into the senior (n = 149) and the younger group (n = 158). The clinic data were retrospectively analyzed. Male patients accounted for 63.09 and 63.29 % of the senior and the younger group, respectively. Sex composition between the two groups was not significantly different (p > 0.05). Senior patients were associated with significantly more complications than the younger adults (p < 0.05). 46.31 and 55.70 % of patients in the respective two groups had infections involving more than two spaces. Patients in both groups visited the hospital at a similar time after the symptoms manifested (p > 0.05). Elderly patients had similar glucose levels, white blood cell counts and neutrophil cell counts compared to those of the younger groups (p > 0.05). 55.06 % of the younger patients had negative bacterial culture results, which was significantly more than those of the senior groups (p < 0.05). The bacterial compositions of the infection of two groups were also found significantly different (p < 0.05). In the event of postoperative multi-space maxillofacial infection, senior patients shared many similar clinical features with the younger adults. But they also had unique features, such as more complications. As a result, it is more difficult to treat senior patients with multi-space infections. Therefore, more medical attention is required to senior patients.
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Affiliation(s)
- Jianmin Wei
- Department of Spine Surgery, Baoji Hospital of Traditional Chinese Medicine, 43 Baofu Road, Baoji, 721001, Shaanxi, China
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12
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Brito MO. Male Circumcision and HIV: Do All Roads Lead to Rome? J Glob Infect Dis 2012; 4:4-5. [PMID: 22529619 PMCID: PMC3326957 DOI: 10.4103/0974-777x.93748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Maximo O Brito
- Department of Medicine, Section of Infectious Diseases, University of Illinois at Chicago, United States
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