Medicine (Abingdon, England : UK ed.)最新文献_第2页

Non-infective complications for people living with HIV 艾滋病毒感染者的非传染性并发症

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-05-01 Epub Date: 2026-03-25 DOI: 10.1016/j.mpmed.2026.02.014

Dylan Z Salih, Andrew T Read, Tristan J Barber

{"title":"Non-infective complications for people living with HIV","authors":"Dylan Z Salih, Andrew T Read, Tristan J Barber","doi":"10.1016/j.mpmed.2026.02.014","DOIUrl":"10.1016/j.mpmed.2026.02.014","url":null,"abstract":"<div><div>In 2024, 40.8 million (estimated between 37.0 and 45.6 million) people globally had HIV, with 31.6 million (27.8–32.9 million) accessing antiretroviral therapy. Women and girls accounted for 45% of all new HIV cases. HIV is, for most, a treatable chronic health condition, and people diagnosed with HIV at an early stage can expect to live long and healthy lives with access to antiretroviral therapy. There is evidence, however, that people with HIV are more likely to develop certain age-related diseases, including cardiovascular disease, chronic airway disease, kidney failure, liver failure, cancer, type 2 diabetes and other complications. People with HIV also continue to experience intersecting social stigma, which affects their health outcomes compared with the general population. Amid recent US-led cuts to foreign aid, which risk threatening the long-term stability of the global HIV response, it is vital that clinicians maintain a working knowledge of HIV and its potential complications because, in the absence of international support, robust clinical expertise will become increasingly important in ensuring continuity of care, safeguarding vulnerable populations and protecting decades of progress.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 5","pages":"Pages 361-365"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147828314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Syphilis 梅毒

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-05-01 Epub Date: 2026-04-16 DOI: 10.1016/j.mpmed.2026.03.001

Margaret Kingston

{"title":"Syphilis","authors":"Margaret Kingston","doi":"10.1016/j.mpmed.2026.03.001","DOIUrl":"10.1016/j.mpmed.2026.03.001","url":null,"abstract":"<div><div>This article provides an overview of the history, epidemiology and clinical features of syphilis, a sexually transmitted infection caused by <em>Treponema pallidum</em> subspecies <em>pallidum</em>. It traces the first recorded European outbreak in Naples in the late 15th century and examines the disease's persistent stigma, protean clinical presentations and significant public health impact. The narrative details fluctuations in the incidence of syphilis, highlighting major increases after both World Wars, the introduction of penicillin and public health campaigns in the 1940s, and the resurgence among men who have sex with men in the 1960s and again after the advent of effective HIV treatments in the 1990s. Recent trends underscore rising infection rates in England, including among heterosexual individuals and a concerning increase in congenital syphilis linked to late antenatal care and missed diagnoses. The document also summarizes the clinical stages of syphilis, underscoring the importance of early recognition and treatment to prevent severe complications, and the importance of testing, access to services and partner notification plus innovations such as doxycycline post-exposure prophylaxis to prevent infection.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 5","pages":"Pages 322-325"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147828273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Systemic manifestations of sexually transmitted infections 性传播感染的全身表现

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-05-01 Epub Date: 2026-03-25 DOI: 10.1016/j.mpmed.2026.02.005

Fiona Windebank, Michael Ewens

引用次数: 0

Sexually transmitted causes of urethritis, proctitis, pharyngitis, vaginitis, cervicitis and enteric infections 性传播引起尿道炎、直肠炎、咽炎、阴道炎、宫颈炎和肠道感染

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-05-01 Epub Date: 2026-03-25 DOI: 10.1016/j.mpmed.2026.02.011

Leah McVeigh, John White

{"title":"Sexually transmitted causes of urethritis, proctitis, pharyngitis, vaginitis, cervicitis and enteric infections","authors":"Leah McVeigh, John White","doi":"10.1016/j.mpmed.2026.02.011","DOIUrl":"10.1016/j.mpmed.2026.02.011","url":null,"abstract":"<div><div>Sexually transmitted infections (STIs) can cause urethritis, proctitis, pharyngitis, vaginitis and/or cervicitis depending on the site of infection, although asymptomatic infections are the norm, particularly at extragenital sites. Classical STIs such as gonorrhoea and chlamydia are well-recognized causes, but many others, such as trichomoniasis, lymphogranuloma venereum, syphilis, <em>Mycoplasma genitalium</em>, herpes simplex and mpox can affect mucosal sites and cause inflammatory symptoms and signs. In addition, sexually transmitted enteric infections can cause symptomatic proctitis, proctocolitis, enteritis and hepatitis. In the UK there is a higher burden of STIs among those living in the most deprived regions, as well as among specific populations, including young people, gay, bisexual and other men who have sex with men and individuals from racially minoritized communities. Symptoms are often similar regardless of the underlying aetiology, and non-infectious inflammatory conditions also occur. A structured history, appropriate examination and targeted investigations are necessary to make a specific STI diagnosis. Management is best guided by the organisms detected, but treatment is often given syndromically to cover common causative organisms before results are available. Novel rapid molecular tests have the potential to improve antimicrobial stewardship in this setting. Partner notification is an integral component of STI care.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 5","pages":"Pages 293-301"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147828308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Antimicrobial resistance in bacterial sexually transmitted infections 细菌性传播感染中的抗菌素耐药性

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-05-01 Epub Date: 2026-03-25 DOI: 10.1016/j.mpmed.2026.02.009

Rachel Pitt-Kendall, Helen Fifer

引用次数: 0

Sexual history taking and examination 性史记录和检查

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-04-01 Epub Date: 2026-03-07 DOI: 10.1016/j.mpmed.2026.01.001

Annie A Blizard, Alex W Tatlow, Komal Plaha

引用次数: 0

Antiretroviral pharmacology and drug–drug interactions 抗逆转录病毒药理学和药物-药物相互作用

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-04-01 Epub Date: 2026-03-18 DOI: 10.1016/j.mpmed.2026.02.002

Baldip Kaur, Stephen Taylor

引用次数: 0

HIV prevention strategies 艾滋病毒预防策略

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-04-01 Epub Date: 2026-03-03 DOI: 10.1016/j.mpmed.2026.01.007

Melissa A Cabecinha, Manik Kohli, Tristan J. Barber

{"title":"HIV prevention strategies","authors":"Melissa A Cabecinha, Manik Kohli, Tristan J. Barber","doi":"10.1016/j.mpmed.2026.01.007","DOIUrl":"10.1016/j.mpmed.2026.01.007","url":null,"abstract":"<div><div>Advances in treatment and prevention technologies have led to a decrease in incident HIV infections in the UK; however, sustained efforts are required to meet global and national targets to end HIV transmission. Combination HIV prevention programmes employ a mix of biomedical, behavioural and structural interventions and strategies to meet the prevention needs of a given population. They operate at the three levels of prevention in public health: preventing transmission and acquisition of HIV (primary prevention), reducing the severity of HIV infection through early detection and diagnosis (secondary prevention), and improving the quality of life for people living with HIV through treatment and support (tertiary prevention). HIV stigma can act as a barrier to accessing prevention and treatment. Educational and awareness campaigns, increasing opportunities for engagement through community and self-testing, and integrating HIV testing into routine healthcare environments can decrease stigma and encourage testing uptake. A ‘status-neutral’ approach to prevention can provide an entry point for testing and engagement with HIV care and prevention, encouraging testing uptake, and reducing stigma around HIV.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 4","pages":"Pages 267-273"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Public health aspects of STIs including prevention strategies and partner notification 性传播感染的公共卫生方面，包括预防战略和伙伴通知

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-04-01 Epub Date: 2026-03-05 DOI: 10.1016/j.mpmed.2026.01.003

Larissa Mulka

{"title":"Public health aspects of STIs including prevention strategies and partner notification","authors":"Larissa Mulka","doi":"10.1016/j.mpmed.2026.01.003","DOIUrl":"10.1016/j.mpmed.2026.01.003","url":null,"abstract":"<div><div>Sexually transmitted infections (STIs) can present in a wide variety of settings, where they can be unexpected and present a challenge for communication and effective care. In all cases of STI, consideration must be given to treatment of the sexual partner(s), through partner notification, which can be via the patient (patient referral) or anonymously via the sexual health clinic (provider referral). Diagnosing and treating STIs provides opportunity for the prevention of other STIs. Several infections that are not generally seen as sexually transmitted (e.g. gastrointestinal infections) can and do cause sexually transmitted outbreaks; these should be managed with the support of health protection units and sexual health clinics. STIs have a prolonged duration of infectivity, which should be taken into account in supporting partner notification. Evidence suggests that patients and the public find the offer of HIV and STI testing acceptable in healthcare settings, and are increasingly using online facilities for self-directed testing. HIV testing should be routinely available in all clinical settings; advice should be sought on the correct way to test and process samples if an STI might be the underlying cause of a condition.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 4","pages":"Pages 233-238"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

2026 update in asthma diagnosis and management 2026年哮喘诊断和管理的最新进展

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-04-01 Epub Date: 2026-03-04 DOI: 10.1016/j.mpmed.2026.01.008

Hugo Andres Farne, Ernie Hoi Cheung Wong

{"title":"2026 update in asthma diagnosis and management","authors":"Hugo Andres Farne, Ernie Hoi Cheung Wong","doi":"10.1016/j.mpmed.2026.01.008","DOIUrl":"10.1016/j.mpmed.2026.01.008","url":null,"abstract":"<div><div>The diagnostic criteria for asthma, and its management, are evolving. This article, to accompany the more detailed 2023 review, focuses on recent updates, particularly the recommendation that the treatment regimen for all patients with asthma include an inhaled corticosteroid (ICS). In individuals with a low symptom burden (‘mild asthma’), initial treatment should be with a combination inhaler containing an ICS and formoterol, a fast-acting β-adrenoceptor agonist, used on an as-required basis. A major change is that salbutamol should no longer be prescribed as monotherapy. To put it another way, all types of symptomatic asthma should be on treatment including an ICS, as an anti-inflammatory reliever or for maintenance therapy. Other notable updates include: (1) the use of the blood eosinophil count and/or fractional exhaled nitric oxide (FeNO) testing to assess for eosinophilic airways inflammation and aid diagnosis; (2) the addition of tezepelumab as a biologic treatment for severe asthma, which uniquely can be prescribed to patients without evidence of ‘type 2’ inflammation (raised blood eosinophils and/or FeNO); (3) guidance when choosing an asthma biologic given the lack of head-to-head trials; (4) guidance on the use of biologics in pregnancy; and (5) updated thoughts on future developments.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 4","pages":"Pages 284-287"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0