{"id":146,"date":"2011-01-18T21:46:40","date_gmt":"2011-01-18T21:46:40","guid":{"rendered":"https:\/\/blogs.bmj.com\/sti\/?p=146"},"modified":"2011-01-18T21:54:35","modified_gmt":"2011-01-18T21:54:35","slug":"sti-news","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/sti\/2011\/01\/18\/sti-news\/","title":{"rendered":"STI news"},"content":{"rendered":"

The cost of Pelvic Inflammatory Disease: a case for the promotion of outpatient services?<\/strong>
\nA US study on the financial implications of PID in adolescents draws attention to patients\u2019 under-use of appropriate outpatient services and the enormous cost of cases requiring hospitalization. The adolescents in the study, from black, low-income backgrounds, were mostly first seen for care in Emergency Departments. The authors, who favour a \u201cstrategic approach to adolescent care\u201d, point out that the care provision by EDs may often be \u201csuboptimal\u201d as compared to outpatient clinics, i.e. general pediatric adolescent medicine and gynaecology clinics. The study evaluates the direct financial costs of existing, apparently very un-strategic, care arrangements: estimated charge for patients treated in outpatient clinics or emergency departments is $7440 lower than the charge for those requiring to be treated as inpatients.
\nReference: Maria Trent et al., \u201cEstimating the Direct Costs of Pelvic Inflammatory Disease in Adolescents: A Within-System Analysis\u201d, Sexually Transmitted Diseases, Volume 37, Number 12, December 2010.
\njournals.lww.com\/stdjournal\/Abstract\/publishahead\/Estimating_the_Direct_Costs_of_Pelvic_Inflammatory.99089.aspx
\n<\/a><\/p>\n

Solid evidence for the reproductive sequelae of Chlamydia \u2013 especially ectopic pregnancy?<\/strong>
\nTubal ectopic pregnancy accounts for 1-2% of all pregnancies in Europe and the US, and is the most common cause of maternal mortality in these countries. Its association with Chlamydia has been demonstrated by epidemiological studies. But there is nothing like fingering the pathological mechanism, when it comes to bringing home the reality and importance of such an association.
\nThe mechanisms of tubal damage are believed to be immunologically mediated, rather than a consequence of tissue destruction. A recent study reported in the American Journal of Pathology seeks to cast light on these mechanisms, thus corroborating the epidemiological link. Alterations in PROK signalling have previously been shown to promote a micro-environment conducive to embryo implantation. This study postulates that Chlamydia infection increases Fallopian Tube PROKR2 via TLR2 and NF?B activation.
\nDoes this add new justification for screening programmes?
\nReference: Jule L.V. Shaw et al., \u201cChlamydia trachomatis Infection Increases Fallopian Tube PROKR2 via TLR2 and NF?B Activiation Resulting in a Microenvironment Predisposed to Ectopic Pregnancy\u201d, The American Journal of Pathology, Volume 178, no. 1, January 2011.<\/p>\n

http:\/\/science.cjb.net\/science\/journal\/00029440
\n<\/a><\/p>\n

Russia and Ukraine adopt an \u201costrich policy\u201d on HIV.<\/strong>
\nAs regards its impact on HIV transmission the benefits of what health-care professionals term the \u201charm-reduction package\u201d for intravenous drug users (i.e. opiate substitution, and supply of clean needles) is taken for granted in many Western countries. And not just in the West. Last July, harm-reduction was endorsed by the \u201cVienna Declaration\u201d at the 18th International AIDS Conference. But in Russia and the Ukraine, home to 90% of those infected in HIV in central and eastern Europe, it is quite another story \u2013 according to Jon Cohen, author of Shots in the Dark, in a recent opinion piece. Partly, this is due to the government\u2019s failure to bankroll the harm-reduction effort until recently assured by Global Fund money, partly the outright ban on methadone.
\nOrganizers of the Vienna Conference held the meeting in Vienna specifically because \u201cit is the gateway to Eastern Europe\u201d. For the first time, all proceedings were translated into Russian. But no high-level Russian or Ukraininan official attended.
\nProject Syndicate
\nwww.project-syndicate.org\/commentary\/jcohen1\/English<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

The cost of Pelvic Inflammatory Disease: a case for the promotion of outpatient services? A US study on the financial implications of PID in adolescents draws attention to patients\u2019 under-use of appropriate outpatient services and the enormous cost of cases requiring hospitalization. The adolescents in the study, from black, low-income backgrounds, were mostly first seen […]<\/p>\n

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