ABSTRACT
ABSTRACT: A pregnant woman with a non-IgE-mediated penicillin allergy was treated for syphilis with doxycycline with resolution of infection and no evidence of adverse outcome for mother or infant.
Subject(s)
Drug Hypersensitivity , Pregnancy Complications, Infectious , Syphilis , Anti-Bacterial Agents/therapeutic use , Doxycycline/therapeutic use , Drug Hypersensitivity/drug therapy , Female , Humans , Penicillins/therapeutic use , Pregnancy , Pregnancy Complications, Infectious/drug therapy , Pregnant Women , Syphilis/drug therapyABSTRACT
Introduction: This standardized-patient-based module prepares medical students to take inclusive, comprehensive sexual histories from patients of all sexual orientations and gender identities. Health disparities faced by lesbian, gay, bisexual, transgender, and queer (LGBTQ) people are at least partially the result of inadequate access to health care and insufficient provider training. This module incorporates implicit bias activities to emphasize the important role providers can play in mitigating these disparities through compassionate, competent care. Furthermore, two of the three included cases highlight the negative impact sexual dysfunction can have on emotional well-being. Methods: Over 3 hours, students participate in a 30-minute large-group lecture and three 40-minute small-group standardized patient encounters with debrief. Prework consists of a short video on sexual history taking, assigned readings, and an implicit bias activity. These materials are included in this resource, along with lecture slides, facilitator guide, and standardized patient cases. Though the cases are adaptable to all levels of medical education, this module is designed for second-year and early third-year medical students. Results: Qualitative student evaluations were positive, and postparticipation surveys revealed statistically significant improvement in comfort with their ability to take a sexual history in general, and take one from patients with a differing sexual orientation. Deployed in the second year of our Doctoring curriculum, this module continues to receive positive evaluations. Discussion: Introducing these skills begins to address the curricular deficiencies seen across medical education and lays the foundation for a more competent health care workforce to address the needs of LGBTQ patients.
Subject(s)
Homophobia/prevention & control , Homosexuality/psychology , Medical History Taking/methods , Physician-Patient Relations , Adult , Curriculum/trends , Female , Gender Identity , Homophobia/psychology , Humans , Male , Medical History Taking/standards , Patient-Centered Care/methods , Patient-Centered Care/standards , Psychometrics/instrumentation , Psychometrics/methods , Qualitative Research , Schools, Medical/organization & administration , Schools, Medical/statistics & numerical data , Sexual Health/education , Sexual Health/standards , Surveys and QuestionnairesABSTRACT
Based on data obtained using vaccine efficacy studies in mice, hamsters, and baboons, the credentials of Sm-p80 as a first tier vaccine candidate for schistosomiasis have been well established. Sm-p80-based vaccine formulation(s) have consistently exhibited potent prophylactic efficacy in reducing adult worm burden following cercarial challenge and induce killing of established adult worms in chronic infection. This vaccine is protective against both intestinal and urinary schistosomiasis. In this study, the longevity of Sm-p80-specific antibody responses was studied in mice and in baboons. Robust antibody titers were detected in mice for up to 60 weeks following vaccination with Sm-p80 recombinant vaccine (Sm-p80 + GLA-SE). In the follow-up experiments to our published studies, Sm-p80-specific IgG was also detected in baboons 5-8 years following the initial vaccination with an Sm-p80 DNA vaccine. In one baboon, transfer of Sm-p80-specific antibody was detected in umbilical cord blood and in the baby. These long-lasting humoral immune response data coupled with the vaccine efficacy data in rodents and nonhuman primates further strengthens the case for Sm-p80 to be moved forward through development leading to human clinical trials.
Subject(s)
Antibodies, Helminth/blood , Schistosoma mansoni/immunology , Schistosomiasis mansoni/prevention & control , Vaccines/immunology , Animals , Antigens, Helminth/immunology , Biomphalaria/parasitology , Cricetinae , Female , Fetal Blood/chemistry , Fetal Blood/immunology , Immunity, Maternally-Acquired , Immunoglobulin G/blood , Mice , Papio , Pregnancy , Schistosoma mansoni/genetics , Vaccination , Vaccines, DNA/immunologyABSTRACT
Sm-p80, the large subunit of Schistosoma masoni calpain, is a leading antigen candidate for a schistosome vaccine. Prophylactic and antifecundity efficacy of Sm-p80 has been tested using a variety of vaccine approaches. However, the mechanism of Sm-p80-mediated killing is still unknown. In this study, potential role of complement in Sm-p80-mediated protection was studied using both in vitro (cobra venom factor inhibition) and in vivo using mice deficient in C3 (C3 -/-; B6.129S4-C3tm1Crr/J). In the absence of C3, Sm-p80-based vaccine was able to provide significant reduction in adult worm burden following challenge with schistosome cercariae in mice suggesting the effector functions of complement may be limited in this vaccine-induced protection.
