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Le Touquet – Paris-Plage, France

Bohbot J.-M.,Institute Fournier
Medecine Therapeutique Medecine de la Reproduction, Gynecologie et Endocrinologie | Year: 2015

Male genital infections are mostly due to sexually transmitted diseases (STI). Worldwide, the incidence of these infections steadily increases since 1990s. In France, an increase as high as 63.8% of cases of gonococcal infections and 29.3% of recent syphilis has been observed in the last two years. STI in male patients show a wide range of clinical presentations: urethritis, anitis, ano-genital lesions with, sometimes, atypical symptoms. This clinical variety can lead to a delayed etiological diagnosis and a delayed suitable treatment with a risk of complications (prostatitis, epidydimitis. . .). In addition, some microorganisms involved in STI, like Mycoplasma genitalium are not routinely screened even though this bacteria is responsible for 15 to 20% of urethritis. In case of urethritis or anitis, the prescription of a systematic treatment for all sexual partners is recommended even if this item creates of debate from a forensic point of view. At least, the increasing resistance of bacteria like Neisseria gonorrhoeae to antibiotics reduces the therapeutic choices and requires a steady updating of our prescriptions. Source

Bohbot J.-M.,Institute Fournier
Medecine Therapeutique Medecine de la Reproduction, Gynecologie et Endocrinologie | Year: 2015

Despite the increasing prevalence of sexually transmitted infections (STI) since fifteen years, the number of pelvic inflammatory diseases (PID) seems to stay stable, or even decreasing. The improvement of screening methods for STI (especially for Chlamydia trachomatis and Neisseria gonorrhoeae) using vestibular self-sampling methods, and the shortening of therapeutic protocols can explain a less frequent progression from STI to PID. However, the important proportion of subclincal PID is a concern as these subclinical PID lead to delayed diagnosis and treatment with a high risk of sequels (tubal infertility, ectopic pregnancies, chronic pelvic pains). Furthermore, the increasing implication of Mycoplasma genitalium in PID, the difficulties for its microbiological diagnosis and the limited range of efficient antibiotics are other causes of delayed diagnosis and treatment. The targeted screening for C. trachomatis and N. gonorrhoeae in high risk population (i.e. 14 to 25 years old female) lead to a reduction of PID. The epidemiological management of STI (systematic treatment of all sexual partners) is a determining factor to reduce the risk of recontamination, which increases the risk of developing PID. Source

Bouree P.,University Paris - Sud | Bouree P.,Institute Fournier | Bisaro F.,University Paris - Sud | Bisaro F.,University Paris Diderot | And 3 more authors.
Revue Francophone des Laboratoires | Year: 2011

Yellow fever is an acute hepatonephritis due to a flavivirus which is transmitted by mosquitoes (Aedes and Haemagogus). Yellow fever is found in tropical Africa and Amazonia areas. The monkeys are the reservoir hosts. After a short incubation period, the onset is abrupt with fever, headache, jaundice and haemorrhagic manifestations. Hepatic tests are disturbed and death results from failure of the liver and kidneys. Diagnosis is made by the liver biopsy (Councilman bodies) but often too late, post mortem. There is no specific treatment but the vaccination is safe and provides a long-lasting immunity. © 2011 - Elsevier Masson SAS. Source

Bohbot J.-M.,Institute Fournier | Lepargneur J.-P.,Novescia
Gynecologie Obstetrique Fertilite | Year: 2012

Bacterial vaginosis is one of the most frequent vaginal affections. It results from a deep imbalance of the vaginal ecosystem whose mechanisms remain mysterious, even if recent progress were accomplished in their comprehension: if the flora implied in the bacterial vaginosis is recognized like polymorphic, it appears that Gardnerella vaginalis plays a major part with two genomically different forms: a commensal form (slightly adhesive to the epithelial cells), and a pathogenic one (strongly adhesive to the epithelial cells); the changes in lactobacilli are also to take into account: L. iners could be a marker of the vaginal flora imbalance whereas L. crispatus is generally met in the normal vaginal flora. These findings could influence the composition of coming probiotics; it is recognized that bacterial vaginosis is involved in the risk of prematurity but molecular quantification of G. vaginalis (and of Atopobium vaginae) is more sensitive for the diagnosis of BV what could improve the detection of high-risk pregnant women. The isolated antibiotic treatments are not very effective on the prevention of recurrences. The rebalancing of the vaginal flora is essential. In this field, the local estrogens showed some effectiveness. The use of probiotics is promising and can be recommended in complement of the antibiotic treatment even if the results of the clinical studies are still too heterogeneous to lead to precise indications. © 2011 Elsevier Masson SAS. All rights reserved. Source

Bohbot J.-M.,Institute Fournier
Gynecologie Obstetrique Fertilite | Year: 2011

The female prevalence of the genital infections due to Chlamydia trachomatis (Ct) is considered at 1.6%, but reached 3.6% among women from 18 to 24 years. Ct is one of the most implied bacteria in PID, even if it is not possible to quantify exactly the prevalence of chlamydial salpingitis because of the frequency of the asymptomatic forms. The physiopathology of these complications is not completely elucidated. The natural clearance of Ct at the cervical level has been demonstrated but it varies with the bacterial serovar. The period between cervical infection and salpingitis is also vague. However, we know that the risk of salpingitis increases with the time of start-up treatment. In addition, the risk of PID and sequelae increases with the number of cervical infections. The diagnosis can be evocated on a rise in the rate of anti-Ct IgG correlated with a rise in CRP. The diagnosis of certitude rests on the coelioscopy, but endo-vaginal echography or the MRI can direct the diagnosis. The prevention of these complications remains the targeted screening of chlamydial infections in at-risk populations, teenagers in particular. The recent techniques of self-administrated vaginal swabs are, in this respect, a real progress. © 2011 Elsevier Masson SAS. All rights reserved. Source

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