Results For BMSMO who had a high sexual risk profile the syndemic factors characterizing this group included perceived racism, incarceration, IPV, depression, and binge drinking. For BMSMW with a high sexual risk profile, the syndemic factors that characterized this group were incarceration, depression, and binge drinking. Conclusions The current analysis highlights syndemic profiles that differentiated BMSMO and BMSMW from one another and support the need for tailored interventions that address specific syndemic factors for both subpopulations of BMSM.Almost half of MSM visiting Dutch STD clinics reported sex abroad in the past six months, mainly in Western countries. One in four MSM who had sex abroad used drugs during sex ('chemsex') abroad. Having sex abroad was associated with having multiple sex partners and casual sex partner(s).The authors describe an atypical primary syphilis of the neck. The unusual clinical presentation and localization led to an initial diagnostic mistake. This case confirms the polymorphic character of syphilis. Considering the increased incidence of sexually transmitted infections worldwide, a high index of suspicion should be maintained by physicians.A 23-year-old HIV-positive woman presented with persistent yellowish verrucous plaques on both ankles, which had been present for for two years, and blurred vision, which had persisted for one month. Serological tests confirmed a syphilis diagnosis. Her condition improved after systemic penicillin treatment, with no topical treatment except petrolatum ointment.Neisseria gonorrhoeae osteomyelitis is a rare complication of disseminated gonococcal infection (DGI). As the rates of N. gonorrhea continue to increase in the U.S., clinicians may encounter patients with DGI complicated by gonococcal osteomyelitis. Screening and appropriate treatment of N. https://www.selleckchem.com/products/su1498.html gonorrhoeae remains paramount, especially with growing antibiotic resistance.Objectives Chemsex - using illicit drugs during sex - is prevalent among men who have sex with men (MSM) and associated with sexual and mental health harms. Sexually transmitted diseases (STD) clinics are a frequently visited and trusted healthcare facility for MSM. This study assessed the frequency and extent to which chemsex is addressed by Dutch STD nurses. Methods Of the 24 Dutch public STD clinics, an online questionnaire was distributed in 20 STD clinics (83%) in 2019; the questionnaire was sent to 191 STD nurses of whom 108 (57%) completed the questionnaire. The main outcome was addressing chemsex during regular MSM consultations, measured on a five-point Likert scale (never-always). Items measuring knowledge, attitude, self-efficacy and the social norm, were also measured on a five-point Likert scale (totally disagree-totally agree). Results Of the 108 participating STD nurses, 77 (71%) addressed chemsex regularly or always during MSM consultations. In general, STD nurses indicated to have sufficient knowledge about chemsex (mean 3.6, SD 0.5) and a positive attitude towards addressing chemsex (mean 4.3, SD 0.5). A need for training on chemsex was reported by 82 (76%) STD nurses, especially in signaling problematic chemsex (56/82, 68%). Three STD clinics (15%) had a protocol on addressing chemsex and three STD clinics (15%) had referral pathways to addiction care. Conclusion STD nurses from Dutch STD clinics regularly addressed chemsex during MSM consultations. Our results show relevance of educating STD nurses on signaling problematic chemsex and arranging referral pathways to addiction care to optimize chemsex related health care.Background COVID-19, a novel coronavirus originating in December 2019 in Wuhan, China, has spread rapidly throughout the globe over 3 months. On March 11, 2020 the World Health Organization declared COVID-19 a global pandemic. COVID-19 represents a nearly unprecedented threat to both the public health and the durability of our healthcare systems and will profoundly affect the field of plastic and reconstructive surgery. The objective of this paper is to provide a natural history of COVID-19 - including virology, epidemiology and transmission patterns - and a guide for plastic surgeons regarding patient and resource management. Methods The authors reviewed existing literature regarding COVID-19, both primary research and secondary reviews, via PubMed queries, and recommendations from relevant professional organizations (e.g., American College of Surgeons and American Society of Plastic Surgeons). The literature and recommendations were summarized to provide a specific guide for plastic surgeons. Results Internationally, over 5.7 million cases and 357,000 deaths from COVID-19 have been reported at time of writing. No pharmacological treatments have been identified, but epidemiological strategies were identified to prevent viral spread, preserve healthcare resources, and protect patients and surgeons globally. Specific recommendations for plastic and reconstructive surgeons include postponing elective cases and transitioning to telecommunication platforms for patient consultations and education. Conclusions COVID-19 represents a nearly unprecedented threat to the public health and the durability of healthcare systems in the contemporary era. While plastic and reconstructive surgery may seem relatively remote from the pandemic in direct patient care and exposure, our field can significantly enhance healthcare resource management.Introduction The purpose of this study was to compare leg, sagittal plane knee and ankle and and frontal plane ankle stiffness over the course of a prolonged treadmill run in neutral and stability footwear. Methods Thirteen male habitual rearfoot runners completed two biomechanical testing sessions in which they ran for 21 minutes at their preferred running speed in a neutral shoe, then changed either into the same neutral shoe or a stability shoe and ran a further 21 minutes on a force instrumented treadmill. Three-dimensional kinematics and kinetics were recorded at the beginning and end of each 21-minute interval. Results No differences were observed in leg stiffness between footwear conditions throughout the run (p > 0.05). Knee stiffness increased during the first 21 minutes (p = 0.009), while ankle stiffness reduced at minute 21 (p = 0.004) and minute 44 (p = 0.006). These changes were modulated by an increase in ankle joint compliance and knee joint moments. No differences were observed between footwear conditions for leg and sagittal plane lower extremity joint stiffness (p > 0.