One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action. In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.

One of the greatest challenges faced by William Clark and Meriwether Lewis on their 1804?6 Corps of Discovery expedition was that of medical emergencies on the trail. Without an attending physician, even routine ailments and injuries could have tragic consequences for the expedition?s success and the safety of its members. Of these dangers, the most insidious and potentially devastating was the slow, painful, and oftentimes fatal ravage of venereal disease. ø Physician Thomas P. Lowry delves into the world of nineteenth-century medicine, uncovering the expedition?s very real fear of venereal disease. Lewis and Clark knew they were unlikely to prevent their men from forming sexual liaisons on the trail, so they prepared for the consequences of encounters with potentially infected people, as well as the consequences of preexisting disease, by stocking themselves with medicine and the latest scientific knowledge from the best minds in America. Lewis and Clark?s expedition encountered Native peoples who experienced venereal disease as a result of liaisons with French, British, Spanish, and Canadian travelers and had their own methods for curing its victims, or at least for easing the pain it inflicted. ø Lowry?s careful study of the explorers? journals sheds new light on this neglected aspect of the expedition, showing in detail how sex and venereal disease affected the men and their mission, and describes how diverse peoples faced a common threat with the best knowledge and tools at their disposal.

Multidisciplinary collection of essays on the relationship of infertility and the "historic" STIs--gonorrhea, chlamydia, and syphilis--producing surprising new insights in studies from across the globe and spanning millennia.

Male genital disorders represent a common issue in medical practice, especially in the dermatological setting. Correct clinical evaluation of these disorders is essential when addressing the diagnosis, which in some cases may require histopathological confirmation. Depending on the disease, early diagnosis may be not only lifesaving, but also of fundamental importance to the planning of successful treatment. This atlas introduces the most common penile diseases, along with more rarely encountered ones. It provides invaluable guidance on clinical diagnosis by highlighting prominent clinical features and presenting particular videodermatoscopy findings when these are indicative of the diagnosis. In addition, for each condition the most appropriate treatment is proposed, taking into account recent therapeutic advances of proven benefit.

The United States has the dubious distinction of leading the industrialized world in overall rates of sexually transmitted diseases (STDs), with 12 million new cases annually. About 3 million teenagers contract an STD each year, and many will have long-term health problems as a result. Women and adolescents are particularly vulnerable to these diseases and their health consequences. In addition, STDs increase the risk of HIV transmission. The Hidden Epidemic examines the scope of sexually transmitted infections in the United States and provides a critical assessment of the nation's response to this public health crisis. The book identifies the components of an effective national STD prevention and control strategy and provides direction for an appropriate response to the epidemic. Recommendations for improving public awareness and education, reaching women and adolescents, integrating public health programs, training health care professionals, modifying messages from the mass media, and supporting future research are included. The book documents the epidemiological dimensions and the economic and social costs of STDs, describing them as "a secret epidemic" with tremendous consequences. The committee frankly discusses the confusing and often hypocritical nature of how Americans deal with issues regarding sexualityâ€"the conflicting messages conveyed in the mass media, the reluctance to promote condom use, the controversy over sex education for teenagers, and the issue of personal blame. The Hidden Epidemic identifies key elements of effective, culturally appropriate programs to promote healthy behavior by adolescents and adults. It examines the problem of fragmentation in STD services and provides examples of communities that have formed partnerships between stakeholders to develop integrated approaches. The committee's recommendations provide a practical foundation on which to build an integrated national program to help young people and adults develop habits of healthy sexuality. The Hidden Epidemic was written for both health care professionals and people without a medical background and will be indispensable to anyone concerned about preventing and controlling STDs.

Written with the busy practice in mind, this book delivers clinically focused, evidence-based gynecology guidance in a quick-reference format. It explores etiology, screening, tests, diagnosis, and treatment for a full range of gynecologic health issues. The coverage includes the full range of gynecologic malignancies, reproductive endocrinology and infertility, infectious diseases, urogynecologic problems, gynecologic concerns in children and adolescents, and surgical interventions including minimally invasive surgical procedures. Information is easy to find and absorb owing to the extensive use of full-color diagrams, algorithms, and illustrations. The new edition has been expanded to include aspects of gynecology important in international and resource-poor settings.

In response to a request by President Barak Obama on November 24, 2010, the Presidential Commission for the Study of Bioethical Issues oversaw a thorough fact-finding investigation into the specifics of the U.S. Public Health Service-led studies in Guatemala involving the intentional exposure and infection of vulnerable populations. Following a nine-month intensive investigation, the Commission has concluded that the Guatemala experiments involved gross violations of ethics as judged against both the standards of today and the researchers' own understanding of applicable contemporaneous practices. It is the Commission's firm belief that many of the actions undertaken in Guatemala were especially egregious moral wrongs because many of the individuals involved held positions of public institutional responsibility. The best thing we can do as a country when faced with a dark chapter is to bring it to light. The Commission has worked hard to provide an unvarnished ethical analysis to both honor the victims and make sure events such as these never happen again.