anal health in rectal microbicide studies ross d. cranston md frcp assistant professor university of...
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Anal Health in Rectal Microbicide Studies
Ross D. Cranston MD FRCP
Assistant Professor
University of Pittsburgh
Plan
Anatomy and physiology Adverse events in microbicide studies Anal diagnoses RAI and the anal canal Anal care for populations who have RAI
Anal Sphincter
Resting 70 mmHg (ref. vagina 0 mmHg)
Squeeze 180 mmHg
Perception (Anus vs. Rectum)
Anus Rectum
Sensation HotColdWet DryLight touchPin prickDistensionPleasurePain
DistensionPleasurePain
Rectal Microbicide AE Reporting
AE severity will be graded per the Division of AIDS Table for Grading Adult and Pediatric Adverse Events, Version 1.0, December 2004 (Clarification dated August 2009) and the Rectal Grading Table for Use in Microbicide Studies, Addendum 3 in the Division of AIDS Table for Grading Severity of Adult and Pediatric Adverse Events, Version 1.0, December 2004 (Clarification dated August 2009)
Adverse Events
Anal Rectal
Symptoms and signs 11 13
MTN 007 protocol
RAI and the Anal Canal
Increase in anal: Fissure Fistula Abscess Ulceration Herpes simplex Human papillomavirus/dysplasia/cancer
Anal Care in Populations who have RAI
Increasing anal awareness What can go wrong?
It is NOT always a hemorrhoid
When to seek help?
Pitt 2007
Summary
The anal canal is distinct from the rectum with a unique set of diagnoses
Anal sensation informs the perception of rectal products including candidate rectal microbicides
Study clinicians must be aware of anal conditions and examine ppts appropriately
There is a need to increase anal awareness in populations who have RAI
