Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:2.7.10.2 (focal adhesion kinase)
 44,029 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical applications of azithromycin in gonorrhoea, often complicated by simultaneously acquired infection with Chlamydia trachomatis, are reviewed in this paper. Clinical trails from major centres in Europe are compared with a large, more recent US study. At the present time, azithromycin is recommended throughout the world as a useful antibiotic in treatment of gonorrhoea. It has several advantages in that it can be given as single-dose therapy, it can be given where the causative pathogen of urethritis/cervicitis is uncertain, and it is often, therefore, most useful in acute therapy where there is no immediate microbiological back-up. All these considerations are reviewed in detail.
Int J STD AIDS 1996
PMID:Azithromycin in gonorrhoea. 922 99

The unique pharmacological profile of the azalide macrolide azithromycin, coupled with its in vitro activity against both Chlamydia trachomatis and the ureaplasmas, suggested that genital infections caused by these bacteria could be successfully treated with a single dose of the antibiotic. This has now been confirmed in worldwide clinical studies. A single oral dose of azithromycin 1 g eradicates C. trachomatis in almost 100% of cases of non-gonococcal urethritis and cervicitis. Unfortunately, there are no specific clinical signs for genital chlamydial infection. It is therefore necessary to use therapy effective against known and unknown pathogens for treating lower genital tract infection. Clinical cure rates for both chlamydial and non-chlamydial, non-gonococcal infections compare favourably with standard 7-day doxycycline therapy, being in excess of 85%. Side effects are few (< 20%) and essentially minor.
Int J STD AIDS 1996
PMID:Azithromycin in the management of Chlamydia trachomatis infections. 865 27

A significant decrease in the incidence of most STDs has been reported in Norway during the last decade, especially the last 5 years. Today, syphilis, hepatitis B and gonorrhoea are almost non-existent with incidence rates (IR) of 1.1, 0.9 and 4.4 per 100,000 respectively. The frequency of genital herpes, however, has remained unchanged (IR = 45), while chlamydial infection has shown a decrease of 13% during the last year (IR women = 240). The Chlamydia epidemic became evident in the early 1980-ies and since then has represented the major threat to the reproductive condition in young women resulting in PID, tubal occlusions and ectopic pregnancies. In Norway a preoperative screening program in connection with the performance of abortions was introduced 8-9 years ago. Since then a gradual decrease in the frequency of chlamydial positivity has been notified. At our hospital a reduction of 75% (from 11.7% to 3.1%) in the prevalence of C. trachomatis has been observed in women seeking abortion. The decrease is evident is all age groups, but predominantly in those below 25 years. At the same time the frequency of PID has decreased by 80%, while so far only a slight reduction in the frequency of ectopic pregnancies has been observed. Public and professional awareness, together with an increased prescription of anti-chlamydial drugs to women with genital infections may have contributed to this decrease. Partner tracing is not satisfactory, being performed in only one out of 5 cases. A new act for the prevention of communicable diseases will be introduced next year. This act will make partner notification mandatory and STD treatment free of charge. In Norway, 350,000 chlamydial tests (8 per 100 inhabitants) are performed per year, 39% in women < 25 years. Even today the age-specific prevalence of these women are so high that Chlamydia screening is cost-effective.
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PMID:[Prevention of sexually transmitted diseases. The norwegian experience]. 868 4

This study was carried out to assess the management by general practitioners of patients with genital warts. An anonymized postal questionnaire was sent to 2060 general practitioners in the north west of England; 1260 (61.2%) completed questionnaires were returned. A total of 76.69% of GPs saw one or more cases per quarter. Of 468 (37.1%) GPs who managed patients in-house, 393 (83.9%) used podophyllin of concentration between 0.5 and 50%; 169 (43%) did not specify the podophyllin concentration and 112(23.9%) used podophyllotoxin. Of 395 GPs (31.3%) prescribing patient self-treatment, 259 (65.6%) prescribed podophyllin, but 60.23% did not specify the concentration; 134(33.9%) prescribed podophyllotoxin. Screening for selected sexually transmitted infections (STIs) was performed by 258/618 (41.7%) GPs. Only 74 (11.97%) screened for Chlamydia trachomatis and Neisseria gonorrhoeae and Trichomonas vaginalis. Partner notification was advised by 1138 (90.3%) and condom use by 1027 (81.5%). Only 333 (26.4%) referred all patients to GUM departments. Many GPs manage patients in-house, most using podophyllin solutions which vary in concentration, are non-standardized and potentially hazardous. Most GPs who instigate patient self-treatment prescribe podophyllin which is not licensed for this usage. Podophyllotoxin 0.5% is a safe, effective alternative. Few non-referring GPs screened for the 3 common STIs, thus putting patients at risk of complications such as pelvic inflammatory disease. Non-referral of patients with genital warts to GUM departments may have costly medical and financial consequences.
Int J STD AIDS
PMID:Patients with genital warts: how are they managed by general practitioners? 879 86

AIDS-associated Kaposi's sarcoma (KS) is much more frequent in patients acquiring HIV infection via the sexual route. Epidemiological studies have confirmed the likely involvement of a sexually acquired cofactor in the pathogenesis of this form of KS. We have formulated a set of postulates, epidemiological and experimental, to fit a single unifying hypothetical agent. Chlamydia trachomatis is one of 3 agents to fit the epidemiological criteria. Our data suggest a possible association between increased IgG serum antibody to C. trachomatis and the occurrence of KS. Conversely, higher titres of IgG serum antibody to C. pneumoniae were associated with the absence of KS. We feel that it is important to study further the relationship between C. trachomatis and KS.
Int J STD AIDS
PMID:Chlamydia trachomatis as a possible cofactor for Kaposi's sarcoma in AIDS. 884

Among 120 non-gonococcal male urethritis, 83 were found to be Chlamydia trachomatis (CT) positive by Chlamydiazyme with 2 to 5 times repeated urethral swab collection during pre-treatment period. Among 97 female partner of male CT urethritis, 76 were CT positive by the same repeated specimen collection from cervix. In the 83 male CT urethritis and the 76 female CT cervicitis, EIA reactive values by Chlamydiazyme and serum CT antibody titer by FA at the first visit were investigated. The EIA reactive values of cervicitis were lower than those of urethritis. There was no case of "CT negative at the first visit and positive at repeated detection" in male urethritis. 3 case of "CT negative at the first visit and CT positive at repeated detection" were experienced among females who were the partner of male CT urethritis. The sensitivity of Chlamydiazyme was found to be enough to decide presence or absence of CT by single specimen collection in male urethritis but not enough in female cervicitis. It could be assumed that by the improved sensitivity of CT detection, CT detection rate would be raised among female cervicitis but not in male urethritis. Positive rate CT serum antibody were 63.9% in male urethritis and 100% in female cervicitis. The clinical value of CT antibody detection might be not as detection method of CT infection in progress, but as non-invasive screening for CT infection up to the present, namely the risk factor of STD, especially in females in whom detection of CT is not complete.
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PMID:[Distribution of EIA reactive values and serum antibody titers of Chlamydia trachomatis urethritis and cervicitis at the first visit]. 885 Nov 99

A significant association of Mycoplasma genitalium with non-gonococcal urethritis has been reported, but the prevalence of this mycoplasma in men with gonococcal urethritis has not been so well studied. In this study, we examined urethral swab specimens from 45 Japanese male patients with gonococcal urethritis for the presence of M. genitalium by using a polymerase chain reaction-based assay. We also sought Chlamydia trachomatis by an enzyme immunoassay (Chlamydiazyme). Of the 45 specimens, 2 (4.4%) were positive for the mycoplasma and 12 (26.7%) were positive for C. trachomatis. The findings suggest that M. genitalium may be a cause not only of non-gonococcal urethritis but also of postgonococcal urethritis.
Int J STD AIDS 1996 Oct
PMID:Prevalence of Mycoplasma genitalium in men with gonococcal urethritis. 925 7

In England, clinical researchers enrolled 1056 women aged 13-56 years attending the genitourinary medicine clinic in Bristol during February-October 1994 in a study on the relationship between the menstrual cycle and the detection rate of Chlamydia trachomatis from the cervix. They conducted a routine speculum examination and an amplified enzyme immunoassay (EIA) to take a swab from the cervix and a swab from the urethra. The chlamydia incidence rate was 8.8% (93 women) at any site, 2.3% at both sites, 4.9% at the cervix alone, and 1.5% in the urethra alone. Sampling at the urethra increased the detection of C. trachomatis by 17%. 808 women had a regular menstrual cycle. C. trachomatis was more likely to be detected in women aged under 25 years than in those of older age groups (14% for age 15-19 and 12.2% for 2-24 vs. 3.6-8%; p 0.0001). Detection of C. trachomatis at the cervix had a significant association when weeks 1-2 were compared to weeks 3 and later (5.4% vs. 9.4%; p = 0.029) and when weeks 1-3 were compared to week 4 and later (6.2% vs. 10.8%; p = 0.023). It had a relative risk (RR) of 1.7. Detection of C. trachomatis at any site was also significant when weeks 1-3 were compared to weeks 4-5 (11.8% vs. 7.5%; p = 0.048) (RR = 1.6). Combined oral contraceptive (OC) use and the lack of a cervical ectropion (i.e., cervix turning outward) both had an independent association with the variation in detection of C. trachomatis with the menstrual cycle. Specifically, the elevated detection at the cervix occurred after the second week in OC users (14.2% vs. 6%; RR = 2.3; p = 0.008) and only after the third week in women without a cervical ectropion (9.3% vs. 3.5%; RR = 2.7; p = 0.004). Based on these findings, the authors recommend sampling the urethra in addition to the cervix to increase chlamydia detection and chlamydia screening for young women with no cervical ectropion who use OCs. They also recommend that screening for chlamydia be performed in the latter part of the menstrual cycle in OC users who do not have a cervical ectropion.
Int J STD AIDS 1997 Jan
PMID:Hormonal factors and the laboratory detection of Chlamydia trachomatis in women: implications for screening? 904 77

It is a retrospective study supporting 82 cases continued series of feminine sterility and which objective is to evaluate the nursing management quality of genital infection in exploration and treatment of sterility. Women mean age is 26 years old, sterility is most primary frequently (68%) and from fallopian origin (80%). Followers examinations have been asked: vaginal taking (100%), urines cytobacteriology examination (56%), syphilis serology (23%), chlamydia serology (57%), mycoplasma serology (03%). Genital infection have been diagnosed in 75% of cases, in 33% of cases positive Chlamydia serology was found. Three molecules have been used principally in treatment: cyclines 50%, imidazoles derived 47%, lactamines 15%. The upper cost of diagnostic and treatments produce a wishest of prevention which based is the tracking and the precocious treatment of STD.
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PMID:[Sexually transmitted diseases and female sterility at the University Hospital Center of Dakar: management and prevention]. 906 54

Data on 259 notified cases of genital chlamydia infection diagnosed in Victoria Australia in January and February 1995 were augmented by call-back. Risk factor data was available for 221. Patients were primarily adolescents or young adults (median age 23 years); 66% were women. Men were more commonly symptomatic. Persons without symptoms were tested as a result of partner notification, sexual risk, termination of pregnancy, or because of abnormalities on genital examination. Limitations of antigen-based screening tests in low prevalence populations were rarely considered. Although antimicrobial treatment usually accorded with available guidelines, case management was not well geared to reducing the broader issue of risk of this infection in the community. Data management systems for handling name-coded data, and systems for recall and follow-up of diagnosed patients and their partners were often inadequate. Sexual history taking had not generally identified details of sexual partners. Partner notification was generally regarded as the patient's responsibility and professional help with contact tracing was rarely sought. Control of chlamydia will require much greater attention to management issues, particularly contact tracing.
Int J STD AIDS 1997 Jun
PMID:The epidemiology of notified genital Chlamydia trachomatis infection in Victoria, Australia: a survey of diagnosing providers. 917 49


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