Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:2.7.10.2 (focal adhesion kinase)
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Clinicians caring for sexually active adolescents are likely to be called on to diagnose and treat many of the STDs discussed in this article. A variety of other STDs not covered here also may be observed, including lymphogranuloma venereum, granuloma inguinale, molluscum contagiosum, scabies, pediculosis, and hepatitis A, B, and C. Some of the special issues related to gay and lesbian youth are discussed in the article by Drs Bidwell and Deisher (see "Adolescent Sexuality: Current Issues," pp 293-302). Nonetheless, it should be mentioned that the same STDs occur in homosexual youths as in their heterosexual counterparts. However, the prevalence rates for many STDs differ between the two groups, and some STDs are rarely seen in heterosexual males. These discrepancies may be explained by a number of determinants including anatomic and physiologic factors (eg, lesbian women have lower rates of STDs), differences in sexual practices (eg, genital-anal and oral-anal contact), and numbers of sexual partners, although this last factor may be less important in adolescents as compared with adult gay men. Discovery of one STD should always prompt a search for others because multiple concurrent infections is the rule rather than the exception. A serologic test for syphilis and a discussion of the potential for HIV infection (possibly testing for HIV as well) should take place at each new encounter for an STD. Some patients, including those with multiple partners, have an increased chance for acquisition of an STD. However, the reality is that any adolescent who has had sexual intercourse could have an STD.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sexually transmitted diseases in adolescents: update 1991. 186 93

Aspects of sexually transmitted diseases (STDS) peculiar to the developing countries in South America and sub-Saharan Africa are discussed. The most common STD infections are N. Gonorrhoeae, Chlamydia trachomatis, T. pallidum and T. vaginalis. Vertical transmission, particularly of syphilis among prostitutes, and of Chlamydia and gonorrhea after ophthalmia neonatorum, are common. Chlamydia is also a common respiratory tract infection in African neonates. Late complications of STDs, infertility and ectopic pregnancy, and particularly pelvic inflammatory disease, are responsible for a high proportion of hospitalizations. Antibiotic resistant gonorrhea strains are common, a result of poorly managed antibiotic treatment. Genital ulcer diseases (GUD), which predispose to HIV infections, are more common in Africa than in developed countries, not only herpes but chancroid, donovanosis and lymphogranuloma venereum. Chancroid, caused by Haemophilus ducreyi, causes 36-49% of ulcers in 2 reports. The L1-L3 strains of Chlamydia trachomatis cause lymphogranuloma venereum, the agent responsible for ulcers in 3.6-6.1% of 2 clinic populations. HIV infections have an equal sex ratio in Africa, with a younger age incidence in women and a high vertical transmission rate, while in Latin America, bisexual men, and increasingly, heterosexual transmission by intravenous drug users is reported. There is also an HIV-2 virus, whose virulence is in question, common in West Africa.
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PMID:The epidemiology of sexually transmitted diseases in Africa and Latin America. 220 6

This article will review the 1993 STD Treatment Guidelines of particular importance to dermatologic clinical practice. Topics include STD/HIV prevention, management of sexual partners, STD in persons with HIV co-infection, genital ulcer disease (GUD) including syphilis, herpes simplex virus (HSV) infection, lymphogranuloma venereum (LGV) and chancroid, therapy of nongonococcal (NGU) and chlamydial urethritis and cervicitis, gonococcal (GC) infections, HPV infection, hepatitis B virus (HBV) infection, pediculosis pubis, and scabies.
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PMID:The 1993 sexually transmitted disease treatment guidelines. 784 21

Travel to tropical countries is an important factor in the spread of sexually transmitted diseases. In spite of intensive anti-AIDS campaigns, some 30% of Swiss tourists have casual sexual contacts abroad. The prevalence of sexually transmitted diseases is higher in tropical countries than in western industrialized countries. More than 25% of cases of gonorrhea treated in Switzerland from 1989-1991 were imported from abroad. The penicillin producing Neisseria gonorrhoeae strains (PPNG) isolated in Switzerland from 1989-1991 are mainly imported from abroad (60%). The typical "imported sexually transmitted diseases" in Switzerland are chancroid, lymphogranuloma venereum and donovanosis. The clinical manifestations, laboratory and special examinations, and treatment of these diseases are described. The most frequent sexually transmitted disease from the so-called "imported tropical STD's" is chancroid. Chancroid is also a major risk factor for HIV infection.
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PMID:[Sexually transmissible diseases following travel in tropical countries]. 832 73

An immunoperoxidase test detecting Chlamydia trachomatis specific serum IgG and IgA antibodies, was carried out to determine its efficacy in establishing chlamydial etiology in 104 clinically diagnosed patients attending a major STD Clinic in Delhi. The patients consisted of 58 with nonspecific urethritis/cervicitis (NSU/NSC), 11 with pelvic inflammatory disease (PID), 23 with primary infertility in either male or female and 12 with lymphogranuloma venereum (LGV). IgG antibodies were tested at a dilution of 1:64 and 1:128 and IgA antibodies at 1:16. Although 27.7 per cent (5 of 18) of the controls had IgG antibodies (> or = 1:128), none had IgA, showing the IgA marker as 100 per cent specific. In 80.8 per cent of all the patients, active infection was detected, 81.0 per cent in NSU/NSC, 81.8 per cent in PID, 76.9 per cent in female infertility, 80 per cent in male infertility and 83.3 per cent in LGV patients. The immunoperoxidase test was found to be an extremely simple and rapid test especially suited for laboratories where facilities are limited.
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PMID:Usefulness of immunoperoxidase test for serodiagnosis of genital chlamydial infections. 850 77

A randomized, comparative study undertaken in Nairobi, Kenya and a non-comparative evaluation undertaken in Carletonville, South Africa have both shown that a single oral dose of azithromycin 1 g is effective in the treatment of the genital ulcer disease (GUD), chancroid, with cure rates of 89% and 92% recorded respectively. While treatment failure was associated with human immunodeficiency virus seropositivity and lack of circumcision in Kenya, no such association could be found in the South African study. In both series, azithromycin treatment resulted in cure of both Haemophilus ducreyi culture-positive and culture-negative cases of GUD, including two cases subsequently diagnosed as lymphogranuloma venereum. A combination of single-dose azithromycin with single-dose benzathine penicillin may provide effective 'single-visit' syndromic treatment for GUD in many developing countries.
Int J STD AIDS 1996
PMID:Treatment of chancroid with azithromycin. 865 28

In the former West Germany, in specific venereal diseases legislation passed in 1953, only syphilis, gonorrhoea, ulcus molle, and lymphogranuloma venereum were defined as venereal diseases and subject to mandatory notification. The proportion of unreported cases was as high as 75% for syphilis and up to 90% for gonorrhoea. Epidemiological data for the past 10 years exist only on selected populations from research studies and are summarized in this article. In the former East Germany reporting of sexually transmitted infections (STIs) was mandatory and, due to the centralized organization, underreporting was considered to be low, although no specific studies have examined this. After the unification in 1990 of the two German states the West German laws were adopted in East Germany. Since 1982 - when the first AIDS case was reported in Germany - information on AIDS cases has voluntarily been collected at the national register at the AIDS Centre of the Robert Koch Institute in Berlin. The law governing the reporting of infectious diseases has recently been revised. Under the new Protection against Infection Act, which became effective on 1 January 2001, clinical diagnoses of STIs (with the exception of hepatitis B) are no longer notifiable diseases. Laboratory reporting of positive test results for Treponema pallidum has been introduced. With T. pallidum and HIV notifications, additional disaggregated data are collected. Since T. pallidum and HIV remain the only notifiable STIs, all other STIs have to be monitored through sentinel surveillance systems. These surveillance systems are currently being established. Under the new legislation, local health authorities have to provide adequate counselling and testing services for STIs, which may be provided free of charge if necessary.
Int J STD AIDS 2002 Apr
PMID:Sexually transmitted diseases in Germany. 1188 9

Genital elephantiasis (esthiomene), which is the dramatic end-result of lymphatic obstruction, is rather rare. Although mainly associated with filariasis and sexually transmitted diseases, such as lymphogranuloma venereum and donovanosis, it could also be an uncommon complication of tubercular lymphadenitis, a common infection in tropical countries. We report a rare case of a 32-year-old Indian female in whom genital elephantiasis occurred as a complication of tubercular lymphadenitis.
Int J STD AIDS 2002 Jun
PMID:Genital elephantiasis. 1201 20

The African Union Against Venereal Diseases and Treponematoses (AUVDT), inaugurated in 1979, held its 3rd biannual conference in Nairobi in March 1983 with local participants and participants from 15 English and French speaking countries as well as from Europe, USA and Canada. The conference was devoted to high level training and discussion, workshops on genital ulcer diseases (GUD) and scientific sessions during which many papers were read and discussed. Resolutions and recommendations were made concerning STD in Africa and later passed on to relevant health authorities for necessary action. It was agreed that all African governments who have not already done so should set their own STD control committees as soon as possible. The establishment of microbiological laboratories was strongly urged as well as specific training of health workers. It was felt that gonorrhea and genital ulcer disease were the most frequent sexually transmitted diseases and so management recommendations were made. The efficacy of current regimens using penicillin is increasingly dropping and trimethoprim sulfametrole should be substituted. Failure rates of over 10% would indicate the need to review the accepted regimen. The ideal drug should be effective, orally administered as a single dose, whithout harmful side-effects and preferably not masking syphilis. National programs can purchase drugs through WHO's and UNICEF's purchasing channels at very low prices and governments should utilize these channels. Monitoring of antimicrobial sensitivities should be encouraged and assistance should be sought from university departments of microbiology whenever possible. Genital Ulcer Disease (GUD) is an important public health problem in Africa. Chancroid is the most frequently diagnosed and etiologically proven GUD in eastern, central and southern Africa, accounting for 3-60% of GUD cases. Syphilis, herpetic ulceration, lymphogranuloma venereum and donovanosis are other GUDs found in Africa. Consideration of efficacy, availability, and compliance should be given to treatment. Recent studies have shown that single doses or short-term therapy regimens are as efficient for both ulcers and bubos. Syphilis may be treated with benzathine penicillin im or aqueous procaine penicillin G. No current curative therapy is available for herpes. Local management includes keeping lesions clean and dry; symptomatic treatment involves giving analgesics.
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PMID:AUVDT recommendations for management of gonorrhoea and genital ulcers in Africa. 1234 Jan 86

A 38-year-old man who had sex with men, presented at the outpatient department for Sexually Transmitted Diseases in Amsterdam with a painful, red, fluctuating swelling in the left groin and general discomfort. He had been sexually active in the population of men who have sex with men, in which an anorectal lymphogranuloma venereum (LGV) epidemic has recently been discovered. Unlike other cases where there was anorectal involvement, this patient was the first case of LGV with the classical inguinal presentation although he had not visited the tropics where the inguinal form of LGV occurs as an STD. Routine investigation using PCR on material from urethra and rectum and from the urine, repeatedly failed to detect LGV. However, PCR on pus aspirated from the enlarged lymph node demonstrated Chlamydia trachomatis serovar type L2. Treatment with doxycycline 100 mg twice daily was started. This case illustrates that routine analysis from urethra and rectum and of urine may fail to detect LGV. Furthermore, this case of a patient who probably had LGV initially in the urethra may be the missing link in explaining the route of transmission of the anorectal LGV epidemic.
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PMID:[Inguinal lymphogranuloma venereum in a man having sex with men: perhaps an example of the missing link to explain the transmission of the recently identified anorectal epidemic]. 1563 78


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