Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:2.7.10.2 (focal adhesion kinase)
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To identify the importance of heterosexual activity as a possible route for the transmission of the hepatitis C virus (HCV), a screening of antibodies against HCV (anti-HCV) was performed in 200 sexually transmitted disease patients with different risks for incurring genital infections as well as in 100 registered prostitutes. Out of all 300 persons tested, 14 cases of HCV infection were detected. Anti-HCV was present in 3 of the prostitutes and in 11 of the STD patients. Evaluating known risk factors, such as intravenous drug use or blood transfusion, 6 out of the 11 STD patients and all of the prostitutes in whom anti-HCV was present were intravenous drug users and exhibited highly promiscuous behavior. Intravenous drug use was the probable means of acquisition in 9 of the 14 subjects in whom anti-HCV was present, and homosexual promiscuous behavior was assumed to be the means of acquisition in another 2 subjects. In heterosexual patients engaging in high-risk behavior (high number of sexual partners and genital infections), the exclusion of intravenous drug use decreased the prevalence of anti-HCV from 12.1% to 4.1%, demonstrating no significant increase from the prevalence among low-risk persons. Most of the patients were screened for STDs, such as syphilis, Neisseria gonorrhoeae, Chlamydia trachomatis, human immunodeficiency virus (HIV), hepatitis B virus (HBV), trichomoniasis, and yeast infections. The highest rate of coinfection with anti-HCV was found in patients with serologic evidence of an HIV infection (50%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Seroepidemiologic study of hepatitis C virus in sexually transmitted disease risk groups. 138 51

A total of 24 cases of recalcitrant trichomoniasis were reported from 18 centres widely scattered throughout the UK. Most cases had received numerous courses of unsuccessful treatment. Nine (75%) of 12 tested isolates had a decreased susceptibility to metronidazole. Local laboratories were often unable to evaluate fully trichomonal isolates and it is recommended that consideration be given to the establishment of a national reference laboratory. Although there were no universal cures, successful alternatives to conventional treatments are detailed.
Int J STD AIDS
PMID:An investigation, by questionnaire, of cases of recalcitrant vaginal trichomoniasis seen in genitourinary medicine clinics in the United Kingdom. British Co-operative Clinical Group. 154 63

Sexual activity is the primary method of transmission for several important parasitic diseases and has resulted in a significant prevalence of enteric parasitic infection among male homosexuals. The majority of parasitic sexually transmitted diseases involve protozoan pathogens; however, nematode and arthropod illnesses are also included in this group. Trichomoniasis, caused by Trichomonas vaginalis, is the most common parasitic STD. Infection with this organism typically results in the signs and symptoms of vaginitis. Trichomoniasis can be diagnosed in the office setting by performing a microscopic evaluation of infected vaginal secretions and can be successfully treated with metronidazole. Both pediculosis pubis, caused by the crab louse Pthirus pubis, and scabies, caused by the itch mite Sarcoptes scabiei, present with severe pruritus. A papular or vesicular rash and linear burrows seen in the finger webs and genital area are characteristic of scabies. Pediculosis pubis is diagnosed by observing adult lice or their nits in areas that bear coarse hair. The diagnosis of scabies is confirmed by scraping suspicious burrows and viewing the mite or its byproducts under the microscope. Lindane, 1% used in treating scabies, is also very effective for treating pediculosis pubis. Synthetic pyrethrins, also applied as a cream or lotion, are less toxic alternatives for the treatment of either condition. Oral-anal and oral-genital sexual practices predispose male homosexuals to infection with many enteric pathogens, including parasitic protozoans and helminths. The most common of these parasitic infections are amebiasis, caused by Entamoeba histolytica, and giardiasis caused by Giardia lamblia. Both entities may cause acute or chronic diarrhea, as well as other abdominal symptoms. Most gay men with amebiasis are asymptomatic, and invasive disease in this group is extremely rare. Both amebiasis and giardiasis can be diagnosed on the basis of microscopic examination of stool specimens, although duodenal aspiration is occasionally necessary to confirm a diagnosis of giardiasis. Multiple treatment regimens exist for amebiasis. Iodoquinol is a good choice for asymptomatic cyst carriers, whereas the combination of metronidazole plus iodoquinol is used for symptomatic patients. Quinacrine and metronidazole are both efficacious in the treatment of giardiasis.
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PMID:Sexually transmitted parasitic diseases. 201 32

We studied specific vaginal infections in 351 consecutive women who visited the Rotterdam STD clinic. Prostitutes less often had vaginal or vulvar complaints than non-prostitutes (Fisher test, p less than 0.01), but more often had abnormal discharge (Fisher test, p less than 0.001). Normal secretions were found in 52% of the women. Clue cell-positive discharge (CCPD) was by far the most prevalent vaginal disease entity (32%). The wet mount showed pseudo-hyphae in 14 women (4%) and Trichomonas vaginalis was detected in 20 (6%). Microscopy (normal saline, no KOH 10%) had an overall sensitivity of 18% in the diagnosis of vaginal yeast infection. The sensitivity substantially rose with the 'degree' of infection. In the case of trichomoniasis the sensitivity was 55%. The rates of positive cultures of Candida species, T. vaginalis, N. gonorrhoeae and C. trachomatis were 21%, 13%, 9% and 10% respectively. Symptoms and signs were not of much help in the correct classification of the different diagnostic categories due to considerable overlap. However, curdy secretions are indicative of candidal infection. Tests for anaerobic overgrowth showed a 99% correct classification of normal secretions, which implies that smelling the vaginal secretions on the withdrawn speculum is a major diagnostic office procedure.
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PMID:Some aspects of the diagnosis of specific vaginal infections in the Rotterdam STD clinic population. 313 62

A study of diagnostic patterns in patients attending sexually transmitted disease clinics in England and Wales during 1978 showed that homosexuals contributed 10% of all male cases but 15% of gonococcal infections. In heterosexual and homosexual men only 6% of disease episodes included more than one positive diagnosis compared with 16% in women. One or more diseases occurred concurrently in over 30% of cases of gonorrhoea, trichomoniasis, candidosis, genital herpes, and genital warts in women. Men with multiple episodes of disease contributed a disproportionate number of gonococcal infections but were less likely to have candidosis or genital herpes than patients with only one disease episode. Thus, counting cases treated appears to be an inadequate way of measuring the problems caused by STDS. To enable more rapid identification of the diseases which are the most difficult to control, STD statistics should include the sexual orientation of male patients and differentiate between genuine "new" attenders at clinics and those previously seen.
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PMID:Study of STD clinic attenders in England and Wales, 1978. 2. Patterns of diagnosis. 689 42

The trends for gonorrhea and pelvic inflammatory disease in England and Wales are presented. Reported cases of gonococcal infection during a 12 year period, 1966 through 1977, were examined to determine incidence trends. Incidence rates by sex and age groups were calculated per 100,000 population. The number of patients with pelvic inflammatory disease (PID) admitted to hospitals in England and Wales can be derived from the Hospital In-Patient Enquiry. This is a 10% sample of all hospital deaths and discharges. The Enquiry records cases, not patients, and there are no criteria for the establishment of a diagnosis of PID except that it is the physician's final diagnosis. The rates for gonorrhea for both sexes have shown a steady increase (more marked in women) from 1966 to 1977. These increases appear to have leveled off recently. In 1977, the rates represetned 37,831 and 22,273 cases in men and women, respectively. Despite the leveling off over the last few years, there has been an increase of 31% for men from 1966 to 1977 and 130% for women over the same time period. The major increases have been in women aged 16-19 years and 20-24 years. From 1968 to 1977, both the number of cases of PID and the rate have increased by 50%. The number of cases requiring hospitalization was 10,960 in 1977. The age-specific PID rates are similar to the female age-specific rates for gonorrhea with major increases occurring in the 15-19 and 20-24 year age groups. A total of 2286 women were screened in the special examination of asymptomatic women. Altogether, 228 (10%) were found to have candidiasis, 97 (4%) trichomoniasis, and 5 (0.2%) gonorrhea. The screening concentrated on those who had not sought care for sexually transmitted diseases. England and Wales have excellent STD clinic service with a sophisticated recording system for cases seen in clinics and patients hospitalized with the complications of the diseases. Yet, the data systems can still be improved. These systems indicate only part of the total clinical picture of the STDs. Accurate comprehensive figures are essential for monitoring changes in the STDs and for planning appropriate medical and other facilities needed for clinical care and control.
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PMID:Trends for gonorrhea and pelvic inflammatory disease in England and Wales and for gonorrhea in a defined population. 746 78

The control of sexually transmitted diseases, including HIV-1, among sex workers and their clients in urban areas in developing countries, is considered a valuable and cost-effective intervention to contain the spread of HIV-1. The effect of a programme of STD treatment combined with condom promotion on HIV-1 incidence has so far not been measured. During an intervention including condom promotion, as well as monthly sexually transmitted disease screening and treatment among 531 initially HIV-1 negative female sex workers in Kinshasa, Zaire, 70 became infected with HIV-1 (incidence of 8.0 per 100 women-years [wy]). A decline of HIV-1 incidence was observed over time, from 11.7/100 wy during the first 6 months, to 4.4/100 wy over the last 6 months, 3 years later (p = 0.003). Simultaneously, regular use of condoms with clients went up from 11% to 52% and 68%, after 6 and 36 months of intervention, respectively. Risk factors for HIV-1 seroconversion after multivariate analysis included irregular condom use (RR 1.6 [95% Cl 1.1-2.8]), gonorrhoea (RR 2.5 [1.1-6.4]), trichomoniasis (RR 1.7 [1.1-2.8]), and genital ulcer disease (RR 2.5 [1.1-6.4]), during the probable period of acquisition of HIV-1. In women who attended more than 90% of their clinic appointments, the HIV-1 incidence was 2.7/100 wy compared to 7.1, 20.3, and 44.1 per 100 wy among women who attended 76-90%, 50-75%, and less than 50% of the monthly appointments, respectively (p < 0.0001). These trends remained after controlling for reported condom use and number of clients. This study confirms earlier findings that STDs facilitate transmission of HIV-1 and shows that a clinic-based intervention consisting of STD care and condom promotion can result in a major decline of HIV-1 incidence among female sex workers.
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PMID:Condom promotion, sexually transmitted diseases treatment, and declining incidence of HIV-1 infection in female Zairian sex workers. 791 64

Of 6125 women attending an STD clinic from 1988 to 1991, 5365 (88%) were tested for vaginitis of whom 97 (1.8%) had trichomoniasis, 945 (17.6%) had candidiasis, 734 (13.7%) had bacterial vaginosis and 3628 (67.6%) were free of vaginal infection. Dual infections occurred in 49 (0.9%) patients. Independent predictors for trichomoniasis by multivariate analysis were being pregnant (odds ratio (OR) = 2.4), having vaginal discharge or dysuria (OR = 4.7), being Aboriginal (OR = 4.3), being Asian (OR = 5.0), being unemployed (OR = 2.1) or tattoed (OR = 1.9). Many factors, including use of oral contraception (OR = 1.2) and current antibiotic medication (OR = 1.5), had a small significant association with candidiasis. Independent predictors for bacterial vaginosis were having multiple sex partners in the past month (OR = 1.6), being unmarried (OR = 1.5), being unemployed (OR = 1.3) being a prostitute (OR = 1.5) and not currently using antibiotic medication (OR = 2.5). The epidemiological profiles were consistent with trichomoniasis and bacterial vaginosis being sexually transmitted diseases with epidemiology different from that of gonorrhoea and chlamydia and different from each other, and candidiasis being a disease in which constitutional factors are more important than issues relating to sexual transmission.
Int J STD AIDS
PMID:Factors associated with trichomoniasis, candidiasis and bacterial vaginosis. 842 98

Trichomonas vaginalis (TV) has, in the past, been regarded as a useful marker for other asymptomatic sexually transmitted infections such as gonorrhoea and chlamydia in women. The aim of this study was to determine whether TV is still such a marker. All women attending the Department of Genito-urinary Medicine at the Leeds General Infirmary with a diagnosis of TV during 1983 and 1993 were identified and concurrent infections were tabulated. In 1993 approximately 30% of women with TV had at least one other sexually transmitted infection. The prevalence of gonorrhoea in women with trichomoniasis fell from 20% in 1983 to 10% in 1993 whilst the prevalence of chlamydia in these women remained unchanged at 15%. Thus trichomoniasis is still frequently associated with other pathogens in women and screening of these women for other infections remains essential.
Int J STD AIDS
PMID:Is Trichomonas vaginalis still a marker for other sexually transmitted infections in women? 873 38

Of 22,274 patients > or = 12 years old attending a Nairobi primary health care (PHC) clinic, 1076 (4.8%) had STD-related complaints, of whom 980 underwent assessment of risk factors for human immunodeficiency virus (HIV) infection and infrequent condom use. Gonorrhoea, chancroid, syphilis seroactivity, trichomoniasis, or objective signs of STD were found in 78%, and HIV seropositivity in 15% of men and 19% of women. Most women were married, living with a spouse; while most men were single, or married, but living separated from a spouse. Among married men, last sex was with a female sex worker (FSW) or casual partner for 60% not living with a spouse and 26% living with a spouse (P<0.005). Two or more partners during the past year were reported by 82% of men and 25% of women (P <0.001), and 55% of men and 11% of women reported the last partner was high risk. HIV seropositivity among both genders was associated with numbers of partners, and among women, with being widowed or divorced. Only 3% reported use of a condom with the last partner. Among men whose last sex was with a FSW, 74% said the reason for not using a condom was not having one. Thus, infrequent condom use, low condom availability, and gender differences in behaviour necessitate modifying development policies that separate families; and better coordination between family planning, PHC, and AIDS/STD programmes, with improved supply, social marketing and community-based distribution of condoms in high-risk settings for STD/HIV prevention.
Int J STD AIDS 1997 Aug
PMID:High HIV prevalence, low condom use and gender differences in sexual behaviour among patients with STD-related complaints at a Nairobi primary health care clinic. 925 99


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