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Query: EC:2.7.10.2 (
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Further studies are needed to define the clinicopathologic manifestations of CT infection. Many questions remain regarding the natural history and pathogenetic mechanisms of CT and its biologic and clinical interactions with other prevalent STDs. However, it is apparent that CT is a major cause of
STD
in the Western world and that its incidence and prevalence have increased to epidemic proportions in young, sexually active women and men. As with other STDs, epidemiologic control of CT infection is of paramount importance. The clinician and pathologist should develop a heightened awareness of the probability of Chlamydia infection in all patients at risk for
STD
, and in clinical settings, only a high index of suspicion will result in timely therapeutic intervention. Although more simplified and less expensive diagnostic procedures for CT are being investigated, presently, culture isolation is the best and most accurate diagnostic method for CT genital infection and its use should be popularized and made more easily available. Immunofluorescent staining using monoclonal and heterologous antibodies to extracellular CT elementary bodies in preselected smears appears promising as a diagnostic technique and requires further study. There is no apparent role for the use of routine cyto- and histologic microscopy in the diagnosis of CT infection and the practice of diagnosing presumed chlamydial vacuoles or inclusions from cervicovaginal Pap smears should be actively discouraged. Although CT cervicitis plays a dominant role in the pathogenesis and dissemination of CT infections, it should be remembered that multiple sites of genital involvement occur commonly with CT infection and this multifocality should be considered when CT cervical cultures are negative and in post-treatment follow-up. Cultures should be obtained from sites of suspected involvement and should include scrapings or biopsy sampling of the tissue surface to insure the presence of sufficient numbers of epithelial cells. Local secretions or exudate should not be considered adequate. In the female, sampling of the
urethra
, rectum, and endometrium may facilitate accurate diagnosis. Scraping or sampling of the tubal epithelium by biopsy may provide diagnostic material in acute salpingitis and PID and should be considered if laparoscopy or laparotomy are performed. Routine screening by culture for CT cervicitis has been suggested in high-risk clinical groups and in antepartum patients for prophylaxis of fetal and neonatal disease and requires serious consideration because of the high prevalence of CT infection.(ABSTRACT TRUNCATED AT 400 WORDS)
...
PMID:Chlamydia trachomatis infection of the female genital tract. Pathogenetic and clinicopathologic correlations. 355 20
Urethral swabs from 322 men without urethritis, 73 of whom had venereal warts (condylomata acuminata, CA) and 249 who had none, were investigated between 1981 and 1984 by microscope and culture for the presence of Neisseria gonorrhoeae, Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma species, Trichomonas vaginalis, Garderella vaginalis, B streptococci, aerobic pathogenic bacteria and Candida species. The isolation frequencies in patients with and without CA were as follows: N. gonorrhoea: with CA 0%, without 0.4%; C. trachomatis: with CA 6%, without 4.4%; U. urealyticum in high CFU: with CA 15%, without 17.7%; Mycoplasma spp. in high CFU: with CA 6%, without 4%; T. vaginalis: with CA 0%, without 0.4%; G. vaginalis: with CA 4%, without 5%; B streptococci: with CA 4%, without 6%; Candida spp. only in low CFU: with CA 3%, without 2.4%.--The results indicate that as far as the isolation frequencies of sexually transmittable pathogens in the
urethra
are concerned, there are no significant differences between patients with CA and asymptomatic patients presenting to an
STD
department. However, N. gonorrhoeae was significantly less frequently isolated and C. trachomatis and U. urealyticum significantly more frequently isolated in our patients than has been reported in previous studies.
...
PMID:[Condylomata acuminata-associated STD infections of the urethra of the male. A comparative epidemiologic study]. 355 79
The Gardnerella vaginalis infection of the urogenital tract, an
STD
, is of clinical importance in females and of epidemiological importance in males. Females suffer from vulvovaginitis amine colpitis, with a bad-smelling grey vaginal discharge with a pH of 5.0-5.5, which contains "clue cells". The
urethra
of males is often asymptomatically infected. The identification of G. vaginalis is time-consuming and requires a lot of material. Isolation and identification of G. vaginalis can not yet be made in the routine examination of outpatients suffering from urogenital tract infections. If the diagnosis is based on signs such as bad-smelling grey discharge containing "clue cells", and the increase in pH about 20% false-positive and 20% false-negative results will be obtained. If G. vaginalis is isolated, simultaneous infections with further agents such as Chlamydia trachomatis, Neisseria gonorrhoeae etc., Trichomonas vaginalis, Candida species and HSV 2 should be excluded. Metronidazole (1 g/day for 5 days) is the drug of first choice in G. vaginalis infection.
...
PMID:[Gardnerella vaginalis infection--another sexually transmitted disease]. 638 37
We examined patients attending an
STD
clinic (Department of Dermatology, Lasarettet, Lund). Chlamydia trachomatis was demonstrated in 26% of 2021 male patients by culture from the
urethra
(using cyclo-heximide-treated McCoy cells). The corresponding figure for Neisseria gonorrhoeae was 15%. Both organisms were found in 5% of the patients. In women, culture from the cervix demonstrated C. trachomatis in 16% of 1039 patients. N. gonorrhoeae was found in 14%, and both organisms in 4% of the patients. Men with chlamydial urethritis were more frequently found to have a watery discharge than those with gonococcal urethritis. They also had fewer leucocytes in smears from the
urethra
. Treatment with different tetracyclines gives good therapeutic results in both men and women infected with C. trachomatis. In contact-tracing, 53% of 95 male partners and 65% of 103 female partners were found to harbour C. trachomatis. About 50% of these contacts were free of symptoms. This indicates the importance of contact-tracing in genital chlamydial infection.
...
PMID:Diagnosis and treatment of chlamydial venereal disease. 708 80
A cross-sectional study is undertaken to determine the prevalence of male intrameatal and distal urethral warts, using meatoscopy. A group of 169 patients presenting for anogenital warts and a group of 74 unselected patients attending the Department for a variety of reasons during the study period, were examined. Twenty-one patients (13.5%) out of 155 patients with anogenital or related warts had external warts at the meatus. Of these 21 cases, 12 (57.1%) had further extension of their warts into the distal
urethra
. Fifteen other cases of intrameatal and distal urethral warts were detected in the absence of external warts at the meatus. Twenty-three cases out of 107 males with genital warts (21.5%) were found to have intrameatal or distal urethral warts, thus reflecting the common occurrence of these lesions. A highly significant association between the presence of intrameatal/distal urethral warts and the presence of male genital warts was found (P = 0.003). One hundred and fifty-three repeat meatoscopic examinations were carried out, 6 weeks after their first examination. Three new cases of intrameatal/distal urethral warts were found. Intrameatal and distal urethral warts occurred from a depth of 5 mm to 25 mm. One hundred and eighty-three female partners of the study patients were examined. An association between the presence of intrameatal/distal urethral warts and female anogenital warts was found (P = 0.028). No corroborating association between the presence of male and female anogenital warts was found (P = 0.47). This observation may have a bearing on disease transmission and control. The detection of intrameatal/distal urethral warts will be important in achieving successful treatment of male anogenital warts.
Int J
STD
AIDS
PMID:A study of the prevalence of male intrameatal warts using meatoscopy in a genitourinary medicine department. 764 21
One hundred and fifty women who attended a genitourinary medicine clinic and who required a speculum examination were investigated to determine the association between Chlamydia trachomatis and urethral symptoms and signs. Those who had taken antibiotics with anti-chlamydial activity within 3 months or those who were menstruating, pregnant or using an intrauterine contraceptive device were excluded. C. trachomatis infection of the
urethra
, or infection of the
urethra
and cervix together, combined with each separately, were strongly associated with > = 5 polymorphonuclear (PMN) leucocytes per high-power field (x 1000) in a Gram-stained urethral smear (P < 0.00005 and P < 0.0005, respectively). This appeared not to arise from leucocyte contamination from the lower genital tract. However, C. trachomatis infection of the
urethra
was not associated with symptoms of dysuria or frequency. In conclusion, it seems likely that C. trachomatis infection of the
urethra
in women probably causes urethritis which is usually asymptomatic. Women who have objective evidence of urethritis might best be managed by appropriate antibiotic therapy and counselling, and advice that partners should attend for review.
Int J
STD
AIDS
PMID:The role of Chlamydia trachomatis in urethritis and urethral symptoms in women. 779 76
A total of 506 meatoscopic examinations showed this is a simple, safe, rapid, well-tolerated, useful procedure to assess the extent of warts at the meatus and in the distal
urethra
of men. The procedure was performed in 307 patients. Sixty-five (52.5%) of 124 men with meatal warts had additional urethral lesions not readily treatable. All proximal warts were confined to the fossa navicularis. Meatoscopy assisted in immediate rational planning of therapy. In assessing patients without meatal warts, lesions in the fossa navicularis were observed in 4 (6.7%) of 60 men with external penile warts, 4 (7.8%) of 51 men with a history of 3 previous episodes of urethritis, and in 8 (23.5%) of 34 men who had been in contact with warts. No relation was found between the distribution of warts, demographic details of patients, or duration of warts; the effect of previous urethritis on development of warts was unclear. It was concluded, following 199 repeated examinations, that the procedure was not associated with recurrence or proximal extension. Only 2 minor adverse events were recorded. Meatoscopy is recommended as part of the assessment of men with meatal warts and men who have been in contact with warts. The procedure should be considered in patients with external warts but no meatal warts, and in patients with a history of 3 previous episodes of urethritis over 3 years.
Int J
STD
AIDS
PMID:Meatoscopy: an important technique for assessing meatal warts in men. 814 22
To determine the incidence of anogenital papillomavirus infections and to assess the value of available diagnostic methods, we compared the cytological, colposcopic and histological features of anogenital papillomavirus-related lesions with their associated human papillomavirus types (HPV) in 300 women and in their male partners. HPV-type deoxyribonucleic acid was detected by blot hybridization in 398 out of 624 subclinical and clinically defined anogenital lesions. Whatever the site of the lesion, condylomas and low-grade intraepithelial neoplasia (IEN) were found in 84% of lesions associated with HPV 6-11, compared with 32% of lesions containing HPV 16-18 (P < 0.001). Among the HPV 16-18 associated lesions, high-grade cervical, vaginal, vulvar and anal intraepithelial neoplasias represented 45% (P < 0.001) of the lesions. In 65% of 23 cases of squamous anogenital cancer, HPV 16-18 and mixed types were present (P < 0.001). In 54% (161/300) of cases, the lesions were multicentric (161/300). On cytological examination, 27% of the samples gave false negative results. In cervical lesions, there was a good correlation between virological and colposcopic findings, but this was not true for extracervical mucous epithelia in the vagina or on the vulva. With peniscopy in the male partners 220 out of 410 had penile condylomatous lesions and more than half of the 350 male specimens examined by molecular hybridization contained HPV DNA. A correlation was found between the virus types in penile lesions or in cells of the distal
urethra
and in the cervical lesions of the sexual partner.(ABSTRACT TRUNCATED AT 250 WORDS)
Int J
STD
AIDS
PMID:Genital human papillomavirus infections: correlation of cytological, colposcopic and histological features with viral types in women and their male partners. 838 4
The goal of this study was to evaluate whether the new commercially available PCR-based assay Amplicor C. trachomatis (Roche Molecular Systems) could improve the diagnosis of chlamydial urogenital infections in men, compared with cell culture of C. trachomatis considered as the reference method. A total of 466 men attending the
STD
clinic were tested by the Amplicor test in urine and by cell culture in
urethra
. The prevalence of C. trachomatis was 13.7% (64/466) by cell culture and 14.4% (67/466) by the Amplicor test. After resolution of the discrepant results, the sensitivity of culture was 91.4% in male urethral specimens. The resolved sensitivity of the PCR assay was 92.7% in male urine and the specificity was 99.5%. We concluded that this rapid PCR-based assay showed an improvement in quality for diagnosing C. trachomatis infections in men.
...
PMID:[Detection of Chlamydia trachomatis infection by PCR in first voided urines in men]. 852 Jun 51
Urethral stenosis is the most frequently acquired disease of the male
urethra
. Currently there is a progressive increase of this condition's occurrence due to: improved living standard, increased number of permanent catheter bearers, surge of STDs incidence, and abuse of transurethral diagnostic or therapeutical instrumentation. However, and in spite of such increased incidence, the epidemiological features have been forgotten by most authors consulted who now focus more attention in the therapeutical aspects. This paper analyzes the most outstanding epidemiological aspects, in the province of Alicante, of 180 urethral stenosis corresponding to 175 males and 5 females, making some final considerations on the relevance of certain factors in the genesis of urethral stenosis: advanced age, depressed social class, active sexual life,
STD
history, urinary or genital infections.
...
PMID:[Epidemiology of urethral stenosis in the province of Alicante]. 865 6
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