Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:2.7.10.2 (focal adhesion kinase)
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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

Seventy-eight men with symptoms of chronic or subacute prostatitis were enrolled. Investigations for the presence of Chlamydia trachomatis in urethral swabs were carried out. The expressed prostatic secretions were additionally examined for Mycoplasma hominis, Ureaplasma urealyticum, Gardnerella vaginalis, other gram-negative and gram-positive bacteria, Trichomonas vaginalis, yeast-like fungi and leucocyte count. Furthermore, all patients were evaluated for the presence of serum anti-chlamydial IgG antibodies. Signs of inflammation on the basis of the count of leucocytes per hpf in the prostatic secretions were detected in 42 patients (group I). Prostatodynia was found in the remaining 36 men (group II). In group I, chlamydial antigen was detected in the urethra and expressed prostatic secretions (EPS) in 6 (14.3%) and 9 (21.4%) patients, respectively. No evidence of current chlamydial infection was found in group II. The presence of serum anti-chlamydial IgG antibodies was demonstrated in 13/42 (30.9%) patients with prostatitis and in 3/36 (8.3%) patients with prostatodynia (P < 0.01). The results suggest that chlamydia may be one of the causative agents of chronic prostatitis.
Int J STD AIDS 1998 Jun
PMID:Chlamydia trachomatis: probable cause of prostatitis. 987 30

The objective of this retrospective study was to determine the possible source of infection in homosexual men with rectal gonorrhoea: the probable source of rectal gonorrhoea was identified in 46/155 cases. Although the urethra was the site of infection in 33 (72%) of these contacts, only pharyngeal gonorrhoea was identified in 9 (20%) men. In 25/26 cases, there was concordance in the auxo/serotypes of Neisseria gonorrhoeae between contacts with urethral gonorrhoea and the index men with rectal gonorrhoea. Eleven out of 12 pharyngeal isolates were of the same auxo/serotype as the index cases. This study supports the hypothesis that rectal gonorrhoea in homosexual men can be acquired from the oropharynx. Because infection at this site is an independent risk factor for acquisition of HIV, screening for rectal and pharyngeal gonorrhoea should be offered to men who have sex with men, even when there is no history of unprotected receptive anal intercourse.
Int J STD AIDS 2000 May
PMID:Rectal gonorrhoea in homosexual men: source of infection. 1082 35

Anaerobic bacteria are frequent inhabitants of the urethra of both normal men and men with non-gonococcal urethritis. All microbiologically-based studies have shown them not to have a role in the aetiology of the condition. However, Bacteroides ureolyticus continues to be an enigma having been isolated more commonly from men with urethritis in some studies, not confirmed by others, as well as in treatment-based studies in which the organism has been implicated by some authors. Few studies related to anaerobic organisms in the male genital tract have been conducted during the last decade.
Int J STD AIDS 2000 Jun
PMID:Anaerobic bacteria and non-gonococcal urethritis. 1087 5

The sensitivity of Roche Cobas Amplicor Chlamydia trachomatis polymerase chain reaction (PCR) including the internal control (IC) programme to identify inhibition, was investigated on 3 different samples from women: (1) swab samples from the urethra and the cervix pooled in 2-SP transport medium, (2) swab sample from the cervix transported in a urine sample from the same patient, and (3) urine sample alone. Out of the 2412 patients, 193 (8.0%) were chlamydia positive and in 14 of these the results showed discrepancies between sampling methods. The sensitivity of PCR on urethra/cervix, urine/cervix and urine was 98.4% (190/193), 97.9% (189/193) and 93.3% (180/193) respectively. The higher sensitivity of PCR on urethra/cervix and urine/cervix as compared with urine alone was statistically significant. Without the IC, the sensitivity of PCR on urethra/ cervix, urine/cervix and urine would have been 95.9% (185/193), 94.8% (183/193) and 90.7% (175/193) respectively. Factors influencing the rate of inhibition were also studied.
Int J STD AIDS 2000 Oct
PMID:Chlamydia trachomatis PCR (Cobas Amplicor) in women: endocervical specimen transported in a specimen of urine versus endocervical and urethral specimens in 2-SP medium versus urine specimen only. 1105 36

We studied the value of carrying out urethral samples in women to diagnose gonorrhoea. All cases of genital gonorrhoea in women were identified (between 1 October 2000 and 30 September 2001) at the Whittall Street Clinic and the genitourinary medicine department at the Coventry and Warwickshire Hospital. Two hundred and twenty-four cases of female urethral gonorrhoea were identified. In 20 cases (6.3%) the urethra was the sole site of the infection. At the Whittall Street Clinic, we had to carry out 643 urethral samples in order to treat one additional case of gonorrhoea. On the other hand, 1204 urethral samples were requested to treat one additional case of female gonorrhoea at the Coventry and Warwickshire Hospital. In both units, use of the Gram-stained urethral smear permitted early treatment in only 1.8% of cases of genital gonorrhoea. Units with low prevalence of gonorrhoea should consider abandoning urethral samples for the diagnosis of gonorrhoea in women.
Int J STD AIDS 2004 Jan
PMID:The role of urethral samples in the diagnosis of gonorrhoea in women. 1560

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

The aim of this retrospective study was to determine the prevalence of Chlamydia trachomatis co-infection in men with gonorrhoea attending a sexually transmitted diseases clinic in Edinburgh, Scotland. During the study period, there were 660 cases of culture-proven gonorrhoea. Chlamydial DNA was detected in the urethra in 79 (31%; 95% confidence interval [CI], 25-37%) heterosexual men who have sex with women (MSW); the median age was significantly lower than those with gonorrhoea alone (24.0 versus 30.0; P <0.0005). The prevalence of urethral chlamydial infection among MSW was significantly higher than among men who have sex with men (MSM) (32 [12%; 95% CI, 8-16%] of 268 MSM) (chi2 = 27.21; P <0.001). Sixteen (24%; 95% CI, 14-34%) of 68 MSM with rectal gonorrhoea had concurrent rectal chlamydial infection. The high prevalence of concurrent gonorrhoea and chlamydiae therefore warrants empirical treatment and/or testing for chlamydia in all men with urethral gonorrhoea.
Int J STD AIDS 2005 May
PMID:Concurrent gonococcal and chlamydial infections among men attending a sexually transmitted diseases clinic. 1594 65

The practice guideline on STD consultations from the Dutch College of General Practitioners sets out guidelines for the diagnosis and treatment of Chlamydia-infection, gonorrhoea, syphilis, trichomoniasis, genital herpes condylomata acuminata, hepatitis B, HIV-infection and pubic lice. Testing for Chlamydia-infection is always indicated if an STD is suspected but the necessity of also testing for gonorrhoea, syphilis, hepatitis B or HIV-infection depends on the likely risk. For the diagnosis of Chlamydia in a symptomatic woman it advises taking material from the cervix and urethra. In an asymptomatic woman Chlamydia infection is excluded by means of a urine test. In men a urethral swab of the first part of the urinary stream can be used for diagnosis. The first choice of treatment for gonorrhoea is a single 1 g intramuscular dose ofcefotaxime. The practice guidelines also examine other aspects of treatment for STDs including counselling and telling partners.
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PMID:[Summary of the practice guideline 'The STD consultation' from the Dutch College of General Practitioners]. 1635 25

Adenoviruses infect mucous membranes, including - on rare occasions - the urethra. Adenoviruses should therefore be considered as yet another cause of chlamydia-negative non-gonococcal urethritis. The following case illustrates the dilemma posed in a patient with conjunctivitis and urethritis.
Int J STD AIDS 2006 Mar
PMID:Adenoviral non-gonococcal urethritis. 1651 12


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