Gene/Protein Disease Symptom Drug Enzyme Compound
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Reactive arthritis (ReA) develops after an infection elsewhere in the body, generally in the genitourinary or intestinal tract. Chlamydia trachomatis, Yersinia enterocolitica, salmonella, shigella, and campylobacter are frequent triggering agents. Between 60% and 90% of patients are positive for HLA-B27. The arthritis occurs within 4 weeks of the primary infection and is oligoarticular and asymmetric. Extra-articular manifestations include mucocutaneous symptoms, ocular inflammation, and urethritis. The average duration of arthritis is 4 to 5 months but two-thirds of patients have symptoms for more than a year. Bacterial antigens have been found in synovial specimens from patients with ReA, but cultures are sterile. The treatment of ReA comprises non-steroidal anti-inflammatory drugs, intra-articular steroid injections, and physical treatment. Short-term antibiotic treatment has no effect in manifest ReA, whereas a tendency to improvement has been seen with treatment over months, at least after chlamydia infection.
Int J STD AIDS
PMID:Reactive arthritis. 764 16

A prospective study of 356 consecutive heterosexual male patients attending the Department of Genitourinary Medicine at University College Hospital was carried out to determine the prevalence of Chlamydia trachomatis. Patients were asked about their symptoms, use of condoms and change of sexual partner. The prevalence of non-gonococcal urethritis (NGU--chlamydia positive and negative urethritis) was 37% (131 of 356). C. trachomatis was shown to be the causative organism in 24% (31 of 131) of patients with NGU. The prevalence of other STDs in men with C. trachomatis and with non-chlamydial urethritis was 15% and 10% respectively. Men with C. trachomatis were significantly more likely than men with non-chlamydial urethritis to be asymptomatic (56% vs 35%). The prevalence of C. trachomatis was highest in men who had changed partner in the previous 3 months (20 of 32 men). A third of men never used condoms in the first 3 months of a new relationship and over half failed to use them after 3 months. There was no evidence that the reported use of condoms reduced the rate of infection with C. trachomatis.
Int J STD AIDS
PMID:Chlamydial urethritis in heterosexual men attending a genitourinary medicine clinic: prevalence, symptoms, condom usage and partner change. 754 97

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

Magic Lite Chlamydia assay (commercial test kit for the identification of Chlamydia trachomatis) was evaluated on urogenital samples and urine with chlamydial culture as the reference method. The sediment of the transportation buffer of specimens which were Magic Lite positive but culture negative or toxic was investigated for elementary bodies with fluorescein-labelled anti-chlamydial antibodies. The prevalence of chlamydial infection among the 577 men investigated was 13.7% as estimated by culture and direct immunofluorescence and 6.4% among the 173 women. In order to improve the sensitivity a cut-off value below that recommended by the manufacturer was used. The sensitivity of Magic Lite in male urethral specimens was then 60.8% and that in female urethral/cervical specimens 90.9%. The specificity was 99.6% and 100%, respectively. In urine specimens the sensitivity of Magic Lite was 63.3% (men) and 63.6% (women). The specificity was 99.4% and 100%, respectively. The sensitivity of Magic Lite on male urethral specimens was related to the number of inclusion bodies per well in culture and it was higher among men attending with clinical findings of urethritis (69%) than among asymptomatic men sampled as a screening procedure (36%) (P < 0.05). Corresponding differences between the sexes and between those with and without symptoms were not noted for Magic Lite applied on urine samples.
Int J STD AIDS
PMID:Magic Lite Chlamydia immunoassay in urogenital samples and urine versus chlamydial culture. 806 Nov

During the progress, in 1989, of a programme of social marketing of condoms in Cameroon, it was obvious that this approach should be supplemented by a similar programme for the management of STD's. Nine surveys were carried out in 1992 in Yaounde and Douala in the sexually most active male population (in the general community, at the workplace and in the leisure environment) in order to collect the basic data necessary for its implementation. Treatment essentially consists of mono-chemotherapy with drugs which are generally inefficient against the two principal etiologies of urethritis: Neisseria gonorrhoeae and Chlamydia trachomatis. The cost of treatment is considered excessive and leads to poor follow-up of the complete prescription. Simultaneous treatment of partners should be developed. All these data have been taken into account for the elaboration of a pilot programme which should be implemented in 1993.
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PMID:[Management of sexually transmissible diseases in an urban environment in Cameroon in 1992]. 812 71

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

This article summarizes surveillance data of STDs at 16 urban monitoring centers in 1987-1990. During the four year period, 125 493 STD cases were reported. The average annual incidence was 77.80/100,000. Because the rate of increase in females (65.85% per year) was greater than that in males (36.81% per year), the male-to-female ratio fell from 2.39:1 (1987) to 1.34:1 (1990). The number of STD cases reported from all centers tended to increase and the overall rate of increase was 46.61% per year. The major disease was gonorrhea, with a constituent ratio of 59.22% (1990). However, condyloma acuminatum and nongonococcal urethritis had greater rates of increase (105.03% and 85.14% per year, respectively). The 20-39 year age group accounted for 82.10% of total cases, for STD patients were mostly in the sexually active population. The STD incidence among self-employed businessmen (1,206.06/100,000, in 1990) was the highest among professional populations. According to analysis of different regions, STD incidence was the highest in the southern cities (203.00/100,000, in 1989). The greatest rate of increase of STDs was in Yangtse valley cities, where the average annual rate of increase was 71.41%.
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PMID:[STD epidemiologic analysis in 16 cities during the period 1987-1990. National STD Surveillance Cooperative Group]. 832 40

Over a 13-year period non-gonococcal neisseriae (NGN) were isolated from 114 of 88,670 patients (0.13%) screened for anogenital gonorrhoea at a Genitourinary Medicine Unit. During the same period there were approximately 9000 anogenital gonococcal infections (10%). The prevalence of NGN was 0.09% (27/31,500) in women, 0.04% (20/52,800) in heterosexual men and 1.5% (67/4370) in homosexual men: the differences in prevalence between women and heterosexual men (P < 0.01) and between heterosexual patients and homosexual men (P < 0.001) are highly significant. Neisseria meningitidis was isolated most frequently and accounted for 85% (99/114) of the NGN. Whenever possible, N. meningitidis was serogrouped and its occurrence correlated with patient symptoms. Eleven of 18 heterosexual men who had meningococci isolated from their urethras had urethritis but co-existing chlamydial infection was excluded in only 5. None of 9 women with cervical colonization had clinical evidence of pelvic inflammation. Only one of 49 men with rectal colonization had proctitis. The management of anogenital NGN infection is discussed in relation to our findings and those of previously published studies. Within each patient group the prevalence and incidence of anogenital NGN were similar at the beginning and end of the study period indicating that levels have not been influenced by the advent of AIDS.
Int J STD AIDS
PMID:Anogenital non-gonococcal neisseriae: prevalence and clinical significance. 842 10

A single-blind randomized follow-up study was conducted to evaluate the efficacy and tolerance of roxithromycin 300 mg once a day compared to doxycycline 200 mg day 1 and 100 mg day 2-10 in the treatment of genital chlamydial infection in men and women and non-specific urethritis (NSU) in men. A total of 211 patients (200 men and 11 women) between 18 and 46 years were enrolled. The women were excluded from the efficacy analysis because of the low number, but were included in the tolerance analysis. The clinical (clearance of polymorphonuclear leucocytes in urethral smears) and bacteriological response was evaluated one and 11 days after the treatment. Of 113 included men with chlamydial infection, 105 (93%) and 96 (85%) were evaluable on respective follow-up visits and of 87 included men with NSU, 74 (85%) and 64 (74%) were evaluable one and 11 days after treatment, respectively. The bacteriological eradication rate immediately after the treatment in chlamydia positive patients was 92.7% and 100% for roxithromycin and doxycycline, respectively, and 91.8% and 100% at follow-up. The clinical cure rate of all evaluable patients was 83.1% and 80.7% for roxithromycin and doxycycline, respectively, one day after the treatment and 80.5% and 85.3% for the two drugs, respectively, 11 days after treatment. None of these observed differences was statistically significant. The diagnosis did not influence the clinical response rate with either drug. Probable and possible drug-related side-effects were more common after doxycycline than after roxithromycin, 35% and 19% respectively (P = 0.0032).(ABSTRACT TRUNCATED AT 250 WORDS)
Int J STD AIDS
PMID:Roxithromycin compared to doxycycline in the treatment of genital chlamydial infection and non-specific urethritis. 847 60

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


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