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Query: UMLS:C0017536 (giardiasis)
 1,714 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

As early syphilis becomes more uncommon in the community, it will present frequently to the tertiary hospital as a diagnostic problem. Twenty patients with classic signs and symptoms of primary and secondary syphilis in whom the correct diagnosis was initially missed are presented. The importance of a routine admission Venereal Disease Research Laboratory test (VDRL) in making the correct diagnosis is emphasized. The laboratory techniques for diagnosing syphilis and recommended treatment schedules are presented. Clinical manifestations of herpes progenitalis, problems with pregnancy and association with cervical carcinoma are also presented. Enteric diseases (hepatitis, shigellosis, giardiasis and amebiasis) as sexually transmitted diseases in homosexual men are summarized.
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PMID:Syphilis and other sexually transmitted diseases. 626 Apr 32

Ninety-four U.S. students who acquired diarrhea in Mexico were treated with furazolidone (47 subjects) or ampicillin (47 subjects) on a double-blind random basis. Of 47 students, 26 (55%) who received furazolidone (100 mg four times daily for 5 days) recovered from illness within 48 h after initiation of therapy, in contrast to 15 of 47 (32%) who received ampicillin (500 mg four times daily for 5 days) (P less than 0.05). Altogether, 74% of students treated with furazolidone and 49% of those receiving ampicillin were well within 72 h (P less than 0.05). When furazolidone was compared with ampicillin, clinical illness was shortened on the average from 65 to 61 h for enterotoxigenic Escherichia coli diarrhea, from 83 to 58 h for shigellosis, from 82 to 51 h for diarrhea unassociated with a detectable agent, and from 72 to 57 h for all cases irrespective of etiology. Although not dramatically effective in the current trial, the broad spectrum of activity of furazolidone is of interest. Because of in vitro activity against Campylobacter strains and known effectiveness in treating giardiasis, furazolidone should be considered in therapy for diarrhea of unknown etiology in certain settings when laboratory processing of stools for etiological agent is not feasible.
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PMID:Furazolidone versus ampicillin in the treatment of traveler's diarrhea. 638 38

Hepatitis viruses, enteric pathogens, and anorectal infections may commonly be transmitted by various sexual practices. Because of their larger numbers of sexual partners and sexual practices such as anilingus and anal intercourse, homosexual men are at particularly high risk of acquiring hepatitis B, giardiasis, amebiasis, shigellosis, campylobacteriosis, and anorectal infections with Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, herpes simplex virus, and human papilloma viruses. The evidence for sexual transmission of these infections as well as their diagnosis and treatment are discussed.
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PMID:Sexually transmitted viral hepatitis and enteric pathogens. 642 96

Due to the number of sexual encounters and variety of practices, men who have homosexual experiences have increased incidence and prevalence rates of many diseases. Diseases that are covered here include hepatitis A and B, syphilis, gonorrhea, condylomata accuminata, herpes simplex, AIDS (acquired immune-deficiency syndrome) and several enteric diseases, namely amebiasis, giardiasis, shigellosis and salmonellosis. An overview of each disease is included along with diagnostic testing and treatment regimens. This report concludes with a system of risk assignment and recommendations for frequency of sexually transmitted disease screening.
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PMID:Sexually transmitted diseases in homosexual men. 668 65

Certain enteric ailments are particularly common among homosexual men. They are primarily infectious diseases and include not only such common venereal diseases as gonorrhea and syphilis but also infections not usually regarded as being sexually transmitted. Among the latter are shigellosis, salmonellosis, giardiasis, and amebiasis. Patients' symptoms are non-specific and seldom helpful in diagnosing particular diseases. The practitioner must be prepared to identify a number of infections with similar presentations that may occur singly or together in gay men. Gonorrhea is probably the most common bacterial infection in gay men. Carriage rates as high as 50% have been reported, and extra-genital carriage is common; this necessitates culturing the urethra, rectum, and pharynx. Procaine penicillin G is the treatment of choice for most patients; spectinomycin is probably the drug of choice in penicillin-sensitive patients. In contrast to other venereal diseases, syphilis may have a characteristic protoscopic presentation. Benzathine penicillin G is the treatment of choice for most patients. Lymphogranuloma venereum causes penile lesions and inguinal lymphadenitis in heterosexual men, whereas homosexual men are more prone to proctitis. The disease may mimic Crohn's disease. Recommended treatment includes tetracycline or sulfamethoxazole-trimethoprim. Shigellosis usually presents as an acute diarrheal illness. Patients generally require only supportive treatment with fluids. Herpes simplex viral infection is difficult to diagnose and has several different presentations, including lumbosacral radiculomyelopathy. Symptomatic treatment with sitz baths, anesthetic ointment, and analgesics is recommended. Venereal warts are believed to be caused by the same virus that causes verrucous warts; they are usually found in the anal canal or around the anal orifice. They are commonly treated with 25% podophyllin solution. Parasitic infections include giardiasis, amebiasis, and pinworm infections. Metronidazole may be used in the treatment of symptomatic giardiasis and amebiasis, but it is not approved for the former indication; quinacrine is approved for giardiasis. Pinworm infestation may be treated with pyrantel pamoate or mebendazole. Cure of enteric diseases in homosexual men must be documented.
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PMID:Enteric diseases of homosexual men. 676 90

The prevalence of most sexually transmitted diseases is disproportionately increased in gay men and paradoxically decreased in lesbian women. The spectrum of diseases seen in gay men include a variety of enteric infections including hepatitis A, shigellosis, salmonellosis, Campylobacter enteritis, amebiasis, giardiasis, and enterobiasis as well as the more common sexually transmitted diseases. Hepatitis B is endemic in gay male populations. The patterns of sexual behavior are the major factors contributing to this unique epidemiology and pathology. Increased sexual activity explained by the unrestrained cultural expectation of maleness, the functional overlap during sex between the genital-urinary and gastrointestinal systems, and anonymous sexual activity are all significant epidemiologic components.
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PMID:Hepatitis and other sexually transmitted diseases in gay men and in lesbians. 689 98

In addition to gonorrhea and syphilis, both of which may develop primarily at anorectal or pharyngeal sites, a number of conditions, including Neisseria meningitidis urethritis, nonspecific urethritis, anorectal herpes, condyloma acuminatum, amebiasis, giardiasis, shigellosis, typhoid fever, enterobiasis, and hepatitis A and B, have been identified as being transmitted by male homosexual contact. Proctologic complications of anal intercourse include allergic reactions to anal lubricants, prolapsed hemorrhoids, and fistulas, and fissures. Rectosigmoid tears may result from fist, forearm, and foreign body penetration of the bowel. Physicians can best help their homosexual patients by accepting them and their relationships nonjudgmentally and by understanding their special health needs.
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PMID:Sexually transmitted diseases and traumatic problems in homosexual men. 699 80

The inner city population of the Los Angeles county has rapidly become largely Latino. The 3.3 million Latinos living in the county in 1990 had much higher poverty rates and lower educational attainment rates than Anglo (non-Hispanic white) or blacks. The health indicators of the three groups are compared for 1990. In birth outcome, although Latinos were the least likely to receive care in the first trimester, Latinos and Anglos had identical rates of low birth weight babies, and lower rates than blacks. Latino infant mortality was the lowest of the three. The age-adjusted death rates showed that Latinos have a lower overall death rate than Anglos or blacks, and lower specific rates for heart disease, cancer, AIDS and stroke. Latinos did have higher death rates than Anglos for accidents, homicides, cirrhosis and diabetes. Latinos had incidence rates of gonorrhoea and syphilis similar to Anglos and lower than blacks. The communicable disease rates for Latinos was many times higher than Anglos or blacks, including those for measles, shigellosis, giardiasis and hepatitis A. Implications for family medicine are discussed.
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PMID:Latino health in Los Angeles: family medicine in a changing minority context. 784 24

Giardia lamblia is a common gastrointestinal pathogen but is not generally appreciated as a cause of severe illness. To describe the epidemiology of severe giardiasis, we reviewed data on hospital discharges from the United States and the state of Michigan and compared results for giardiasis with those for shigellosis. From 1979 to 1988, an estimated 4,600 persons were hospitalized for giardiasis annually in the United States; the incidence of giardiasis was 2.0 hospitalizations per 100,000 persons, compared with 2.4 hospitalizations per 100,000 persons for shigellosis. Rates of giardiasis were highest among children younger than 5 years old and women of childbearing age; the median length of hospital stay was 4 days (annual total, 23,238 days). Among residents of Michigan from 1983 to 1987, the average annual incidence of hospitalization was 1.4 per 100,000 persons for giardiasis, compared with 1.0 per 100,000 persons for shigellosis. Volume depletion was the most frequently listed codiagnosis (33.2%); 18.7% of children younger than 5 years old who had severe giardiasis had failure to thrive. Physicians should consider the diagnosis of giardiasis for persons with severe gastrointestinal illness.
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PMID:Severe giardiasis in the United States. 807 67

Empirical antimicrobial therapy is indicated in patients with diarrhoea who have high fever and systemic toxicity, dysenteric disease, or travellers' diarrhoea. Antimicrobials are essential for those with severe shigellosis and amoebiasis. They are useful or possibly useful for other forms of diarrhoeal disease including amoebiasis (milder forms), campylobacteriosis, cholera, giardiasis, shigellosis, and diarrhoea due to a variety of other laboratory-defined bacterial enteropathogens. Furazolidone is useful in infantile giardiasis and mildly effective in other forms of bacterial diarrhoea. Trimethoprim/sulphamethoxazole is effective against Shigella spp. in ost parts of the world. Erythromycin is considered the treatment of choice for campylobacteriosis. For adults, the quinolone antimicrobials represent the most useful class of drugs for bacterial enteropathogens. Several dilemmas currently exist in the area. They include the lack of drugs for the therapy of trimethoprim-resistant shigellosis in children, overuse of antimicrobials in the developing world, and the potential for post-treatment prolongation of intestinal excretion of non-typhoid salmonellae. Antimicrobial chemoprophylaxis can be used in the rare person from an industrialized area during brief travels to a tropical region who has a serious underlying medical problem, cannot exercise care in what is eaten and drunk, and will have the purpose of the trip put at jeopardy should any illness develop (even that rendered short-term by effective therapy). For most people, therapy of illness is preferred to prophylaxis.
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PMID:Diarrhoeal disease: current concepts and future challenges. Antimicrobial therapy and prophylaxis. 810 47


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