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

The availability of new biotechnologies has led to the prediction that new or improved vaccines can be developed for 27 diseases within the next decade. The reasons why such optimism cannot be extended to the availability of vaccines for many other infectious diseases are considered by reviewing the steps in vaccine development, from identification of the etiologic agent to construction of attenuated or inactivated vaccines. Impediments to development may exist or arise at any point in this pathway (e.g., multiplicity of serotypes, inability to cultivate the pathogen, multistage life cycles with multiple antigens, unpredictability of epidemics, inadequate knowledge of pathogenesis and immunity, fear of gene splicing, need for an adjuvant, and lack of profitability). Diseases for which vaccines are not likely to be available in the next decade include trachoma, onchocerciasis, pneumonia due to Legionella and to mycoplasmas, amebiasis and giardiasis, schistosomiasis, syphilis, chlamydial urethritis, trypanosomiasis, leishmaniasis, and filariasis, and non-A, non-B hepatitis.
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PMID:Impediments to the development of additional vaccines: vaccines against important diseases that will not be available in the next decade. 266 4

The common practice of sexual relations with many different and anonymous partners and the great variety of responsible micro-organisms account for the high incidence, growing complexity and uneasy prevention of sexually transmitted diseases of the digestive tract in male homosexuals. Syphilis, gonorrhoea, papillomas, chancroid, donovanosis, herpes virus or Chlamydia infections are known to be transmitted by anal coitus; amebiasis, giardiasis and shigellosis by oro-anal contact (faecal contamination). Still under discussion, however, are the predominant mode of transmission of Campylobacter jejuni, the true frequency in homosexuals of intestinal anguilluliasis, oxyuriasis and salmonellosis and the anorectal pathogenicity of Neisseria meningitidis, intestinal spirochetes, Mycoplasma homini, Ureaplasma urealyticum and Campylobacter-like organisms. Diagnosis is difficult since these infections are polymicrobial as a rule and often clinically asymptomatic or atypical and may be further modified by features of the acquired immunodeficiency syndrome, traumatic lesions or anorectal tumours. Microbiological examination is an essential prerequisite to rational treatment.
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PMID:[Digestive localizations of sexually transmitted diseases in male homosexuals]. 316 35

This study is a mapping of intestinal protozoal and pathogenic bacterial infections, and sexually transmitted urethral and anorectal infections among 365 consecutive male patients attending a veneric disease (VD) clinic in Copenhagen. The profile of diseases was strongly correlated to sexual life-style. Amoebiasis and giardiasis were found respectively in 31.9% and 13.8% of homosexuals. None of the heterosexuals had pathogenic protozoa. Protozoal infections were correlated to anilingus. Forty-five percent of the patients were infected in Denmark. Travelling to endemic areas was of no obvious importance. Among males with homosexual partners, 14% had rectal infections. Gonococcal and chlamydial infections were equally frequent. Three percent had symptomatic anorectal herpes simplex infection and 11% anal warts. Gastrointestinal symptoms were not reliable indicators of gastrointestinal infection; symptoms were claimed frequently among homosexuals without infections compared to heterosexuals. Urethral gonorrhoea and/or chlamydia infections were diagnosed in 39% of the heterosexuals compared to only 10% of the homo-bisexuals. Twelve percent of the homosexuals had untreated early syphilis, whereas syphilis was exceptional among heterosexuals. The total burden of infections expressed as the actual number of infections was largest among homosexuals, 40.4%, 22.4%, and 5.3% having one, two, and three infections respectively.
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PMID:Sexually transmitted diseases in hetero-, homo- and bisexual males in Copenhagen. 316 56

Travelers to developing countries participated in a follow-up study of the health risks associated with short (less than three months) visits to these nations. Travelers to the Greek or Canary Islands served as a control cohort. Participants completed a questionnaire to elicit information regarding pretravel vaccinations, malaria prophylaxis, and health problems during and after their journey. Relevant infections were confirmed by the respondent's personal physician. The questionnaire was completed by 10,524 travelers; the answer rate was 73.8%. After a visit to developing countries, 15% of the travelers reported health problems, 8% consulted a doctor, and 3% were unable to work for an average of 15 days. The incidence of infection per month abroad was as follows: giardiasis, 7/1,000; amebiasis, 4/1,000; hepatitis, 4/1,000; gonorrhea, 3/1,000; and malaria, helminthiases, or syphilis, less than 1/1,000. There were no cases of typhoid fever or cholera.
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PMID:Health problems after travel to developing countries. 359 28

The authors compared cases of acquired immunodeficiency syndrome (AIDS) diagnosed in San Francisco, California, during 1983-1984 with human immuno-deficiency virus (HIV) antibody-negative neighborhood and clinic controls, looking for risk factors for clinical AIDS. They also compared antibody-positive with antibody-negative neighborhood and clinic controls for risk factors for HIV infection. Odds ratios were 52.0 for AIDs and 7.8 for seropositivity for more than 100 sexual partners versus 0-5 partners when antibody-negative neighborhood controls were compared with cases and with antibody-positive neighborhood controls, respectively. Odds ratios were only 2.9 and 3.4 when antibody-negative clinic controls were compared with cases and with antibody-positive clinic controls, respectively. Odds ratios of 4.6-7.3 for rectal receptivity with most or all partners versus none or one partner were statistically significant, independent of the number of partners. Douching before sex was independently associated with odds ratios of 2.2-2.8. There was no evidence for oral-genital, oral-anal, or other sexual transmission of AIDS. In multivariate analysis, independent odds ratios of 2.4-6.0 for prior syphilis and 10.8-27.9 for prior giardiasis were statistically significant or marginally significant in all comparisons. There was a moderate association with nitrite use. No other drugs were consistently associated with clinical AIDS or HIV seropositivity. Odds ratios associated with AIDS and seropositivity were closely comparable except for number of partners.
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PMID:Risk factors for AIDS and HIV seropositivity in homosexual men. 364 28

Homosexual men are at increased risk for traditional sexually transmitted anorectal infections (gonorrhea, syphilis, venereal warts, herpes and chlamydial infection) and enteric infections characterized by a low infecting inoculum (hepatitis A and B, amebiasis, giardiasis, shigellosis and campylobacteriosis). Infections account for most of the gastrointestinal symptoms in homosexual men seen at sexually transmitted disease clinics, but asymptomatic and polymicrobial infections are also common. Distinguishing three syndromes-proctitis, proctocolitis and enteritis-is clinically useful because these syndromes correlate with specific microorganisms and modes of transmission. A careful anoscopic examination, rectal Gram's stain, cultures for gonorrhea and chlamydia, VDRL and darkfield examination of suspicious lesions should be routinely done when sexually active homosexual men present with unexplained gastrointestinal symptoms. Based on the history, physical examination and initial laboratory studies, patients can usually be classified as having proctitis, proctocolitis or enteritis. This distinction facilitates selection of both confirmatory diagnostic tests and antimicrobial therapy. The effectiveness of empiric treatment regimens for asymptomatic sexual contacts or for symptomatic patients in whom microbiological tests are pending has not been studied.
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PMID:Anorectal and enteric infections in homosexual men. 383 33

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

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

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


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