Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019163 (hepatitis B)
 38,309 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This overview provides a discussion of the special concerns of sexually transmitted diseases (STDs) for women, particularly because of its asymptomatic character; screening; primary prevention; e.g., abstinence, selection of sexual partners restriction of sexual activities, use of barriers (condoms, vaginal spermicides, diaphragm in conjunction with spermicides), and vaccines; and the role of the gynecologist in StD prevention. Gonorrhea and chlamydial infection are usually asymptomatic STD infections in women; long term sequelae are pelvic inflammatory disease (PID), infertility, and pregnancy complications. There is an increased risk of cervical cancer. Infection is lifelong for herpes simplex virus (HSV) and HIV and malingering for chronic hepatitis B (HPB). Genital human papillomavirus (HPV) and HSV infections cannot be identified serologically. The fetus can be fatally or severely affected by STDs. Abstinence is the only effective prevention for STDs. Likelihood of infection may be reduced by limiting partners, but how partners are chosen and knowledge of infection is a more important determinant. Partners need to be asked about current symptoms, history of STDs, multiple partners, and history of known STD partners, as well as past history of homosexual activity, intravenous drug use, hemophilia, and previous exposure to high-risk persons for STDs. Visible genital warts or lesions, wartlike growths, ulcers, or rash need explanations. Avoidance of oral anal and digital anal activity reduces transmission of hepatitis A, giardiasis, amebiasis, and shigellosis. Any mechanical barrier that remains intact should reduce the risk of STD; barriers specifically covering the cervix are excellent. Condom use is effective when used as follows: 1) at the onset of sexual activity, 2) without petroleum jelly or baby oil on latex, 3) with care of fingernails which may tear holes, 4) with complete withdrawal of the penis before complete detumescence, and 5) with a withdrawal hold at the base of the penis. Spermicides, such as nonoxynol 9, are effective against STDs. Diaphragm use with spermicide may be effective because of the spermicide. There is a reduced risk of transmission of HSV or HPV to a partner. Vaccines are only available for hepatitis B. Obstetrics and gynecology residency training in STDs in unavailable in 4 out of 5 medical schools, and gynecologists are ethically obligated to accurately inform about STD diagnosis, treatment, and diagnosis.
 ...
PMID:Avoiding sexually transmitted diseases. 209 42

The prevalence of sexually transmitted diseases was determined among 370 prostitutes in Kuala Lumpur, Malaysia. Chlamydial cervicitis (26.5%) was detected more frequently than gonorrhoea (14.25%) and was associated more often with pelvic inflammatory disease. Concurrent infections and asymptomatic infections were common. Seropositivity to hepatitis B and syphilis were 66.3% and 13.6% respectively. Women under 20 years of age had significantly higher rates of infection with Chlamydia trachomatis and hepatitis B virus than older women.
 ...
PMID:The prevalence of sexually transmitted diseases among prostitutes in Malaysia. 224 80

In 1985, 132 female prostitutes and 55 female nonprostitutes at a sexually transmitted disease (STD) clinic in Sydney, Australia requested to be tested for HIV antibodies and completed a questionnaire covering a wide range of social and medical issues. The 2 groups were matched for age and were similar in other respects, excluding the number of sexual partners. Laboratory personnel tested the serum using the ELISA test and confirmed by the H9 exclusionary ELISA and by immunofluorescence using a T cell line infected with HIV. All the women tested seronegative for HIV antibodies. 19% of the prostitutes and 24% of the nonprostitutes had used IV drugs. A substantial number of women from both groups reported using 1 or more other drugs. 37% of the prostitutes and 45% of nonprostitutes claimed to not have used any of the illegal drugs listed in the questionnaire, during the preceding 6 months. 29% of the prostitutes and 33% of the nonprostitutes recorded partners at risk from IV drug use. The number of sexual partners reported by the 2 groups in the month prior to the survey ranged from 1-250 (median 24.5) for prostitutes and 0-4 (median 1.50) for nonprostitutes. For a 1 year period the corresponding figures included 1-3000 (median 175) for prostitutes and 1-13 (median 3.5) for nonprostitutes. More than 1/3 reported having bisexual partners during the previous 5 years. Prostitutes had significantly more episodes of gonorrhea, chlamydial infection, and pelvic inflammatory disease than the nonprostitute group (p.05). 1/2 of the 8 prostitutes who had hepatitis B were IV drug users. 76% of nonprostitute partners and 49% of prostitute partners did not use condoms. Despite the fact that HIV antibodies were not detected in these women, the researchers concluded that HIV could spread rapidly within the prostitution population and back into the wider community through sexual contacts and IV drug use. Current control measures need to be enhanced and the medical community needs to continue to monitor prostitutes' health.
 ...
PMID:Human immunodeficiency virus and female prostitutes, Sydney 1985. 341 Apr 67

A survey of 181 Ethiopian females ages 14-19 years recruited from health facilities in Addis Ababa revealed a high incidence of obstetric and gynecologic problems. All subjects completed a questionnaire administered by a female health worker and underwent a gynecologic examination and serologic tests. 49% of subjects were married and 18% were divorced; 11% were prostitutes. Age at first intercourse was under 12 years in 18%, 13-15 years in 38%, and 16 years or above in 44%; 40% were sexually active before menarche. 92% of adolescents had at least one sexually transmitted disease (STD), predominantly gonorrhea (40%), genital chlamydia (51%), hepatitis B (36%), herpes simplex virus (32%), and syphilis (21%), and 43% had clinical signs of pelvic inflammatory disease (PID). 53% had had at least one pregnancy. The earlier the age at first intercourse, the more likely it was that the adolescent would have multiple sexual partners and several STDs; adolescents in this category were also more likely to be from poor families from rural areas. Only 21% were attending a family planning clinic for annual check-ups; 14% of these females were using contraception. Although only 8% were infertile at the time of assessment, 23% had clinical evidence of salpingitis--a risk factor for future infertility. Given the long-term health risks (e.g., infertility, cervical cancer, and gonorrhea-related infant morbidity) associated with the patterns observed among these adolescents, it is recommended that STD education receive higher priority and that the Ethiopian Government consider greater enforcement of the law prohibiting sexual intercourse and marriage before the age of 16 years.
 ...
PMID:Teenage obstetric and gynaecological problems in an African city. 783 12

Spermicides kill a wide range of bacteria and viruses causing sexually transmitted diseases (STDs), including the human immunodeficiency virus (HIV) in vitro, and protect in vivo from infection by gonorrhoea, chlamydia, and pelvic inflammatory disease (PID). In the UK and the US, the most commonly used compound in spermicidal agents is the neutral surfactant nonoxynol-9. Although spermicides reduce the incidence of reinfection by some STDs, an in vivo virucidal action is not supported by convincing data. Among barrier methods, latex condoms provide an impervious barrier in vitro to most STD pathogens, including HIV. Natural condoms made of sheep intestinal membrane can allow passage of hepatitis B viral particles but not HIV in vitro. Several studies have shown protection against cervical gonorrhoea and PID among diaphragm users; however, diaphragm use has been associated with an increased rate of urinary infection and also bacterial vaginosis. It is conceivable that women using oral contraceptives (OCs) do not develop as much tubal damage as women not using OCs because of a modified immunological reaction. A study carried out in Europe showed a statistically significant protective effect against PID of the levonorgestrel-containing IUD as compared with the copper-containing Nova-T. A case/control study of 1028 women in Chicago in 1970 noted admission for PID during the following 7 years of only 1 woman who had been sterilized compared to 9 controls. A case/control study examining risk factors for cervical intraepithelial neoplasia (CIN) in 103 women with biopsy-confirmed CIN II or III did not find an increased risk with either OC or IUD use after adjusting for other known risk factors. After adjustment for age and education, the odds ratio for diaphragm use was .3 and the odds ratio for condom use was .5. Thus, hormonal contraception and tubal ligation give protection to the upper genital tract but not to the cervix.
 ...
PMID:Contraception and the prevention of sexually transmitted diseases. 832 7

Additional information has become available since the US Centers for Disease Control's summary of 1988 on the effectiveness of consistent and proper condom use in preventing the transmission of HIV and other sexually transmitted diseases (STD). The Food and Drug Administration has also approved a polyurethane "female condom" in the interim. This report updates laboratory and epidemiologic information regarding the effectiveness of condoms in preventing HIV infection and other STDs and the role of spermicides used together with condoms. It is clear that condom use reduces the risk for gonorrhea, herpes simplex virus infection, genital ulcers, and pelvic inflammatory disease. Intact latex condoms also provide a continuous mechanical barrier to HIV, HSV, hepatitis B virus, Chlamydia trachomatis, and Neisseria gonorrhea. Three prospective studies in developed countries found that condoms are unlikely to break or slip during proper use; reported breakage rates were 2% or less for vaginal or anal intercourse. Lab studies further indicate that the female condom is an effective mechanical barrier to viruses, including HIV; no clinical studies, however, have been completed to determine the level of protection actually conferred in vivo against HIV infection and other STDs. An estimated 12-month contraceptive failure rate of 11% was found among 86 women who used the device consistently and correctly over a six-month period. Lab studies further indicate that nonoxynol-9, a nonionic surfactant used as a spermicide, inactivates HIV and other sexually transmitted pathogens. Although cohort studies have found the vaginal use of nonoxynol-9 by women without condom use to reduce the degree of infection with gonorrhea and chlamydia, no reports as yet indicate that nonoxynol-9 used alone without condoms can effectively prevent the sexual transmission of HIV. Instead, a randomized controlled trial among prostitutes in Kenya found no protection against HIV infection with use of a vaginal sponge containing a high dose of nonoxynol-9. No studies have shown that nonoxynol-9 used with a condom increases the protection provided by condom use alone against HIV infection.
 ...
PMID:Update: barrier protection against HIV infection and other sexually transmitted diseases. 833 89

WHO estimates 250 million new cases worldwide of sexually transmitted diseases (STDs) each year. STDs of growing concern are chlamydial infections responsible for pelvic inflammatory disease (PID) in women and pneumonia and ophthalmia in newborns, and incurable viral infections, including Herpes simplex virus, human papilloma virus (HPV), hepatitis B virus, and HIV infection. HPV types 16 and 18 are associated with cervical intraepithelial neoplasia, one of the most serious complication of STDs. PID is another serious STD complication because it tends to recur and causes chronic abdominal pain, eventually resulting in hysterectomy, infertility, ectopic pregnancy, or chronic backache. STDs adversely affect pregnancy, often leading to ectopic pregnancy, stillbirth, prematurity, congenital and perinatal infections, and puerperal maternal infections. Genital ulcer diseases, e.g., chancroid, facilitate HIV transmission. HIV infection boosts the virulence of STD pathogens, e.g., Herpes simplex virus. Many people with STDs are asymptomatic and the clinical profile of STDs is always in flux, thus resulting in less than optimal case detection. Obstacles of STD treatment include antibiotic resistance of betalactamase-producing Neisseria gonorrhoea strains and the immunocompromising effect of HIV infections. Tourists are responsible for introducing HIV infection into many countries. Some countries (e.g., Saudi Arabia) require a negative HIV test before foreigners can work in those countries. Health resources are not keeping up with the spread of STDs and HIV. Governments should embark on health education campaigns to stem the spread of HIV. They should also integrate AIDS prevention with the control of other STDs.
 ...
PMID:Sexually transmitted diseases in the age of AIDS. 847 83

A significant decrease in the incidence of most STDs has been reported in Norway during the last decade, especially the last 5 years. Today, syphilis, hepatitis B and gonorrhoea are almost non-existent with incidence rates (IR) of 1.1, 0.9 and 4.4 per 100,000 respectively. The frequency of genital herpes, however, has remained unchanged (IR = 45), while chlamydial infection has shown a decrease of 13% during the last year (IR women = 240). The Chlamydia epidemic became evident in the early 1980-ies and since then has represented the major threat to the reproductive condition in young women resulting in PID, tubal occlusions and ectopic pregnancies. In Norway a preoperative screening program in connection with the performance of abortions was introduced 8-9 years ago. Since then a gradual decrease in the frequency of chlamydial positivity has been notified. At our hospital a reduction of 75% (from 11.7% to 3.1%) in the prevalence of C. trachomatis has been observed in women seeking abortion. The decrease is evident is all age groups, but predominantly in those below 25 years. At the same time the frequency of PID has decreased by 80%, while so far only a slight reduction in the frequency of ectopic pregnancies has been observed. Public and professional awareness, together with an increased prescription of anti-chlamydial drugs to women with genital infections may have contributed to this decrease. Partner tracing is not satisfactory, being performed in only one out of 5 cases. A new act for the prevention of communicable diseases will be introduced next year. This act will make partner notification mandatory and STD treatment free of charge. In Norway, 350,000 chlamydial tests (8 per 100 inhabitants) are performed per year, 39% in women < 25 years. Even today the age-specific prevalence of these women are so high that Chlamydia screening is cost-effective.
 ...
PMID:[Prevention of sexually transmitted diseases. The norwegian experience]. 868 4

These guidelines for the treatment of patients who have sexually transmitted diseases (STDs) were developed by CDC staff members after consultation with a group of invited experts who met in Atlanta on February 10-12, 1997. The information in this report updates the "1993 Sexually Transmitted Diseases Treatment Guidelines" (MMWR 1993;42[no. RR-14]). Included are new recommendations for treatment of primary and recurrent genital herpes and management of pelvic inflammatory disease; a new patient-applied medication for treatment of genital warts; and a revised approach to the management of victims of sexual assault. Revised sections describe the evaluation of urethritis and the diagnostic evaluation of congenital syphilis. These guidelines also include expanded sections concerning STDs among infants, children, and pregnant women and the management of patients who have asymptomatic human immunodeficiency virus infection, genital warts, and genital herpes. Guidelines are provided for vaccine-preventable STDs, including recommendations for the use of hepatitis A and hepatitis B vaccines.
 ...
PMID:1998 guidelines for treatment of sexually transmitted diseases. Centers for Disease Control and Prevention. 946 Oct 53

The Centers for Disease Control and Prevention updated its guidelines for the treatment of sexually transmitted diseases. The guidelines include the following information: recommendations for hepatitis A immunization and expanded indications for hepatitis B vaccination; updated diagnostic criteria for pelvic inflammatory disease and parenteral treatment regimens; information on two additional antiviral agents for the treatment of genital herpes; a recommendation for use of a single 1-g dose of azithromycin (Zithromax) to treat urethritis and chlamydial cervicitis; information on the use of quinolones in the treatment of gonococcal infections; information on podofilox and imiquimod, which are both patient-applied medications, in the treatment of noncervical human papillomavirus infection; updated guidelines for the prevention and detection of congenital syphilis; and information on how to prevent the spread of sexually transmitted diseases by educating patients about the importance of changing their sexual behaviors. To have a significant impact on the current rate of transmission of sexually transmitted diseases, family physicians should develop a plan to integrate the guidelines into their practices.
 ...
PMID:Update on the prevention and treatment of sexually transmitted diseases. 1067 May 4


1 2 Next >>