Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

At present, about 250 million new cases of sexually transmitted diseases (STDs) occur in the world each year. This statistics includes 120 million cases of trichomoniasis, 50 million cases of chlamydia, 30 million cases of genital warts, 25 million gonorrhea cases, 20 million cases of genital herpes, 3.5 million syphilis cases, 2.5 million case of hepatitis B virus, 2 million cases of chancroid, and 1 million infections with human immunodeficiency virus (HIV). Among the adverse health sequelae the STDs are sterility, infertility, stillbirth, miscarriage, blindness, brain damage, and cancer. The greatest incidence of STDs is in the 20-24-year age group, followed by persons 15-19 years of age. The finding that lesions caused by some STDs can increase the risk of HIV infection by more than 300% has led governments concerned with control of acquired immunodeficiency syndrome (AIDS) to take a more aggressive stance toward the prevention and treatment of STDs. There are many obstacles to STD prevention, however, including the development of treatment-resistant strains, inadequate infrastructure for diagnostic testing and penicillin treatment, resistance to changing sexual behavior, increased travel and migration, and the practice of exchanging sex for drugs. Even in some developed countries where the rate of STD infection has finally stabilized, the level remains unacceptably high and STDs cannot be considered as under control. In developing countries, STDs have reached epidemic levels and the number of new infections reported annually shows a pattern of steady increase. The World Health Organization is urging governments to intensify STD prevention activities through funding research, health education, and more accessible clinic services.
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PMID:Sexually transmitted infections increasing -- 250 million new infections annually. 1231 65

According to reports from the Program for Appropriate Technology in Health (PATH) and the World Bank, women in less developed countries (LDCs) suffer the greatest risk due to reproductive health problems. At any given time, a woman in a LDC is more likely than not to have at least 1 reproductive health problem that could be treated by a primary care provider or counseling and referral ("Women's Reproductive Health: The Role of Family Planning Programs," a PATH report). Among diseases for which cost-effective interventions exist (treatments or preventive measures), reproductive health problems account for the majority of the disease burden (a measure of healthy years lost due to disability or premature death) among women aged 15-44. A study of 650 women in India found that more than 50% reported specific gynecological problems; clinical examination found more than 90% had 1 or more such problems. In a study of 509 nonpregnant women in rural Egypt, it was discovered that more than 52% had a reproductive tract infection, 56% had some form of uterine prolapse, 14% had a urinary tract infection, and 11% had an abnormal Pap smear. Major reproductive health problems continue into menopause; cervical cancer, which is linked to reproductive tract infections and early and frequent childbearing, strikes 400,000 women in LDCs each year. Sexually transmitted disease (STD) and human immunodeficiency virus (HIV) infections are also problems; women are twice as likely as men to contact gonorrhea from an infected sex partner, and 14 million women will have been infected with HIV by the year 2000 (WHO estimate). Treatment is often unsought by women because they do not understand the risk, are unaware of the symptoms, or fear the stigma of attending a clinic. If all the women who wanted to control their fertility had access to family planning services, maternal mortality would decrease by nearly 50%. Reproductive health services (routine gynecological care, perinatal care, family planning services, cancer screening, STD/HIV services, nutritional supplementation, and other services appropriate to age) are needed.
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PMID:Reproductive health problems loom in LDCs. 1231 59

The Youth Risk Behavior Survey, conducted by the Centers for Disease Control in 1990, 1991, and 1993, found that a substantial proportion of US teens engage in behaviors that place them at risk of unintended pregnancy, human immunodeficiency virus (HIV), and other sexually transmitted diseases. Included in the survey were over 50,000 public and private high school students from all states. The rate of teens who reported having sexual intercourse in the three months preceding the survey remained constant at about 39% between 1990 and 1993, but use of oral contraceptives and condoms at last intercourse rose from 15% to 18% and from 46% to 53%, respectively. Between 1990 and 1991, the number of live births to high school students 15-19 years of age dropped from 62.1 to 60.7/1000 and the induced abortion rate declined in 30 of the 41 states that provided abortion data. Between 1991 and 1992, the gonorrhea rate among teens 15-19 years old decreased 20% for males and 13% for females, but an increasing percentage of chlamydia infections involved adolescents. Despite some encouraging trends, concerns remain regarding the finding that close to half of teenagers are not protected by condom use.
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PMID:Trends in sexual behavior among high school students in the United States: the Youth Risk Behavior Survey. 1231 63

Patients with sexually transmitted diseases (STDs) in developing countries are often untreated for long periods of time or receive ineffective treatment, producing complications that can lead to infertility, blindness, and even death. In addition, there is growing research evidence that people with bacterial or viral STDs are more likely to acquire--and perhaps transmit--the human immunodeficiency virus (HIV). STD control programs in developing countries must be reorganized to include: 1) good management of patients with STDs and their contacts, 2) case finding for syphilis in the antenatal population, 3) screenings and case findings for gonorrhea in high-risk groups, and 4) systematic prophylaxis for ophthalmia neonatorum in newborns. Since diagnosis before treatment is problematic in rural areas, the World Health Organization recommends simple treatment protocols based on the most common STD symptoms--urethral discharge; gynecological complaints such as vaginal discharge, low abdominal pain, or dysuria; genital ulceration; and inguinal bubo, a swelling of the lymph nodes in the groin. Other components of this approach include standardized treatment, contact tracing and treatment, health education targeted at high-risk groups, follow-up and case referral where necessary, and the collection of simple statistics on treatment efficacy and STD epidemiology. The incidence of STDs in developing countries is steadily increasing as a result of urbanization, increased numbers of young people, and delayed age at marriage. However, this situation can be combatted through application of treatment protocols, technological advances, improvements in the health care delivery system, and awareness on the part of policy makers of the seriousness of the STD problem.
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PMID:Management of sexually transmitted diseases. 1234 18

Some 250 million cases of sexually transmitted disease (STD) occur each year, and in some countries 1 or even 2 women in every 10 are infected with an STD. STDs are likely to reach an advanced stage before women notice them. The consequences of STDs are devastating, according to a report by the Population Information Program of the Johns Hopkins School of Public Health, and they include stillbirths, blinding eye infections in the newborn, chronic female abdominal pain, ectopic pregnancy, and infertility. There are social consequences for women such as divorce, and husbands may abandon infertile wives. Gonorrhea and chlamydia can cause both severe inflammation of the pelvis with acute pain and possible infertility. Pelvic inflammatory disease can permanently scar the fallopian tubes, increasing the risk of ectopic pregnancy, which can be fatal when the fallopian tube ruptures. Babies born to mothers with gonorrhea and chlamydia are likely to develop eye infections that may make them blind. Chlamydia infection in pregnant women may also cause premature rupture of the membranes, sepsis, and the death of premature neonate. Infection may spread to the lungs of newborns, leading to chlamydial pneumonia. Syphilis can cause spontaneous abortion, stillbirth, neonatal death, or congenital syphilis in the infant. Trichomoniasis and herpes can also be transmitted from mother to fetus. And infection with an STD increases the risk of infection with the human immunodeficiency virus (HIV). The World Health Organization (WHO) recommends that prenatal care should always include checks for STDs. A WHO Technical Working Group on Care of Mother and Baby has stressed the importance of detecting and treating STDs in pregnant women. The working group urged training of health workers to distinguish between STDs and other infections. The group, which met July 5-9, 1993, outlined health center strategies for prevention and treatment.
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PMID:STDs infect 250 million a year. 1234

Sexually active men who have sex with men (MSM) at 5 Seattle clinics were assessed for bacterial sexually transmitted diseases (STDs), human immunodeficiency virus (HIV)-discordant partnerships, sexual behavior, and drug use. Of the HIV-positive men, 45% reported having HIV-negative sex partners and 42% reported having sex partners with unknown serostatus during the past 2 months, whereas 14% and 57% of HIV-negative men reported having HIV-positive and unknown-serostatus sex partners, respectively. Correlates of sex partners with unknown serostatus were recruiting sex partners at bathhouses or parks. Gonorrhea, chlamydia, or syphilis was diagnosed in 12% of HIV-positive and 13% of HIV-negative MSM, and the rates did not differ between men with HIV-concordant and HIV-discordant partnerships. High prevalences of bacterial STDs and HIV-discordant partnerships emphasize the need for interventions to foster serostatus discussion, condom use, fewer anonymous partners, and STD screening.
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PMID:Sexually transmitted diseases and human immunodeficiency virus-discordant partnerships among men who have sex with men. 1235 90

The seroprevalence of herpes simplex virus type 2 (HSV-2) infection was studied among 4128 patients from sexually transmitted disease (STD) clinics who were enrolled in a randomized controlled trial of human immunodeficiency virus and STD counseling efficacy. HSV-2 seroprevalence was 40.8% and was higher in women than in men (52.0% vs. 32.4%; P<.0001) and higher in blacks than in nonblacks (48.1% vs. 29.6%; P<.0001). Among 14-19-year-old patients, 36.8% of black women and 25.8% of nonblack women were infected with HSV-2. Independent predictors of HSV-2 seropositivity included female sex, black race, older age, less education, more lifetime sex partners, prior diagnosis of syphilis or gonorrhea, and lack of HSV-1 antibody. The majority of HSV-2-seropositive persons (84.7%) had never received a diagnosis of genital herpes. HSV-2 infection is common in STD clinic attendees in the United States, even among young age groups, especially among women. Efforts to prevent genital herpes should begin at an early age. The high rate of undiagnosed HSV-2 infection likely contributes to ongoing transmission.
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PMID:Seroprevalence and correlates of herpes simplex virus type 2 infection in five sexually transmitted-disease clinics. 1568 3

Neisseria gonorrhoeae is a major cause of pelvic inflammatory disease, ectopic pregnancy, and infertility, and it can facilitate human immunodeficiency virus (HIV) transmission. Gonorrhea is the second most frequently reported communicable disease in the United States, with 361,705 reported cases in 2001. During the 1980s, gonococcal resistance to penicillin and tetracycline became widespread; as a result, CDC recommended using cephalosporins as first-line treatment for gonorrhea. Since 1993, CDC also has recommended using fluoroquinolones (i.e., ciprofloxacin, ofloxacin, or levofloxacin) for gonorrhea treatment. Fluoroquinolone therapy is used widely because it is a relatively inexpensive, oral, and single-dose therapy. However, fluoroquinolone-resistant N. gonorrhoeae (QRNG) is being identified more frequently. This report summarizes investigations of increases in QRNG in Hawaii and California in 2001 and provides data to support the recommendation that cephalosporins (i.e., ceftriaxone or cefixime) be used instead of fluoroquinolones as first-line treatment for gonorrhea acquired in these two states. The increases in QRNG highlight the importance of monitoring gonococcal resistance throughout the United States to guide local treatment decisions.
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PMID:Increases in fluoroquinolone-resistant Neisseria gonorrhoeae--Hawaii and California, 2001. 1271 45

A healthy vaginal ecosystem has been shown to be protective against the acquisition of human immunodeficiency virus and gonorrhea, and women who are colonized with H(2)O(2)-producing lactobacilli are more likely to maintain a normal vaginal flora than women with lactobacilli that do not produce H(2)O(2). The purpose of this study was to formulate a testing medium that better supports the growth and detection of H(2)O(2) by a broader range of lactobacilli than a published, widely used agar formulation (TMB). The new medium (TMB-Plus) consists of brucella agar base, 3,3',5,5'-tetramethylbenzidine, horseradish peroxidase, starch, vitamin K, hemin, magnesium sulfate, manganese sulfate, and horse serum. To validate the new formula, 256 vaginal isolates and ATCC strains were inoculated onto TMB-Plus and, for comparison, onto TMB. Growth was enhanced for 69% of the isolates on TMB-Plus, and 48% had enhanced color production. The percentage of H(2)O(2)-positive isolates increased from 71% on TMB to 79% on TMB-Plus. Formulations using Rogosa or MRS agar base in combination with peroxidase and a chromogen did not support the growth of all of the strains of Lactobacillus, and fewer H(2)O(2)-producing strains were detected on these formulations than on TMB-Plus. This new medium better supports the growth of a wider range of Lactobacillus strains isolated from the vagina and enhances the color production of H(2)O(2)-producing strains.
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PMID:Optimization of media for detection of hydrogen peroxide production by Lactobacillus species. 1284 73

In this retrospective review of cases of clinical proctitis, we identified the frequency of common sexually transmitted diseases (STDs) among men who have sex with men on the basis of reports from the municipal STD clinic in San Francisco. Of note, gonorrhea and chlamydia were the most common STDs, followed by herpes and syphilis. Current STD treatment guidelines recommend empiric treatment for gonorrhea and chlamydia, but treatment for herpes should also be considered. The implications for human immunodeficiency virus (HIV) transmission are also discussed.
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PMID:Etiology of clinical proctitis among men who have sex with men. 1469 67


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