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 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We reported a study undertaken in a Sexually Transmitted Disease care unit in Antsiranana amongst two groups of patients: 299 prostitutes and 350 STD patients (204 women and 146 men). The 20-29 years old age group represented 50.3% of the patients. A 12 days average delay between appearance of first symptoms of STD and the visit to the care unit was recorded. The most important clinical signs were cervicovaginal discharge (83%), pelvic pains (67%), and pruritus (53%) in women, urethral discharge and urination pain (64%) in men. Among prostitutes on a routine visit, 22.7% had at least one STD clinical sign. Syphilis serology by TPHA showed a high prevalence among prostitutes (39%) and STD patients (32%). Direct examinations emphazed the major importance of gonorrhoea in more than 70% of STD patients, both men and women, and trichomonasis in women (22%). Chlamydia investigation could not be done. HIV antibodies were recorded in 4 prostitutes (1.3%) and in none of the STD patients. 79.3% of prostitutes and 39.4% of STD patients had at least 2 partners a week and 47.5% of prostitutes used a condom "every time" and only 21.1% STD patients "sometimes" used it. The role of STD care units must be reinforced for information, education and counselling of the population in a non medical context.
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PMID:[Epidemiological approach for sexually transmitted diseases in Antsiranana (north Madagascar). Between prevention and treatment, the choice of a strategy against sexually transmitted diseases]. 1246 7

The aetiological importance of Chlamydia (C.) trachomatis in non-gonococcal urethritis (NGU) is undisputed. Mycoplasma (M.) genitalium has been shown to be strongly associated with NGU and with mucopurulent cervicitis and also with acute endometritis independent of C. trachomatis. In this prevalence study we examined 946 patients, 445 women and 501 men, attending the STD clinic, for M. genitalium as well as C. trachomatis and Neisseria gonorrhoeae. M. genitalium was detected in urethral samples from 17 (13.4 per cent) of 127 men with both symptoms and signs of urethritis and from 2 (1.3 per cent) of 160 men without (p < 0.001). Corresponding figures for M. genitalium in the women were 15 (11 per cent) of 136 women with symptoms and signs of urethritis or cervicitis compared to 3 (2.2 per cent) of 139 women without (p = 0.005). Examinations of partners of female and male index patients indicated that M. genitalium is sexually transmitted. Some M. genitalium infected patients had a history of irregular vaginal bleeding, lower genital tract pain, epididymitis and arthritis. Investigation of the aetiological role of M. genitalium in salpingitis, epididymitis and sexually acquired arthritis is urgently needed.
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PMID:[Chlamydia-like symptoms can have another etiology. Mycoplasma genitalium--an important and common sexually transmitted disease]. 1252 71

Surgical abortion in the first trimester comprises the majority of voluntary pregnancy interruptions performed in the United States. The majority of these procedures are done in outpatient settings with the patient under local anesthesia. Appropriate volume of and deep injection of local anesthetic can reduce pain associated with the procedure. Waiting between administration of the paracervical block and initiating the procedure does not affect pain. Intravenous administration of sedation and analgesia improves patient satisfaction but does not significantly affect pain ratings. Antibiotic prophylaxis is warranted. Vasopressin is useful for prevention of hematometra and hemorrhage. Less evidence supports the routine use of ergots. Preoperative cervical priming reduces the risk of cervical injury and uterine perforation. Attention to operative technique can reduce the risk of incomplete abortion. Routine postoperative care at 2 or 3 weeks is timed to identify complications and to reinforce pregnancy and sexually transmitted disease prevention.
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PMID:Best practices in surgical abortion. 1452 Feb 10

An increasing number of women with vulval problems and pain attend Olafiaklinikken, the centre for sexually transmitted infection (STI) in Oslo. The aim of the study was to investigate the prevalence of long-standing vulval problems and entry dyspareunia in a consecutive sample of STI-clinic visitors in Oslo. A self-administered questionnaire was distributed before and independent of the consultation. Response rate was 89.6% (502/560). Mean and median age were 25.9 and 24.0 years respectively, range 16-65 years. Vulval soreness, burning, dryness and fissures present for at least three months were reported by 23.1% (116/502), entry dyspareunia by 6.9% (34/494). Independent risk factors for dyspareunia were a history of >/=4 treatments for vulvovaginal candidiasis during the last year, reported by 34.6%, odds ratio (OR) 4.45, 95% confidence interval (CI) 1.81-11.0, and a history of bacterial vaginosis, reported by 42.4%, OR 2.34, 95% CI 1.11-4.92. Contraceptive methods, hygienic habits, a history of STIs, depression or sexual abuse were factors unrelated to longstanding symptoms. Investigation with regard to longstanding vulval problems and entry dyspareunia is required for a certain group of sexually transmitted disease-clinic visitors in Oslo, and referral to a special service for vulva patients would be beneficial for selected patients.
Int J STD AIDS 2003 Dec
PMID:Longstanding vulval problems and entry dyspareunia among STD-clinic visitors in Oslo-results from a cross-sectional study. 1467 85

The objective of the study was to determine the association of neurocognitive impairment with health-related quality of life (HRQoL) in patients receiving highly active antiretroviral therapy (HAART). Seventy subjects were cross-sectionally analysed with a standardized neuropsychological test battery and a questionnaire including an Italian translation of the MOS-HIV Health Survey. The presence of neurocognitive impairment was significantly associated with lower HRQoL scores: pain (P = 0.03), physical functioning (P = 0.01), role functioning (P = 0.01), social functioning (P = 0.029), mental health (P = 0.001), energy (P = 0.036), health distress (P = 0.002), cognitive functioning (P = 0.05), current health perception (P <0.001), physical health summary score (PHS) (P = 0.005), mental health summary score (MHS) (P = 0.002). Years of education (odds ratio [OR] 0.79; 95% confidence interval [CI] 0.65-0.96), PHS (OR 0.71; 95% CI 0.54-0.95) and MHS (OR 0.67; 95% CI 0.51-0.88) were also associated with cognitive impairment. Neurocognitive impairment in patients receiving HAART was associated with reduced HRQoL. Identifying cognitive impairment may provide motivation for additional treatment to help patients to compensate for deficits in functioning.
Int J STD AIDS 2004 Apr
PMID:Neurocognitive impairment influences quality of life in HIV-infected patients receiving HAART. 1507 20

The objective of the study was to review the indications for scrotal ultrasound scans and to assess the impact on patient management. We therefore performed a retrospective analysis. Case notes of all males referred for a scrotal ultrasound between April 1998 and March 2001 were studied. Data were extracted for the following: age, presenting complaints, physical findings on examination, results of a full sexual screen, treatment, ultrasound result and the designation of the person requesting the scan. All data were tabulated and summated using 'Windows Excel' software. One hundred and fifteen men were referred for an ultrasound in this period of time. None had an ultrasound more than once. Of these, 25 subjects could not be included as they either failed to attend for their scan (n=8) or their notes could not be traced (n=17). Twelve subjects were excluded as they did not fit the selection criteria (n=12). Median age was 30 years (Range 19-61 years). The commonest reason for referral was testicular pain (n=43) followed by testicular lump (n=19). The commonest abnormality on examination was an inflamed epididymis (n=18). Forty-two of the ultrasound scans were normal. A testicular mass was detected in only five of the 78 patients (6.4%), of which one was a malignancy (1.2%). A direct referral to a urologist for further management was made in only nine patients. Scrotal ultrasound for pain has limited impact on patient management apart from reassuring a worried patient. However, it remains an important investigation in the management of a suspected testicular lump.
Int J STD AIDS 2004 May
PMID:What is the role of scrotal ultrasound scans in genitourinary medicine? 1511 97

Sexually transmitted diseases are the most common infectious diseases in the United States. Physicians, nurses, and other health care providers are uncomfortable discussing sexual issues with their clients. Therefore many health care needs are not addressed, and many opportunities for education aimed at preventing STDs are missed. In the periodic health history, the health care provider must elicit information about sexual practices (vaginal,oral, or anal intercourse), sexual orientation (heterosexual, homosexual, or bisexual), sexual risk behaviors (ie, unprotected intercourse with multiple partners), contraceptive use (particularly condoms), and prior STDs. Based on this information, the health care practitioner moves to more specific questions regarding sexual health. The health care practitioner asks about sores on the penis, dripping or discharge from the penis, staining of the underwear, testicular pain, and scrotal swelling. For the client who engages in oral sex, the health care practitioner asks about sore throat. For the client who engages in anal intercourse ask about diarrhea, rectal bleeding, anal itching, and pain. Probe the desire phase, the arousal phase (erection), and the ejaculation phase. Ask about the desire for fatherhood and concerns about fatherhood. An important part of health care is prevention. Culturally specific and sensitive information should be available for patients. Patient education should not consist of simply handing a brochure to a man. Using the brochure as a guide for including all the necessary information and ascertaining the man's understanding may be a very effective method of patient education. For men who are at increased risk for STDs or who present with symptoms of STDs, offering diagnostic testing is necessary. Men who have multiple sexual partners especially need diagnostic testing and prevention counseling. The CDC recommends annual HIV and hepatitis C testing for men who have sex with men and other men who have increased risk for contracting HIV. Another important consideration at the periodic screening examination is the vaccinations that are to be recommended. Men who have sex with men should receive hepatitis A and hepatitis B vaccine. Additionally, it is recommended that all adolescents should receive hepatitis B vaccine.
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PMID:Sexually transmitted diseases in men. 1515 85

Ultrasonography of the scrotum permits assessment of testicular and extratesticular masses with high sensitivity. It can differentiate a variety of conditions involving the scrotum, testicles, and epididymis with similar clinical manifestations, including infectious and tropical diseases. The authors performed conventional and color Doppler ultrasonographic examinations in 76 patients who presented with scrotal pain, swelling, and/or tenderness. Their diagnoses included sexually transmitted disease (eg, gonorrhea, syphilis, chlamydial infection), tuberculosis, mumps, and various tropical diseases (eg, filariasis, leishmaniasis, schistosomiasis, paracoccidioidomycosis). The most common imaging findings were enlarged hypoechoic testes, hypervascularity, small hydroceles, and cutaneous edema. This report reviews these and other possible presentations of tropical and infectious diseases affecting the scrotum, emphasizing ultrasound findings that facilitate diagnosis.
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PMID:Ultrasound of tropical and infectious diseases that affect the scrotum. 1548 Feb 15

The cause of category III A prostatitis, chronic prostatitis/chronic male pelvic pain syndrome category A (CP/CPPS A), is uncertain. Treatments for it are based on consensus opinion rather than on scientific data. Our aim was to examine the effect of zafirlukast, a leucotriene antagonist, on the symptoms of CP/CPPS A in our genitourinary (GU) medicine unit. CP/CPPS A was diagnosed by comparative white cell counts of split urine (Stamey) analysis or by finding an excess of polymorphs in expressed prostatic fluid. Symptom change was assessed by the National Institutes of Health Chronic Prostatitis Symptom Index (CPSI). Patients were given zafirlukast or placebo for four weeks in a random double-blind fashion. All patients also received doxycycline. In all, 31 patients were asked to participate and 17 entered the study. No difference in outcome could be shown between the active (10) and placebo (seven) patients. Zafirlukast cannot be demonstrated to be useful in the symptomatic treatment of CP/CPPS A. The problems of recruitment into this study (in spite of a large number of patients with prostatic type pain being seen in our unit) suggest that multicentre treatment trials using non-invasive diagnostic techniques such as the CPSI (rather than single GU medicine units diagnosing CP/CPPS A by uncomfortable direct prostatic testing) are likely to be the most effective and objective methods of undertaking treatment trials in the CP/ CPPS A field in the future.
Int J STD AIDS 2005 Mar
PMID:Treatment of category III A prostatitis with zafirlukast: a randomized controlled feasibility study. 1582 18

Surgeons of the Royal Navy during the Napoleonic and revolutionary wars, between 1793 and 1815, were solely responsible for all health care of the officers, men, and boys of their ships. This paper examines the genitourinary medicine and surgery encountered by the naval surgeons at the time of Nelson. Primary sources are examined to explore the presentation, case mix, and management of genitourinary disease during this period. A general overview is given of the life and work of the Royal Naval surgeons at the end of the 18th century. The documents that were examined contained 39 surgeon's journals, these were written by 26 surgeons on 13 different ships. The journals contained 446 presentations to the sick list of men with genitourinary symptoms. The presenting symptoms are grouped together under the following headings; venereal disease, penile pathology, scrotal pain and swelling, urinary symptoms and retention, stone disease and trauma. Examination of these journals permits a glimpse of medical life in the Royal Navy during the time of Nelson. The case load and management of genitourinary disease shows the diversity of presentation to these surgeons.
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PMID:Genitourinary medicine and surgery in Nelson's navy. 1599 14


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