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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Trichomonas vaginalis was detected by culture or wet-mount examination in 118 (15%) of 779 randomly selected women attending a sexually transmitted disease clinic. Vaginal trichomoniasis was significantly associated with symptoms of yellow discharge, abnormal vaginal odor, and vulvar itching and with signs of colpitis macularis ("strawberry cervix"), purulent vaginal discharge, and vaginal and vulvar erythema. A logistic regression model was used to adjust for coinfections, as well as for demographic, behavioral, and other possible confounding variables. Trichomonas vaginalis remained significantly associated with symptoms of yellow vaginal discharge (odds ratio [OR] = 2.4) and vulvar itching (OR = 3.0) and with signs of colpitis macularis (OR = 241), purulent vaginal discharge (OR = 8.0), vulvar erythema (OR = 2.5), and vaginal erythema (OR = 4.3). The sensitivity of symptoms and signs associated with trichomoniasis was relatively low. Nevertheless, clinical manifestations can be used to identify those patients for whom a wet-mount examination would likely have high yield. Careful clinical examination and selective use of wet-mount examination together with wider use of more sensitive tests for subclinical infection, such as culture or direct immunofluorescent staining of vaginal fluid, could lead to improved detection and control of this infection.
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PMID:Clinical manifestations of vaginal trichomoniasis. 278 46

We screened 392 women attending the Laboratory of Microbiology of Toulouse Purpan Hospital for symptoms of lower genital tract infection for six microorganisms. Rates of isolation of Neisseria gonorrhoeae, Chlamydia trachomatis, Candida albicans, Mycoplasma hominis, and Gardnerella vaginalis were 1%, 7.7%, 29.8%, 23.8%, and 37.5%, respectively. Trichomonas vaginalis was detected by direct examination in specimens from 3.1% of patients. Another goal of this study was to determine the relative prevalence of these microorganisms in relation to clinical and epidemiologic findings. C. trachomatis was isolated significantly more often from patients under 25 year old (P less than 0.001), from those who use oral contraceptives (P less than 0.01), from those who have a male sexual partner with symptoms of sexually transmitted disease (P less than 0.001), and from those who present signs of cervicitis (P less than 0.05). Isolation of C. albicans was significantly associated with vulvar pruritus (P less than 0.01), vulvitis (P less than 0.01), and vaginitis (P less than 0.001). G. vaginalis and M. hominis are significantly associated with bacterial vaginosis (P less than 0.001). This syndrome was diagnosed clinically in 27.2% of our study population and was highly correlated with use of an intrauterine device (P less than 0.05).
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PMID:Lower genital tract infections in women: comparison of clinical and epidemiologic findings with microbiology. 313 8

The symptoms, signs, and laboratory findings for 69 women who were seen at a sexually transmitted disease (STD) clinic and who had acute urinary tract infection (UTI) were compared with those for women who had vaginitis, gonorrhea, or chlamydial infection. Escherichia coli and Staphylococcus saprophyticus were the two most common causes of acute cystitis in this population and accounted for 62 (90%) of 69 infections. Forty-three percent of the women had positive tests for antibody-coated bacteria (ACB), an observation implying renal infection although symptoms of upper tract infection were infrequent. Frequency, urgency, dysuria, and suprapubic tenderness were significantly associated with cystitis, whereas vaginal discharge and vulvar itching were associated with vaginitis. There was, however, considerable overlap in symptoms among the four groups of women, and their accurate differentiation required objective information based upon pelvic examination, examination of vaginal fluid, and urinalysis. In the absence of vaginitis on wet mount and mucopurulent cervicitis on examination, pyuria, as determined by examination of centrifuged urine, had an 88% sensitivity, 76% specificity, 61% positive predictive value, and 93% negative predictive value for acute UTI. Because of the high prevalence of positive ACB tests and the possibility that infection with Chlamydia trachomatis and/or Neisseria gonorrhoeae may be mistaken for cystitis, we prefer a five- to seven-day course of antibiotics over single-dose therapy for treatment of patients with possible UTI in the setting of an STD clinic.
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PMID:Urinary tract infection among women attending a clinic for sexually transmitted diseases. 654 11

Nonspecific vaginitis was present in 37% of 40 patients attending the Special Urology (Sexually Transmitted Disease) Clinic at the Victoria General Hospital, in 23% of 75 patients attending the Family Planning Clinic, and in 23% of 13 patients attending the Prenatal Clinic at the Grace Maternity Hospital in Halifax, Nova Scotia. The mean prevalence was 27%. Subjective complaints of vaginal odor were significantly associated with nonspecific vaginitis (P less than .001), but symptoms of vaginal discharge or vulvar irritation and itching were not. No correlations were found between the presence of nonspecific vaginitis and the isolation of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, Trichomonas vaginalis, or vaginal yeast species. The organic acid present in vaginal washings that best correlated with the presence of nonspecific vaginitis was succinic acid.
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PMID:Nonspecific vaginitis and other genital infections in three clinic populations. 664 45

The epidemiology, clinical course, diagnosis, and attempted treatments of herpes genitalis are reviewed. Herpes genitalis is an increasingly common sexually transmitted disease for which there is no effective treatment. It can occur in either sex and is mot commonly first found in patients 14 to 29 years old. Initial exposure to the virus may result in prolonged local symptoms (pain, itching, discharge) and signs (ulcerative lesions) as well as fever, malaise, myalgias, and fatigue. After the initial exposure, the virus may be found in a latent stage in the dorsal nerve root ganglia in the sacral area, and recurrences of disease may ensue. The frequency and clinical course of recurrent genital herpes can be of varying duration and severity. Although antiviral substances, immune potentiators, topical surfactants, and photodynamic inactivation have been used to treat genital herpes infections, there is no proven effective therapy.
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PMID:Genital herpes simplex virus infection: clinical course and attempted therapy. 701 31

Focus in this discussion of the pharmacology of gynecology is on the following: vaginal infections; genital herpes; genital warts; pelvic inflammatory disease; urinary infections; pruritus vulvae; menstrual problems; infertility; oral contraception; and hormone replacement therapy. Doctors in England working in Local Authority Family Planning Clinics are debarred from prescribing, and any patient with a vaginal infection has to be referred either to a special clinic or to her general practitioner which is often preferable as her medical history will be known. Vaginal discharge is a frequent complaint, and it is necessary to obtain full details. 1 of the most common infections is vaginal candidosis. Nystatin pessaries have always been a useful 1st-line treatment and are specific for this type of infection. Trichomonas infection also occurs frequently and responds well to metronidazole in a 200 mg dosage, 3 times daily for 7 days. It is necessary to treat the consort at the same time. Venereal diseases such as syphilis and gonorrhea always require vigorous treatment. Patients are now presenting with herpes genitalis far more often. The only treatment which is currently available, and is as good as any, is the application of warm saline to the vaginal area. Genital warts may be discovered on routine gynecological examination or may be reported to the doctor by the patient. 1 application of a 20% solution of podophyllum, applied carefully to each wart, usually effects a cure. Pelvic inflammatory disease seems to be on the increase. Provided any serious disease is ruled out a course of systemic antibiotics is often effective. Urinary infections are often seen in the gynecologic clinic, and many of these will respond well to 2 tablets of co-trimoxazole, 2 times daily for 14 days. In pruritus vulvae it is important to determine whether the cause is general or local. Menstrual problems regularly occur and have been increased by the IUD and the low-dose progesterone pill. Infertility necessitates investigation. It is helpful to use the temperature chart method to determine whether the patient is ovulating. Oral contraception merits only passing mention, i.e., the introduction of a new sequential pill containing ethynloestradiol and levonorgestrol. There is always the question of a possible relationship between long-term OC use and the development of endometrial cancer. There are certain definite indications for hormone replacement therapy, i.e., hot flushes, sweating and atrophic vaginitis.
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PMID:The pharmacology of gynaecology. 744 23

The purpose of this study was to demonstrate the prevalence of cervical human papilloma virus (HPV) infection correlated to reason for attending an STD clinic, presence of clinical signs of HPV infection, concomitant infection and abnormal cytology. Samples from the cervical canals of 588 consecutive women attending the STD clinic, Department of Dermato-Venereology, Sahlgrenska Hospital, Gothenburg, were taken with a Cytobrush for detection of HPV DNA with the dot blot/Southern-blot technique. Visible condylomata, i.e. filiform or papular condylomata, were registered. Acetic acid test and colposcopy were not routinely performed. Cytological examination was performed as well as isolation of Chlamydia trachomatis on Mc Coy's cells and culture on Sabouraud agar for Candida albicans. The prevalence of HPV DNA was 8% (48/588). In the group of 233 women attending because of concern about HPV infection, 94 (40%) had visible signs of HPV infection and 30 (13%) were positive for HPV DNA in the cervix. In 355 women attending for other reasons, such as discharge, pruritus or STD check-up, 4 (1%) had visible signs of HPV infection and 18 (5%) were HPV DNA positive. Of 98 women with visible signs of vulvar/vaginal HPV infection, 33 (34%) were HPV-positive in the cervix with a commercial Southern-blot test. Of 490 patients without visible signs of HPV infection, 15 (3%) were HPV-positive in the cervix. In the group of HPV-positive women a positive culture for Candida was demonstrated in 26% (11/43), Compared to 16% (79/504) of the HPV-negative women.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Human papilloma virus infection among women attending an STD clinic correlated to reason for attending, presence of clinical signs, concomitant infections and abnormal cytology. 774 43

An exploratory study was conducted in Malawi to determine whether a correlation exists between human immunodeficiency virus (HIV) and traditional practices involving the intravaginal application of substances such as herbs and pulverized stone. Included in the survey were 6603 consecutive consenting volunteers who presented at the prenatal clinic of an urban hospital from October 1989-October 1990. The median age of study participants was 24 years. Although only 11% reported having had a sexually transmitted disease (STD) in the three years preceding the interview, laboratory analysis revealed the presence of such an infection in 46%. HIV infection was found in 1502 (23%). A total of 2953 (45%) of these pregnant women reported use of vaginal agents or vaginal incision, either for the treatment of discharge or itching or for the enhancement of sexual pleasure through vaginal tightening. Concerns have been raised that the placement of desiccants, irritants, and astringents in the vagina can induce certain physiological changes that increase the risk of HIV infection. Demonstrated in this survey was a slight association between HIV seropositivity and the use of vaginal agents for self-medication but not for vaginal tightening. In the univariate analysis, this finding persisted only for pregnant women without past or current STD infection. In the multivariate analysis, users of vaginal agents for treatment had a small increased risk of HIV in addition to--and independently of--the risk conferred by an STD history. It is possible, however, that the use of vaginal agents for self-medication is a marker for the presence of genital tract inflammation--a co-factor for HIV transmission. Given the extent of this traditional practice and its potential risk, more research is urged on the type of vaginal agents used and their effects on vaginal tissue.
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PMID:Traditional vaginal agents: use and association with HIV infection in Malawian women. 775 19

Genital warts are common and are a sexually transmitted disease affecting all socioeconomic groups and life-styles. They are caused by the human papillomavirus (HPV) and are highly contagious. Genital warts are often symptomless, but occasionally cause itching, bleeding after intercourse burning and pain. Referral to a Genitourinary Medicine Clinic is recommended, where specialist treatment and counselling are available. Special care is needed with children or if the patient is pregnant. At the clinic, patients may be shown how to treat themselves at home with podophyllotoxin.
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PMID:Modern management of genital warts in women. 868 Jan 65

Efficacy of chemical and/or surgical treatment for penile and anal condylomata acuminata was investigated in two retrospective studies of hetero- and homosexual men. Variation in clinical features and symptomatology as well as the reliability of diagnostic criteria by different methods for acetowhite penile lesions was also studied. Furthermore, the antibody response in the course of penile wart disease as well as in asymptomatic genitoanal papillomavirus infection (GPVI) was analysed. In the first retrospective study, as much as 23% of patients still had condylomas after one year of chemical and/or surgical treatment. On the other hand, 38% were cured after a single treatment session. In the group mainly with anal warts, concurrent penile warts were significantly more common among heterosexual men compared to homosexual men (p < 0.001), while intra-anal wart growth was more common among the homosexual males (p < 0.001). When comparing diagnostic methods for subclinical penile HPV infection, conventional histopathology appeared to be the most valuable diagnostic aid to penoscopy, while the additional use of Southern blot, in situ hybridisation and PCR assays for HPV DNA detection did not increase the predictive value of GPVI. We also describe a new distinct clinical entity, HPV-associated balanoposthitis, comprising a wide range of often long-lasting symptoms, such as itching, burning and dyspareunia. A significant increase in the IgG antibody response against defined epitopes in the L1 and L2 capsid proteins of HPV 6, was found among men with previous condylomata. By following a cohort of STD clinic patients with multiple brush samples from the genitoanal region as well as serum samples taken at several consecutive clinical visits, we identified 16 patients who had seroconverted to HPV seropositivity during follow-up. Antibody responses to several HPV-derived peptide and protein antigens were induced at the same time. Seroconversions were usually seen concomitantly with HPV acquisition or at the visit after HPV DNA was first detected. The HPV antibody response was frequently transient and declined or disappeared after clearance of infection. The antibody responses were induced by several different HPV types, indicating limited type-specificity. The most type-restricted response was against HPV 16 capsids, where seroconversions to continuous seropositivity were induced by infection with HPV 16.
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PMID:Clinical and serological manifestations of genital human papillomavirus infection. 872 19


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