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Biomedical subjects

A M Worm

Publications and source records attributed to A M Worm.

At least 19 recordsLinked to original sources

[HIV testing and HIV surveillance of a venereological clientele in Denmark].

The object of this investigation was to evaluate the suitability of unlinked anonymous HIV screening of persons visiting one of eight out of the nine Danish clinics for venereal diseases in the national HIV surveillance. Data were collected during the period July 1, 1990-March 31, 1991 and included: gender, sexual orientation, history of intravenous drug use (IVDU), syphilis testing and HIV testing. A total of 7,455 persons participated of whom 75% were tested for HIV antibodies. The HIV test activity was significantly higher among male IVDUs than homo/bisexuals, and higher among female IVDUs than heterosexuals. The overall HIV prevalence among tested individuals was 0.6%, ranging from 0.1% among heterosexual women to 5.3% among female IVDUs. A total of 81% were tested for syphilis with an overall HIV prevalence of at least 1.1%, ranging from 0.2% among heterosexuals to 9.3% among homo/bisexual men. Since the non-participation is great and the venereological clientele is very heterogeneous, using blood taken for syphilis serology from this group for unlinked anonymous HIV screening, would not be particularly important as a supplement to the Danish HIV surveillance.

Denmark

[Sexually transmitted infections in HIV-positive persons].

In 1989 and 1990, newly-acquired sexually transmitted bacterial disease was found in 41 HIV-antibody-positive men seen at a sexually transmitted disease (STD) clinic in Copenhagen. In 38 homo/bisexual men, the new STD was transmitted from a male contact in 36 cases and from a female contact in two cases. In three male intravenous drug users, the new STD was transmitted from a female contact. In two men, the HIV-infection was first diagnosed together with the new STD, the other men had been aware of their HIV-infection for a mean period of 38 months. Gonococcal infections were diagnosed in 33 men, Chlamydial infections in ten men and syphilis in three men. Anorectal gonococcal infections were found in 13 men, corresponding to 43% and 30% of the total number of anorectal gonococcal infections in 1989 and 1990 respectively. The data presented might indicate a relapse to unsafe sexual practices among homosexual men in Copenhagen. This could influence the HIV prevalence as at least 12% of the contacts were known to be HIV-antibody-negative.

Adult

Sexual behaviour of women attending an inner-city STD clinic before and after a general campaign for safer sex in Denmark.

OBJECTIVES: To examine the sexual behaviour and the prevalence of sexually transmitted diseases (STD) among females attending an inner-city STD clinic before and after safer sex campaigns. SUBJECTS: In 1984 981 women and in 1988 684 women were interviewed immediately after the venerological examination. SETTING: Department of Dermato-Venereology, Bispebjerg Hospital, Copenhagen, Denmark. METHODS: In a face to face interview, details of symptoms, age at coitarche, number of sexual partners (lifetime and during the last year), obstetric history, and contraceptive methods were recorded. RESULTS: A substantially higher proportion of women used condoms in 1988 than in 1984. A dramatic decrease in the prevalence of gonorrhoea occurred (from 22% in 1984 to 6% in 1988, p < 0.01), whereas an increase in the number of patients with genital warts was observed (from 4% in 1984 to 10% in 1988, p < 0.05). The prevalence of chlamydia, genital herpes, and cervical dysplasia remained unchanged. No significant changes in the number of sexual partners, or the frequency of sexual intercourse or unplanned pregnancy could be detected from 1984 to 1988. CONCLUSIONS: The safer sex campaigns have only been partly successful, as a general reduction in all sexually transmitted diseases should be expected as a result of the increased use of condoms. Future campaigns should focus on the correct use of condoms, and encourage a lifestyle with stable sexual relationship.

Adolescent

HIV-2 infection in Denmark.

A collection of 3019 selected serum samples (ss), comprising 329 ss from intravenous drug abusers, 558 ss from homosexual men, 682 samples from persons attending a STD clinic, 100 ss from individuals of African origin, 300 ss from sexual contacts to Africans, 650 ss from Danish blood donors who resided in Africa greater than 2 years prior to donating the ss, and 400 ss with equivocal antibody reactions in an HIV-1 Western blot was tested for antibodies against HIV-2 by in-house HIV-2 ELISA and Western blot. Four ss were positive for antibodies against HIV-2. Three of the ss originated from West African men, the fourth belonged to the spouse of one of these men. Three of the samples presented with an uncharacteristic reaction in a HIV-1 Western blot. The study indicates that HIV-2 infection is not yet widespread in Denmark and that it remains closely related to West Africa.

Africa, Western

HIV infection among intravenous drug users in Copenhagen.

From October 1985 until the end of December 1986, 439 intravenous drug users (IVDU) presented themselves at the outpatient venereal disease clinic of Copenhagen for an HIV-test. HIV-antibodies were found in 53 out of 272 men (19.5%) and in 25 of 167 women (15.0%), giving an overall prevalence of 17.8%. Risk factors for HIV were the length of drug abuse (p less than 0.05) and having injected drugs within the last six months before testing (p less than 0.005). HIV-antibodies were found in 18 of 90 women (20%) and in three of 20 men (15%), who had a history of a past or ongoing life as a prostitute. The IVDU in this study have been chosen as a cohort and recalled for an ongoing follow-up study focusing on drug and sexual behaviour in relation to the initial HIV-test result.

Acquired Immunodeficiency Syndrome

Human immunodeficiency virus surveillance at a sexually transmitted disease clinic in Copenhagen.

During four study periods, each of 3-4 weeks' duration in 1987 and 1988, all patients attending the Copenhagen outpatient Venereal Disease Clinic were encouraged to have a test for human immunodeficiency virus (HIV) antibody. Anonymous testing or testing for research purposes only without any data was also offered. Patients known to be HIV antibody-positive were not re-tested. A total of 1753 patients (1118 men, 635 women) were counselled and testing recommended. Testing was refused by 255 patients, 57 of whom had been tested (all negative) within the previous 3 months. HIV serology was therefore unknown in 11.7% (198 of 1696 persons), including 120 of 922 heterosexual men (13%), 16 of 159 homo/bisexual men (10%) and 62 of 615 women (10%). There was no substantial difference between the four study periods in the numbers refusing the test. Sixteen of the 1498 patients tested were HIV antibody-positive, including one woman and 3 men with a history of intravenous drug abuse and 11 homo/bisexual men; one heterosexual man with HIV antibodies had no known risk behaviour. It is concluded that HIV testing with informed consent at a sexually transmitted disease clinic will not include all persons, and therefore will not exclude a self-selection bias. Surveillance studies using unlinked HIV testing are therefore necessary and it is recommended that they should be performed in Denmark. In this study, unlinked HIV testing of the serum specimens taken for syphilis serology would have decreased the percentage of 'non-attenders' from 12.4% to 0.8% during the final study period.

Bias

Roxithromycin and erythromycin in chlamydia-negative non-gonococcal urethritis.

The clinical efficacy and safety of roxithromycin 300 mg once a day was compared with that of erythromycin 500 mg twice a day in 87 men with chlamydia-negative non-gonococcal urethritis. In the roxithromycin group the clinical efficacy rate was 88% on day 8 and between 78% and 84% on day 21. In the erythromycin group the clinical efficacy rate was 98% on day 8 and 86% on day 21, a non-significant difference. Side effects were mainly gastrointestinal, occurring in about 15% of patients receiving each treatment.

Chlamydia Infections

Condoms and sexual behaviour of young tourists in Copenhagen.

Sleep-in is a summer youth hostel in the center of Copenhagen with 459 beds, which was used for 19,296 overnight stays in July and August 1987. In the summer of 1987, each of the guests, 95% of whom were young tourists, received an envelope with a condom and a written reminder about the use of condoms during sexual relationships. During a period of the summer, 1,229 guests (498 women and 731 men) completed a questionnaire. The results showed that 21% of the men always, and 43% never had condoms in their luggage when travelling and 6% of the women always, and 79% never had condoms in their luggage. Of the 40 men who had sexual contact with Danish girls, 19 had always used a condom. Of the nine men with Danish homosexual contacts, three had always used condoms. Of the four women who had sexual contact with Danish men, none had used condoms.

Adolescent

Skin and oral mucosal changes in patients infected with human immunodeficiency virus.

During a 6-month-period, 150 patients infected with Human Immunodeficiency Virus (HIV) were repeatedly examined by dermatologists and dentists for lesions of skin and oral mucosa. The most frequently encountered diseases were: oral hairy leukoplakia (21%), dermatophytosis (including tinea unguium/tinea pedis et inguinalis) (20%), seborrheic dermatitis (19%), viral infections (10%), oral candidiasis (7%), acne vulgaris (6%), and folliculitis (5%). A variety of other manifestations were seen, with frequencies less than 5%. Herpes zoster was seen in 3% of the patients, indicating a rate of 60/1,000 per annum. The presence of seborrheic dermatitis was statistically associated with low T-helper lymphocyte count. Patients with low T-helper lymphocyte count had on average twice as many mucocutaneous lesions as patients with a normal or moderately decreased count. Any one of the manifestations seborrheic dermatitis, oral candidiasis or oral hairy leukoplakia was associated with a greater average number of additional mucocutaneous changes than seen in patients exhibiting none of these three conditions. The high proportion of HIV-infected patients with cutaneous and oral lesions underlines the importance of referring the patients to dermatologists and dentists for examination. Prospective examinations of the study population remain to elucidate the prognostic significance of mucocutaneous manifestations of HIV-infected patients.

Acquired Immunodeficiency Syndrome

Bone marrow involvement in mycosis fungoides demonstrated by needle biopsy.

A bone marrow needle biopsy was performed in 19 patients with mycosis fungoides (MF). Two patients, one previously classified as stage 4 and the other with diffuse erythroderma had pathological bone marrow findings. Seventeen patients showed no evidence of bone marrow involvement, 10 of these were in the plaque stage. Bone marrow biopsy can be of value in assessing the stage of the disease.

Adult

Thyroid function in malignant lymphoma.

Thyroid function was studied in 36 patients with various stages of malignant lymphoma. Stage IVB patients exhibited characteristic changes in thyroid biochemistry in the form of lowered triiodothyronine (T3) and elevated free thyroxine (FT4), but normal thyroxine. Moreover, the concentration of thyroxine-binding prealbumin and albumin was lowered, whereas thyroxine-binding globulin was normal. Thyroid-stimulating hormone was slightly elevated but showed a normal increase after administration of thyrotrophin-releasing hormone. Patients with less extensive disease differed only slightly from the controls. The results agree with previous studies of patients suffering from other chronic diseases. The mechanisms underlying the hormonal changes have been only partially elucidated. When investigating patients with disseminated malignant disease for thyroid disease, the above mentioned changes in thyroid biochemistry must be borne in mind. Single analyses of FT4 and T3 may give rise to a false assumption of hyper- or hypothyroid states in patients who are in fact euthyroid.

Adolescent

Transcapillary escape rate of albumin and plasma volume in patients with varying degrees of psoriasis.

Plasma albumin, plasma volume and the transcapillary escape rate of albumin (TERalb), i.e. the fraction of the intravascular mass of albumin that passes to the extravascular space per unit time, were determined using 125I-labelled albumin in 26 patients with varying degrees of psoriasis. For the patients as a group the plasma albumin concentration and the TERalb values were not significantly different from the control group. This contrasts with earlier findings in erythrodermic patients. The plasma volume was significantly reduced whether it was expressed in relation to body weight, height or surface area (P less than 0.001). Thus the intravascular mass of albumin (IVM), determined as the product of the plasma volume and the plasma albumin concentration, was also significantly reduced (P less than 0.001). We found no correlation between the involved skin area and any of the above mentioned parameters. The possible mechanisms in the reduction of the plasma volume and the IVM are discussed. It is suggested that reduced IVM may reflect reduced total albumin mass due to lowered rates of albumin synthesis or increased rates of turnover.

Adolescent

Chronic myelocytic leukaemia presenting in blastic transformation. Two cases primarily diagnosed as acute myelocytic leukaemia.

The interval from diagnosis of chronic myelocytic leukaemia (CML) to onset of blastic transformation (BT) can vary from days to several years. This blastic phase of CML is indistinguishable from acute myelocytic leukaemia (AML), both clinically and morphologically. The Ph1 chromosome has occasionally been demonstrated in acute leukaemia and it has been suggested that these cases may represent CML presenting in BT. 2 such patients are reported, in 1 of whom the characteristics after treatment further confirmed the diagnosis of CML. Differentiation between CML presenting in BT and AML has both prognostic and therapeutic value. For this reason it is recommended that cytogenetic screening for the Ph1 chromosome should be included in the initial examination of patients with acute leukaemia.

Adult