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Biomedical subjects

A Mindel

Publications and source records attributed to A Mindel.

At least 91 records · Page 5Linked to original sources
PubMed1989

Primary and secondary syphilis, 20 years' experience. 3: Diagnosis, treatment, and follow up.

The methods of diagnosis (dark ground microscopy and serology), treatment, and follow up of 946 patients with primary and 854 with secondary syphilis who presented to a London STD clinic between 1965 and 1984 were reviewed retrospectively. On dark ground microscopy spirochaetes typical of Treponema pallidum were seen in 673 (78%) of 884 patients with primary syphilitic chancres. Of the patients with primary syphilis, 137 (14.5%) had negative serology results at presentation. Eight (0.9%) of the patients with secondary syphilis had negative results at presentation, but seven of these gave positive results one month later. Procaine penicillin was the treatment used most, and erythromycin the commonest alternative. The Jarisch-Herxheimer reaction occurred more often after treatment with penicillin than with erythromycin or tetracycline (p less than 0.005). In most patients the Venereal Diseases Research Laboratory (VDRL) test showed a consistent fall in titre after treatment; a small proportion, however, continued to give positive results (some at a high titre) with no other evidence of reinfection or treatment failure.

Erythromycin↗
PubMed1988

Outcome of untreated infection with Entamoeba histolytica in homosexual men with and without HIV antibody.

Among homosexual men the prevalence of infection with Entamoeba histolytica is high. To determine the clinical importance of this infection 55 homosexual men carrying the parasite were investigated in detail. No clinical, serological, or histological evidence of invasive amoebiasis was found in any of them. The patients were not treated and were followed up for 12 to 29 months (mean 21.6 months), during which period none developed symptoms that could be attributed to E histolytica. Spontaneous loss of the parasite occurred in 17 patients, some of whom later became reinfected. Sixteen patients had antibody to human immunodeficiency virus, and infection with E histolytica showed the same benign course in them as in the patients who did not have antibody. Throughout the study classification of the isolates of E histolytica consistently showed that they belonged only to non-pathogenic zymodemes. The findings provide further evidence that E histolytica in homosexual men is a commensal organism.

Animals↗
PubMed1988

Comparative studies of inosine pranobex and acyclovir.

A total of 77 patients with first-attack genital herpes received acyclovir, 400 mg four times per day, inosine pranobex, 1 g four times per day, or both drugs for seven days. Patients treated with acyclovir healed in a shorter time and had a shorter duration of viral shedding and symptoms than those treated with inosine pranobex. Neither acyclovir nor inosine pranobex had any effect on the time to first occurrence or the frequency of subsequent recurrences. Preliminary results from two trials suggest that suppressive acyclovir is more efficacious than inosine pranobex in patients with frequently recurring genital herpes.

Acyclovir↗
PubMed1988

Dosage and safety of long-term suppressive acyclovir therapy for recurrent genital herpes.

131 patients with frequently recurring genital herpes were treated for 1 year with reducing doses of oral acyclovir. The time to first recurrence in patients who commenced therapy on 400 mg twice a day was statistically significantly shorter than those on 200 mg four times a day (p less than 0.02) and as the total daily dose and frequency of therapy were lowered so the time to first recurrence was shortened. By the end of 60 days on 200 mg once a day (the lowest daily dose) 56% of patients had recurrences. Patients showed a marked reduction in the frequency of recurrence during therapy (from a mean of 1.1 per 28 days before to 0.11 during treatment, p = 0.0001). After stopping treatment the frequency of recurrences (0.71 per 28 days) was significantly less than the pre-treatment period (p = 0.001). No important side-effects were seen. It is concluded that long-term suppression with acyclovir is safe and effective for patients with recurrent genital herpes.

Acyclovir↗
PubMed1988

Recurrent genital herpes: clinical and virological features in men and women.

One hundred and forty eight patients (69 women and 79 men) with often recurring genital herpes were observed for two months. Men had 119 observed recurrences and women 104. The attacks were significantly longer in men than women (8.7 days v 6.6 days, p = 0.005). Significantly more women complained of symptoms, however, and when symptoms occurred they were more severe. Other significant differences between men and women included age (men were older than women); more men had previously had sexually transmitted diseases; more men had infected a sexual partner, but fewer knew the source of their infection; and men had more lesions at each attack. Positive viral culture results were shown to depend on the amount of erythema, the number of lesions, and the presence of vesicles.

Adult↗
PubMed1987

Treatment of first-attack genital herpes--acyclovir versus inosine pranobex.

77 patients with a first attack of genital herpes were entered into a double-blind trial to compare the efficacy of acyclovir with that of inosine pranobex. 24 patients received acyclovir with that of inosine pranobex, and 28 both drugs. Patients treated with acyclovir or both drugs healed more quickly and had a shorter duration of viral shedding than those treated with inosine pranobex. The time to first recurrence and frequency of subsequent recurrences were similar in the three treatment groups. Acyclovir is the treatment of choice for patients with a first attack of genital herpes.

Acyclovir↗
PubMed1987

Sex and the bowel.

Patients with gastrointestinal symptoms may not associate their problems with sexual activities or be unwilling to admit to homosexuality. The diagnosis may be delayed or missed and sexual partners are unlikely to be investigated. To complicate matters further the clinical manifestations of some infections may be markedly altered in a patient whose immune system has been compromised by infection with Human Immunodeficiency Virus.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Primary and secondary syphilis, 20 years' experience. 1. Epidemiology.

The case notes of 946 patients with primary and 854 with secondary syphilis who attended the department of genitourinary medicine at the Middlesex Hospital in 1965-84 were analysed retrospectively. Most patients were homosexual men, and the proportion of homosexuals showed a significant (p less than 0.0005) upward trend during the study period. There was also a significant upward trend in the percentage of British attenders (p less than 0.0001), as well as an increase in patients in social classes I, II, or III non-manual (p less than 0.0001). Homosexual men had a greater number of sexual partners than heterosexuals or women, and were also more likely to have had a sexually transmitted disease. The proportion of homosexuals with multiple partners showed a significant (p less than 0.0005) upward trend during the study period.

Adolescent↗
PubMed1986

Entamoeba histolytica as a commensal intestinal parasite in homosexual men.

Entamoeba histolytica is considered to be an uncommon, imported organism in the United Kingdom and in many parts of North America, but recent attention has been drawn to the possibility of sexual transmission of this parasite among homosexual men. To determine the prevalence and clinical importance of enteric parasitic infections in men attending a clinic in London for the treatment of sexually transmitted diseases, we studied 354 randomly selected patients who provided a single stool sample that was examined for E. histolytica and other intestinal parasites. Forty-five of the 225 homosexual patients (20 percent) were infected with E. histolytica, but no such infections were found among the 129 heterosexual subjects (P less than 0.0001). With the use of isoenzyme electrophoresis, 34 of the 45 E. histolytica isolates were classified according to zymodeme. All were Zymodeme I or III, which are considered to be nonpathogenic. There was no correlation between the presence of E. histolytica and gastrointestinal symptoms. These findings suggest that E. histolytica is a common commensal in the homosexual population and that, in the absence of evidence of invasive disease, treatment of persons passing cysts of the organism may have little practical benefit.

Adult↗
PubMed1986

Typing and subtyping of herpes simplex isolates by monoclonal fluorescence.

The type specificity of 16 herpes simplex monoclonal antibodies was tested on 50 isolates previously typed by endonuclease restriction. A panel of antibodies was selected and used to type isolates from 50 primary and 50 recurrent genital infections. Sixty-four isolates from 18 patients followed up for six months were subtyped by using a larger panel of monoclonal antibodies and predominant HSV1 and HSV2 subtypes were demonstrated. In addition to confirming recurrences, four possible reinfections were identified. Type-specific differences in the location of viral antigens in infected cells were noted and a possible association of this finding with the type-specific differences in rates of recurrence of genital infections discussed.

Antibodies, Monoclonal↗
PubMed1986

Acyclovir in first attacks of genital herpes and prevention of recurrences.

Sixty women patients experiencing a first attack of genital herpes were randomly treated with either oral acyclovir for 42 days or oral acyclovir for five days followed by placebo for 37 days. The median time to the first recurrence in patients receiving acyclovir for 42 days was 66.5 days compared with 24 days in those who received acyclovir for only five days (p less than 0.0001). This significant difference, however, was only observed for the treatment period. The frequency of recurrences was also reduced during the period of treatment in those who received prolonged treatment. During the subsequent follow up period, however, patients in both groups had a similar frequency of recurrences. Patients with infections due to herpes simplex virus type I (HSV I) had a significantly longer time to the first recurrence (p less than 0.001) and fewer recurrences (p less than 0.001) than those infected with HSV II, irrespective of treatment.

Acyclovir↗
PubMed1985

Rising prevalence of human T-lymphotropic virus type III (HTLV-III) infection in homosexual men in London.

The prevalence of antibody to HTLV-III has increased from 3.7% (4/107) amongst unselected British homosexual men attending a London sexually transmitted disease (STD) clinic during one week in March, 1982, to 21% (26/124) in those attending during one week in July, 1984. Seropositive men had a significantly higher prevalence of infection with hepatitis B virus than did seronegative men. 82% (27/33) of the seropositive men in 1984 were symptomless or had only local genito-urinary symptoms referable to the STD for which they were attending. The evidence suggests that HTLV-III was initially an imported but is now an endemic sexually transmitted agent. As of July, 1984, at least 2600 homosexual men in London would probably have been infected.

Acquired Immunodeficiency Syndrome↗