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Biomedical subjects

D Goldmeier

Publications and source records attributed to D Goldmeier.

36 records · Page 2Linked to original sources
PubMed1983

Topical acyclovir in the treatment of genital herpes: a comparison with systemic therapy.

Controlled trials of acyclovir cream were conducted in the treatment of initial and recurrent genital herpes. For 54 patients with the first episode of genital infection (initial disease) treated with acyclovir the duration of viral shedding, formation of new lesions, times to crusting and healing and duration of symptoms were significantly reduced compared with the results obtained in 47 placebo recipients. When applied early in the course of recurrent episodes in 44 patients, acyclovir cream significantly reduced viral shedding, a new lesion formation, time to healing and the duration of symptoms compared with the effects in 41 control patients. Topical therapy with acyclovir cream is well tolerated and compares quite favourably with systemic treatment, especially for recurrent genital herpes.

Acyclovir↗
PubMed1983

Immunocompromise syndrome in homosexual men. Prevalence of possible risk factors and screening for the prodrome using an accurate white cell count.

The immunocompromise syndrome in homosexual men in the USA is thought to be associated with cytomegalovirus (CMV) infection and nitrite intake. Such men often have a lymphopenia. In a clinic in London 76% of 46 unselected homosexual men and 50% of 76 heterosexual controls had serum CMV IgG antibody at a titre of 1/16 or more (p less than 0.01). No case of excretion of CMV in the urine was found. Thirty per cent of the homosexual men admitted to using nitrites. These figures suggest that this population of homosexual men uses nitrites less often than their counterparts in the USA and is less likely to have evidence of active or past CMV infection. In addition, these male homosexual patients seem to be less promiscuous than those reported from the USA. Mean accurate total and differential white blood cell counts, using the Haemalog D automatic white cell counter, were no different in homosexual men (and various at risk subgroups of them) than heterosexuals, suggesting that the prodrome to the immunocompromise syndrome was not present in the London clinic population.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Entamoeba histolytica in male homosexuals.

The mobility patterns of four enzymes using cultured trophozoites of Entamoeba histolytica were examined by electrophoresis. By this means the stocks of amoebae isolated from male homosexuals were characterised into zymodemes. No amoebic stock isolated corresponded to a pathogenic zymodeme.

Animals↗
PubMed1982

Does psychiatric illness affect the recurrence rate of genital herpes?

The progress of 58 patients with first attacks of genital herpes was monitored for up to 30 weeks. The effects of sex (gender), age, social class, and non-psychotic psychiatric illness (as measured by the "general health questionnaire," GHQ) on the recurrence rate of herpes was studied. The recurrence rates, measured by the actuarial percentage recurrence-free curves, showed that the 29 patients with GHQ scores above 11 had a significantly higher recurrence rate than those who scored less than 11 (P = 0.002). There were no important differences between recurrence rates according according to sex, age, or social class. These findings suggest that non-psychotic states, such as anxiety or obsessionality resulting in GHQ scores above 12, may possibly cause an excess production of adrenergic substances which encourages reactivation of latent genital herpes. Thus, to lessen the recurrence rate in such patients, a psychological or chemical approach to treatment could be used to modify the autonomic sympathetic response.

Adolescent↗
PubMed1981

Gonococcal septicaemia presenting as a subcutaneous abscess.

In a case of disseminated gonococcal infection the diagnosis was delayed until Neisseria gonorrhoeae was grown from pus from a discharging abscess of the biceps muscle. This unusual skin manifestation appears not to have been reported before.

Abscess↗
PubMed1981

Penetration of penicillin into the cerebrospinal fluid of patients with latent syphilis.

Eighteen patients with latent syphilis were treated with 360 mg, 720 mg, 1080 mg or 1440 mg intramuscular procaine penicillin daily for 14 days. Penicillin was assayed in serum and cerebrospinal fluid collected 3 hours after the second injection in each patient. Penicillin was present in all sera in concentrations greater than the generally accepted fully treponemacidal level, but none was detected in cerebrospinal fluid from 11 patients. The significance of these results is discussed, particularly with a view to changes in standard treatment regimens for latent syphilis.

Adolescent↗
PubMed1980

Proctitis and herpes simplex virus in homosexual men.

In a study of the prevalence of rectal infection with herpes simplex virus (HSV) in a group of homosexual men the magnified appearance of the rectal mucosa correlated with isolation of the virus. HSV was isolated from rectal material from five of 77 men with proctitis of unknown cause but from none of 44 control patients without proctitis; two of four men with HSV proctitis were asymptomatic. Thus, the magnified rectal mucosal image, showing severe congestion, haemorrhage, and pus, appears to be a sensitive indicator of the presence of HSV proctitis.

Adult↗
PubMed1979

Relatives and friends group in a psychiatric ward.

To enable relatives and friends of psychiatric patients in a 30-bed acute admission ward to meet the staff team together a relatives and friends group was initiated. The group was intended to provide a forum for questions about the patients' illness and treatment; allow feelings, such as anger and anxiety, about the patient's illness to be expressed; and enable relatives and friends to share their experiences and offer advice and support to each other. A study was designed to assess the feasibility of the group scheme. Relatives and friends were invited to the day room of the admission ward each Wednesday evening for one hour. The visitors chose their own topics for discussion and the staff team tried to answer questions and to facilitate a free exchange of views. An account of each meeting was documented, including details of attenders, the nature of the topics raised, and a simple measurement of some of the emotions expressed by the visitors. Overall, the effect of the meetings seemed positive and productive, for they allowed relatives and friends to ask questions about many topics, to express pent-up emotions, and to gain a better understanding and tolerance of the patient's illness. The relatives and friends group has become an integral part of treatment on the wards. Now that the feasibility of such a group is established, further studies are required to evaluate its efficacy.

Communication↗
PubMedDate not supplied

Traumatic proctitis.

Explore the source record for details and available documents.

Chlamydia Infections↗
PubMedDate not supplied

Treatment of gonococcal urethritis in men with a rifampicin-erythromycin combination.

A group of men with uncomplicated gonococcal urethritis were treated with a single oral dose of rifampicin (900 mg) and erythromycin stearate (1 g). Neisseria gonorrhoeae was isolated from four of 108 men at the first follow-up examination, and from none of 68 who attended a second follow-up examination. It is concluded that this rifampicin-erythromycin combination may be useful for the therapy of gonorrhea. It may be of particular value in the treatment of infections due to penicillin-resistant N. gonorrhoeae, since in vitro studies showed that both rifampicin and erythromycin were active against 20 strains of beta-lactamase-producing N. gonorrhoeae. The effect of this rifampicin-erythromycin combination against associated infections with Chlamydia trachomatis was disappointing. This organism was isolated from five of nine patients who had yielded isolates of C. trachomatis before treatment.

Administration, Oral↗
PubMedDate not supplied

A review and update on adult syphilis, with particular reference to its treatment.

Syphilis has become less common in Europe in the last decade, but has once again become a major problem in the USA, and remains so in many developing countries. Several treponemal genes have now been cloned and expressed in Escherichia coli, allowing study of treponemal proteins. The importance of cell mediated immunity in syphilis has been demonstrated in animal models. A diagnosis of syphilis is usually confirmed by dark-field microscopy or serological tests. Seroconversion may be delayed in HIV infected individuals. A positive reaginic test in cerebrospinal fluid (CSF) has a high specificity but low sensitivity in the diagnosis of neurosyphilis. Indeed, virulent treponemes can be identified in CSF samples which have negative reaginic tests, normal cell counts and protein levels. In the CSF, the FTA-Abs test has a high sensitivity but low specificity for neurosyphilis. Penicillin remains the treatment of choice for all stages of syphilis, although it penetrates the blood brain barrier poorly. Treatment with intramuscular benzathine penicillin 2.4 million units stat, or 600,000 units procaine penicillin daily does not produce treponemicidal levels within the CSF. However, the incidence of neurosyphilis is low in immunocompetent patients treated with such regimens during early syphilis. Acceptable alternatives in penicillin-allergic patients include ceftriaxone and doxycycline. Erythromycin is not recommended as it has produced unacceptably high rates of treatment failure. Recently, a strain of macrolide-resistant Treponema pallidum was isolated from a patient with secondary syphilis. For the treatment of neurosyphilis, treponemicidal levels of penicillin can be achieved in the CSF using 2.4 million units procaine penicillin daily with concurrent probenecid 500 mg 4 times a day, or an intravenous infusion of benzyl penicillin 12-24 million units daily. Early syphilis can be treated adequately over 10 days, but 21 to 28 days is appropriate for late syphilis. In HIV-infected patients syphilis may present atypically with initially negative serological tests. Treatment of early syphilis in HIV-positive patients has been associated with the early development of neurosyphilis. It is advisable to treat all patients co-infected with HIV with an antibiotic regimen that achieves adequate levels within the CSF.

Adult↗
PubMedDate not supplied

Sexual behaviour among London GUM clinic attenders: implications for HIV education.

The aim of this study was to describe the sexual behaviour of a sample of genitourinary medicine (GUM) clinic attenders, 5 years after the launch of the UK government HIV media campaigns. A gender-specific and anonymous cross-sectional self-completion questionnaire was modified from the National Survey of Sexual Attitudes and Lifestyle and completed by 250 men and 250 women. The majority of the respondents were in their twenties, lived in London and were employed or students. Sixty-eight per cent of the men reported that one or more of their last 3 partners was not a regular partner. For those men whose last sexual encounter was with a new partner, 27% of heterosexuals and 33% of homosexuals reported using a condom. Fifty-one per cent of women reported one or more non-regular partners among their last 3 partners. For those women whose last sexual encounter was with a new partner, 43% of heterosexuals and 75% of bisexuals used a condom. Seventy-eight per cent of men and 75% of women had had a previous sexually transmitted disease (STD). These findings highlight the persistence of practices associated with the risk of contracting or transmitting HIV infection and which needs to be addressed in future educational campaigns. The GUM clinic population is an important population to monitor over time, either by longitudinal or serial cross-sectional studies. The results of this study provide a baseline against which to gauge the effects of future educational interventions.

Adult↗