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F Lassau

Publications and source records attributed to F Lassau.

17 recordsLinked to original sources

Virological, serological and epidemiological study of 255 consecutive cases of genital herpes in a sexually transmitted disease clinic of Paris (France): a prospective study.

Some studies (mostly retrospective) have pointed to an increasing frequency (up to 60%) of herpes simplex virus type 1 (HSV-1) in genital herpes (GH), but they were biased towards severe or atypical cases. We wished to evaluate the frequency of HSV-1 in patients attending our clinic for both first and recurrent episodes of GH. All patients (men and women) with genital lesions compatible with GH were included in a prospective study between May 1999 and April 2002. For all patients a standardized questionnaire, clinical examination, MRC5 culture (Dade Behring), polymerase chain reaction (PCR)-herpes consensus (Argène Biosoft) in case of negative culture and type-specific herpes serology HSV-1 and HSV-2 (Elisa Eurobio) were obtained. Predictive factors associated with HSV-1 and HSV-2 GH were studied by uni- and multivariable analyses. In all, 255 patients had a positive culture (n = 216) or PCR (n = 39). A total of 248 patients had typable herpes (148 men and 100 women). Median age was 33 (27-43); 20% had anal herpes; 48% had clinically recurrent lesions; 21% were HIV +; 20% of men were homosexual; 77% practised oral sex. In all, 36 were HSV-1 (14.5%): more in women, 25/100 (25%), than in men, 11/148 (7.5%) (odds ratio [OR]: 4 [1.8-9.1], P = 0.008). HSV-1 accounted for 23% of cases of first clinical episodes (women: 31.5%; men: 14.7%) (P = 0.02) and 6% of clinically recurrent episodes (women: 15%; men: 1.2%) (OR: 3.8 [1.6-9.1], P = 0.0033). Serological study was done in 239: primary infection was disclosed in 33 (HSV-1: 61%), HSV-2 non-primary first episode in 22 and recurrence in 184 (HSV-1: 8%). In all, 37% of recurrent episodes presented as a first clinical episode. HSV-1 was linked in men with homosexuality (P<0.01) and anilingus (P<0.01), in women with younger age (P<0.01), more sexual intercourses (P<0.0001) and more oral sex (P<0.001). Although HSV-1 is frequent in first clinical (23%) and primary (61%) episodes of GH, recurrent GH remains mostly due to HSV-2 (94%).

Adult↗

Seroprevalence of herpes simplex virus type 2 antibodies in an STD clinic in Paris.

Our objective was to evaluate the seroprevalence of herpes simplex virus (HSV)-2 and HSV-1 in a population of men and women attending the STD clinic of Hôpital St-Louis (Paris, France). Four hundred and eighty-seven patients (264 men and 223 women) were tested for HSV-2 and HSV-1 antibodies by specific enzyme immunoassay (EIA) (Smithkline-Beecham Biologicals). Univariate and multivariate analyses were carried out for correlations with clinical, socio-epidemiological and behavioural data. HSV-2 seroprevalence was 55% (44.7% in men, 67.3% in women). HSV-1 seroprevalence was 93% (94.7% in men, 91% in women). The predictive factors of HSV-2 seropositivity being female (OR: 3.37), age (OR: 1.04), country of origin (Central Africa OR: 3.52, North Africa OR: 1.36), history of genital herpes (OR: 10.97), hepatitis B virus (HBV) markers (OR: 1.92) and hepatitis C virus (HCV) markers (OR: 3.96). The only protective factor was HSV-1 seropositivity (OR: 0.25). The predictive factors of HSV-1 seropositivity were only the country of origin (Central Africa OR: 2.95, North Africa OR: 1.83) and the absence of genital herpes (OR: 11.01). Only 23 (8.6%) HSV-2 seropositive patients had a history of genital herpes. This study underlines the very high HSV-2 seroprevalence of patients with STDs, only a few of whom have a history of genital herpes. Detection and counselling is urgently needed for these patients.

Adolescent↗

[Detection of Chlamydia trachomatis infection by PCR in first voided urines in men].

The goal of this study was to evaluate whether the new commercially available PCR-based assay Amplicor C. trachomatis (Roche Molecular Systems) could improve the diagnosis of chlamydial urogenital infections in men, compared with cell culture of C. trachomatis considered as the reference method. A total of 466 men attending the STD clinic were tested by the Amplicor test in urine and by cell culture in urethra. The prevalence of C. trachomatis was 13.7% (64/466) by cell culture and 14.4% (67/466) by the Amplicor test. After resolution of the discrepant results, the sensitivity of culture was 91.4% in male urethral specimens. The resolved sensitivity of the PCR assay was 92.7% in male urine and the specificity was 99.5%. We concluded that this rapid PCR-based assay showed an improvement in quality for diagnosing C. trachomatis infections in men.

Adolescent↗

[Asymptomatic carriage of Chlamydia trachomatis in men consulting for condylomata acuminata].

A search for Chlamydia trachomatis by cell culture was carried out in the urethra of 82 male patients consulting for condyloma acuminata at the Clinical and Biological Centre for Sexually Transmissible Diseases of the Saint-Louis hospital, Paris. Three patients had discreet urethral signs, but none had urethral discharge. Cell culture was positive for C. trachomatis in 36 of the 82 patients (44 percent). This high prevalence suggests that C. trachomatis should systematically be looked for in the urethra of male patients consulting for condylomata acuminata. If this cannot be done, then a systematic treatment with tetracyclines should be instituted.

Adult↗

[Prevalence of HIV-1, HIV-2 and HTLV-1 infections. Experience in a Parisian center for sexually transmitted diseases].

Human immunodeficiency virus (HIV) infection is, to a great extent, a sexually transmitted disease (STD). Its diffusion among the heterosexual population is still limited. STD treatment centres are particularly well organized to watch this diffusion. At the STD centre of the Saint-Louis hospital, Paris, we conducted a 6-week prospective study concerning the systematic detection of HIV-1 infection in 240 consecutive female out-patients in 1988, and in 504 male out-patients in 1989. The results obtained were as follow: 5/240 women (2.1 percent) and 19/504 men (3.8 percent) were seropositive for HIV-1. Out of these 24 subjects, 15 did not know they were seropositive. Predictive factors for seropositivity were male homosexuality, addiction to heroin and, in women, drug addicts as sex partners. Altogether, 23 of the 24 seropositive subjects had the classical risk factors for HIV-1 infection. None of the 744 subjects in this study were HIV-2 seropositive, and only 1 out of 504 men was HTLV-1 seropositive. We conclude that the prevalence of HIV-1 infection was high in our centre, and this prompts us to suggest that the serological test should be proposed to all out-patients and that patient's education and preventive measures should be organized by STD centres, even though the infection is still limited to patients at a particularly high risk (drug addicts, homosexuals, country of origin).

Adult↗

[Re-evaluation of single-dose treatment with thiamphenicol and spectinomycin of uncomplicated male gonococcal urethritis].

Gonococcal urethritis being highly contagious, the ideal treatment should be effective, well tolerated and relatively cheap. Among antibiotics fulfilling these conditions, thiamphenicol and spectinomycin are widely used throughout the world and particularly in France. However, the ever increasing incidence of infections caused by penicillinase-producing Neisseria gonorrhoeae (PPNG) strains, the growing number of strains with low sensitivity to penicillin and/or other antibiotics and the recent emergence of strains that are highly resistant to penicillin make it necessary from time to time to re-evaluate the main therapeutic approaches to gonococcal urethritis. In this study thiamphenicol and spectinomycin were compared for effectiveness as single-dose treatments of uncomplicated gonococcal urethritis in 207 male patients who consulted at the Clinical and Biological Centre for Sexually Transmitted Diseases, Saint-Louis Hospital, Paris, during April and May, 1985. Prior to the trial the patients had not received antibiotics for at least 2 weeks. They were allocated at random to two therapeutic groups: 89 patients received a single 2.5 g dose of thiamphenicol orally, and 84 patients received a single 2 g dose of spectinomycin by intramuscular injection. In every case the gonococcal origin of the urethritis had been confirmed by culture. The patients were examined 3 to 7 days after treatment for clinical and bacteriological evaluation. Specimens were cultivated on agar-blood medium, and N. gonorrhoeae was also identified by biochemical and antigenic reactions. The minimum inhibitory concentrations (MIC) of the two antibiotics were determined by the agar plate dilution method, using an agar nutrient medium. The possible production of beta-lactamase and the auxotypic and plasmidic profiles of the PPNG strains were investigated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[One-dose treatment of male gonococcal urethritis by ofloxacin].

Ofloxacin is a new fluoroquinolone with excellent in vitro activity against N. gonorrhoeae. 32 adult males with acute uncomplicated gonococcal urethritis were treated with a single-dose of orally administered ofloxacin (400 mg). 1 out of 32 isolates was penicillinase-producing N. gonorrhoeae. Urethral cultures were obtained before treatment and on day 3-5. Microbiological cure was achieved in all patients (100%). No side effects were observed. According to these results, single-dose ofloxacin therapy (400 mg) is effective and safe against uncomplicated gonococcal urethritis in adult males.

Adult↗

[Stage I malignant melanoma of the skin. Prognostic value of thickness and level (author's transl)].

In a retrospective study of 95 patients seen between 1950 and 1978, the outcome of malignant melanoma levels III, IV and V of Clark's classification was reviewed. Patients with lentigo malignant melanoma were excluded. The overall survival rate was 63% at 5 years and 48% at 10 years. For the whole population of patients significant differences in survival rate were associated with level (p = 0,00002), thickness (less than 2 mm or greater than or equal to 2 mm; p less than 0.0,0001) and histological type (p = 0,02). The significance of prognostic variables taken separately was calculated by the Breslow method and was found to be: p = 0,0005 for thickness, p = 0,0009 for patient's age and p = 0,02 for histological type. In analysis with two variables, including level, thickness was the variable that added most to the information on prognosis supplied by level. For the population of patients with melanoma levels III and IV significant differences in survival rate were associated with thickness (less than 2 mm or greater than or equal to 2 mm; p less than 0,001), though not with level. When the variables were studied separately, thickness and patient's age were significant (p = 0,02 and p = 0,03 respectively). Analysis with two variables, including thickness, showed that age was the variable that added most to the information on prognosis supplied by thickness.

Adolescent↗

Male urethritis with and without discharge: a clinical and microbiological study.

BACKGROUND: The definition of male urethritis in the absence of urethral discharge has not been well established. The sensitivity of urethral swabs and first-catch urine is controversial. GOAL OF THIS STUDY: To correlate clinical data (discharge or not), urethral swabs, and first-catch urine examinations with the microorganisms found within the urethra in a cohort of men attending the sexually transmitted disease clinic of Hôpital Saint Louis (Paris) for treatment of urethral symptoms with or without discharge. STUDY DESIGN: Two-hundred-seventy-three consecutive male patients entered this prospective study between October 1, 1992 and November 30, 1992. Fifty-two patients were excluded because they had been treated with antibiotics in the previous 3 months. All patients were screened for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, Ureaplasma urealyticum, Mycoplasma hominis, and Candida albicans. RESULTS: Two-hundred-nineteen patients were eligible for the study (122 with discharge and 97 with no discharge). The prevalence of microorganisms was as follows: Chlamydia trachomatis in 13%, Neisseria gonorrhoeae in 11%, Ureaplasma urealyticum in 7%, Mycoplasma genitalium in 17%, Trichomonas vaginalis in 1%, and indeterminate pathogens alone in 20%. All major pathogens and Mycoplasma genitalium were more common in patients with discharge. Stratification of results according to the presence of polymorphonuclear leukocytes on the urethral swab and first-catch urine showed a low sensitivity of both tests for Chlamydia trachomatis (29%), Mycoplasma genitalium (50% and 62%), and Ureaplasma urealyticum (33%) in patients with no discharge. CONCLUSION: A specific and sensitive search for Chlamydia trachomatis should be done in every patient with urethral symptoms whether or not the classic symptoms of urethritis are present (discharge, presence of polymorphonuclear leukocytes in the urethra or first-catch urine).

Adult↗

[Gonococci].

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Female↗

[Male urethritis].

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Humans↗