Use of nontreponemal tests in the diagnosis of syphilis.
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False Negative Reactions↗
Biomedical subjects
J D Ross
Publications and source records attributed to J D Ross.
Gonococcal infection in Edinburgh and Newcastle: serovar prevalence in relation to clinical features and sexual orientation.
AIMS: The variable distribution of gonococcal serovars in different areas is well recognised but the factors that are important determinants of serovar prevalence are less clear. The aim of this study was to identify relevant clinical variables by comparing serovar prevalence in two cities over the same time period. METHODS: A prospective analysis of serovar prevalence was made between January and December 1992 in Edinburgh and Newcastle with respect to age, sex, sexual orientation, antibiotic sensitivity and presence of symptoms. RESULTS: 224 infective episodes of gonorrhoea were studied. The serovar distribution varied between the two cities with serovar 1B-1 being more common in Edinburgh (20/91 cf. 4/133, p < 0.01) and serovar 1B-6 more common in Newcastle (26/133 cf. 2/91, p < 0.01). Serovar 1A-2 was associated with heterosexual infection (35/114 in heterosexuals cf. 0/85 in homosexuals, p < 0.01) and was more sensitive to penicillin than average (39/39 1A-2 strains highly penicillin sensitive cf. 98/184 for all other strains, p < 0.01) whilst 1B-6 was mostly acquired through homosexual contact (22/26 cf. 63/142 for all other strains, p < 0.01) and tended to show reduced penicillin susceptibility (13/28 1B-6 strains less penicillin sensitive cf. 45/195 for all other strains, p < 0.01). Infection with serovar 1A-2 was significantly less often symptomatic in heterosexuals than average (15/33 asymptomatic 1A-2 infections cf. 17/59 for all other serovars, p = 0.015). Subgroup analysis of male heterosexual infections confirms an association between asymptomatic infection and serovar 1A-2 (2/14 asymptomatic 1A-2 infections cf. 1/72 for all other serovars, p = 0.02). The distribution of infections over the year differed between the cities. CONCLUSIONS: A variety of factors including penicillin sensitivity and virulence may be important in determining the prevalence of gonococcal serovars within a given area.
Adult↗
An outbreak of penicillin-sensitive strain of Neisseria gonorrhoeae in Sydney men.
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Gonorrhea↗
Gonorrhoea in Aberdeen: a serovar analysis.
The serotyping of gonococcal isolates has enabled detailed studies of the epidemiology of gonorrhoea in different geographical areas. This study reports the patterns of infection found in 1992 in Aberdeen and relates these to a variety of clinical parameters. 140 cases of gonorrhoea were isolated the majority of which belonged to one strain (lA-2) in contrast to the diversity of strains seen in other Scottish cities. Most isolates were highly sensitive to penicillin and only 3 penicillinase producing strains were found. A low rate of infections in homosexual men is reported again in contrast to the situation seen in other geographically close cities. Compared to the rest of Scotland Aberdeen has a high prevalence of gonorrhoea.
Adolescent↗
Serotype patterns of gonococcal infection in contact pairs.
The use of gonococcal serovars in studying the epidemiology of Neisseria gonorrhoeae is well established. Most studies assume that the isolated serovar remains stable in vivo indefinitely. This study was designed to observe the correlation between serovars isolated in patients naming each other as sexual contacts. The overall rate of discordant transmission episodes was 12% (26/220). There were however significantly more discordant transmission episodes for partners of patients infected with IB serovars than IA serovars: 19% (23/124) versus 3% (3/96) - p < 0.01. The overall prevalence of serogroup IB isolates although significantly higher at 53% (p < 0.01) was thought insufficient to account for the correlation between discordant pairs and serogroup IB infection. Reasons considered for the discrepancies in contact pairs included: problems of partner reporting involving inaccurate or incomplete information; technical problems with reagents; culture induced phenotypic variation in antigenic expression or differences in the in vitro recognition of epitopes; and antigenic differences resulting from genetic mutation within the Protein I gene. It was concluded that carefully planned and controlled prospective studies involving duplicate parallel testing of isolates from patients and their well documented partners are needed to assess the extent to which these various factors contribute to discordancies in serovars isolated from contact pairs. Serotyping should be combined with other methods such as auxotyping for detailed microepidemiological studies involving partner notification.
Bacterial Typing Techniques↗
The association between HIV media campaigns and number of patients coming forward for HIV antibody testing.
AIM: To assess the relationship between national and local media campaigns with respect to the number of patients requesting HIV antibody tests as a surrogate marker of the effectiveness of different campaign strategies. METHODS: Analysis by month of the numbers of HIV tests performed in the regional genitourinary (GUM) clinic for Lothian over a 5 year period and in the whole of Lothian Region, Scotland over a 3 year period. Changes in testing rates were monitored with respect to media campaigns over the same time period. RESULTS: Television based media campaigns produced the greatest increase in testing rates (average 46% increase over 2 months) compared with newspapers and poster campaigns (average 6% increase over 2 months). Regional HIV testing rates correlated significantly with GUM clinic testing rates. No increase in positive HIV tests was seen following media campaigns. CONCLUSIONS: Using HIV testing rates as a surrogate marker, television based media campaigns appear to be the most effective way of increasing awareness of HIV. The effect of media campaigns is short-lived indicating a need for constant reminder of the dangers of HIV infection. The increase in HIV testing occurs largely in the "worried well" with few additional HIV positive patients being identified.
AIDS Serodiagnosis↗
The epidemiology of herpes simplex types 1 and 2 infection of the genital tract in Edinburgh 1978-1991.
INTRODUCTION: The changing epidemiology of genital herpes in Edinburgh is described in relation to herpes simplex virus (HSV) Type 1 and herpes simplex virus Type 2 infection over a period of 14 years. METHODS: 2018 episodes of genital herpes in 1794 patients over a 14 year period were assessed. Data on age, sex, sexual orientation, geographical origin and herpes antibodies were also analysed. RESULTS: The proportion of cases that were HSV Type 1 increased over the period from approximately 20% to over 40%. Type 1 infection is more common in the young, in women and as a primary infection. CONCLUSIONS: HSV Type 1 is of increasing importance as a cause of genital herpes in our population. This may reflect changes in sexual attitudes and practises over the past decade.
Adult↗
Condylomata acuminata in pre-pubertal children.
The medico-legal significance of anogenital warts as a marker of sexual abuse in children is unclear. This review article presents three case reports and discusses the possible modes of transmission of papilloma virus in children. Although genital warts can indicate sexual abuse, non-sexual transmission may also occur.
Child↗
Trichomonas vaginalis infection in pre-pubertal girls.
This short paper discusses the implications of Trichomonas vaginalis infection of the genital tract in children with respect to suspected child abuse. Two case reports are described to illustrate the problems that can arise in the investigation of such cases T. vaginalis is usually transmitted sexually but the potential for non-sexual transmission does exist.
Adolescent↗
Seasonal variation in gonorrhoea.
Seasonal variations in the incidence of gonorrhoea were observed in the 1970's with a peak in the third quarter of the year and a trough in the first and fourth quarters. The aim of this study was to determine what, if any, seasonal trends were present in Scotland and Lothian between 1984 and 1989 and postulate mechanisms to explain our observations. We observed a change in the previously reported pattern with regular peaks of infection in the first and third quarters of the year for Scotland but no regular trend in the Lothian region. The most likely explanation for the observed trends are changes in sexual behaviour related to summer vacations and seasonal work patterns but other unidentified factors probably also contribute.
Female↗
Assessment of deficiencies of fatty acyl-CoA dehydrogenases in fibroblasts, muscle and liver.
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2,6-Dichloroindophenol↗
Changing trends of gonococcal infection in homosexual men in Edinburgh.
In an attempt to explain the recent resurgence of homosexually-acquired gonorrhoea in the Lothian region of Scotland the number of infections and pattern of infection (urethral, rectal and pharyngeal) of all gonococcal isolates from homosexual men attending the Department of Genitourinary Medicine at Edinburgh Royal Infirmary between 1985 and 1990 were analysed. Serovar typing data were available from infections acquired between January 1986 and December 1990. A correlation between one serovar, Bacejk/Brpyust, and the overall pattern of gonorrhoea was observed. The number of infections caused by minor serovars also correlated with rates of gonococcal infection. The number of minor serovars isolated, which may represent strains from other geographical locations, is related to the total incidence of gonorrhoea. It is possible that the incidence of Bacejk/Brpyust may be determined by the size of the infected pool of gonorrhoea. The most likely explanation for the recent increase in gonorrhoea is a change in sexual behaviour and/or an influx of strains from other geographical areas.
Adult↗
Equine exertional rhabdomyolysis: activity of the mitochondrial respiratory chain and the carnitine system in skeletal muscle [see comment].
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Animals↗
Patterns of homosexually acquired gonococcal serovars in Edinburgh 1986-90.
AIM: The aim of this study was to observe the changes in gonococcal serovar pattern in homosexual men over a 5 year period. METHODS: All men who presented to the Genitourinary Medicine clinic at Edinburgh Royal Infirmary between 1986 and 1990 with homosexually acquired gonococcal infection were included in the study. Gonococcal isolates were serotyped and the temporal change in isolated serovars noted. RESULTS: Over the 5 year period 32 different serovars were associated with 175 homosexually acquired infections. There was a dynamic temporal change in the dominant serovars with a continual influx of new strains some of which become established in the community but most of which appeared only transiently. Rapid variation in incidence over time was observed for certain serovars while others remained at more constant levels. There was a marked association between certain serovars (Ae/Av; Back/Bropyt; Bacejk/Brpyut; Bacejk/Brpyust; Baejk/Brpyut) and homosexually acquired infection. CONCLUSIONS: Possible determinants for the patterns observed are discussed but the underlying mechanism is probably multifactorial.
Gonorrhea↗
Rape and sexually transmitted diseases: patterns of referral and incidence in a department of genitourinary medicine.
A retrospective study was carried out of all women attending a Department of Genitourinary Medicine over a 3-year period. Note was taken of referring source, presenting symptoms, infection detected at STD screening and follow-up attendance. Comparison was also made between the number of women referred by the police surgeon and the number who actually attended. We observed an overall incidence of STD of 35% and noted that many infections had a similar prevalence to that of our normal clinic population over the same time period. Only 13% of the women referred by the police attended although after the initial visit attendance was similar regardless of referral source. A number of asymptomatic women were noted to have infection with Neisseria gonorrhoeae and Chlamydia trachomatis. Although, the risk of significant STD following sexual assault is low greater efforts should be made to encourage women to attend for screening whether or not they are symptomatic.
Adolescent↗
Oxidative phosphorylation in human muscle in patients with ocular myopathy and after general anaesthesia.
The fuel preference of human muscle mitochondria has been given. Substrates which are oxidized with low velocity cannot be used to detect defects in oxidative phosphorylation. After general anaesthesia, the oxygen uptake with the different substrates is much lower than after local analgesia. The latter was therefore used in the subsequent study. In 15 out of 18 patients with ocular myopathy, defects in oxidative phosphorylation could be detected in isolated muscle mitochondria prepared from freshly biopsied tissue. Measurement of the activity of segments of the respiratory chain in homogenate from frozen muscle showed no, or minor defects. In two of these patients showing exercise intolerance, decreased oxidation of NAD(+)-linked substrates and apparently normal mitochondrial DNA, further study revealed deficiency of pyruvate dehydrogenase in a girl with ptosis and a high Km of complex I for NADH in a man. Both patients responded to vitamin therapy.
Adolescent↗
The effect of malonyldialdehyde on viscosity of normal and sickle red blood cells.
This study has examined the effect of MDA, an end product of lipid peroxidation, on the viscosity of AA and SS RBC suspensions. MDA accumulation in RBC was accomplished in vitro in human RBC by treating them with exogenous standard MDA. MDA accumulation assessed by the thiobarbituric acid reactivity of in vitro MDA-treated RBC was comparable to that of the RBC in vivo in hemolytic anemias. There was a significant increase in the viscosity of both AA and SS RBC suspensions after in vitro treatment with MDA. The increase in viscosity or RBC was significantly positively correlated with the extent of MDA accumulation.
Anemia, Sickle Cell↗
Low plasma prealbumin and carotenoid levels in sickle cell disease patients.
This study was undertaken to discover whether reduced levels of micronutrients in patients with sickle cell disease are due to the generalized undernutrition. Protein undernutrition was determined by measuring plasma levels of prealbumin. One micronutrient, carotene, was also simultaneously assayed in the plasma. Eighteen sickle cell disease patients were enrolled at random. Controls were 19 normal volunteers and seven family members of the patients. The patients showed significantly reduced levels of prealbumin and carotenoids compared with either normals or family members. Levels of carotenoids did not significantly correlate with level of prealbumin, which suggests that the undernutrition was not the only factor contributing to lower levels of carotenoids in these patients.
Adolescent↗