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At least 397 records · Page 22Linked to original sources
PubMed1995

Procedural pain in a paediatric surgical emergency unit.

Pain induced by various types of procedures was assessed in the Paediatric Surgical Emergency Department at St Göran's Children's Hospital in Stockholm. Assessments of pain were obtained from the nurse, the parent, and children over 10 years of age by means of a visual analogue scale. In children aged 3-9 years, the Smiley Five-Face Scale was used. The nurse and the parent also answered questionnaires about analgesic medication, the child's behaviour, and the parent's overall opinion of the pain management, etc. Irrigation of the glans penis because of balanitis, treatment of fractures and paronychia were considered to be the most painful procedures. Forty-four per cent of the children cried during the procedure and 16% fought against being restrained. In 24% of the cases, the child was judged to be in a state of "panic". In conclusion, we believe that the pain induced by procedures in the emergency rooms is unacceptably high. Children estimate higher pain scores than parents and nurses do. There was a poor correlation between the parent's and child's estimates of pain. Parents are not well informed about the possibilities for pain treatment. Infants and children attending emergency rooms must also benefit from recent advances in the treatment of pain.

Adolescent↗
PubMed2003

Axial rotation of the lower human spine by rhythmic torques automatically generated at the resonant frequency.

Subjects sat on a 'Balans' chair supported by the shaft of a large torque generator. The lower but not the upper part of the body was free to make to/fro movements maintained by feeding back a modified velocity signal to the generator. The stiffness could be increased by the use of a position signal. Using the equations for a torsion pendulum the good linearity observed in relationship to the applied forces allowed stiffness, inertia, damping, critical damping and the damping factor to be determined in absolute terms. The method enables parameters relevant to back function and problems to be evaluated. Eleven adults acted as subjects.

Biomechanical Phenomena↗
PubMed1999

The bZip transcription factor Cap1p is involved in multidrug resistance and oxidative stress response in Candida albicans.

Candida albicans is an opportunistic pathogenic yeast which frequently develops resistance to the antifungal agent fluconazole (FCZ) in patients undergoing long-term therapy. FCZ-resistant strains often display a reduced intracellular FCZ accumulation which correlates with the overexpression of the ATP-binding cassette transporters CDR1 and CDR2 or the major facilitator (MF) MDR1. We have recently cloned a C. albicans gene, named CAP1, which codes for a bZip transcription factor of the AP-1 family homologous to the Yap1 protein involved in multidrug resistance and response to oxidative stress in Saccharomyces cerevisiae. CAP1 was found to confer FCZ resistance in S. cerevisiae by transcriptionally activating FLR1, a gene coding for an MF homologous to the C. albicans MDR1 gene product (A.-M. Alarco, I. Balan, D. Talibi, N. Mainville, and M. Raymond, J. Biol. Chem. 272:19304-19313, 1997). To study the role of CAP1 in C. albicans, we constructed a CAI4-derived mutant strain carrying a homozygous deletion of the CAP1 gene (CJD21). We found that deletion of CAP1 did not affect the susceptibility of CJD21 cells to FCZ, cerulenin, brefeldin A, and diamide but caused hypersensitivity to cadmium, 4-nitroquinoline N-oxide, 1,10-phenanthroline, and hydrogen peroxide, an effect which was reverted by reintroduction of the CAP1 gene in these cells. Introduction of a hyperactive truncated allele of CAP1 (CAP1-TR) in CJD21 resulted in resistance of the cells to all of the above compounds except hydrogen peroxide. The hyperresistant phenotype displayed by the CJD21 CAP1-TR transformants was found to correlate with the overexpression of a number of potential CAP1 transcriptional targets such as MDR1, CaYCF1, CaGLR1, and CaTRR1. Taken together, our results demonstrate that CAP1 is involved in multidrug resistance and oxidative stress response in C. albicans. Finally, disruption of CAP1 in strain FR2, selected in vitro for FCZ resistance and constitutively overexpressing MDR1, did not suppress but rather increased the levels of MDR1 expression, demonstrating that CAP1 acts as a negative transcriptional regulator of the MDR1 gene in FR2 and is not responsible for MDR1 overexpression in this strain.

Antifungal Agents↗
PubMed1988

Save the prepuce. Painless separation of preputial adhesions in the outpatient clinic.

In most boys referred for circumcision preputial adhesions are the only problem, but these can predispose to recurrent balanitis. A simple technique using Emla cream (eutectic mixture of lignocaine and prilocaine) has been devised which allows the adhesions to be separated painlessly in the outpatient clinic. The technique was used on 39 boys aged 2 to 12 years referred for circumcision, none of whom had a retractable foreskin. The cream was applied under an occlusive dressing and left for 60 minutes before the adhesions were separated with a probe and a gauze swab. The procedure was completely pain free in 32 boys. One boy had to undergo a repeated procedure because he failed to follow the advice regularly to retract his foreskin in the three weeks after the procedure. Only one boy had to undergo circumcision later because of fibrous phimosis. In many boys referred for circumcision separation of preputial adhesions is all that is needed, and the use of this local anaesthetic technique avoids the need for general anaesthesia.

Ambulatory Surgical Procedures↗
PubMed1975

Natamycin in genital candidosis in men.

In a trial of natamycin, an antifungal antibiotic in a vanishing cream base, assessment was possible in 66 men with genital or anal candidosis. The overall cure rate was 82 percent, In 43 patients with culturally proven candidosis it was 98 percent. but in 23 patients treated solely on clinical impression it was only 52 percent. Symptoms were rapidly relieved in those who responded and there were no side-effects. In our hands, natamycin 2 per cent cream has proved to be a valuable preparation in the treatment of candidal balanitis.

Administration, Topical↗
PubMed1975

Herpes genitalis and circumcision.

214 patients with genital herpes infection proven by culture and a control group of 410 other patients were included in a retrospective study devised to investigate the relationship of circumcision to genital HSV infection in the male. The percentage of patients circumicised in the control group was significantly larger than in the herpes group (P less than 0-01). The was not found to be the case for other sexually-transmitted diseases apart from monilial balanitis. There was also a significant difference in contraceptive methods in the two groups, barrier methods being used less ofter than other methods in the herpes group and the reverse in the control group. It is concluded that there is a positive relationship between absence of circumicision and genital HSV infection, but that a prospective study should be undertaken to confirm these results.

Adult↗
PubMed1982

Carriage and transmission of group B streptococci among STD clinic patients.

High rates of carriage of group B streptococci were found among men (38%) and women (42.3%) attending a clinic for sexually transmitted diseases. Swabs from the perineal/anorectal area gave the highest isolation rate and those from the urethra the lowest. The subpreputial sac was an important site for carriage of the organism, and there was a strong association between streptococcal isolation and balanitis. Of 92 couples studied, neither partner was colonised with group B streptococci in 36. In a further 36 one or other was colonised and in 20 both were colonised. Serotyping and phage typing showed that only three of these 20 couples were colonised with similar strains of the organism.

Carrier State↗
PubMed1992

The acetic acid test in evaluation of subclinical genital papillomavirus infection: a comparative study on penoscopy, histopathology, virology and scanning electron microscopy findings.

OBJECTIVES: To evaluate colposcopic criteria in acetowhite lesions of the penis ("penoscopy") for the diagnosis of subclinical genitoanal papillomavirus infection (GPVI) compared with histopathological criteria of HPV involvement and to various hybridisation assays for HPV DNA detection, and to depict typical lesions by scanning electron microscopy. DESIGN: The study included 101 randomly selected male partners of females with known GPVI, or with penile symptoms such as itching, burning and dyspareunia who did not exhibit overt genital warts but appeared to be afflicted with acetowhite penile lesions after topical application of 5% acqueous acetic acid. Lesions were judged by penoscopy as either typical, conspicuous or nontypical for underlying HPV infection. Biopsy specimens from 91 men were examined by light microscopy and by either Southern blot (SB), polymerase chain reaction (PCR) and/or in situ hybridisation (ISH) assays for the presence of HPV DNA of the HPV types 6, 11, 16, 18, 31, 33 and 42 (Group A). From another ten men lesions clinically typical for GPVI were also examined topographically by scanning electronic microscopy (Group B). SETTING: The STD out-patient clinic of the Department of Dermatovenereology of Karolinska Hospital, Stockholm, Sweden. RESULTS: Group A Seventy eight (86%) of the biopsied lesions met the penoscopy criteria of being either typical of or conspicuous for GVPI. The agreement between penoscopy and histopathology was fairly good, as HPV diagnosis was made by both methods in 56 (62%) of the cases. The reliability of applying strict colposcopic hallmarks was further substantiated by the finding that 55 (60%) of the biopsy specimens taken from penoscopically typical/conspicuous lesions contained HPV DNA. However, there are diagnostic pitfalls for the acetic acid test. Coexistence of an eczematoid reaction with changes indicative of HPV influence was detected in six (7%) of the cases, while an inflammatory response only occurred in 17 (19%) of the specimens. Additional histopathological diagnoses (normal epithelium, lichen sclerosus et atrophicus, balanitis circinata parakeratotica, verruca plana) were established in another eight (9%) of the cases. Among the HPV DNA positive cases, all of the HPV types tested for were detected with the exception of HPV 18. A severe penile intraepithelial neoplasia (PIN III) was revealed in five (5%) of biopsies; HPV 16 was present in two and HPV 42 in one of these biopsy specimens. GROUP B: Scanning electron microscopy depiction harmonised with the penoscopy findings showing that subclinical GPVI characteristically exhibits a well demarcated, slightly elevated border and that the central area of lesions often displays a "groove" in which the epithelium appears to be thin with protrusions from beneath that probably represent capillaries. CONCLUSION: Use of the acetic acid test for evaluation of GPVI should be combined with a colposcopic evaluation based on strict topographic hallmarks, followed by a directed biopsy for light microscopic evaluation. We found that the positive predictive value of colposcopy was as high when correlated with histopathological findings (72%) as when virological methods were used, whether HPV DNA hybridisation testing was performed with the well established SB and ISH assays (45%), or by applying the newly introduced and highly sensitive PCR assay as well (71%). False positivity from the acetic acid test occurs and is mainly due to inflammatory conditions but also to the presence of other conditions. Epithelial fissures are evidently associated with some subclinical GPVI lesions and may potentially represent loci minores for infectious stimuli and perhaps facilitate the transmission of some blood-borne STDs. We prose that the term "papillomavirus balanoposthitis" should be used for penile HPV infection associated with inflammatory responses. Our study indicates that PIN III frequently occurs in a subclinical form and may be associated with not only previously identified "high-risk" HPV types such as type 16, but also with the HPV type 42 that has not previously been considered as oncogenic.

Acetates↗
PubMed1997

Sexual relationships, risk behaviour, and condom use in the spread of sexually transmitted infections to heterosexual men.

OBJECTIVE: To examine the effect of patient defined non-regular sexual relationships and other risk behaviours on the incidence of sexually transmitted infections in heterosexual men and the role of condom use in the prevention of their spread. DESIGN: A prospective cross sectional study of sexual behaviour reported by a standardised self administered questionnaire in new patients who presented for screening and diagnosis. SETTING: A genitourinary medicine clinic in west London. SUBJECTS: 957 consecutive newly attending heterosexual men who completed a sexual behaviour questionnaire in 1993/94. MAIN OUTCOME MEASURES: Variables relating to sociodemographic status, sexual behaviour, condom use, sexually transmitted infections and testing for HIV infection, stratified by the reporting of non-regular partners. RESULTS: We found that the 65% of men who reported non-regular sexual partners were more likely to be white collar class (d = 7.5%, 95% CI = 1.3, 13.7) and to have had sexual intercourse with non-United Kingdom born women (d = 7.8%, 95% CI = 3.5, 12.2). They also reported coitarche before 16 years of age (d = 13.4%, 95% CI = 8.0, 18.8) and many more sexual partners both in the last year (d = 13.1%, 95% CI = 10.2, 16.0) and in their lifetime (d = 27.9%, 95% CI = 21.6, 34.2). They were significantly more likely to practise anal intercourse (d = 8.7%, 95% CI = 3.3, 14.1), to smoke (d = 16.3%, 95% CI = 9.8, 22.6), to drink alcohol (d = 4.9%, 95% CI = 1.2, 8.6), and to have chlamydial infection (d = 5.7%, 95% CI = 2.2, 9.2), of which 30% was subclinical. Increasing condom use with regular partners correlated with decreasing incidence of urethral infection (gonorrhoeal and/or chlamydial infection) (p < 0.03) and candidal balanitis (p < 0.03) and a greater likelihood of no infection being detected (p = 0.0002). Use of condoms with non-regular partners was much more frequent than with regular partners (d = 21.4%, 95% CI = 16.7, 26.1). However, we found evidence of oral transmission of urethral gonorrhoea and chlamydial infection among men who reported always using condoms. HIV infection was found in only two men (0.2%), both of whom reported intercourse with non-United Kingdom born women. CONCLUSIONS: Heterosexual men who reported non-regular sexual relationships compensated for their increased risk lifestyle by using condoms more frequently and showed only an increased incidence of chlamydial infection. More consistent condom use with regular partners was significantly associated with the absence of sexually transmitted infection. These findings suggest that transmission between regular partners has been underestimated.

Adolescent↗
PubMed2006

[Isolation of group A beta-hemolytic Streptococcus in children with perianal dermatitis].

INTRODUCTION: Perianal dermatitis due to group A beta-hemolytic streptococcus is a rare diagnosis in pediatrics. Clinical manifestations include erythema, edema, and perianal pruritus associated with vulvovaginitis or balanitis, painful defecation, constipation, anal fissures, purulent discharge, and/or rectal bleeding. MATERIAL AND METHODS: A descriptive, observational, prospective study was conducted between May, 2004 and April, 2005. In children presenting to the emergency room with erythema, edema, and perianal pruritus, a rapid streptococcal antigen test and bacterial cultures of their perianal secretions were obtained. Patients with a positive result in the rapid test were treated with oral phenoxymethylpenicillin (40-50 mg/kg/day) for 10 days, after which clinical and bacteriological evaluations were conducted. RESULTS: Of the 24 patients presenting with erythema, edema, and perianal pruritus, 19 patients (12 boys and 7 girls), aged between 6 months and 4 years (median age: 30 months), tested positive for group A beta-hemolytic streptococcus. Nine patients also presented with constipation, 5 with anal fissures, 4 with rectal bleeding, 2 with vulvovaginitis, and 1 with streptococcal pharyngoamygdalitis. Outcome was favorable in 85 % of the patients, and perianal isolation of group A beta-hemolytic streptococcus was negative after treatment in 95 %. CONCLUSIONS: In patients presenting with erythema, edema, and perianal pruritus, perianal streptococcal dermatitis should be ruled out. The rapid test for streptococcal antigen detection is a quick and reliable method for this diagnosis. The antibiotic of choice is oral penicillin.

Anus Diseases↗
PubMed2003

Is preputioplasty effective and acceptable?

Foreskin complaints in childhood, if not manageable conservatively, are usually treated by circumcision. A less radical surgical option, when balanitis xerotica obliterans is absent, is preputioplasty. We sent questionnaires to the parents of 23 boys who had had this procedure and 22 replied. Mean interval since operation was 20 months (range 3-36). The main indications for surgery had been irretractable foreskin in 9, recurrent balanoposthitis in 10 and ballooning on voiding in 3 and the operation had dealt successfully with these in 7, 7, and 3, respectively. In all but one case the parents were satisfied with the cosmetic result. However, in 8 cases (36%) the parents said they would have preferred circumcision and 3 of the boys had been listed for further surgery. Preputioplasty is a satisfactory alternative to circumcision in selected cases.

Child↗
PubMed2005

Lichen sclerosus.

Lichen sclerosus (LS) is a chronic inflammatory disorder of the skin and mucosa, presenting to genitourinary physicians and dermatologists. It affects both sexes and all age groups. Although the exact aetiology is uncertain, genetic predisposition, infections and autoimmune factors have been implicated in its pathogenesis. Symptoms include pruritus and soreness, but asymptomatic presentations are not uncommon. The classical clinical picture is of atrophic white plaques in the anogenital region. Histopathology is specific with basal cell degeneration, upper dermal oedema, homogenization of collagen and a chronic inflammatory infiltrate. Short courses of potent topical corticosteroids form the mainstay of treatment. The condition tends to be remitting and relapsing, with spontaneous regressions reported in a few. In men, the term balanitis xerotica obliterans is sometimes used to describe late and severe LS of the penis. Scarring and progression to squamous cell carcinomas can occur in chronic LS, resulting in significant morbidity. A multidisciplinary approach to care and the need for long-term monitoring cannot be overemphasized.

Carcinoma, Squamous Cell↗
PubMed2005

Association between the intact foreskin and inferior standards of male genital hygiene behaviour: a cross-sectional study.

This study was undertaken to determine whether non-circumcised men have inferior standards of genital hygiene behaviour, as measured by reported washing of the whole penis, compared with circumcised men. Male attenders at a sexually transmitted infections (STI) clinic at Ealing Hospital, London had routine STI tests and examinations performed and were asked about the frequency and thoroughness of genital washing. One hundred and fifty non-circumcised and 75 circumcised men were enrolled. Not always washing the whole penis, including retracting the foreskin in non-circumcised men every time they washed (defined as inferior genital hygiene behaviour) was more common in non-circumcised (26%) than circumcised men (4%) (crude odds ratio = 8.43, 95% confidence interval: 2.51-28.3, P<0.001) and those with balanitis (42% and 5%, P=0.036). Circumcised men were more likely than non-circumcised men to wash the genital area more than once a day (37% and 19%, P=0.011). Studies investigating the relationship between male circumcision status and other outcomes, for example HIV infection, should include assessment of genital hygiene.

Adolescent↗
PubMed2006

Is frenuloplasty worthwhile? A 12-year experience.

INTRODUCTION: Frenuloplasty is commonly performed. Its outcome has never been reported. PATIENTS AND METHODS: We have performed 213 frenuloplasties since 1992. Patients were sent a questionnaire regarding indication, treatment advised on presentation, anaesthetic, outcome (linear analogue satisfaction score), and further intervention required. RESULTS: Overall, 48 of 209 (23%) patients replied (median age of series, 27 years; range 16-78 years: and of respondents, 27 years; range, 17-78 years). Indications included tearing/bleeding of the foreskin (n = 32), balanitis (n = 3), pain on intercourse (n = 26), phimosis (n = 4), ejaculatory (n = 1) and hygiene (n = 1) problems. Twenty-five patients received general anaesthesia. Median satisfaction score was 8 (range, 1-10). Thirty-four patients would recommend frenuloplasty to another with similar symptoms. Three of nine patients initially advised to undergo circumcision later underwent circumcision (frenuloplasty satisfaction score, 1-3), 1 awaits circumcision (score, 5), 1 has a tight foreskin (score, 3), and 4 are satisfied (scores 6,9,10,10). In total, 23 of 209 patients (11%; median age, 27 years) underwent circumcision following frenuloplasty. Median time to circumcision was 11 months (range, 5-52 months). CONCLUSIONS: This is the only reported series of frenuloplasty. The response rate reflects a young mobile population. Most men are satisfied with the outcome, including some initially advised to undergo circumcision. The overall rate of circumcision following frenuloplasty is likely to be 15-20%.

Adolescent↗
PubMed1996

Effect of practice of a throwing skill in one body position on performance of the skill in an alternate position.

The effect of learning a throwing skill with the body in one position on performing the skill in a different position was investigated. 40 normal women, aged 20 to 34 years, were randomly assigned to experimental or control groups. Subjects threw darts from two positions, sitting on a Balans chair or reclined on a slanted table. Practice and transfer sessions each included 4 sets of 5 throws. Performance was significantly poorer after switching positions than when remaining in the same position. Performance after practice in an alternate position was significantly worse than performance after no practice. These findings suggest that practicing a skill in one position may not improve learners' ability to perform that skill in a different position.

Adult↗
PubMed1986

Circumcision for phimosis: a follow-up study.

All 117 boys circumcized for phimosis during one year at the Department of Pediatric Surgery in Lund were subject to a follow-up study five years postoperatively. In 45 cases the main operative indication was recurrent balanitis, in 25 cases scarring of the prepuce and in 41 cases an expressed ballooning at voiding. Early operative complications included 7 cases of postoperative haemorrhage which in 1 case necessitated reoperation. In 1 case there was a postoperative infection. 13/117 patients developed a stricture of the urethral orifice necessitating meatotomy. The study included a questionnaire which was answered by 97/117 patients, 92 of whom expressed complete satisfaction with the operation. The complaints of the others were cosmetic in nature. There was in no instance any sign of more severe psychological disorder than a certain shyness which was expressed in 8 cases. It is concluded that circumcision for phimosis in young boys is complicated by meatal stenosis in a certain frequency (13/117) but not loaded with serious complications. There seems to be no reason to fear psychological disturbances due to circumcision.

Child↗
PubMed1989

Aeromonas as a human pathogen.

Although the first Aeromonas strain was described by Zimmermann as early as in 1890, it took 60 years until Caselitz established human pathogenicity of strains then called "Vibrio jamaicensis". Since then, and especially in the last 10 years, there have been increasing numbers of reports on different infections caused by members of the genus Aeromonas. These include sepsis; meningitis; cellulitis; necrotizing fasciitis; ecthyma gangrenosum; pneumonia; peritonitis; conjunctivitis; corneal ulcer; endophthalmitis; osteomyelitis; suppurative arthritis; myositis; subphrenic abscess; liver abscess; cholecystitis and/or ascending cholangitis; urinary tract infection; endocarditis; ear, nose, and throat infections; balanitis; etc. The role of Aeromonas in gastrointestinal disease is very controversial. Increasing epidemiological data suggest that these organisms play a major role in enteric infections, but so far enteropathogenicity has not been demonstrable in experiments where volunteers were given high numbers of Aeromonas possessing different virulence factors. Virulence factors include hemolysin(s), enterotoxin(s), hemagglutinins, invasivity, and others; but these are not found more frequently in strains isolated from patients with diarrhea than from healthy controls. Whether there is a correlation between species and disease remains to be elucidated and requires more information about the taxonomy of this genus.

Aeromonas↗