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At least 433 records · Page 24Linked to original sources
PubMed2003

Evaluation of diagnostic efficacy of PCR methods for Chlamydia trachomatis infection in genital and urine specimens of symptomatic men and women in India.

In India, given the scarce availability of sensitive and specific methods, Chlamydia trachomatis genital infections may lead to severe clinical complications when left undiagnosed or underdiagnosed. The present study was conducted to evaluate the diagnostic efficiency and feasibility of polymerase chain reaction (PCR) assays using genital and urine specimens from men and women in India. Genital swabs and urine specimens collected from 143 patients attending the sexually transmitted disease (STD) clinic, Government General Hospital, Chennai, were tested by culture and a plasmid based PCR. Culture was positive in 27 (18.9%) patients. PCR gave positive results for 46 (32.2%) cases using genital specimens, and the positivity rate in urine was 25.2%. Once the discordant results between culture and PCR had been resolved by using a major outer membrane protein PCR, the overall sensitivity, specificity, and positive and negative predictive values for the plasmid PCR in genital specimens were 100%, 98%, 95.7%, and 100%, respectively. Corresponding values for urine PCR were 81.8%, 100%, 100%, and 92.5%, respectively. The prevalence of confirmed C. trachomatis infection was 30.8% in this STD population. The results confirmed the need to use sensitive and specific molecular assays like PCR to prevent underdiagnosis of genital chlamydial infections and to facilitate better clinical management of this infection in India.

Adult↗
PubMedDate not supplied

[Genital herpes infections].

Genital infections caused by herpes simplex viruses (HSV), are the most frequently seen sexually transmitted diseases (STD), in both developed and developing countries like our country. These infections take part of the third important place among STD after from the chlamydial cervicitis and genital wards, and are of the major public health problem, recently. Genital herpes infections produced mainly (90%) by HSV type 2, and rarely (10%) by HSV type 1. The infections may have seen in two clinical forms, called primary and recurrent infections. The data have indicated that, the incidence of genital herpes increased approximately 20 folds in the world during the last two decades. The main factor attributed to the spread of HSV infections includes asymptomatic virus shedding. Genital herpes is associated with significant morbidity and complications such as neonatal herpes, results from the transmission of HSV from mother to fetus. In this review article, the clinical characteristics, epidemiology, diagnostic methods, prevention and therapy choices of HSV genital infections, have been discussed under the light of recent literature.

Global Health↗
PubMed2003

[Female genital mutilations, forced marriages, and early pregnancies].

Female genital mutilations, as well as forcible childhood marriage and their correlate adolescent pregnancies are traditional practices which, not only violate the dignity, but also jeopardize the health, and even the life, of women and their children. The complications of genital mutilations are frequent for a number of reasons: the fact that the clitoris is highly vascularized, the nature of the mutilations, excision or infibulation, and the poor conditions of hygiene. The short term complications are pain, hemorrhage, shock, and urinary retention. Medium term complications include gangrene, septicemia, tetanus, pelvic inflammatory disease, HIV/AIDS, and hepatitis B or C infections. Serious sequelae may occur, including infertility and gynecologic disorders, and sexual life is invariably altered. The main obstetrical complications of genital mutilations are genital lacerations involving the labia minor and the perineum, which can lead to hemorrhage and sequelae such as urinary or anal incontinence, recto-vaginal and vesico-vaginal fistulas. The role of doctors, which is delicate because these customs are entrenched, is to detect genital mutilations, repair them and prevent them, by participating in health education programs. The consequences of forcible childhood marriage are serious, besides the fact that this is a disguised form of rape. The obstetrical risks favored by the underdevelopment of the uterus and the pelvis, include uterine rupture, preeclampsia and eclampsia, and obstetrical hemorrhage. The fetus/neonate are jeopardized by these complications, which can result in perinatal asphyxia and death, as well as the high rates of intrauterine growth retardation and preterm delivery. The impact of genital mutilations on delivery are compounded in childhood pregnancies for anatomical reasons, but also because these adolescents or children are extremely vulnerable and have poor access to perinatal care. In France, as well as in Africa, non-governmental and women's rights organizations are active in preventing these practices. We strongly recommend that these groups should receive aid and encouragement.

Adolescent↗
PubMed2004

Genital herpes in a sexually-transmitted infection clinic in Singapore: a 1-year retrospective study.

INTRODUCTION: This study describes the clinical features of genital herpes seen in a sexually-transmitted infection (STI) clinic in Singapore and the characteristics of the affected population. The distribution of herpes simplex virus (HSV) subtypes within the population, correlation of HSV culture result with duration of disease and prescribing habits of doctors were also examined. MATERIALS AND METHODS: This is a retrospective study of cases of genital herpes seen at the Department of Sexually-transmitted Disease Control (DSC) clinic over a 1-year period. All records of clinically diagnosed HSV genital infections at the DSC clinic in 2001 were retrieved and reviewed and the data collated. RESULTS: There were 324 cases of genital herpes, of which 153 (47.2%) were first-episode and 171 (52.8%) were recurrent HSV infections. There were 259 males and 65 females; their mean age was 35.2 years (range, 17 to 75 years). Of the 241 cases with positive culture results, 28 (11.6%) tested positive for herpes simplex virus type 1 (HSV-1) and 213 (88.4%) were positive for herpes simplex virus type 2 (HSV-2). HSV-1 accounted for 19.3% of first-episode and 4.7% of recurrent infections. HSV-2 accounted for 80.7% of first-episode and 95.3% of recurrent infections. Cultures taken from lesions < or = 4 days, between 5 and 7 days and > 7 days of onset were positive in 79.2%, 75.7% and 75% of cases, respectively. Oral acyclovir was prescribed more commonly in females (53.8%) than in males (21.6%). CONCLUSION: Genital herpes is a common STI seen at the DSC clinic. HSV-2 is the most common cause of genital herpes and accounts for most of the recurrent cases seen.

Acyclovir↗
PubMed2005

A local pathway for increased testosterone supply from the testis to the epididymis, vas deferens and accessory genital glands of the rat.

Radiolabeled testosterone (3H-T) was infused into the testes or left and right mesofuniculus (106 dpm) or injected into a testes (2 x 10(6) dpm). The 3H-T concentration was estimated 15 or 10 min after 3H-T infusion or injection, respectively, in the tissue samples collected from the prostate, seminal vesicles, caput and cauda epididymides, vasa deferentia and the mesofuniculi. The abdominal aorta and posterior vena cava were cannulated, and the posterior part of the body perfused with blood (at blood pressure 70-140 or 260-300 mm Hg in abdominal aorta) was used to study 3H-T transfer from the testes to venous blood and other male genital organs. The concentration of 3H-T found in the accessory genital glands, epididymes and vasa deferentia was affected by blood pressure in the abdominal aorta. The reduced blood pressure and partial blocking of blood supply to the genital organs (after ligation of both testicular arteries or the terminal part of the abdominal aorta) increased the concentration of 3H-T in accessory genital glands, vasa deferentia and epididymes. The removal of the mesofuniculi and vasa deferentia with their mesoducti reduced 3H-T concentration in the prostate, seminal vesicles and cauda epididymides. Both arterial trunks, testicular arteries and common iliac arteries, were shown to be connected by anastomoses in target organs so effectively, that supplying the male genital organs with blood by only one of them assures the transfer of testosterone from the testes to the epididymes, vasa deferentia, mesofuniculi as well as prostate and seminal vesicles. It was concluded that lymphatic vessels of the mesofunicules and of the spermatic cords as well as venous and arterial vasculature of the mesofunicules create a recently unknown pathway for the increase of testosterone supply from the testes to the epididymes, vasa deferentia and accessory genital glands of rats.

Animals↗
PubMed2005

Increase of genital HSV-1 and mixed HSV-1 and HSV-2 infection in Bangkok, Thailand.

From January 1998 to December 2004, 207 out of 1125 samples were HSV isolation positive and typed. Two groups of patients, Thai and foreigner, as well as site of infection, non-genital and genital area, were identified. The prevalence of non-genital HSV-1 infection from 27 samples of Thai patients was 81.84%. Out of 180 genital samples, 39.02% HSV-1 and 43.09% HSV-2 from 123 Thai patients and 36.84% HSV-1 and 49.12% HSV-2 of 57 foreigner patients were determined. Moreover mixed infection of HSV-1 and HSV-2 was found in both Thai and foreigner groups, 17.89% and 14.04%, respectively. The prevalence of genital HSV-1 infection in Thai patients chronologically increases from 1.6% to 56.91% from of 1985 to 2004. Increase of HSV-1 genital infection and mixed HSV-1 and HSV-2 infection in Thai people might probably be due to changing of sexual behavior in the AIDS era.

Antibodies, Viral↗
PubMed1991

Early genital naming.

To evaluate the clinical impression that young girls are given little or confusing information about their genitals, a sample of 117 mothers with 1- to 4-year-old children were asked which words for genitals, if any, they used with their children. The ethnically and socioeconomically heterogeneous sample was composed of 63 girls and 54 boys, with the average ages of 26 and 29 months, respectively. Neither boys nor girls were likely to be given a standard anatomical genital term, although many children received colorful colloquial expressions. However, girls were less likely than boys to receive a term for their genitals. Receiving names for genitals was related to certain family circumstances, such as higher parental education, exposure to adult male nudity, having a sibling of the opposite sex, and cosleeping. Pediatric health professionals have the opportunity to contribute to early sex education by conveying accurate information regarding genital terms in the course of routine physical examinations.

Child Language↗
PubMed1987

Genital findings in sexually abused, symptomatic and asymptomatic, girls.

Although evaluation of the vulva of sexually abused girls using magnification with a colposcope or pediatric otoscope has become increasingly popular, the incidence of various genital findings in sexually abused and asymptomatic children has not been reported. A prospective study was carried out in which 20 genital findings from three groups of girls (mean age 4.8 +/- 2.6 years) were analyzed. The three groups were (1) sexually abused girls (n = 119), (2) normal girls with no genital complaints (n = 127), and (3) girls with other genital complaints (n = 59). Group 1 was more likely than group 2 to have scars on the hymen or posterior forchette (9% v 1%, P = .002), increased friability of the posterior forchette (10% v 1%, P = .001), attenuated hymen (18% v 4%, P = .0003), and synechiae from the hymenal ring to the vagina (8% v 0%, P = .0009). Groups 1 and 3 were remarkably similar with the exception of erythema which was more common in group 3 (34% v 68%, P = .0001). Hymenal diameter was slightly greater in group 1 than 2 but not 3. Although genital findings distinguish some sexually abused girls from asymptomatic girls, many findings also occur in girls with other genital complaints, which suggests that many of these girls have also been molested or that vulvar inflammation may lead to some of these findings.

Adolescent↗
PubMed1995

Nonsexual assaults to the genitals in the youth population.

OBJECTIVE: To assess the frequency with which youth suffer nonsexual assaults to the genitals and their context and consequences. DESIGN: Telephone survey with follow-up interview 1 year later. SETTING: General population of the United States living in households with telephones. PARTICIPANTS: Random sample of 1042 boys and 958 girls aged 10 through 16 years. RESULTS: A nonsexual assault to the genitals was experienced by 9.2% of the boys and 1.0% of the girls in the year prior to the initial interview and 9.1% of the boys and 2.2% of the girls in the year prior to the follow-up interview. Among the boys, about a quarter of the assaults involved some injury, but only one in 50 needed medical attention. The most common assailants were same-aged peers. The assaults occurred in a variety of contexts including gang attacks, peer fighting, bullying, and some situations in which girls retaliated against the genitals of harassing boys. Boy victims of nonsexual genital assault had significantly higher levels of posttraumatic and depression symptomatology than boys without such assaults. CONCLUSIONS: Nonsexual genital violence needs additional clinical and research attention. Youth should be educated about its possible consequences. Clinicians should ask about nonsexual genital violence when taking a history, particularly with youth who have experienced other kinds of assaults.

Adolescent↗
PubMedDate not supplied

Human papillomaviruses and the diagnosis of genital microorganisms.

Considerable evidence points to certain types of human papillomaviruses (HPV) as high risk factors in the malignant progression mechanism in lesions of the lower genital tract. Since infection of the genital mucosa by papillomaviruses includes a wide variety of viral types, it is essential to recognize the specific HPV type eventually present in a genital lesion to ensure an appropriate follow-up of the patient. We have developed a polymerase chain reaction (PCR) based assay which differentiates in a single amplification reaction the "malignant" HPV genital types from the "benign" ones. We report also the use of PCR for the detection of other frequent sexually transmitted agents, such as herpes simplex virus and Chlamydia trachomatis. We show that it is possible to design and use a PCR-based assay for the simultaneous detection of various genital agents from a single genital swab. This assay can be a model for the development of additional multidetection systems of microorganisms potentially involved in similar pathologies.

Chlamydia Infections↗
PubMed1993

Cesarean delivery for women presenting with genital herpes lesions. Efficacy, risks, and costs.

OBJECTIVE: To assess the effect of cesarean delivery on neonatal and maternal morbidity and mortality and their associated costs for two populations of women presenting with genital herpes lesions at delivery: those with and those without a history of genital herpes. DATA SOURCES: MEDLINE (search for herpes simplex virus and neonatal, cesarean, and mortality) and recognized experts. DATA EXTRACTION: The quality of the overall data used for baseline values was graded using a predetermined scale. RESULTS: The practice of cesarean delivery for women with a history of genital herpes lesions that recur at delivery results in more than 1580 excess cesarean deliveries performed for every poor neonatal outcome prevented, a cost per neonatal herpes case averted of $2.5 million and a cost per quality-adjusted life-year gained of $203,000. For these women, lowering the efficacy of cesarean delivery or the herpes simplex virus vertical transmission rate could result in maternal deaths outnumbering neonatal deaths prevented. In contrast, cesarean delivery for women with no history of genital herpes simplex virus who have lesions at delivery has low maternal costs per neonatal benefit and saves money. CONCLUSIONS: Women who present with their first clinical episode of genital herpes at delivery should have a cesarean section performed. However, the current practice of cesarean delivery for women with a history of genital herpes lesions that recur at delivery results in high maternal morbidity and mortality at substantial financial expense, underscoring the urgency of examining alternative management strategies.

Cesarean Section↗
PubMed1996

Genital herpes simplex virus and its treatment: focus on famciclovir.

The incidence of genital herpes continues to increase worldwide. Primary first-episode genital herpes are commonly associated with severe systemic symptoms. Primary first-episode lesions are usually bilateral and may from over a period of 10 days. Nonprimary first-episode genital herpes are often associated with less severe systemic symptoms and lesion formation. Although recurrent genital herpes episodes are generally limited to localized lesions without systemic symptoms, the frequent recurrence and chronicity may have a substantial psychosocial impact on a patient's well-being. Presently, there are no available treatments capable of abating the latent virus in human beings. Current management of genital herpes focuses on treatment with antiviral agents, which are effective in reducing the course of genital herpes.

2-Aminopurine↗
PubMed1998

Prevalence of herpes simplex virus infection in patients suspected of genital herpes; and virus typing by type specific fluorescent monoclonal antibodies.

During the period between April 1994 and February 1996, a total of 154 female patients who attended the Clinic of Female Sexually Transmitted Diseases, Siriraj Hospital with clinical symptoms suspected of genital herpes were investigated for herpes simplex virus (HSV) infection by the virus isolation method in Vero cell cultures. Swabs from external genital lesions and the cervix from each patient were collected separately and used as the clinical specimens for isolation of HSV. The virus isolates were identified by indirect immunofluorescence (IIF) staining of the infected cell cultures using polyclonal HSV-2 specific antiserum which was reactive to common HSV antigens for both types of viruses. Typing of HSV was performed by direct IF using monoclonal antibody specific to HSV-1 or HSV-2. HSV was isolated from 78.6 per cent (121 of 154) of the cases studied; and among the infected cases, there were 47.9 per cent (58 of 121) in whom the infection involved both external genital lesions and cervixes, and 50.4 per cent (61) in whom the infection was limited to external genital lesions only. There were 2 cases (1.7%) in whom HSV was isolated from cervixes but not external genital lesions. Seventy-five HSV isolates were further subjected to typing. The present study showed that HSV-1 was accounted for 18.7 per cent (14 isolates), while HSV-2 took the remaining part of 81.3 per cent (61 isolates). The data demonstrated an increase in the prevalence of HSV-1 in genital herpes in our people.

Antibodies, Monoclonal↗
PubMed1998

Absence of p53 mutations in benign and pre-malignant male genital lesions with over-expressed p53 protein.

Mutations of the tumor-suppressor gene p53 are common in epithelial tumors. Clonal mutations of p53 have been found in cervical and vulvar carcinomas negative for human papillomavirus (HPV), though at least in cervical cancer HPV infection and p53 mutations are not mutually exclusive. We have previously shown that about 40% of male genital warts and bowenoid papulosis lesions exhibit immunohistochemically detectable aberrant p53 protein, irrespective of the presence of HPV DNA. We studied p53 mutations in exons 4-8 with SSCP and sequencing in 13 male patients with 1 to 3 therapy-resistant genital warts or intra-epithelial neoplasias each and in 4 patients with penile squamous cell carcinoma. Thus, 13 genital warts, 6 bowenoid papulosis, 1 Queyrat's erythroplasia and 1 carcinoma in situ were studied. p53 protein was detected immunohistochemically, and HPV status was analyzed with DNA in situ hybridization and amplification of HPV-specific DNA. There was no correlation between p53 protein expression and HPV status. No mutations in exons 5-8 of the p53 gene were found in any of the lesions, and furthermore, no exon 4 mutations were found in lesions positive in p53 immunohistochemistry. In conclusion, overexpression of p53 does not indicate a p53 mutation in male genital warts, pre-malignant lesions or malignant squamous cell carcinomas. Our study thus suggests that p53 mutations are not important, or at least not early, events in male genital carcinogenesis.

Biopsy↗
PubMed1988

Tolerance and efficacy of recombinant human interferon gamma in the treatment of refractory genital warts.

PURPOSE: The intralesional administration of recombinant interferon alpha has led to resolution of genital warts in 50 to 70 percent of cases. However, continuous warts do not respond to such treatment, and human papillomavirus (HPV) infection of other anatomic sites remains untreated, so infection may continue to be transmitted. Since interferons have shown promise as effective therapies for genital warts, we decided to investigate the tolerance and efficacy of recombinant human interferon gamma in the treatment of refractory genital warts. PATIENTS AND METHODS: Nineteen women and nine men with refractory genital warts were treated in an open-label, dose-response trial of intramuscular recombinant human interferon gamma. RESULTS: Complete responses were seen in two (7 percent) and partial responses were seen in 13 (46 percent). Of 12 women with concomitant cervical HPV infection, eight demonstrated resolution with therapy. Response rates were higher in those patients who had warts less than nine months (73 percent) prior to therapy and in women (63 percent). Responses were not associated with HPV type. Flu-like symptoms during treatment were frequent but well tolerated. Transient abnormal laboratory results were more frequent with daily administration than with three times weekly therapy. Eleven of 16 subjects treated with cryotherapy after treatment with interferon experienced long-term remissions. CONCLUSIONS: In ambulatory patients with refractory genital warts, recombinant human interferon gamma appears to be biologically active and to have few adverse effects. The high efficacy rate achieved in subjects treated with cryotherapy after treatment with interferon suggests that further studies of combination therapy with these modalities are warranted.

Adolescent↗
PubMed1992

Oral condyloma lesions in patients with extensive genital human papillomavirus infection.

OBJECTIVES: The incidence, location, and morphologic appearances of human papillomavirus oral lesions in patients with genital condylomatosis were investigated with clinical, colposcopic, and histologic examination as diagnostic procedures. The human papillomavirus types were also evaluated with filter in situ hybridization. STUDY DESIGN: One hundred one patients, 66 female and 35 male, with genital condyloma underwent an oral cavity examination. Ninety-nine (99%) practiced orogenital sex, and all were asymptomatic for oral lesions. RESULTS: Ninety-one underwent biopsy; histologic studies gave a diagnosis of condyloma in 48% of 101 specimens collected. In 8 of 91 (9%) oral lesions were suspected by naked-eye examination; they were confirmed histologically in all eight. Of 83 patients suspected of having oral condyloma on colposcopic examination, 38 (46%) were confirmed histologically. Thus 38 of 46 patients (83%) had oral condyloma not visible to the naked eye. Colposcopically, oral lesions appeared filiform (50%), moruloid (26%), and mixed (24%). Twenty cytologic oral samples were also collected for deoxyribonucleic filter in situ hybridization analysis. Human papillomavirus deoxyribonucleic genital types were observed in 45% (9/20) of all oral scrapings collected, and all were histologically confirmed. CONCLUSION: Our data indicate that genital human papillomavirus types are capable of establishing a local infection in the oral cavity and demonstrate a high incidence of human papillomavirus oral lesions in patients with genital condyloma.

Adult↗
PubMed2003

Genital ulcers during treatment with ALL-trans retinoic acid for acute promyelocytic leukemia.

Scrotal ulcer is a unique adverse effect of all-trans retinoic acid (ATRA) in patients with acute promyelocytic leukemia (APL). The pathogenesis of scrotal ulceration remains unknown. We describe genital ulcers that developed in four patients with APL who were undergoing ATRA therapy (45 mg/m2 per day p.o.). Two of the patients were female, in whom this condition is quite rare. Genital ulcers with concomitant fever appeared between 17 and 32 days of therapy in all four patients. Genital ulcers healed in three of the patients while another patient developed Fournier's gangrene and underwent left testectomy. Ulcer healing was brought by either local or intravenous corticosteroids. Intravenous dexamethasone actually enabled continued ATRA administration in one patient, while ATRA was discontinued in other two patients. If corticosteroids cannot control progression of genital ulcers nor concomitant fever, ATRA administration should be discontinued so as not to induce Fournier's gangrene nor retionic acid syndrome. Our experience indicates the importance of recognizing genital ulcers associated with ATRA in order that appropriate countermeasures can be taken.

Adrenal Cortex Hormones↗
PubMed2005

Changes in the etiology of sexually transmitted diseases in Botswana between 1993 and 2002: implications for the clinical management of genital ulcer disease.

BACKGROUND: In recent years, increasing evidence has accumulated that suggests the majority of cases of genital ulcer disease in sub-Saharan Africa are due to viral and not bacterial infections. Although many cross-sectional studies support such a trend, few serial cross-sectional data are available to show the evolution of genital ulcer disease over time. METHODS: We surveyed the prevalence of sexually transmitted diseases (STDs) among patients with STD symptoms and women recruited from family planning clinics in 3 cities in Botswana in 2002 and compared our findings with those from a survey of a similar population conducted in 1993. RESULTS: The observed proportion of cases of genital ulcer disease due to chancroid decreased from 25% in 1993 to 1% in 2002, whereas the proportion of ulcers due to herpes simplex virus increased from 23% in 1993 to 58% in 2002. Although the proportion of ulcers due to syphilis was similar for both surveys, the rate of positive serologic test results for syphilis among patients with genital ulcer disease decreased from 52% in 1993 to 5% in 2002. During this period, decreases in the prevalence of gonorrhea, syphilis-reactive serologic findings, chlamydial infection, and trichomoniasis were also detected among patients with STDs and women from family planning clinics. These changes remained significant after estimates were adjusted for the sensitivity and specificity of diagnostic tests. CONCLUSIONS: Our findings suggest a decrease in the prevalence of bacterial STDs and trichomoniasis, a reduction in the proportion of ulcers due to bacterial causes, and an increase in the proportion of ulcers due to herpes simplex virus during the period 1993-2002. These changes should be taken into consideration when defining new guidelines for the syndromic management of genital ulcer disease.

Adult↗