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Inapparent genital herpes simplex infection in women attending a venereal disease clinic.

The purpose of this study was to determine the prevalence of asymptomatic genital infection with herpes simplex virus in women attending a venereal disease clinic in Puerto Rico. Genital samples were obtained from 123 consecutively enrolled patients. Vero cells were used for viral isolation; isolates demonstrating cytopathic effect were stored at -70 C and were typed by use of monoclonal antibodies. Herpes simplex virus was isolated from six patients, three of whom were free of any possible complaint that might be associated with a genital herpes virus infection. One patient was diagnosed as having herpetic cervicitis, and the remaining two were clinically diagnosed as well as laboratory confirmed cases of genital herpes. Virus isolated from all six women was identified as herpes simplex virus type 2. Thus the prevalence of laboratory confirmed genital herpes infection in women attending this clinic was 4.9% (6/123). Inapparent virus infection was detected in 2.5% (3/120) of the patients.

Adolescent↗

Treatment of venereal disease in the penicillin-allergic patient: administration of penicillin following testing with major and minor determinants.

We describe the administration of penicillin for venereal disease in three penicillin-allergic patients for whom alternative antibiotics were not considered suitable. Each patient was skin test negative to the major penicillin determinant benzylpenicilloyl-polylysine and a minor determinant mixture of potassium penicillin, benzylpenicilloate and benzylpenicilloyl-n-propylamine provided by the National Institute of Allergy and Infectious Diseases. Therapeutic doses of penicillin were administered without anaphylaxis, but one patient developed serum sickness on day five following benzylpenicillin. The skin testing results were determined within 30 minutes such that penicillin or its derivatives could be administered safely and rapidly to seriously ill patients, i.e. disseminated gonococcemia. When treating neurosyphilis or disseminated gonococcal infection for which non-penicillin therapy is unacceptable, use of the current skin test reagents provides a level of safety in avoiding anaphylaxis not previously attainable.

Adult↗

[20th century medical debate over venereal disease and prostitution].

In the early twentieth century a wider debate took place about how Swedish society was to fight the spread of contagious venereal diseases and in 1910 a government committee had written a law proposal that would dramatically reform these measures previously, Swedish physicians had been united against any measures against these diseases that did not involve the regulation of prostitutes, but this consensus was slowly withering away in the early parts of the century. Female doctors and a younger generation of venereologists was drawing the conclusion that mandatory checks of only one out of two sexes was insufficient. This article reviews the debate regarding the regulation of prostitution that took place between conservative and liberal members in the Swedish Medical Association in 1911. It depicts a fierce discussion between members that still clung to nineteenth-century ideas of women as being prone to prostitution if left idle and unemployed, and liberal members that believed social injustices such as low wages laid behind women's decisions. The study gives an insight into the complexities of building the Swedish welfare state.

Communicable Disease Control↗

Comparison of a new rapid plasma reagin card test with the standard rapid plasma reagin 18-mm circle card test and the venereal disease research laboratory slide test for serodiagnosis of syphilis.

The rapid plasma reagin (RPR) card test manufactured by Beckman Instruments, Inc., was compared, qualitatively and quantitatively, with the Venereal Disease Research Laboratory (VDRL) slide test and the standard RPR 18-mm circle card tests for the serodiagnosis of syphilis. Sera from 638 individuals were used in this study. Two pilot lots and two production lots of antigen were submitted by Beckman Instruments, Inc., for evaluation. Qualitative agreement among the three RPR card tests was 98.1%; between the Beckman RPR card and the VDRL slide tests, 95.0%; and between the reference RPR card and the VDRL slide tests, 95.5%. The Beckman RPR card test was 95.3% specific, whereas the specificities of the reference RPR card and the VDRL slide tests were 98.8% and 96.1%, respectively. Sensitivities of the three nontreponemal tests were: Beckman RPR card test production lots, 94.7%; reference RPR card test, 96.8%; and VDRL slide test, 90.6%. Quantitative agreement +/- 1 dilution among the three RPR card tests was 93.0%, whereas quantitative agreement was approximately 40% when both RPR card tests were compared with the VDRL slide test. We found the Beckman RPR card test comparable to the standard RPR card tests. Therefore, the decision of which test to use for the serodiagnosis of syphilis is at the discretion of the user.

Antibodies↗

Enzyme-linked immunosorbent assay for detection of antibodies to the venereal disease research laboratory (VDRL) antigen in syphilis.

An enzyme-linked immunosorbent assay (ELISA) for detection of immunoglobulin G (IgG) and IgM to cardiolipin, lecithin, and cholesterol (VDRL [Venereal Disease Research Laboratory] ELISA) is described. The specificity of the VDRL ELISA for IgG and IgM was 99.6 and 99.5%, respectively, with sera from 1,008 persons without syphilis. For a group of patients with false-positive results in traditional nontreponemal tests and for patients with autoimmune diseases, the VDRL ELISA for IgG had a higher specificity than the VDRL ELISA for IgM. The sensitivity for IgG and IgM with 118 sera from patients with untreated syphilis was 96.6 and 94.9%, respectively, which was equivalent to the sensitivities of the traditional nontreponemal tests. The performance of the VDRL ELISA was compared with that of an ELISA that uses cardiolipin as the antigen (cardiolipin ELISA). The VDRL ELISA was significantly more sensitive (P less than or equal to 0.01) than the cardiolipin ELISA with 25 sera from syphilis patients but was less sensitive (P less than or equal to 0.01) with 53 sera from patients with autoimmune diseases. The antibody reactivity in the VDRL ELISA could not be absorbed out by lecithin and cholesterol, and the sera from patients with syphilis did not react in an ELISA that uses cholesterol and lecithin as the antigen. This indicates that cholesterol and lecithin, although not antigenic by themselves, may change the structural form of the epitope on cardiolipin so that it becomes more recognizable for antibodies in syphilis and less recognizable for antibodies in autoimmune diseases. The results of the VDRL ELISA were expressed in percentages of the absorbance value of a positive control. The VDRL ELISA gave, without titration of sera, quantitative results that correlated with the quantitative results of the traditional nontreponemal tests obtained by titration. The VDRL ELISA will be well suited for large-scale testing for syphilis and may replace other nontreponemal tests.

Antibodies, Bacterial↗

Homosexuality and venereal disease in the United Kingdom. A second study. British Co-operative Clinical Group.

The proportion of homosexually acquired cases of primary and secondary syphilis in patients attending venereal disease clinics in the United Kingdom has risen from 42.4% to 54% over a six-year period. Similarly, over the same period, the proportion of homosexually acquired cases of gonorrhoea has risen from 9.8% to 10.9%. The increase in incidence of homosexually acquired infections in both diseases occurred in all areas but particularly in London. Thus the very considerable epidemiological importance of male homosexuals as a high-risk group should receive more, not less, emphasis.

Gonorrhea↗

[Investigations on the present status of infections with Chlamydia trachomatis (Ct), Mycoplasma hominis (Mh) and Ureaplasma urealyticum (Uu) in patients with venereal diseases, sexual abusers and healthy people in Da Lian].

From January to June 1992, we conducted the detection of serum antibodies against Ct, Mh and Uu in patients with venereal diseases, sexual abusers and healthy people. The results showed that the positive rates of antibodies against Ct, Mh and Uu in patients were the highest, while in healthy people those of antibodies against Ct and Uu were the lowest. The positive rates between the antibody against Uu and that against Mh have no obvious difference between male and female. All samples have dual infection of Ct and Mh.

Adolescent↗

Relationship of phospholipid chemistry to serological reactivity in the Venereal Disease Research Laboratory slide test antigen.

A total of 13 egg lecithins, 12 beef heart lecithins, and 15 beef heart cardiolipins were assayed for the ability to function in the Venereal Disease Research Laboratory microflocculation test, as well as for purity, fatty acid composition, free amines, metals, and products of oxidation. We found that the presence of peroxides and oxidation-related ultraviolet-absorbing chromophores showed a close inverse relationship to acceptable serological activity. The degree of purity of the lipids had only a slight influence on serological activity, whereas fatty acid composition, saturation, and configuration had none at all. We did not detect contaminating iron, copper, cobalt, nickel, or free amines in these lipids. We discuss the implications of our findings for improving the chemical standards for these lipids.

Antigens↗

Sexual factors, venereal diseases, and the risk of intraepithelial and invasive cervical neoplasia.

The relation between major indicators of sexual habits (age at first intercourse and total number of sexual partners), history of selected venereal diseases, and cervical neoplasia was investigated using data from a case-control study of 206 cases of cervical intraepithelial neoplasia compared with 206 age-matched outpatient controls, and of 327 cases of invasive cancer compared with 327 control subjects in hospital for acute conditions unrelated to any of the established or suspected risk factors for cervical cancer. The relative risks increased with decreasing age at first intercourse and increasing number of sexual partners both for intraepithelial and for invasive cancers. The effects of these two variables were independent, since they were only marginally affected by reciprocal adjustment, or by allowance for several other identified potential distorting factors. The negative association with age at first intercourse was particularly strong in the case of invasive cancers, with risk estimates over five-fold elevated for women reporting their first intercourse before age 18 compared with those aged over 22 years. This relation might be discussed in terms of multistage models of carcinogenesis, which predict that the incidence of epithelial carcinomas is a function of duration of exposure. In fact, when age was allowed for, the relative risks of cervical neoplasia were positively and strongly related with the total duration of the interval between age at diagnosis/interview and age at first intercourse. Clinical histories of several sexually transmitted diseases were positively associated with the risk of intraepithelial neoplasia. In particular, genital warts were reported by nine cases but no control subject. No such association, however, emerged for invasive carcinomas. Thus, the current findings confirm that, although intraepithelial neoplasia and invasive cervical cancer appear to share several important epidemiological features, the specific (infectious) agents implicated in dysplastic lesions probably differ to some extent from those causing invasive cancer.

Adult↗

Sexual transmission of enteric protozoa and helminths in a venereal-disease-clinic population.

We examined the prevalence of enteric protozoan and helminthic infections and the associations between infection and gender, sexual preference, and sexual practices in 180 consecutive patients at a venereal-disease clinic. Of 163 men, 29 were infected with one or more enteric parasites. None of the 17 women had an enteric infection. The prevalence of infections with Entamoeba histolytica or Giardia lamblia (or both) was 21.5 per cent in homosexual men, 6.2 per cent in bisexual men, and 0 in heterosexual men. There were significant associations between oral-anal sex and infection with E. histolytica (P less than 0.01) or with helminths (P less than 0.05). Homosexuality and oral-anal sex were the most important risk factors in E. histolytica, G. lamblia, and helminthic infections. We conclude the "hyperendemic" enteric protozoan infection rates in homosexual men are related to three factors: the original endemic level in the general population; the prevalence of sexual acts that facilitate transmission; and the frequency of exposure to an infected person.

Entamoebiasis↗

Gonococcal infections in women attending the Venereal Disease Clinic of the Nashville Davidson County Metropolitan Health Department, 1984.

During the first six months of 1984, slightly more than a third (34.1%) of the 1,549 women who attended the Venereal Disease Clinic of the Nashville Davidson County Health Department in this study were found to be infected with Neisseria gonorrhoeae. Infection prevalence was 36.7% for black women and 27.1% for white. The frequency of sexual intercourse and the number of sexual partners during the previous 30 days were similar for black and white patients. Fewer women were using contraceptives (67.8%) than in 1979 (87%). Exceptionally high rates of infection were found in women whose sexual partners had gonorrhea. Even with similar levels of sexual activity, black women faced greater risk of infection than white women, possibly because they were much more likely to be exposed to an infected man.

Adult↗

Reactivity of microhemagglutination, fluorescent treponemal antibody absorption, and venereal disease research laboratory tests in primary syphilis.

Seroreactivity in 130 cases of primary syphilis was 91.5% by fluorescent treponemal antibody absorption test, 82.3% by microhemagglutination (MHA-TP test), and 68.5% by the Venereal Disease Reseach Laboratory (VDRL) test. The MHA TP test generally became reactive earlier than the VDRL test and confirmed all reactive and most weakly reactive VDRL results.

Antibodies, Bacterial↗

[The nature of male patients being informed about sexual relations and venereal diseases].

Experimental studies and special tests designed to gain insights into the particular character of knowledge that young male individuals have of sexual contacts and of risks they run of being infected with venereal diseases because of the above contacts suggest the existence of an information structure inadequate in its content, not giving an essentially complete picture of the matter, that a major proportion of adolescents and young men are forced into having recourse to. This in its turn accounts for manifestly inadequate results of the present-day system of sanitary-education work aimed at preventing further spread among the population of infectious diseases, predominantly those transmitted by sexual intercourse.

Adolescent↗