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At least 649 records · Page 36Linked to original sources
PubMed2001

Exorcising excision: medico-legal issues arising from male and female genital surgery in Australia.

Genital surgery is one of the most controversial and contested practices, yet it is frequently described and referred to with little or no attention to cultural and social context. This article examines the practice, performed on both men and women, and the extent to which it clashes with issues of consent and capacity, as well as multicultural concepts of toleration for minority group practices. It then questions why female genital surgery, unlike male genital surgery, is legally prohibited in Australia. It argues that such legal gender bias stems from a liberal conception of "tolerance" and the limits of consent in Australia, placing female genital surgery in an "unacceptable" category and male genital surgery in an "acceptable" category.

Australia↗
PubMed2002

[Genital herpes: epidemiology, transmission, clinic, asymptomatic viral excretion, impact on other sexually transmitted diseases, prevention, and treatment].

Genital herpes is one of the most widespread sexually transmitted diseases in the world. HSV2 predominates (60-80 p. 100), but the prevalence of HSV1 genital herpes is rising (20-40 p. 100). Erosive lesions of the genital organs due to HSV infection are a factor favoring HIV contamination and other sexually transmitted diseases. The main factor of transmission is asymptomatic viral excretion. Aciclovir, valaciclovir and famciclovir are effective treatment for genital herpes (primary infection, curative and preventive treatment of recurrence), but none of these compounds alters the natural history of the infection. Aciclovir given as a preventive measure reduces the load of asymptomatic viral excretion. Information and education of patients with genital herpes are key elements for prevention. Use of preservatives appears to be effective. New vaccine strategies favoring humoral and cellular response should be studied.

2-Aminopurine↗
PubMedDate not supplied

[Management of external genital warts by dermatologists: a French survey].

BACKGROUND: External genital wart is the most frequent sexually transmitted disease. While there are guidelines for management and treatment, no data about primary care of this viral disease is available in France. So, we conducted a survey on French dermatologists'management of external genital warts. METHODS: In July and August 2001, a questionnaire - including questions on physicians and patients, sexually transmitted diseases, partners, clinical and viral evaluations, treatments, and follow-up - was mailed to 652 French dermatologists (randomization of 20 p. 100 of French dermatologists). RESULTS: Three hundred and fifty (53 p. 100) responses were returned. Dermatologists were mainly exclusively office practitioners (58 p. 100). Thirty-six percent of them were taking care of more than 3 patients per month with external genital warts. Patients were essentially men and immunocompetent. Only 52 p. 100 of physicians systematically performed a sexually transmitted disease evaluation, 38 p. 100 a partner evaluation, and 17 p. 100 a local evaluation for external genital warts. Biopsy was occasionally performed by 48 p. 100 of physicians, mainly in order to confirm diagnosis. Viral genotyping was rare. Cryotherapy (84 to 93 p. 100) and podophyllotoxin (40 to 55 p. 100) were the two treatments used as first line therapy, while laser (61 to 71 p. 100), and imiquimod (39 to 48 p. 100) were second line therapies. Sixty-three percent of physicians proposed a systematic clinical control after clinical recovery. CONCLUSION: This large survey represents an overview on general practice concerning external genital warts among French dermatologists. Our study points out the lack of global management (loco-regional, partner, and STD evaluation) of the disease by dermatologists.

Adjuvants, Immunologic↗
PubMed2002

Gene expression of genital human papillomaviruses and considerations on potential antiviral approaches.

Genital human papillomaviruses (HPVs) are carcinogenic to humans and are associated with most cases of cervical cancer, genital and laryngeal warts, and certain cutaneous neoplastic lesions. Five of the more than 50 known genital HPV types, HPV-6, -11, -16, -18 and -31, have become the models to study gene expression. The comparison of the studies of these five viruses and analyses of the genomic sequences of those genital HPV types that have not been transcriptionally studied make it likely that genital HPVs share most strategies for regulating their transcription. These strategies are quite different from those of unrelated human and animal papillomaviruses. Among these common properties are (i) a specific promoter structure allowing for fine-tuned negative feedback, (ii) a transcriptional enhancer that is specific for epithelial cells, (iii) regulation by progesterone and glucocorticoid hormones, (iv) silencers, whose principal function appears to be transcriptional repression in the basal layer of infected epithelia, (v) specifically positioned nucleosomes that mediate the functions of some enhancer and the silencer factors, (vi) nuclear matrix attachment regions that can, under different conditions, repress or stimulate transcription, and (vii) as yet poorly understood late promoters positioned very remote from the late genes. Most of these properties are controlled by cellular proteins that, due to their simultaneous importance for cellular processes, may not be useful as HPV-specific drug targets. It should be possible, however, to target complex cis-responsive elements unique to these HPV genomes by nucleotide sequence-specific molecules, such as antisense RNA, polyamides and artificial transcription factors. The application of small molecule-based drugs may be restricted to target proteins encoded by the HPV DNA, such as the replication factor E1 and the transcription/replication factor E2.

Antiviral Agents↗
PubMed2003

[Importance of regular screening for genital chlamydiosis in adolescents].

OBJECTIVE: Determination of prevalence of genital chlamydiosis in similar group of adolescents as in that examined two years ago. Comparison of the results with the previous ones to confirm positive impact of a repeated screening on drop of prevalence of the infection. Another objective is to make the epidemiological data on genital chlamydiosis in the countries of the "Eastern Block" more accurate, and at the same time to assess the most suitable screening method. DESIGN: Prospective epidemiological study aimed at finding whether the repeated screening examinations of genital chlamydiosis in adolescents will result in decreased incidence of the infection. SETTING: Veterinary Research Institute, Department of Clinical Microbiology of the Faculty Hospital, Regional Hygienic Station, Department of Gynecology and Obstetrics, Medical Faculty, Masaryk University, Brno. METHODS: The groups under testing comprised male and female students of two secondary medical schools and one private grammar school older than 18 (n = 232, of which 33 were boys and 199 girls). Direct detection of C. trachomatis was carried out from the urinary sediment of the sample of morning urine using ligase reaction, polymerase chain reaction, ELISA and direct immunofluorescence. RESULTS: Identical positive result of C. trachomatis detection by four methods was obtained 4 times, i.e. 1.7%. The result of LCR and PCR were positive identically (4 times), ELISA and IF were, besides the above results, positive in other 1 resp. 5 cases. CONCLUSION: Screening examinations of genital chlamydiosis were performed in adolescents in the town of Brno. Morning samples of urine from 232 students of secondary schools were examined on C. trachomatis using the following methods: LCR, PCR, ELISA, and IF. The LCR and PCR were positive 4 times, ELISA 5 times, IF 9 times. Positive results by LCR and PCR were identical. ELISA and IF were positive in other cases. Noninvasive methods are suitable for screening of latent genital chlamydiosis and for estimation of its prevalence. The authors of the study recommend the ligase chain reaction (LCR) as a most suitable screening method.

Adolescent↗
PubMed2003

[The human beta-defensins expression in female genital tract and pregnancy-related tissues].

OBJECTIVE: Human beta-defensins (HBDs) are small, cationic endogenous antimicrobial peptides isolated from the hemodialates of patients with chronic renal failure (HBD-1) and Psoriasic skin (HBD-2). They may play an important role in mucosal innate host defense against infections. In this study, we examined their mRNAs expression in normal and pregnant women genital tract. METHODS: Reverse transcription-polymerase chain reaction (RT-PCR) was performed in the detection of HBD-1 and HBD-2 mRNA expression in the samples from normal and pregnant women genital tract. beta-actin was taken as positive control. RESULTS: RT-PCR detection revealed that HBD-1 mRNA expressed in all samples of normal women taken from vagina, cervix, endometrium, fallopian tube, and ovary, and HBD-2 mRNA widely expressed in genital tract except vagina and ovary. In pregnant women, HBD-1 mRNA widely expressed in chorion, villus, placenta, and umbilical cord, but not in amnion, and HBD-2 mRNA were detected in chorion, villus and placenta tissues. CONCLUSION: The findings of this study on the wide expression of HBD-1 and HBD-2 in both the normal and the pregnant women genital tract suggest that HBDs may play an important role in human genital tract defense mechanisms.

Adult↗
PubMed1992

The influence of sphincter control and genital sensation on body image and gender identity in women.

The development of one aspect of feeling female is hypothesized to account for certain phenomena in the treatment of young women patients. Fear of loss of genital pleasure experienced as contractions of the anal and genital-urinary sphincters is seen as the central issue in conflicts manifested in genital, oral, and anal modalities. It is suggested that the female's awareness of her genital arises from the generalization of sphincter sensation in the little girl, which is then represented in the body image. The body image is postulated as a link between genital pleasure and the valuing of femininity.

Adult↗
PubMed2004

Genital herpes and human immunodeficiency virus: double trouble.

The synergistic relationship between herpes simplex virus type 2 (HSV-2) and transmission of human immunodeficiency virus (HIV) can be substantial in developing countries that have high prevalences of both viral infections. Genital herpes, most frequently caused by HSV-2, has become the leading cause of genital ulcer disease worldwide. This review of recent research on genital herpes and enhanced susceptibility to, and transmission of, HIV is part of the "Advances in HIV/AIDS research series" which endeavours to form a bridge between the research into HIV and acquired immunodeficiency syndrome (AIDS) and the practice of HIV/AIDS prevention, care and support in developing countries. Research findings have shown that being seropositive for HSV-2 can increase the risk of HIV acquisition among high-risk HIV-negative people exposed to HIV and, likewise, the infectiousness of individuals co-infected with HIV-1 and HSV-2 can increase during periods of HSV-2 reactivation. These observations have led to the initiation of several intervention trials and could ultimately lead to the setting of new priorities in public health and clinical practice. WHO has recently issued new guidelines for the syndromic management of genital ulcer disease that include antiviral treatment for lesions consistent with genital herpes. The United States Centers for Disease Control and Prevention issued updated Sexually Transmitted Diseases Treatment Guidelines in 2002 that recommended the use of type-specific serological tests for diagnosing HSV-2. Recently launched proof-of-concept, HSV-2 intervention trials in several countries will help to determine the proportion of new HIV infections that could be prevented by suppression of HSV-2, and the findings from these studies will inform those involved in setting prevention and treatment priorities and strategies in developing countries.

Africa↗
PubMed2005

Genital herpes in young adults: changing sexual behaviours, epidemiology and management.

Genital herpes is a common sexually transmitted infection throughout the world. The majority of new infections occur in adolescents and young adults, although prevalence rates generally increase with age and cumulative sexual experience. In young adults, herpes simplex virus 1 (HSV-1) infection is becoming a more common cause of genital herpes. Reasons for this trend include changing sexual practices, notably oral-genital exposure and the use of condoms for intercourse. Important implications of having genital herpes include the risk of transmission to sexual partners and the increased risk of acquiring and transmitting HIV. Genital herpes infections are often unrecognized, and transmission to uninfected partners is likely to occur during asymptomatic shedding. A diagnosis of herpes may also affect psychosexual development, particularly in adolescents. Such factors contribute to the growing global HSV prevalence and suggest a need to implement better screening programmes in young adults. Recognizing and treating HSV early offers benefits to patients and their sexual partners by reducing the frequency and severity of outbreaks, limiting the likelihood of disease transmission, and preventing new infections.

Herpes Genitalis↗
PubMed2005

Patient and partner perceptions about preventing genital herpes transmission.

Research over the past decade has provided a new understanding of genital herpes transmission and measures that can reduce transmission risk. It is unclear, however, how those affected by genital herpes access and interpret this information to make decisions about risk behaviours. This study measured how people with genital herpes and their partners perceived prevention methods, barriers and facilitating factors, and information sources. Formative evaluation was conducted, and survey data were collected from visitors to four websites (n=1849). Results suggest that the prevention messages of refraining from sex during disease outbreaks and condom use have had the greatest reach. Misconceptions about the potential role of suppressive antiviral therapy for genital herpes prevention persist among a substantial percentage of respondents. Accurate information concerning transmission between outbreaks, the effectiveness of condoms and the role of antiviral medication is critical in preventing the spread of genital herpes.

Adolescent↗
PubMed2003

Genital prolapse in women of Bhaktapur, Nepal.

Genital prolapse is one of the commonest reproductive morbidity in developing country. Common predisposing factors are multiparity, early postpartum sternous activity, advanced age and menopause. This study conducted in Bhaktapur district in five months included 1337 women aged 20 and above. The prevalence of female genital prolapse found to be 7.55%. Maximum numbers of women were having children eight and more (48.51%). Only 1.9% of women with genital prolapse were nulliparous. Home delivery is still common in Bhaktapur, 79% of women with genital prolapse had all children born at home without help. Regarding post partum activity majority of them (64.3%) told that they took rest at least one month after delivery but 26.73% started working in field in 2-3 weeks after delivery. The use of pessary is 25% among female with genital prolapse but only a few were following medical advice to change the ring. Nine women were having impacted ring in situ for years.

Adult↗
PubMed2006

An evidence-based review of medical and surgical treatments of genital warts.

Genital human papillomavirus (HPV) infection is the most common sexually transmitted disease. Each year 1 million new cases of genital warts are diagnosed, two thirds of which are in women. The estimated prevalence rate in the US population is 15 percent. HPV infects keratinocytes. Such infection can manifest clinically as warts. Treatment options for genital warts are numerous, well established, and effective. Topical treatments include podophyllin resin, imiquimod, trichloroacetic acid, and podophyllotoxin. Surgical or destructive therapies include carbon dioxide laser, surgical excision, loop excision, cryotherapy, and electrodessication. Interferon can be injected locally or administered systemically to treat genital warts. Evidence of efficacy in the treatment of genital warts is drawn from randomized blind-controlled trials, prospective studies, and retrospective cohort studies. Evidence of efficacy appears to be good, but more head-to-head studies and comparisons of combination therapies versus monotherapy need to be done. Treatment of choice depends on the number, size, and location of lesions. There is little certainty that any approach is more effective than another, however costs differ. It would seem that the first line destructive treatment is cryotherapy, but surgery and electrodesiccation are more effective. The first line topical treatments appear to be podophyllotoxin and imiquimod. Interferon is too expensive and trichloracetic acid is too inconsistent to be recommended as primary treatment. It is unclear if combinations of therapies are more effective than monotherapy. Side effect profile, cost, effectiveness and convenience (ability to attend physician's office or to undertake protracted home treatment) define the choice of therapy.

Condylomata Acuminata↗
PubMed1990

Female genital anxieties, conflicts and typical mastery modes.

This paper focuses on the female experience of her own body, the unique anxieties that arise from the nature of the female genitals and the role of the female body in female development. Following Freud's theories of the importance of integrating body experiences in the development of psychic structures, the girl's body and her efforts to integrate it are seen as uniquely feminine. Three anxieties are described--access, penetration and diffusivity. These represent dangers to body integrity comparable to, but different from, boys' experience of castration anxiety. Not only do different genitals give rise to different anxieties, the different body experiences give rise to different modes of mastery (defence) shaping different character structures. While males can readily form discrete, concrete mental representations of their genitals, females cannot. While the boy can rely on direct sensory experience, the developing girl must rely on proprioceptive experiences, symbolization, and on other people to aid her in defining her elusive genital experience. This interpretation of the female genital experience provides a psychoanalytic framework for the object embeddedness long observed as part of the feminine character.

Adult↗
PubMed1989

[Genital herpes infection in Chilean female university students].

This article reports on the prevalence of genital herpes infection in a sample of 635 female university students who were seen at the Gynecology Center of the University of Chile Student Medical Service. Viral isolation of genital secretions yielded 18 students (2.8%) with positive results, of whom 28% were asymptomatic shedders. Of the positive cases, 61% were clinically classified as recurrent and 39% as first episodes of genital herpes. Fluorescent monoclonal antibody typing of the isolated strains revealed that 72% were herpes simplex type 2 and 28% were type 1. The results confirm the importance of type 2 virus in genital herpes infections. They also point to asymptomatic shedders as a potential source of infection, and show the importance of a history of genital herpes in the identification of this population.

Adult↗
PubMed1989

Genital papillomavirus infections: current knowledge and future prospects.

Although much has been learned about the biology of HPV during the last decade, little progress has been made in the development of rational and effective patient management strategies. Without stronger evidence supporting a causal role for HPV in the development of genital tract and anal cancers, and without the availability of effective therapies, it is premature to recommend widespread screening for detection of HPV DNA or RNA with the molecular hybridization tests soon to be available commercially. Papanicolaou smear screening for detection of early precancerous changes of the cervix and referral for colposcopy and biopsy of areas of epithelium that are suspicious for intraepithelial neoplasia of the cervix, vagina, vulva, penis, or anus remain the cornerstones of genital tract and anal cancer prevention. The patient care implications of subclinical persistent HPV infection of the genital tract are not well understood. For this reason, and because none of the available therapies are curative, treatment of large areas of normal-appearing genital tract epithelium also cannot be recommended at this time. It is hoped that, with the growing research focus on therapies that have the potential for virologic cure, some day effective treatment for subclinical infection will be available. Until that time, patients with recalcitrant or recurring genital warts may benefit most by the sequential application of different treatment modalities.

Condylomata Acuminata↗
PubMed1987

Diagnosis and treatment of genital herpes infections.

Oral acyclovir is the treatment of choice for most patients with first episode genital herpes (Table 2). Therapy of first episode herpes may not be indicated in patients whose symptoms and lesions are clearly resolving at the time of presentation, and intravenous acyclovir therapy should be considered in patients with first episode herpes who require hospitalization. A viral culture should be obtained prior to initiating treatment in persons with first episode genital herpes, and typing should be performed to predict the risk and frequency of subsequent recurrences. Serologic differentiation of primary and nonprimary first episode disease is generally not performed outside the research setting. Suppression of recurrent genital herpes infections with daily oral acyclovir therapy has been shown to be safe and effective when continued for periods for up to 2 years. Oral acyclovir suppression should be considered in patients with frequent recurrences who complain of significant morbidity in association with their genital herpes infections (Table 2). The clinical benefit from episodic treatment of recurrent genital herpes infections is less dramatic. Patient-initiated therapy with oral acyclovir at the first sign of prodome or lesions should be considered in patients with relatively severe recurrences who are not candidates for suppressive treatment. Virologic confirmation of infection is encouraged. Oral acyclovir is the treatment of choice for short-term or long-term suppression in immunocompromised hosts, although short-term suppression with intravenous acyclovir may be indicated for persons who cannot take oral medications. Episodic treatment with topical, oral, and intravenous acyclovir is effective in immunocompromised patients, but topical treatment should be limited to persons with external lesions only.

Female↗
PubMed1986

Development of the os penis in genital tubercles cultured beneath the renal capsule of adult rats.

Genital tubercles of male and female rats were cultured beneath the renal capsule of castrated and intact adult male rats treated with androgens, oestrogen, or anti-androgen, and the development of the os penis in the transplants was studied. When the genital tubercles were cultured in normal male hosts, a membrane bone and a hyaline cartilage of the proximal segment of the os penis were formed 8-11 days after transplantation, and a fibrocartilage of the distal segment of the os penis at 11-14 days. In genital tubercles cultured in castrated males, the rudiments of both the proximal and distal segments remained as undifferentiated mesenchymal cell masses. However, similarly cultured genital tubercles were found to develop cartilages and bone when the hosts were treated with high doses of androgens. The potency of androgen-dependent chondrogenesis and osteogenesis was equivalent in the male and female genital tubercles. Chondrogenesis and osteogenesis of the os penis were caused by androgens, while the rudiments of the os penis were formed independently of androgens. The overt differentiation of the corpus cavernosum penis was also caused by androgens.

Animals↗
PubMed1985

Genital herpes infections in private practice in the United States, 1966 to 1981.

We analyzed data on genital herpes infections in the United States from 1966 to 1981 collected by the National Disease and Therapeutic Index survey. The number of private physician-patient consultations for genital herpes increased tenfold during this period. The number of patient visits for newly diagnosed infections increased 7.5-fold. Women aged 20 to 24 years and men aged 25 to 29 years were more likely to consult a private physician for genital herpes than were patients in other age brackets. Our analysis suggests an increasing national incidence of genital herpes infections and supports the concept that genital herpes infections are epidemic in the United States.

Adult↗