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Antibiotic treatment of venereal disease and Reiter's syndrome in a Greenland population.

OBJECTIVE: To assess the effects of antibiotic treatment of urethritis or cervicitis on the incidence of recurrences of articular symptoms in Reiter's syndrome patients. METHODS: Retrospective evaluation of the medical charts of 109 patients living in Greenland. RESULTS: Thirty-seven percent of the episodes of genitourinary tract inflammation that were not treated or were treated with penicillin were followed by arthritis, compared with 10% of those treated with tetracycline or erythromycin. CONCLUSION: Antibiotics active against Chlamydia trachomatis reduced the risk of postvenereal arthritis in the population studied.

Adult↗

Diagnosis and treatment of chlamydial venereal disease.

We examined patients attending an STD clinic (Department of Dermatology, Lasarettet, Lund). Chlamydia trachomatis was demonstrated in 26% of 2021 male patients by culture from the urethra (using cyclo-heximide-treated McCoy cells). The corresponding figure for Neisseria gonorrhoeae was 15%. Both organisms were found in 5% of the patients. In women, culture from the cervix demonstrated C. trachomatis in 16% of 1039 patients. N. gonorrhoeae was found in 14%, and both organisms in 4% of the patients. Men with chlamydial urethritis were more frequently found to have a watery discharge than those with gonococcal urethritis. They also had fewer leucocytes in smears from the urethra. Treatment with different tetracyclines gives good therapeutic results in both men and women infected with C. trachomatis. In contact-tracing, 53% of 95 male partners and 65% of 103 female partners were found to harbour C. trachomatis. About 50% of these contacts were free of symptoms. This indicates the importance of contact-tracing in genital chlamydial infection.

Chlamydia trachomatis↗

Effect of the venereal diseases epidemic on the incidence of ectopic pregnancy -- implications for the evaluation of contraceptives.

This paper identifies a basis for quantifying the risk of ectopic pregnancy in pregnancy seekers and in users of the major means of contraception, with and without prior tubal infection. The doubling, in U.S. in recent years, of both numbers of ectopic pregnancies and the prevalence of nonsurgical sterility is correlated with the epidemic of gonorrhea and other sexually transmitted, salpingitis-producing diseases. The risk of ectopic pregnancy in women who have once had salpingitis is shown, on the basis of Weström's landmark prospective study and many retrospective studies, to be approximately 10-fold that of normal women. Fertilization-preventing contraceptives reduce uterine and ectopic pregnancies in the same proportion and in both categories of users--that is, in normal-risk and high-risk (post-salpingitis) women. Intrauterine contraceptives, however, markedly reduce uterine pregnancies, but have little effect on the incidence of ectopic pregnancy. Among IUD users, therefore, the incidence of ectopic pregnancy will be disproportionately great in relation to the fraction of high-risk women in the population of users. This disproportionate influence of prior salpingitis may confuse the comparative evaluation of contraceptive safety because the proportions of normal-risk and high-risk women probably vary widely, since public health data show extremely wide geographic differences in the incidence of gonorrhea -- the best known but not the only sexually transmitted, salpingitis-producing disease.

Contraception↗