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At least 1,369 records · Page 76Linked to original sources
PubMed1989

Sexually transmitted diseases and Chlamydia trachomatis in women consulting for contraception.

To study the frequency of genital infections in women consulting their family doctor for contraception, 248 women (median age 23 years) were examined for a range of genital microorganisms. The prevalence of clue cells, Candida albicans and Trichomonas vaginalis were 21.0%, 12.9% and 2.0%, respectively. Neisseria gonorrhoeae was isolated in only one case, whereas Chlamydia trachomatis was found in 6.3% of women. A specific clinical picture for an infection with C. trachomatis in women was not seen. Given the prevalence of over 5% for C. trachomatis and the absence of typical signs and symptoms in infected women, screening for this organism is recommended in women requesting an intrauterine contraceptive device, to prevent complications such as pelvic inflammatory disease and their sequelae.

Adolescent↗
PubMed1989

Pelvic inflammatory disease.

Pelvic inflammatory disease (PID) is a genital tract infection that affects a predominantly young and sexually active population. While its exact pathogenesis has yet to be determined, it appears to be caused by several micro-organisms that develop in response to one or more of the following: foreign bodies, such as intrauterine contraceptive devices, retained tampons and douching solutions, and surgery, such as endometrial biopsy and hysterosalpingography. The most common risk factor for PID is multiple sexual partners. The disease is associated with infertility, sterility and adverse pregnancy outcomes. Management calls for aggressive antibiotic therapy and the temporary suspension of sexual activity.

Female↗
PubMed1989

The 'Pap' or cervical smear and the role of colposcopy in screening for carcinoma of the cervix.

Cervical cancer is the commonest female genital tract cancer in Singaporean women with an annual age-standardized rate of 17.4 per 100,000. High risk factors are early sexual intercourse, multiple sexual partners and cigarette smoking. Population screening with annual cervical (Pap) smears after beginning sexual activity until age 35 and at 5 year intervals after that can reduce both incidence and mortality rate from invasive cervical cancer. Benign, premalignant and malignant conditions may be identified in smears. The term cervical intra-epithelial neoplasia (CIN) reflects better the continuum of change in precursor lesions and is preferred over the older dual terminology of dysplasia/carcinoma-in-situ for precursors of cervical cancer. Colposcopy is essential for evaluation of all patients with abnormal cervical smears. Colposcopy is used to identify the site, severity and extent of abnormality as well as to aid directed biopsy, plan treatment and allow use of conservative methods to treat the precursor lesions. Colposcopy however, has no role as a primary screening procedure for cervical cancer but instead cervical smears are used for screening.

Cervix Uteri↗
PubMedDate not supplied

Practicing safer sex.

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Acquired Immunodeficiency Syndrome↗
PubMed1989

AIDS in Africa.

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Acquired Immunodeficiency Syndrome↗
PubMed1987

Update on hepatitis B prevention. Recommendations of the Immunization Practices Advisory Committee. Centers for Disease Control, Department of Health and Human Services.

Since plasma-derived hepatitis B vaccine was licensed for use in the United States in 1982, use of the vaccine in high-risk health care professions has been modest, despite widespread participation in the establishment of vaccination programs among these institutions. The incidence of hepatitis B virus infection has continued to increase in the past 5 years, presumably because vaccination programs have failed to reach the major risk groups of homosexual men, parenteral drug abusers, and heterosexually active persons with multiple sexual partners. Increased efforts toward the development of programs to vaccinate persons in all high-risk groups are recommended. The immunogenicity, safety, efficacy, and precautions involved in the use of a new recombinant DNA vaccine (licensed in 1986) are also discussed, and the need for booster doses of plasma-derived vaccine are evaluated.

Adult↗
PubMed1988

Cervical cytology and the evaluation of the abnormal Papanicolaou smear.

The pap smear is a safe, easy, and inexpensive method for the screening of large numbers of sexually active women for the presence of neoplasia of the cervix. When the pap smear is reported as being abnormal, it is highly accurate. Unfortunately, some cytology laboratories report lesions as "Class II" or "atypical." These reports are not helpful to the clinician and require further evaluation. Most sexually active women are at "high risk" for the development of cervical neoplasia because of early sexual activity for multiple sexual partners. All women at high risk should have annual pap smears. If a woman has a pap smear that suggests the presence of CIN (dysplasia or carcinoma in situ), colposcopy should be performed. This office procedure allows for the detection of the areas causing the abnormal cytology. Colposcopy can often allow outpatient therapy of CIN lesions. Conization should be performed only when the colposcopic examination is unsatisfactory or patient or lesion factors are not favorable for office therapy. Hysterectomy is not recommended for treatment of cervical dysplasia or carcinoma in situ.

Colposcopy↗
PubMed1988

Human papillomavirus infection: a potentially carcinogenic sexually transmitted disease (condylomata acuminata, genital warts).

Human papillomavirus is a sexually transmitted virus that has been associated with intraepithelial neoplasia. The incidence and prevalence of the disease has risen dramatically, to epidemic proportions, within the last two decades. Risk factors for HPV are similar to those for intraepithelial neoplasia: early onset of sexual activity, multiple sexual partners, high-risk sexual practices, and poor hygiene. Health care workers need to screen all patients for HPV through the use of a comprehensive history, including sexual history, a thorough physical examination, and appropriate laboratory methods. Pregnant women must be thoroughly screened because they are at increased risk for HPV, plus there has been an association between genital warts at the time of delivery and subsequent laryngeal papillomas in their infants. Treatment is aimed at the elimination of the lesions. Although in some cases lesions spontaneously resolve without treatment, in other cases there is a significant incidence of recurrence, even with treatment. Cell-mediated immunity seems to play a role in recurrence and regression as well as transformation to atypical cells. Transformation of HPV to neoplasia also seems to be related to co-factors that act synergistically in the oncogenic process. Public education, identification of high risk groups, and prevention are mandatory if the spread of HPV is to be contained. Equally essential is to remain cognizant of the fact that HPV is an STD with potentially carcinogenic properties; thus, screening and treatment of sexual partners are mandatory!

Condylomata Acuminata↗
PubMed1986

Sexually transmissible infectious agents in sexually active and virginal asymptomatic adolescent girls.

Sixty-eight sexually active and 52 virginal adolescent girls were evaluated for six sexually transmissible infectious agents: Gardnerella vaginalis, Ureaplasma urealyticum, Mycoplasma hominis, Chlamydia trachomatis, Trichomonas vaginalis, and Neisseria gonorrhoeae. There were significant differences between sexually active and virginal girls with respect to the prevalence of isolation of U urealyticum (75% v 33%, P less than .005), M hominis (27% v 10%, P less than .05), and C trachomatis (19% v 2%, P less than .025) but not for G vaginalis (34% v 17%, P = .09). N gonorrhoeae and T vaginalis were isolated exclusively from sexually active girls, but their low prevalence (6% and 9%, respectively) made the difference statistically insignificant (P = .2 and .06, respectively). Race, current v previous sexual activity, multiple sexual partners, oral contraceptive use, and concurrent isolation of another organism did not identify those at increased risk for chlamydial isolation. Such girls were significantly more likely to have inflammatory Papanicolaou smears (36% v 10%, P less than .05) and excessive WBC in their vaginal secretions (50% v 19%, P = .05). The data support the contention that C trachomatis, N gonorrhoeae, and T vaginalis are organisms that are predominantly acquired via sexual routes. Significant nonsexual modes of transmission are supported by the data for the genital mycoplasmas and G vaginalis. Finally, a history of sexual activity in an adolescent female warrants specific diagnostic testing for Chlamydia.

Adolescent↗
PubMed1987

[Epidemiology of cervix cancer--a review].

Cervical cancer behaves epidemiologically like a venereal disease of low infectiousness. Early age at first intercourse and multiple sexual partners have been shown to exert strong effects on risk. There are wide differences in the incidence between different countries also influenced by the introduction of screening. Although the general picture remains one of decreasing incidence and mortality, there are signs of an increasing cervical cancer risk probably due to changes in sexual behavior. HSV 2 infection could not be confirmed to play the anticipated role in the aetiology of cervical cancer. Smoking and HPV 16/18 are currently important issues in a concept of multifactorial, stepwise carcinogenesis at the cervix uteri.

Colombia↗
PubMed1987

Therapeutic insemination.

Except in special circumstances, therapeutic insemination with a husband's sample has a low success rate. Couples in whom oligozoospermia has been identified as the principal cause of infertility do not benefit from therapeutic insemination by husband. Because of this low success rate, intrauterine insemination to provide sperm in closer proximity to the egg has become popular, but intrauterine insemination also has a low success rate. We suggest that intrauterine insemination should be approached aggressively in cases of male factor infertility. The recipient should be stimulated to enhance egg production and closely monitored for ovulation. A semen specimen of not less than 1 X 10(6) motile sperm with antibiotics added should be placed in the uterus the day after ovulation. If no pregnancies occur within four cycles, alternate approaches should be considered. Therapeutic insemination by donor involves careful donor selection to avoid inheritance of malformations and familial diseases. Because of the possibilities of sexually transmitted diseases, careful and repeated screening should be conducted. A complete sexual history should be obtained, and donors should be excluded if they have had any homosexual contact since 1978, if they have been an intravenous drug user, if they come from a geographic area where the sex ratio of AIDS is close to 1:1, or if they have recently had multiple sexual partners. A permanent record preserving the confidentiality but allowing the tracing of genetic anomalies, even if not present at birth, should be kept.

Cell Separation↗