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PubMed1989

[Prevalence and risk factors of Chlamydia trachomatis infection in clients of a venereal disease clinic in Amsterdam].

We studied the prevalence of Chlamydia trachomatis (CT) infection as well as its predictors among a sample (1000) of visitors (651 male, 349 female) of a clinic for sexually transmitted diseases (STD) in Amsterdam. The prevalence of CT was higher than that of gonorrhoea: among men, 14.3% and 11.5% and among women, 12.9% and 6.3% respectively. Independent predictors for CT infections were for men: number of leucocytes in discharge or urine, nature of urethral discharge, age and sex behavior, and in women: being warned as source or contact of a STD, age, nature of cervical discharge and bleeding from the cervical ostium after insertion of a swab. As many as 92% of the male and 81% of the female visitors of our STD clinic should be examined for CT if the presence of anyone or more of these predictors is taken as a criterion. Even then, 5% of the CT infections in women would still be missed. Based on our study results, material for the diagnosis of CT will from now on be collected routinely from all female patients of our STD clinic as well as from all males with urethritis. We advocate the expansion in the Netherlands of facilities for laboratory CT detection and its standard inclusion in STD examination.

Adult↗
PubMed1989

[The combined treatment of venereal diseases and alcoholism].

Combined therapy for a sexually transmitted disease and chronic alcoholism or alcohol abuse has been administered in a hospital for sexually transmitted diseases. No side effects were recorded. Late results have been followed up in 111 patients; a stable remission has been achieved in 40%.

Adult↗
PubMed1989

Rapid Plasma Reagin test (RPR) compared to Venereal Diseases Research Laboratory test (VDRL) for the diagnosis of syphilis in pregnancy.

Obstetric departments which provide service for a large number of patients from different parts of the country and socioeconomic backgrounds like the Obstetric Department of Chulalongkorn hospital, need to develop rapid laboratory tests which can cope with the volume of work and yet provide sound laboratory data for management decisions. We, therefore, undertook a study of the suitable Rapid Plasma Reagin (RPR) test as a diagnostic tool for syphilis in 9,347 pregnant women who attended antenatal clinics at this institute from August 1984 to May 1985. The RPR test was used in addition to the routine serological tests for syphilis namely the VDRL, TPHA and/or FTA-ABS. Analysis of results confirmed that the RPR test fulfilled all laboratory results for clinical requirements. The results from RPR and VDRL were not significantly different. Their sensitivities were 90.86 and 89.95 per cent, their specificities were 99.57 and 99.68 per cent, their positive predictive values were 82.11 and 85.92 per cent, their negative predictive values were 99.8 and 99.78 per cent, and their accuracy was 99.39 and 99.47 per cent respectively. In our study it was found that the RPR test could provide a laboratory diagnosis in 60-90 minutes; in the same morning period when 15-20 prenatal patients were seen for the first time. The above results suggest that the RPR test is a rapid and reliable tool which is particularly suitable for syphilis screening in a busy antenatal clinic. The test enabled all 197 patients with syphilis in pregnancy to be treated promptly and without any loss of follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

Diagnostic Errors↗
PubMed1989

[Consultations concerning venereal diseases and AIDS at the weekend outpatient clinic for homosexual men: developments 1983-1987].

In the Amsterdam gay weekend clinic the trends in numbers and sorts of sexually transmitted diseases (STD) and reasons for consultation about AIDS from 1983 till 1988 were assessed. A strong decrease in STD consultations and diagnoses was seen, especially concerning urethral and anorectal gonorrhoea. At the same time, consultations about AIDS strongly increased. These data support the hypothesis that gay men have changed their sexual behaviour.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Venereal diseases in children and sexual abuse].

Sexual abuse in children is reported increasingly frequently. The abuse frequently comes to the attention of the authorities when the children present symptoms which raise the suspicion of sexual abuse. One of these symptoms may be sexually transmitted disease in the child. Previously, there was a tendency to accept the possibility that sexually transmitted disease in children could be transmitted by other means than sexual contact, eg indirectly by infected bedclothes and toilet articles. Where gonorrhoea is concerned, no documentation exists in the literature for non-sexual infection in children. Condylomata acuminata are caused by infection with the human papilloma virus and may possibly infect children by non-sexual contact in rare instances but, in the majority of cases, meticulous investigation of the surroundings of the children will raise the suspicion of sexual abuse as the cause of the infection. The case history of gonococcal vulvo-vaginitis in a girl aged 23 months were the source of infection could not be successfully proved is mentioned. Two case histories are reported concerning anal condylomata acuminata in a girl aged nine years who had been sexually abused and a girl aged 25 months where there was a strong suspicion of sexual abuse but where the source of infection remained unknown. On the basis of literature from recent years and the case histories reported here, it is concluded that all gonococcal infections in children must be regarded as being sexually transmitted and these should, therefore, be reported to the social authorities. In addition, all children with ano-genital condylomata acuminata should be investigated meticulously for sexual abuse and be reported to the social authorities, if the suspicion is well founded.

Anus Neoplasms↗