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3.  Quantitative study of Chlamydia trachomatis in genital infection. 
Chlamydia trachomatis inclusion counts on inoculated McCoy cell coverslips were used as an index of the degree of infection of the cervix in women and of the urethra in men with urethritis. High inclusion counts were obtained significantly more often from men than from women, from women with cervical ectopy, and from women who had had recent sexual intercourse. Low inclusion counts were significantly more common in men with a past history of gonococcal urethritis. Higher chlamydial isolation rates in women with gonorrhoea and in women taking the contraceptive pill could not be attributed to a greater degree of infection, since inclusion counts were not raised in these patients. There was evidence that strains of C trachomatis might vary in their ability to establish themselves in the genital tract because high counts in men with NGU were associated with high counts in their female consorts and the levels of counts in men were associated with the frequency of chlamydial isolation from their female consorts. The relatively simple technique of inclusion counts in cultures for chlamydia from the genital tract may yield valuable information about the behaviour of different strains of C trachomatis in causing pathological changes, in the transmission of infection between individuals, and in the response to specific chemotherapy.
PMCID: PMC1045997  PMID: 7034859
4.  Post-gonococcal cervicitis and post-gonococcal urethritis. A study of their epidemiological correlation and the role of Chlamydia trachomatis in their aetiology. 
In a study of 157 men and 141 women with gonorrhoea post-gonococcal urethritis (PGU) in men was significantly more common among chlamydia-positive (76%) than among chlamydia-negative (22.5%) patients. Clinical investigations of PGU detected 95% of the patients infected with C trachomatis. PGU was, however, asymptomatic in over half of the patients and a careful follow-up for 3-6 weeks was necessary to detect between 80% and over 90% of cases. PGU was not related to age, past history of gonorrhoea or non-gonococcal urethritis, severity of gonococcal infection, or chlamydial inclusion count. Although post-gonococcal cervicitis (PGC) in women was an identifiable entity, it was detected in only one-third of chlamydia-positive patients. PGC was significantly associated with the 20-29 year-old age group but was not related to symptoms or chlamydial inclusion count. In the absence of facilities for culturing chlamydia, selection on an epidemiological basis of all female consorts of men with PGU, together with the remaining women with PGC, would have resulted in some unnecessary treatments and left untreated up to 30% of those harbouring C trachomatis.
PMCID: PMC1045983  PMID: 7326554
5.  Epidemiological and clinical correlates of chlamydial infection of the cervix. 
Of 474 women studied to identify epidemiological and clinical correlates of chlamydial infection of the cervix, Chlamydia trachomatis was isolated from 158 (33.3%) of all women, from 48.3% of those infected with Neisseria gonorrhoeae, from 43% of the sexual consorts of men with nongonococcal urethritis, and from 74% of those whose consorts were also infected with C trachomatis. C trachomatis was the sole pathogen found in 58 women. Age, marital state, occupation, past history of gonorrhoea, menstrual state, and symptoms had no predictive value. The isolation of C trachomatis was significantly associated with N gonorrhoeae, the use of oral contraceptives, cervical ectopy, cervicitis, and last sexual exposure more than one week previously. Except for three patients, none of the criteria alone or in combination was reliable enough to predict with acceptable accuracy that the 30 chlamydia-positive women among the 191 who were not infected with N gonorrhoeae and whose consorts were not known to have urethritis harboured chlamydia.
PMCID: PMC1045886  PMID: 7214119
6.  Role of the medical auxiliary in the control of sexually transmitted disease in a developing country. 
Venereal diseases are becoming a major health problem in many developing countries where the greater part of primary medical care is undertaken by medical auxiliaries. Under these circumstances, the medical auxiliary has an important role to play in the control of these diseases but he can only do this with adequate training, support, and supervision from the professional doctors and specialists. In this paper, the role of the medical auxiliary is outlined and a case is also made for a specially-trained cadre for venereal disease work in busy urban clinics in developing countries.
PMCID: PMC1045235  PMID: 946783
11.  Management of non-specific urethritis in men. Evaluation of six treatment regimens and effect of other factors including alcohol and sexual intercourse. 
A trial comparing the efficacy of three different tetracyclines, each in two different dosage regimens, in the treatment of non-specific urethritis is described. There was a significant association between the retreatment rate and sexual intercourse. Age, race, duration of symptoms, previous infection, and indulgence in alcohol did not appear to influence the results whereas treatment of sexual contacts before resumption of sexual intercourse significantly reduced the retreatment rate. Single-dose treatment with doxycycline was shown to be ineffective. Treatment with doxycycline for seven days or triple tetracycline for seven days was less effective than triple tetracycline for 21 days or oxytetracyline for seven or 21 days, all of which gave the same success rate.
PMCID: PMC1045561  PMID: 737518
12.  Epidemiology and treatment of gonorrhoea caused by penicillinase-producing strains in Liverpool. 
The epidemiological features are described of an outbreak of gonorrhoea caused by penicillinase-producing strains of gonococci in 76 patients in Liverpool between February and November 1976. Initially infections were confined to a socially deprived inner city area with a large immigrant population, and subsequent spread of infection remained circumscribed. The characteristics of those patients acquiring these infections were similar to those infected by gonococci of diminished sensitivity to benzylpenicillin, and showed a strong association with adverse social factors. A comparison of the clinical features of patients harbouring sensitive, less sensitive, and penicillinase-producing strains showed severe symptoms and signs in men and a greater involvement of multiple sites in women infected with penicillinase-producing gonococci. Treatment with penicillins failed. Tetracycline was satisfactory in men but was less so in women in whom gonococci persisted in the rectum. Cefuroxime and spectinomycin were effective.
PMCID: PMC1045466  PMID: 416874

Results 1-15 (15)