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3.  Relative and seasonal incidences of the sexually transmitted diseases. A two-year statistical review. 
In the United States statistics on sexually transmitted diseases (STDs), other than gonorrhoea and syphilis, are meagre. In this study the relative and seasonal incidences of most STDs in an American clinic where 34,938 patient visits were recorded over a two-year period (1975-76) are assessed. Gonorrhoea was the most common STD in male and female patients combined (18%), while nongonococcal urethritis (NGU) was most common in men (23%), and vaginitis (trichomonal 7.5%, yeast 7.1%, and non-specific 7.1%) was the most common in women. A significantly higher incidence of NGU occurred in Caucasian (63%) than in black (42%) men (P less than 0.005). No other STD was diagnosed in more than 5% of patients, and 31% had normal findings on clinical examination and investigation, and could be described as the 'worried well'. Two or more STDs co-existed in 4.2% of patients. In 1976 the incidence of genital herpes and scabies decreased in contrast to other STDs and total patient visits, which increased. A seasonal peak in late summer and early autumn was observed for most STDs. These observations indicate the importance of a comprehensive approach when attempting to compile accurate statistics on selected epidemiological aspects of sexually transmitted diseases.
PMCID: PMC1045564  PMID: 581655
4.  Diagnostic, treatment, and reporting criteria for non-specific genital infection in sexually transmitted disease clinics in England and Wales. 2: Treatment and reporting criteria. 
The current methods of treating and reporting non-specific genital infection (NSGI) are described. The most commonly used drug was tetracycline in one or other form. Epidemiological treatment was widely used, particularly for female sexual contacts. There was considerable variation in the reporting criteria for the quarterly returns. The establishment of acceptable and uniform criteria for notification of NSGI is discussed.
PMCID: PMC1045563  PMID: 581654
5.  Diagnostic, treatment, and reporting criteria for non-specific genital infection in sexually transmitted disease clinics in England and Wales. 1: Diagnosis. 
The current methods of diagnosis for non-specific genital infection (NSGI) in clinics in England and Wales are described. In most clinics (92%) microscopical findings were used by consultants to establish the diagnosis of non-specific urethritis (NSU) in male patients. However, the microscopical criteria that they used in reaching a diagnosis varied between clinics. The most commonly applied criterion was that of less than five leucocytes per high power field. NSGI in female patients and non-specific proctitis in passive homosexuals were recognised as distincy in 60% of clinics and the latter in 57%. Among those who recognised these conditions the diagnostic criteria varied. The establishment of acceptable and uniform criteria for diagnosis are discussed.
PMCID: PMC1045562  PMID: 367527
6.  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
7.  Isolation of Chlamydia trachomatis from Bartholin's ducts. 
Exudate from Bartholin's ducts from 30 selected patients was investigated for Chlamydia trachomatis and Neisseria gonorrhoeae. N. gonorrhoeae was isolated from the duct exudate in 24 patients and C. trachomatis in nine. Concurrent infection of the ducts was present in seven (29.2%); the remaining two patients were sexual contacts of men with non-specific urethritis. The duct exudate was mucopus in seven patients, cloudy mucus in one, and clear mucus in the other. Although contamination of the vulva by C. trachomatis derived from cervical or urethral infection cannot be excluded, three cases are described which suggest that a true infection of the duct occurs and may persist after gonococcal infection has been cured.
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PMCID: PMC1045560  PMID: 104771
8.  Rapid diagnosis of chlamydial infection of the cervix. 
A rapid serodiagnostic test for the presumptive diagnosis of chlamydial infection of the cervix has been developed. The method used in based on the modified micro-immunofluorescence test using pooled chlamydial antigens and the detection of different immunoglobulin classes of chlamydial antibody in sera and cervical secretions. The presence of IgG chlamydial antibody at a level of 1/64, or IgM antibody at a level of 1/8 or greater, or both in sera and IgG or IgA antibody at a level of 1/8 or more or both in cervical secretions was closely associated with the isolation of Chlamydia trachomatis and non-specific genital infection. In general, serodiagnosis was three to nine times more sensitive than cultural methods, and the detection of IgG chlamydial antibody in cervical secretions alone provided the most sensitive of the serological tests. This sensitive, low-cost, rapid, and simple serodiagnostic test for the presumptive diagnosis of chlamydial infection of the cervix, coupled with transportation of specimens by post, offers advantages over conventional isolation techniques for the routine diagnosis and management of chlamydial genital infections.
PMCID: PMC1045559  PMID: 367526
9.  Clinical experience in the use of cefuroxime in gonorrhoea. 
Cefuroxime, a new antibiotic derived from cephalosporin-C which is very stable in the presence of beta-lactamases produced by Gram-negative organisms, was used to treat 856 male patients and 340 female patients with uncomplicated gonorrhoea. In men the drug was used in three different doses, 1.5 g, 1 g, and 750 mg plus 1 g probenecid; in women 1 g and 750 mg cefuroxime plus 1 g probenecid was used. Cure rates ranged from 94.8% to 99.3%. The antibiotic was well tolerated and was free from side effects. Cefuroxime would be a valuable and efficient substitute for penicillin in the treatment of gonorrhoea due to beta-lactamase-producing strains of gonococci.
PMCID: PMC1045558  PMID: 737517
10.  Inactivation of gonococci by procaine penicillin in vivo. A pilot study. 
A pilot study was carried out of 25 male volunteers with gonococcal urethritis. After intramuscular administration of 3 megaunits procaine penicillin and 1 g oral probenecid the urethral culture results for Neisseria gonorrhoeae remained positive up to five hours and thereafter became negative. These results may be useful in providing guidelines for advice on the duration of sexual abstinence following treatment. It is suggested that similar studies should be carried out in women.
PMCID: PMC1045557  PMID: 737516
11.  Bulk growth of Neisseria gonorrhoeae type 1 in a biphasic system. 
A biphasic system for the bulk growth of Neisseria gonorrhoeae is described. It appears to combine the convenience of liquid media with the growth qualities of solid media. By using the agar in dialysis tubes rather than as slabs the surface-to-volume ratio was improved and harvesting made easier. The system is also useful in isolating gonococci from blood and joint fluids in patients with disseminated infection.
PMCID: PMC1045556  PMID: 104770
12.  Method for studying the role of indigenous cervical flora in colonisation by Neisseria gonorrhoeae. 
A method for quantitating cervical flora has been evaluated statistically and used to study the bacterial flora of the cervix in 14 women sexually exposed to men with gonococcal urethritis. A comparison was made between those women who subsequently became colonised with Neisseria gonorrhoeae and those who did not to determine whether either total microbial populations or the different species present could be related to colonisation by N. gonorrhoeae. Two control groups of healthy women, one of patients from a public clinic and the other of patients from a private practice, were studied in the same way. Normal flora isolates were tested in vitro for antagonism or synergism toward N. gonorrhoeae or both. Cervical flora was characterised in all patient groups by wide variations between individuals, both in type and numbers of organisms. No significant differences were found in total bacterial populations or in the number of species isolated from the cervix between patient groups. Populations of N. gonorrhoeae ranged from less than 10 bacteria to log104.36. Only one normal flora isolate, a strain of Streptococcus viridans isolated from a woman exposed to but not infected by N. gonorrhoeae, demonstrated inhibition of growth towards N. gonorrhoeae.
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PMCID: PMC1045555  PMID: 104769
13.  Treponema pallidum immune adherence test for serodiagnosis of syphilis. 3: Clinical significance and evaluation of treatment. 
Antibody titres were measured in patients with clinical syphilis, and the effect of treatment on the results of the Treponema pallidum immune adherence (TPIA) test is reported. In the Treponema pallidum haemagglutination (TPHA) test little change in antibody titre occurred after treatment while in the fluorescent treponemal antibody-absorbed (FTA-ABS) test only a slight decrease occurred. The decrease in the antibody titre in the TPIA test was similar to that in the glass plate test, but the findings were different. From the results of gel filtration of sera obtained from patients with syphilis at different intervals after treatment it was apparent that the decrease in antibody titre after treatment mainly concerned the IgM antibody; thus, because of the high sensitivity of the TPIA test to IgM antibody the test is useful in evaluating the effect of treatment.
PMCID: PMC1045554  PMID: 367525
14.  Treponema pallidum immune adherence test for serodiagnosis of syphilis. 2: Comparison with glass plate, TPHA, and FTA-ABS tests. 
Using sera from 340 patients with syphilis the Treponema pallidum immune adherence (TPIA) test was compared with the glass plate, T. pallidum haemagglutination (TPHA), and fluorescent treponemal antibody-absorbed (FTA-ABS) tests. The results of the TPIA test agreed with those of the glass plate, TPHA, and FTA-ABS tests in 65%, 82%, and 73% of cases respectively. In the quantitative TPIA test no significant correlation with the other tests was observed, and it is, therefore, concluded that the TPIA test has highly individual characteristics. From gel filtration the particular feature of the test was its high sensitivity to the IgM antibody. The TPIA test thus appears to be suitable for estimating antibody in the early stages of the disease.
PMCID: PMC1045553  PMID: 367524
15.  Treponema pallidum immune adherence test for serodiagnosis of syphilis. 1: An improved method of the TPIA test. 
Clinical investigations using the Treponema pallidum immune adherence (TPIA) test as reported by Nelson (1953) were performed only by Olansky et al in 1954. In this paper an improved method of the TPIA test is described. The test was simple to perform and was highly specific for antitreponemal antibody. Furthermore, as it was possible to use heated T. pallidum as antigen the antigen suspension could be preserved for long periods. The TPIA test for syphilis was evaluated by examining the sera from 40 healthy subjects and from 166 patients with syphilis.
PMCID: PMC1045552  PMID: 367523
16.  Venereal syphilis in tropical Africa. 
A steady decline in the incidence of positive results to the Kahn test is reported in Malawian patients during the period 1968-75. Other studies have shown that the incidence of early and late syphilis in sub-Saharan Africa has dropped considerably over the past few decades. The number of reported cases of early syphilis in certain urban areas, however, appears to be high. It is suggested that the downward trend in the incidence of syphilis in Africa is related to the increased and often indiscriminate use of penicillin.
PMCID: PMC1045551  PMID: 104768
17.  Duncan Guthrie Chair of Genitourinary Medicine. 
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PMCID: PMC1045550  PMID: 367522
18.  Abstracts 
PMCID: PMC1045547
22.  Cryosurgery of genital warts. 
PMCID: PMC1045543  PMID: 709351
24.  Which Neisseria? 
PMCID: PMC1045541  PMID: 101277
25.  Carcinoma of the penis developed in lichen sclerosus et atrophicus. 
Malignant change developing in lichen sclerosus et atrophicus is rare in men. A case is described in a 39-year-old man.
PMCID: PMC1045540  PMID: 709350

Results 1-25 (113)