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Biomedical subjects

C Law

Publications and source records attributed to C Law.

10 recordsLinked to original sources
PubMed1990

Sexually transmitted diseases and enteric infections in the male homosexual population.

There are certain special considerations in the management of sexually transmitted diseases (STDs) in homosexual men, with the impact of human immunodeficiency virus (HIV) infection on the presentation, diagnosis, and management of certain STDs just becoming apparent recently. Rectal and pharyngeal gonorrhea are usually asymptomatic and also more difficult to treat. The serological diagnosis of syphillis may be unreliable in acquired immunodeficiency syndrome (AIDS) patients, and HIV-seropositive homosexual men may be at risk of accelerated progression to neurosyphilis, despite treatment with benzathine penicillin. Chlamydia trachomatis is infrequently detected in patients with proctitis so therapy should be directed only at culture-positive cases. Herpes simplex is usually severe and persistent in immunosuppressed patients and may be further complicated by the development of acyclovir-resistance. Concurrent HIV infection may be associated with increased infectivity of homosexual chronic hepatitis B carriers, but milder hepatic injury and reduced efficacy of hepatitis B vaccines and immodulatory or antiviral agents. Although there is some concern regarding the possibility of increased risk of anal cancer in homosexual men, conservative management of human papilloma-virus-associated conditions is advised. The carriage of Entamoeba histolytica in this group is rarely associated with any deleterious effects and treatment should be directed only at symptomatic patients in whom other enteric pathogens have been excluded.

Homosexuality↗
PubMed1989

Trichinosis in the Canadian Arctic: report of five outbreaks and a new clinical syndrome.

Trichinosis is a serious but understudied medical problem in the Arctic. Forty-nine consecutive cases in the Inuit population of northeastern Canada are described. Most developed the disease after eating raw walrus, and the clinical presentation of most of these cases differed from previously reported descriptions of classic trichinosis due to Trichinella spiralis. Unlike the classic syndrome of a brief period of diarrhea followed by fever, myalgia, muscle weakness, and edema, the most common presentation in these cases was a prolonged diarrhea without fever and with brief muscle symptoms. High peripheral eosinophilia, high Trichinella antibody serotiters, and little direct or indirect evidence of muscle invasion in many of those with the chronic diarrheal presentation suggest a new clinical syndrome due to a different species of Trichinella seen in the Arctic or to reinfection with Trichinella.

Animals↗
PubMed1988

Gastrointestinal viral infections in homosexual men who were symptomatic and seropositive for human immunodeficiency virus.

Gastrointestinal viruses, predominantly rotaviruses and adenoviruses, were detected by enzyme-linked immunosorbent assay, electron microscopy, or cell culture in greater than 50% of two groups of homosexual men with symptomatic human immunodeficiency virus (HIV) infection, who did (54%) or did not (50%) have diarrhea. Lower detection rates were observed in HIV-seronegative (15%) and asymptomatic HIV-seropositive (16%) men. In the patients with diarrhea, 95% of the isolates of virus were found in the most immunosuppressed patients, those patients with AIDS-related complex or opportunistic infections associated with AIDS. High excretion rates of these viruses are probably associated with both anal-oral transmission and immunosuppression. These viruses apparently cause acute episodes or relapses of diarrhea in some patients but may be co-pathogens or noncontributory to chronic diarrhea in others.

AIDS-Related Complex↗
PubMed1988

Characteristics influencing informed consent on a congenital malformations registry.

Maryland law requires that all babies born with "sentinel birth defects" be reported to the State Department of Health, but mothers may deny consent for further contact. Consent was not strongly related to maternal age, race, or self-reported data on exposures, smoking, and drugs but was much less likely if the infant was dead. Selection bias in congenital malformations research may lead to underrepresentation of lethal defects, but self-reported data appear to be unbiased.

Adult↗
PubMed1986

Arctic trichinosis presenting as prolonged diarrhea.

We describe an outbreak of trichinosis after the consumption of raw walrus meat in 10 Inuit inhabitants of a northern community. During the presentation of the illness, diarrhea was found in all subjects and was the dominant symptom in 8 of the 10 cases. Myalgia (60%) and muscle weakness (50%) were much less prominent complaints. The diarrhea was characteristically prolonged, lasting up to 14 wk (average 5.8 wk), as opposed to comparatively short episodes of myalgia (average 5.4 days) and muscle weakness (average 4.5 days). Prolonged diarrhea with little or no muscle symptomatology in an epidemic form represents a previously unrecognized clinical presentation of trichinosis. It remains to be determined whether this new clinical presentation is related to variant biological behavior of arctic Trichinella, to previous exposure to the parasite, or to other factors.

Adult↗
PubMed1975

Dogs and intestinal parasites: a public health problem.

The stools of 239 stray dogs were examined for intestinal parasites. Of the helminths found, Toxocara canis (43.5%), tapeworms (25.5%), Ascaris species (21.3%) and hookworms (12.5%) were the commonest. Of the protozoans found, Isospora species and Entamoeba coli were the most prevalent. An unusual feature of the present study was the finding of Ascaris species. The importance of the high prevalence of intestinal parasites in dogs, the close contact of humans with dogs' excreta and the possible role of this environmental pollution in the spread of human disease are discussed.

Animals↗
PubMedDate not supplied

Manifestations of anogenital HPV infection in the male partners of women with anogenital warts and/or abnormal cervical smears.

The prevalence and manifestations of anogenital human papillomavirus (HPV) infection in 154 men, all of whom were the sexual partners of women with either overt anogenital warts or cervical HPV-related abnormalities, were assessed using clinical, histopathological and molecular criteria. Detailed examination of the anogenital region using a colposcope was supplemented by the use of 5% acetic acid to detect possible foci of subclinical HPV infection. Biopsies of warts and aceto-white lesions were examined histopathologically and by HPV DNA hybridization using radiolabelled HPV 6/11 and 16/18 DNA probes. More than two-thirds of the men had clinical indications of genital HPV infection: 37% had apparent macroscopic warts, almost invariably in combination with aceto-white lesions; while 34% had aceto-white lesions only. The overwhelming majority of these lesions (92%) were located on the penis only. However, only 49% of the macroscopic and 29% of the aceto-white lesions showed histological features consistent with a conclusive diagnosis of HPV infection; while the corresponding figures for HPV DNA positivity were 72% and 56% respectively. Current HPV infection was strongly associated with a past history of anogenital warts, but there was little or no correlation between the manifestations of HPV infection in the male and female sexual partners.

Adult↗