Biomedical subjects
Publications and source records attributed to C S Petersen.
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Consecutive female patients attending the Copenhagen Venereal Disease Clinic were interviewed about sexual behaviour in 1984 (981 women) and in 1988 (684 women). Details of symptoms, age at coitarche, number of sexual partners, contraceptive methods, and obstetric history were recorded together with the results of the venereological examination. A substantially higher proportion of women used condoms in 1988 (51%) than in 1984 (11%), but otherwise the safe sex campaigns had had a limited effect on the sexual behaviour in this group of women until 1988. The prevalence of gonorrhea decreased significantly (from 22% to 6%, p < 0.01), whereas an increase in the prevalence of genital warts was observed (from 4% to 10%, p < 0.01).
In an open prospective study 67 patients with refractory genital warts, irrespective of anatomic localization, received CO2-laser vaporization in local anaesthesia, using lidocaine 2% as the local anaesthetic. Sufficient anaesthesia was obtained in all treated patients, with minor pain as the only side effect observed. A single CO2-laser treatment resulted in disappearance of the lesions in 37 (55%) of the patients. Repeated CO2-laser vaporizations in patients with recurrent disease increased the cure rate to 85%. The response rate seemed unaffected by the localization of the warts. It is concluded, that local anaesthesia might replace general anaesthesia in the treatment of patients with multiple refractory genital warts.
In recent years, there have been sporadic reports of aberrant manifestations of syphilis and a changed syphilis serology in AIDS patients, which might indicate difficulties in diagnosing the infection and monitoring the response to penicillin treatment. Six male patients aged 25 to 42 years with asymptomatic HIV infection and secondary syphilis were retrospectively compared with a control group of seven HIV-negative males aged 26 to 52 years with secondary syphilis. All patients presented with macular-papular exanthema of secondary syphilis; in all cases it was also their first episode of the disease. The median WR titre was 13 (range 11 to 20) in syphilis patients with HIV and nine (8 to 14) in the control group (p = 0.1). The median time until WR was found non-reactive after penicillin was four months (3 to 16) and five months (3 to 9), respectively (p = 0.8). Thus, in this small series there was no statistically significant difference in the WR-titres of asymptomatic HIV positive and HIV negative patients with secondary syphilis, although there was a tendency towards initially higher WR titre in the HIV group, as reported by others.
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In an open study with identical criteria for diagnosis, 16 female patients with typical symptoms of chronic vulvodynia associated with acetowhitening of the vestibular epithelium and koilocytosis in biopsy specimens received recombinant interferon alpha-2b 5 MIU intralesionally 3 times weekly for 3 weeks or subcutaneously 3 times weekly for 8 weeks. Three months after end of therapy, clinical symptoms had disappeared in 7 (70%) of the 10 patients treated intralesionally, compared with only one (16%) of the 6 patients treated subcutaneously. In addition, the last 3 (30%) patients in the first group had a partial response to therapy. The acetowhitening persisted in all patients. The koilocytosis remained unchanged in 13 (81%) of the 16 patients. Our results indicate that recombinant interferon alpha-2b administered intralesionally seems to be efficacious in reducing clinical symptoms in vulvodynia with suspected human papillomavirus infection but does not eliminate the infection. Subcutaneous administration had neither symptomatic nor antiviral effect. A placebo-controlled study is needed, but with our present knowledge we recommend intralesionally administered interferon as a symptomatic treatment of vulvodynia.
A randomised double-blind placebo controlled trial was performed to assess the efficacy and safety of tromantadine ointment 1% in male patients with genital herpes. 45 patients with penile genital herpes of less than three days duration were randomised to local treatment with tromantadine ointment 1% or placebo (ointment base alone) five times daily up to 12 days. No difference in time of healing could be detected between the two groups (p = 1.0). Both the objective signs (vesicles, pustules, ulceration, and glandular swelling) and the subjective symptoms (itching, burning, pain and dysuria) all diminished simultaneously in the two groups.
Pseudoporphyria with formation of bullae and vulnerability of skin exposed to light, particularly the backs of the hands, may be provoked medicinally by nalidixinic acid, tetracyclin, nabumeton, pyridoxine, dapsone and high-dosage furosemide and by excessive use of solaria. The present article demonstrates that the condition may also be precipitated by quinidine and ibuprophen.
BACKGROUND: High-dose hydroxychloroquine is rarely used in the treatment of porphyria cutanea tarda (PCT). OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of a novel high-dose hydroxychloroquine regimen in patients with PCT. METHODS: Sixty-five first episodes and 28 recurrent episodes of PCT were treated with hydroxychloroquine, 250 mg three times daily, for 3 days. In patients with a high urine porphyrin concentration a single phlebotomy of 500 ml was performed before therapy of the first episode. Modified high-dose hydroxychloroquine regimens were used in patients with markedly elevated liver transaminases with or without associated chronic liver disease. RESULTS: Long-term follow-up data showed an overall relapse rate of 33%, significantly higher among male patients (45%) than among female patients (17%) (p less than 0.05). A transient hepatotoxic reaction occurred in the majority of patients. The reaction seemed to be especially severe among phlebotomized female patients. CONCLUSION: Hydroxychloroquine, 250 mg three times daily, is a rapid, efficacious, and safe treatment in patients with PCT.
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The safety and clinical impact of isoprinosine in HIV-infected individuals were assessed in a multicentre, randomized, double-blind, 24-week study phase, followed by an optional 24-week open treatment phase. The results of the double-blind phase have been reported. Of 866 HIV-seropositive patients randomized, 832 subjects were eligible for efficacy analysis. On completion of the double-blind phase, 596 patients started open treatment. All patients were evaluated with regard to progression to AIDS and/or death. Within 48 weeks, 10/412 (2.4%) patients assigned isoprinosine and 27/420 (6.4%) patients assigned placebo progressed to AIDS (P = 0.005). Intention-to-treat analysis showed identical results. Viewing the open treatment phase in isolation revealed no difference in progression rates between those treated and those not receiving the drug, perhaps reflecting the higher proportion of patients receiving zidovudine or PCP prophylaxis in the latter group. No severe adverse reactions or toxicities were observed. We conclude that HIV-seropositive patients without AIDS may be safely and effectively treated with isoprinosine.
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OBJECTIVES: To examine the sexual behaviour and the prevalence of sexually transmitted diseases (STD) among females attending an inner-city STD clinic before and after safer sex campaigns. SUBJECTS: In 1984 981 women and in 1988 684 women were interviewed immediately after the venerological examination. SETTING: Department of Dermato-Venereology, Bispebjerg Hospital, Copenhagen, Denmark. METHODS: In a face to face interview, details of symptoms, age at coitarche, number of sexual partners (lifetime and during the last year), obstetric history, and contraceptive methods were recorded. RESULTS: A substantially higher proportion of women used condoms in 1988 than in 1984. A dramatic decrease in the prevalence of gonorrhoea occurred (from 22% in 1984 to 6% in 1988, p < 0.01), whereas an increase in the number of patients with genital warts was observed (from 4% in 1984 to 10% in 1988, p < 0.05). The prevalence of chlamydia, genital herpes, and cervical dysplasia remained unchanged. No significant changes in the number of sexual partners, or the frequency of sexual intercourse or unplanned pregnancy could be detected from 1984 to 1988. CONCLUSIONS: The safer sex campaigns have only been partly successful, as a general reduction in all sexually transmitted diseases should be expected as a result of the increased use of condoms. Future campaigns should focus on the correct use of condoms, and encourage a lifestyle with stable sexual relationship.
The clinical presentation of molluscum contagiosum is described in detail in 16 HIV-infected patients. Atypical facial lesions with either multiple small papules or giant nodular tumors prevailed in patients with AIDS or AIDS-related complex. A theoretical basis for the atypical localization of the disease is lacking.
A patient with an otherwise recalcitrant chronic vesicular hand eczema responded with a dramatical improvement within 2 weeks of cyclosporin A (CsA) therapy 5.0 mg/kg daily. The patient was still free of eczema in spite of reducing the CsA dose to 2.5 mg/kg daily. CsA therapy was finally stopped due to a moderate increase in blood pressure, resulting in rapid recurrence of the hand eczema. The case report clearly demonstrates that oral CsA should be considered in patients with severe hand eczema that cannot be controlled on conventional immunosuppressive treatments.
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