Biomedical subjects

C Sonnex

Publications and source records attributed to C Sonnex.

At least 19 recordsLinked to original sources

PubMed2006

The superiority of polymerase chain reaction over an amplified enzyme immunoassay for the detection of genital chlamydial infections.

BACKGROUND/OBJECTIVES: The polymer conjugate enhanced enzyme immunoassay (IDEIA) and Cobas Amplicor polymerase chain reaction Chlamydia trachomatis (CT) (Amplicor PCR) are two commonly used assays for the diagnosis of CT infection. The performance of these assays was compared for the diagnosis of genital CT infection among 1000 consecutive patients attending a genitourinary medicine (GUM) clinic. Confirmation of positive results and the clinical significance of the absence of cryptic plasmid in chlamydia on the diagnosis of infection by Amplicor PCR were also investigated. METHODS: IDEIA, Amplicor PCR, and two nested in-house PCR assays targeting cryptic plasmid and omp1 gene were performed on all samples. DNA from Amplicor PCR negative samples was pooled for in-house PCR assays. Each pool contained DNA from seven Amplicor PCR negative samples. RESULTS: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and efficiency of IDEIA in the diagnosis of genital CT infection were 80%, 97%, 80%, 97%, and 95%, respectively. Sensitivity, specificity, PPV, NPV and efficiency of Amplicor PCR were 99%, 98%, 89%, 100%, and 98%, respectively. 16 (11%) of 144 Amplicor PCR positive results were identified as false positive by in-house PCR assays. No isolate of plasmid free CT was detected among the study population. CONCLUSIONS: IDEIA should not be used for the diagnosis of CT infection because of its poor sensitivity. Although the analytic specificity of Amplicor PCR was 98%, because of the adverse medical, social, and psychological impact of false positive results for patients, confirmation of Amplicor PCR positive results by a different assay with comparable sensitivity is essential. Amplification assays targeting cryptic plasmid are appropriate for the diagnosis of genital CT infections.

Adolescent↗

PubMed2004

Genital allergy.

Genital allergy should be considered as a possible diagnosis in all patients with genital soreness or irritation for which no infection or dermatosis can be identified and in whom symptoms remain unchanged or worsen with treatment. Type I and IV hypersensitivity reactions are most commonly encountered and can be assessed by performing skin prick testing/radioallergosorbent test (RAST) or patch testing, respectively. Type IV reactions (contact dermatitis) may sometimes prove difficult to distinguish clinically from an irritant dermatitis. This clinical review attempts to summarise key features of genital allergy for the practicing clinician.

Female↗

PubMed2003

Contamination of environmental surfaces by genital human papillomaviruses (HPV): a follow up study.

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DNA, Viral↗

PubMed2002

Contamination of environmental surfaces by genital human papillomaviruses.

OBJECTIVE: To investigate contamination of environmental surfaces with human papillomaviruses (HPV) DNA in two genitourinary medicine (GUM) clinics and in an on-site staff leisure and fitness centre. METHODS: Samples were collected from the treatment rooms and patients' toilets of two GUM clinics situated at two hospital sites and from the toilets of the staff leisure and fitness centre on one of the sites. Samples were tested for the presence of HPV DNA by nested polymerase chain reaction (PCR), and HPV amplicons were typed by reverse line hybridisation using HPV type specific oligonucleotide probes complementary to 35 HPV types. All samples were also tested for beta globin DNA by PCR in order to assess their quality. RESULTS: HPV DNA was found to be present at more than 50% of the sites sampled in one of the GUM clinics, but was absent in the second, and also from the staff leisure and fitness centre. All HPV DNA detected was found to be cell associated. The most commonly found HPV types were 6, 11, and 16, respectively. HPV infected cells were found to be localised mainly to surfaces used predominantly by medical staff. CONCLUSIONS: This study has identified contamination of the environment of a GUM clinic. Possible sources for the contamination of the clinic toilets were from genital sites via hands to the environment. Within the treatment rooms the most likely route of HPV DNA contamination of the environment was via the doctor's gloved hands.

Ambulatory Care Facilities↗

PubMed2001

The treatment of human papillomavirus lesions of the lower genital tract.

Anogenital warts are caused by human papillomavirus types 6 and 11 infection, and are the most common clinical manifestation of lower genital tract human papillomavirus infection. They are the most frequently recognized sexually transmitted disease in the developed world, occurring at an incidence rate of 0.5-1.2% in young men and women aged 18-25 years. Many therapies for genital warts have been described, none being ideal in that all therapeutic modalities fail to clear the warts in a proportion of patients, and the recurrence of warts after successful treatment is seen with all treatments. The current knowledge base of the therapy of genital warts is flawed by a lack of good natural history data either with treatment or without treatment over longer periods of time, in that most trials report comparisons of monotherapies over a short time and there is a lack of structured trials addressing consecutive therapies over longer durations, as occurs in real-life clinical situations.

Adolescent↗

PubMed1999

Detection and typing of human papillomavirus DNA in paired urine and cervical scrapes.

The prevalence of human papillomavirus (HPV) in paired cervical scrape and urine specimens from 144 women attending a clinic for genitourinary medicine was determined by polymerase chain reaction (PCR) and nested PCR, using degenerate and general primer pairs localized within the L1 region. HPV typing was by restriction fragment length polymorphism (RFLP), type-specific PCR (HPV 6, 11, 16, 18, 33), and partial DNA sequencing of PCR products. HPV DNA was detected in 114 (84%) women. HPV DNA was detected in the specimens of 58 patients after amplification with MY09/MY11 primers and in a further 54 patients after nested PCR with the GP5+/GP6+ primers. A total of 106/136 (78%) of women had HPV DNA positive cervical scrapes and 89 (65%) had HPV DNA positive urine specimens. Both the urine and cervical specimens of 81 women were positive. In 25 women HPV DNA was detected in the cervical specimen only, and in 8 women HPV DNA was detected in the urine specimens only. A total of 108 specimens from 75 patients were typed. For 33 patients HPV typing was achieved in both the cervical and the urine specimens and 19 women had identical types in paired specimens. Multiple HPV infections could be detected in 15 (20%) of 75 women where either the cervical and urine specimen or both of the specimens could be typed. More then one HPV type was found in 8 specimens and from multiple sites (cervix and urinary tract) in the same patients on 7 occasions. The results of this study indicate that the detection of HPVs in the urogenital tract can be maximised through the testing of both cervical scrapes and urine specimens in conjunction with the use of a nested PCR to increase the sensitivity of HPV DNA detection. Also, urine cannot be a direct substitute for a cervical scrape as different HPV types are often detected in the urine compared with those detected in the cervix.

Adolescent↗

PubMed1999

Vulvar vestibulitis syndrome: a descriptive study and assessment of response to local steroid and topical clindamycin treatment.

Seventy-six women with insertional dyspareunia and clinical features of vulvar vestibulitis syndrome (VVS) were followed prospectively. The mean age was 26.4 years and the mean duration of symptoms prior to attending the department was 2.7 years. Twenty-nine per cent of women were considered by other clinicians to have no physical cause for their symptoms and had been initially referred for psychosexual counselling. Most women (53/76) had small, localised areas of intoital erythema and tenderness and 15 women revealed, in addition, erythema extending on to the posterior fourchette. Eight women had more extensive introital erythema associated with a distal vaginitis, some of whom exhibited microscopic features suggestive of a desquamative vaginitis in addition to VVS. Approximately 20% of women with localised areas of introital erythema and tenderness responded to a topical potent steroid or to intralesional injection of triamcinolone. Further controlled, long-term follow-up studies using objective methods of clinical assessment are urgently needed.

Journal Article↗

PubMed1999

Detection of human papillomavirus DNA on the fingers of patients with genital warts.

OBJECTIVE: To determine whether patients with genital warts carry human papillomavirus (HPV) DNA on their fingers. METHODS: 14 men and eight women with genital warts had cytobrush samples taken from genital lesions, finger tips, and tips of finger nails. Samples were examined for the presence of HPV DNA by the polymerase chain reaction. RESULTS: HPV DNA was detected in all female genital samples and in 13/14 male genital samples. HPV DNA was detected in the finger brush samples of three women and nine men. The same HPV type was identified in genital and hand samples in one woman and five men. CONCLUSION: This study has identified hand carriage of genital HPV types in patients with genital warts. Although sexual intercourse is considered the usual mode of transmitting genital HPV infection, our findings raise the possibility of transmission by finger-genital contact.

Condylomata Acuminata↗

PubMed1999

Microscopic features of vaginal candidiasis and their relation to symptomatology.

OBJECTIVES: To document the microscopic features of vaginal candidiasis and to examine the relation between yeast morphology and patient symptomatology. METHOD: The study population comprised women undergoing screening for genital infection at a department of genitourinary medicine. RESULTS/CONCLUSION: Data were collected on 267 women of whom 234 were found to have vaginal candidiasis by vaginal culture. The remaining 33 patients had microscopic features of candidiasis (spores and/or hyphae) but were culture negative. Of the culture positive women, microscopy was positive in 182 (78%). "Spores only" were identified in 65 (28%), "hyphae only" in 16 (7%), and both "spores and hyphae" in 101 (43%). 68% of culture positive women were symptomatic, the commonest symptoms being irritation alone (27%) or irritation plus vaginal discharge (25%). No association was found between yeast morphology (spores, budding/non-budding; hyphae, branching/non-branching) as identified on microscopy of vaginal secretions and symptomatology.

Candida↗

PubMed1999

Pearly penile papules: a common cause of concern.

This study of two hundred men attending a department of genitourinary medicine documented a prevalence of pearly penile papules of 48%. Most men with papules had only a few lesions of less than 1 mm in size (73%). Nineteen per cent had papules of less than 1 mm in size extending around the corona and 8% had lesions greater than 1 mm in size extending around the corona. Over one-third of men with papules had previously been concerned or worried by their presence and approximately one-quarter had experienced embarrassment. Fourteen per cent of men with small lesions and 75% with larger lesions wished to have them removed. Two men with large and extensive papules underwent treatment by CO2 laser ablation with excellent cosmetic results.

Adolescent↗

PubMed1998

Human papillomavirus infection with particular reference to genital disease.

HPV is the commonest sexually transmitted viral infection in the United Kingdom and as such poses a major public health problem. In addition to the potential physical morbidity associated with genital warts, abnormal cervical cytology, and anogenital dysplasia and neoplasia, the associated psychological morbidity should not be forgotten. Although our knowledge of viral function and disease pathogenesis has advanced appreciably in recent years, we are still some way from developing an in vitro method of viral propagation. Vaccination against HPV infection will hopefully be achieved within the next 10 years, but a prevention and treatment strategy which is appropriate for both developed and developing nations must be our major long term goal.

Condylomata Acuminata↗

PubMed1998

Influence of ovarian hormones on urogenital infection.

Numerous studies have examined the influence of hormones on infectious diseases and there is now a wealth of data relating to the more specific effect of the sex hormones, oestrogen and progesterone, on urogenital infections. The interaction between these hormones and the immune system is complex and the variation of hormonal effect between species further complicates the true picture as related to humans. Although it is difficult therefore to draw general conclusions regarding predominant effects of specific hormones, there is the suggestion that oestrogen enhances the pathogenicity of many urogenital micro-organisms. Our understanding of the influential role played by sex hormones in disease pathogenesis is at an early stage and illustrates well the importance of drawing together and interpreting as a whole both epidemiological and molecular studies.

Candidiasis, Vulvovaginal↗

PubMed1998

Influence of genital infection on cervical cytology.

OBJECTIVE: To ascertain whether the presence of genital infection adversely affects smear quality. METHOD: A prospective study of all patients having cytology performed. The presence of genital infection was recorded and compared with the smear result. RESULTS: The presence of genital infection was not associated with inadequate cytology. Inflammatory changes were found in association with symptomatic candidiasis, trichomoniasis, Chlamydia trachomatis infection, primary herpes simplex, and the finding of 21-30 polymorphs per high power field (averaged over 10 fields) on cervical samples. Inadequate cytology was significantly associated with the smear taker. CONCLUSION: The presence of genital infection at the time of cytology does not increase the rates of inadequacy, and opportunistic cytology should not be deferred as the patient may default from further appointments.

Adolescent↗

PubMed1998

The management of chlamydial infection: setting standards at a regional level.

Between 1993 and 1997, clinicians from 9 departments of genitourinary medicine (GUM) and one department of sexual health in East Anglia met to audit the process of contact tracing in chlamydial infection. After defining the target group, standards were set for discussion of the diagnosis with the index patient, appropriate treatment of the condition and documented notification of partners. Data were collected for all patients with confirmed chlamydial infection during the periods January to March 1995 and 1996. Considering the combined data for both years, overall 97% of patients were informed of the diagnosis and 100% received appropriate treatment. Notification of partners was addressed at the initial consultation in 99% of cases and again at follow-up in 87%. Where contacts were traceable, there was confirmation that assessment had occurred in 65%, and the index cases reported that 66% had undergone assessment. The achievements and also the problems associated with this audit are discussed.

Chlamydia Infections↗

PubMed1998