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Biomedical subjects

E Rees

Publications and source records attributed to E Rees.

At least 19 recordsLinked to original sources
PubMed1988

Screening for cervical dysplasia in department of genitourinary medicine.

In 632 patients attending a sexually transmitted disease (STD) clinic who were colposcoped because they were in certain high risk groups for cervical neoplasia, and irrespective of cytological findings, 13 out of 51 biopsied had false negative cytology results. Human papilloma virus (HPV) was the most important sexually transmitted agent associated with cervical intraepithelial neoplasia (CIN), but HPV was also present in most patients with false negative (11/13) and false positive (11/14) cytology results. Screening by colposcopy, as well as cervical cytology, is therefore mandatory and must be available for certain STD clinic patients.

Adult↗
PubMed1987

Early intravenous indomethacin prolongs respiratory support in very low birth weight infants.

Infants weighing 1500 g at birth requiring either intermittent positive pressure ventilation or continuous positive airway pressure by 12 hours of age were entered in a randomized double blind controlled trial to test the efficacy of early intravenous indomethacin therapy in preventing chronic pulmonary disease of prematurity. Of the 30 newborns enrolled, 15 were treated with indomethacin and 15 were treated with placebo at 12, 24 and 36 hours of age. The groups were similar for birth weight, gestational age, sex, hyaline membrane disease and intracranial hemorrhage. Infants in the placebo group were successfully weaned from intermittent positive pressure ventilation at an earlier age than infants in the indomethacin group (p less than 0.05). Furthermore, chronic pulmonary disease of prematurity was similar in the two groups despite a reduction in the incidence of patent ductus arteriosus in the indomethacin group.

Clinical Trials as Topic↗
PubMed1985

Chlamydial infections of the urethra in women.

Cervical and endourethral swabs from 360 untreated women attending a sexually transmitted disease (STD) clinic were cultured for Chlamydia trachomatis and other genitourinary pathogens. The patients included contacts of men with non-gonococcal urethritis, women with gonorrhoea, and those in whom symptoms suggestive of urinary tract infection were the main reasons for their attendance. Chlamydial infection of the urethra was less common than, and seldom occurred in the absence of, cervical chlamydial infection; it was frequently silent, producing no signs or symptoms of urethritis. Only 33/96 women with evidence of urethritis gave chlamydia positive urethral swabs, and 14 of them had other concurrent infections of the genitourinary tract. Chlamydia trachomatis thus does not appear to be a major cause of the signs and symptoms of urethritis commonly found in women attending STD clinics, and there seems to be no indication for taking routine urethral swabs to aid in the diagnosis of chlamydial infection in women.

Cervix Uteri↗
PubMed1984

Epidemiology of penicillinase-producing Neisseria gonorrhoeae in Liverpool from 1977 to 1982.

After the 1976 outbreak of penicillinase-producing Neisseria gonorrhoeae (PPNG) infections had been controlled, less than 1 per cent of cases of gonorrhoea in Liverpool in 1977 and 1978 were caused by PPNG. Thereafter the steady increase in PPNG infections to 5.6 per cent of all cases in 1982 was associated with marked changes in epidemiological pattern, plasmids and auxotypes. In 1976 nearly all PPNG infections were acquired by young black males living in the inner city from women frequenting clubs; the PPNG were all of the African 3.2 megadalton (MD) plasmid type and of arginine-requiring auxotype. Between 1977 and 1982 female patients were increasingly ship girl prostitutes associating with seamen who constituted more than 50 per cent of the male patients. These men and other travellers introduced PPNG into Liverpool from the Far East and West Africa. In 1978 PPNG of the Asian type with 4.4 MD plasmid with or without 24.5 MD transfer plasmids were isolated in Liverpool where in 1979 all PPNG carried 4.4 MD and 24.5 MD plasmids. In 1982 strains of the 'new' African type with 3.2 and 24.5 MD plasmids were isolated as were PPNG of the Asian type that had been acquired in West Africa. Auxotyping of the 1982 isolates showed that none were arginine-requiring but three other types were identified: proline-requiring: proline-arginine-requiring; non-requiring. For the control of PPNG, a strategy based on constant vigilance, appropriate diagnostic procedures, rapidly effective treatment and determined contact tracing is needed.

Adolescent↗
PubMed1984

Genital infections with Chlamydia trachomatis in women attending an antenatal clinic.

Cervical swabs for isolation of C. trachomatis and serum for anti-chlamydial antibodies were taken from 252 pregnant women on their first visit to an urban antenatal clinic. Chlamydial infection was found in 18 (7%) women, and antibody at titres greater than 1/32 in 48 (19%); of the 18 infected women only 10 (56%) showed antibody. The likelihood of infection could not have been predicted by urogenital symptoms, the social or medical history or serology. Hypertrophic cervical ectopy and mucopus were significantly more common in infected than in uninfected women but underestimate the true rate of infection. The consorts of 10 infected women had signs of non-gonococcal urethritis but were asymptomatic; C. trachomatis was isolated from the urethra of one man. The indications for routine screening of antenatal patients for chlamydial infections is discussed.

Adolescent↗
PubMed1983

Topical acyclovir in the treatment of genital herpes: a comparison with systemic therapy.

Controlled trials of acyclovir cream were conducted in the treatment of initial and recurrent genital herpes. For 54 patients with the first episode of genital infection (initial disease) treated with acyclovir the duration of viral shedding, formation of new lesions, times to crusting and healing and duration of symptoms were significantly reduced compared with the results obtained in 47 placebo recipients. When applied early in the course of recurrent episodes in 44 patients, acyclovir cream significantly reduced viral shedding, a new lesion formation, time to healing and the duration of symptoms compared with the effects in 41 control patients. Topical therapy with acyclovir cream is well tolerated and compares quite favourably with systemic treatment, especially for recurrent genital herpes.

Acyclovir↗
PubMed1978

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.

Black or African American↗
PubMed1978

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.

Adolescent↗
PubMed1977

Maternal genital chlamydial infection as a cause of neonatal conjunctivitis.

Infections of the cervix with Chlamydia trachomatis are common, at least in those groups of sexually active women of child-bearing age who are seen in STD (sexually-transmitted diseases) clinics. Persistent untreated infection presents a hazard to the women themselves during pregnancy and to their infants who may develop chlamydial conjunctivitis. The clinical and laboratory findings in 1009 women and in 103 infants with conjunctivitis are presented. Practical problems of diagnosis and control of neonatal chlaymdial conjunctivitis are described. A possible association between prematurity and chlamydial infection is discussed.

Chlamydia Infections↗
PubMed1977

Neonatal conjunctivitis caused by Neisseria gonorrhoeae and Chlamydia trachomatis.

In a selected group of 103 babies referred with neonatal conjunctivitis Neisseria gonorrhoeae was isolated from 11 and Chlamydia trachomatis from 33. Concurrent infection was present in three. On toddler sibling developed chlamydial conjunctivitis. After treatment C. trachomatis was re-isolated from six babies during the follow-up period. The discharge started one to three days after delivery in only three babies with gonococcal conjunctivitis and at five to eight days in eight babies. One baby was delivered by caesarean section. N. gonorrhoeae was isolated from four asymptomatic fathers, all of whom had urethritis. The mean onset of discharge in the 33 babies from whom Chlamydia was isolated was 7-1 days. One baby was delivered by caesarean section. Chlamydial conjunctivitis was associated with a high incidence of prematurity and of postpartum infection in the mother. Ten fathers of Chlamydia-positive babies were examined. C. tachomatis was isolated from four, all of whom were asymptomatic but had low-grade urethritis. These findings confirm the pathogenic role of C. trachomatis in the cervix and indicate the importance to the family of an adequate microbiological investigation of neonatal conjunctivitis.

Adult↗
PubMed1976

Penicillinase-producing Gonococci in Liverpool.

Gonococci, which had acquired a TEM-type of penicillinase widely distributed among gram-negative bacilli, appeared in February, 1976, and soon accounted for 9% of isolates at a clinic in Liverpool. In 45 patients infected by such gonococci, the frequency of complications did not suggest reduced communicability or invasiveness, and usual forms of treatment with penicillins always failed. Spectinomycin succeeded in 21 (95%) of 22 patients treated, blt tetracyclines succeeded in only 13 (68%) of 19. Appropriate laboratory tests for recognising penicillinase-producing gonococci must be used since such gonococci have already been transferred to other parts of the U.K. Penicillinase-stable cephalosporins were active in vitro and could prove to be the future treatment of choice.

Cephalosporins↗