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Biomedical subjects

J S Bingham

Publications and source records attributed to J S Bingham.

17 recordsLinked to original sources
PubMed1991

Survey of the management of Chlamydia trachomatis infection of the cervix.

A questionnaire was sent to all genitourinary medicine (GUM) clinics in the United Kingdom. Physicians were asked whether women attending the clinics were routinely screened for Chlamydia trachomatis, what treatment was given and whether and how a test of cure (TOC) was carried out after treatment; 94.5% of clinics responded. Screening for chlamydia was not carried out routinely in 4.8% of clinics. Treatments and their costs varied widely between clinics; six antibiotics were prescribed in 35 different ways. Less than half the clinics used regimens compatible with the advice of the World Health Organisation (WHO) and the Centers for Disease Control (CDC). Antibiotics in larger doses and/or for longer durations than those known to be effective were prescribed in 85% of clinics. Unnecessary routine TOC were carried out by 86% of clinics in 29 different ways. Sixteen percent of clinics carried out TOC immediately after completion of therapy, which is inadvisable on technical grounds. There is a need to standardise and improve the treatment and follow-up of chlamydial infection in women attending GUM clinics.

Anti-Bacterial Agents↗
PubMed1990

Is a test of cure necessary following treatment for cervical infection with Chlamydia trachomatis?

Tests of cure (TOC) were performed on specimens from 106 women following treatment for chlamydial infection of the cervix. 91 women attended for the first TOC with enzyme immunoassay (EIA) within one week of finishing antibiotics. Three were EIA positive, 88 were EIA negative. These three women were subsequently EIA and culture negative although they received no further antibiotics. Ninety women returned for the second TOC with EIA and culture between seven and 27 days after completing treatment. All the results were negative. Routine TOC is unnecessary following appropriate antichlamydial therapy. If TOC is indicated antigen-detection methods should not be used immediately after finishing antibiotics as misleading positive results may be obtained. EIA or culture at one week or later after treatment is reliable.

Chlamydia Infections↗
PubMed1986

The treatment of inveterate vulvo-vaginal candidosis.

The antifungal treatment of recurrent vulvo-vaginal candidosis is described. Factors which predispose to the condition are discussed and details of their investigation and management mentioned. The problem of reinfection, both from a sexual contact and from the bowel is reviewed, and the general features of management considered.

Adrenal Cortex Hormones↗
PubMed1986

Vulvo-vaginal candidosis--an overview.

Genital candidosis is extremely common and its incidence appears to be rising. The epidemiology, clinical features, predisposing factors and treatment of the condition are reviewed.

Candidiasis, Vulvovaginal↗
PubMed1985

Changes in intravascular complement, kininogen, and histamine during Jarisch-Herxheimer reaction in secondary syphilis.

Nine patients with secondary syphilis and one control subject were observed for eight hours after the administration of penicillin. Serial clinical observations were made, and blood samples were obtained for the analysis of complement, histamine, and kininogen. Six patients showed Jarisch-Herxheimer reactions, the intensities of which were found to parallel certain changes in activity of complement and concentrations of histamine and kininogen. Results were analysed statistically. Significant falls were seen in: total haemolytic complement (CH50), C1 inhibitor, C3, functional (haemolytic) C4, and to a lesser extent total C4. Split products of C3 were shown in five of the six patients who had a reaction. There was no change in total glycine rich beta-glycoprotein (GBG) or glycine rich gamma-glycoprotein (GGG) or evidence of conversion of GBG to GGG. Plasma kininogen concentrations fell and plasma histamine concentrations rose appreciably before and during the clinical phase of the reaction. These results are discussed in relation to the clinical features and possible pathogenic mechanisms of the Jarisch-Herxheimer reaction.

Adult↗
PubMed1984

Single blind comparison of ketoconazole 200 mg oral tablets and clotrimazole 100 mg vaginal tablets and 1% cream in treating acute vaginal candidosis.

A single blind study of 103 women with vaginal candidosis was undertaken to compare treatment with conventional topical clotrimazole and oral ketoconazole. Both treatment regimens were equally effective in terms of clinical symptoms, negative results on culture for Candida albicans, and relapse rates. As treatment for vaginal candidosis takes several days, patient compliance is important and the success of a treatment regimen may depend on its acceptability to patients. Those in this study who had previously been treated for vaginal candidosis were asked to compare their current and previous treatments. Significantly more (p less than 0.001) of those treated with ketoconazole than those treated with clotrimazole found it more acceptable than previous treatment. This indicated a strong preference for oral treatment, and oral antifungal agents may be the treatment of choice for vaginal candidosis in the future.

Administration, Oral↗
PubMedDate not supplied

Treatment of gonorrhea with clavulanate-potentiated amoxicillin (Augmentin).

One hundred sixty-one patients with culture-proved Neisseria gonorrhoeae infection were treated with a single oral dose of amoxicillin trihydrate (3 g) and potassium clavulanate (Augmentin, 0.25 g). Of 153 patients infected with non-penicillinase-producing strains of N. gonorrhoeae, 139 (91%) were cured, and five (62.5%) of eight patients infected with penicillinase-producing N. gonorrhoeae were cured. Augmentin was successful in eradicating N. gonorrhoeae from the rectum; 30 (97%) of 31 such infections were cured.

Administration, Oral↗
PubMedDate not supplied

Inflammatory cytology, infection and intraepithelial neoplasia.

The prognostic implications of minor grades of abnormality on cervical cytology are unclear. Women attending genitourinary medicine clinics who had cytology showing inflammatory changes with or without koilocytosis or borderline dyskaryosis have a high incidence of cervical intraepithelial neoplasia and genital infection. Of 119 patients who had a colposcopically directed cervical biopsy after one smear showing these changes, 46 (38%) had cervical intraepithelial neoplasia. Seventy-eight (57%) of 138 women had genital infection of whom 26 (33%) had a sexually transmitted disease. We recommend vigilant follow-up of borderline cytology including colposcopy if adequate facilities exist.

Adolescent↗
PubMedDate not supplied

Urethritis due to Neisseria meningitidis in a London genitourinary medicine clinic population.

A retrospective study was performed in a department of genitourinary medicine to determine the prevalence and clinical features of urethral and cervical infection with Neisseria meningitidis among patients being screened for sexually transmitted diseases. During the 28 month period of the study 11 isolates (from 10 patients) of N. meningitidis were identified from 5571 urethral cultures from homosexual men (0.2%). This compares with an isolation rate of 4.7% for N. gonorrhoeae; 1.2% samples screened for chlamydial antigen were positive. There were no isolates from 8992 urethral cultures from heterosexual men or 15,976 cervical cultures. Eight of the cases identified had features of urethritis at diagnosis; 6 were diagnosed initially as non-specific urethritis (NSU) and 2 as gonorrhoea on the basis of microscopy of a urethral smear. Eight of the 10 patients were treated with amoxycillin and/or a tetracycline, and all but one had a clinical and microbiological cure. In the study population the prevalence of N. meningitidis infection was low and restricted to homosexual men; however, it may be associated with symptoms.

Adult↗