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Biomedical subjects

P E Hay

Publications and source records attributed to P E Hay.

14 recordsLinked to original sources
PubMed1992

Diagnosis of bacterial vaginosis in a gynaecology clinic.

OBJECTIVE: To estimate the prevalence of bacterial vaginosis in women referred to a gynaecology clinic, and to compare two methods of diagnosing bacterial vaginosis. SETTING: Gynaecology Clinic at Northwick Park Hospital SUBJECTS: 114 women aged 16 to 65 referred consecutively to the gynaecology clinic of one consultant. MAIN OUTCOME MEASURES: Detection of bacterial vaginosis by standard compound criteria and by examination of a Gram stained smear of fluid from the posterior vaginal fornix. RESULTS: Bacterial vaginosis was detected by both the Gram stain and the compound criteria in 13 women. There was no correlation between the symptom of vaginal discharge and the diagnosis of bacterial vaginosis in this population, but the presence of discharge noted by the clinician was associated with bacterial vaginosis. CONCLUSIONS: The prevalence of bacterial vaginosis was 11%. The Gram stain provides a simple and inexpensive method for laboratory confirmation of bacterial vaginosis where facilities for using the compound criteria are not available.

Adolescent↗
PubMed1991

Detection of Chlamydia trachomatis by the polymerase chain reaction in swabs and urine from men with non-gonococcal urethritis.

A polymerase chain reaction (PCR) was developed for Chlamydia trachomatis in which a 380 base pair DNA fragment was amplified. Amplification occurred with the DNA from the 15 serovars but not with that from other Chlamydia spp or with DNA from a variety of other organisms. Chlamydial DNA (10(-16) g) could be detected and the PCR seemed to be able to detect single organisms. Urethral swabs were obtained from 37 men with acute non-gonococcal urethritis (NGU), 18 (49%) of whom were positive for C trachomatis by MicroTrak. As a result of clinical re-examinations 65 urethral swabs were available for analysis by the PCR. In comparison with MicroTrak, PCR had a sensitivity of 95%, a specificity of 94%, a positive predictive value of 86% and a negative predictive value of 98%. The PCR was apparently less sensitive (82%) in tests on urine samples. Overall, however, values of sensitivity and specificity of the PCR compared favourably with those of MicroTrak. The PCR for C trachomatis is likely to be a valuable technique for research, but problems of DNA contamination suggest that it should not be recommended for routine diagnosis.

Base Sequence↗
PubMed1991

Simplification of procedures used to test urine samples for Chlamydia trachomatis.

Two methods of simplifying the procedure for examining urine samples for Chlamydia trachomatis were investigated. When 73 urine samples from 56 men with acute non-gonococcal urethritis were examined by direct immunofluorescence (MicroTrak), centrifuging 1 ml volumes of urine at 13,000 rpm for five minutes was at least as efficient for detecting C trachomatis as centrifuging larger volumes at 3000 rpm for 30 minutes. Furthermore, examination of urine produced during a visit to a sexually transmitted disease clinic was at least as efficient as examination of early morning urine for detecting C trachomatis by MicroTrak, or by an enzyme immunoassay (IDEIA). Both modifications have practical advantages and should encourage the use of urine samples for diagnosing chlamydial infections in men.

Bacteriological Techniques↗
PubMed1991

The value of urine samples from men with non-gonococcal urethritis for the detection of Chlamydia trachomatis.

Chlamydia trachomatis was sought at first and subsequent clinic visits in urethral swabs and urines from 112 heterosexual men with acute non-gonococcal urethritis (NGU). In comparison with a urethral swab tested by Micro Trak (MT), a urine deposit tested in the same way was 90% as sensitive. Examining a urine deposit by the enzyme immunoassay IDEIA was a little less sensitive (89%) than examining a similar deposit by MT, and was less sensitive (82%) than examining a urethral swab by MT. The results of testing urines were little influenced by collecting them either before or after swabbing the urethra, and there was evidence that examining all of a urine sample by IDEIA would have increased sensitivity. Overall, 55 (49%) of the men were diagnosed as C trachomatis-positive based on the results of testing both a urethral swab and a urine sample. Furthermore, a small numbers of chlamydiae were detected by examining urine by MT and, to a lesser extent, by IDEIA, so that there is no reason why this non-invasive approach should not be successful in men other than those with acute NGU.

Chlamydia Infections↗
PubMed1990

Use of the polymerase chain reaction to detect DNA sequences specific to pathogenic treponemes in cerebrospinal fluid.

The polymerase chain reaction was used to detect Treponema pallidum in specimens of cerebrospinal fluid (CSF), as a means of diagnosing syphilis. Segments of the TmpA and 4D genes were amplified to provide an estimated threshold sensitivity of approximately 65 organisms in 0.5 ml. A spectrum of pathogens known to cause meningitis, and several non-pathogenic treponemes were unreactive. Treponema pertenue, and only one of 30 control specimens of CSF were positive. In contrast, 10 of 19 CSFs from patients being evaluated for latent or tertiary syphilis were positive, as were 7 of 28 specimens from HIV-positive patients.

Animals↗
PubMed1990

Gummatous lesions in men infected with human immunodeficiency virus and syphilis.

Two HIV-infected men are reported who developed gummatous lesions more than 12 months after appropriate treatment of presumptive syphilis. In one patient the lesions developed without any change in the VDRL titre. The most likely explanation for these lesions is reactivation of syphilis in the context of HIV infection. As these lesions respond to penicillin, the possible reactivation of appropriately treated syphilis, or even yaws, should now be considered in any ulcerative lesion in HIV infected individuals at risk from treponemal infection.

Adult↗
PubMed1990

Detection of treponemal DNA in the CSF of patients with syphilis and HIV infection using the polymerase chain reaction.

The polymerase chain reaction (PCR) was used to detect Treponema pallidum DNA in the cerebrospinal fluid (CSF) of patients with and without syphilis. The CSF from 10 of 19 patients with positive serological tests for syphilis who were being investigated for late syphilis were treponemal DNA-positive. In contrast, the CSF from only one of 30 patients with no known history of syphilis was DNA-positive. CSF from 28 HIV-positive patients was also tested. Fourteen of these patients had central nervous system (CNS) disease and seven were DNA-positive, whereas none of the 14 without CNS disease were DNA-positive. Five of the seven DNA-positive patients had a history of syphilis. Such a history in an HIV-positive patient who had CNS disease was predictive of finding treponemal DNA in the CSF. The PCR had a sensitivity of 47% and a specificity of 93% for detecting a known history of syphilis and is a potentially useful tool in treponemal diagnosis.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Pulmonary tuberculosis in Behçet's syndrome.

Pulmonary tuberculosis has rarely been recorded in patients with Behçet's syndrome, but to date no report has convincingly demonstrated any possible association between these two diseases. We describe three cases of pulmonary tuberculosis in patients with Behcet's syndrome and discuss the possible underlying mechanisms.

Adult↗
PubMedDate not supplied

A reappraisal of chlamydial and nonchlamydial acute non-gonococcal urethritis.

A cohort of 112 men presenting with acute non-gonococcal urethritis (NGU) was investigated for the presence of Chlamydia trachomatis. Men with 3 or more episodes of NGU in the preceding 12 months, or who had received treatment for NGU in the preceding 3 months were excluded. C. trachomatis was sought by examination of urethral smears by direct immunofluorescence, and by examination of the centrifuged deposit from a first pass urine (FPU) sample by direct immunofluorescence, IDEIA, and the polymerase chain reaction. Urethral samples from 48 men were positive for CT, and the FPU samples from an additional 7 men were positive by at least 2 assays. With such intensive investigation it is likely that those men identified as chlamydia-negative were genuinely free from the infection. The clinical history and response to treatment of those men who were chlamydia-positive were compared with those of the chlamydia-negative men. They differed in that a larger proportion of the chlamydia-positive men reported having had intercourse with more than one partner in the previous 3 months, and having had fewer previous episodes of NGU. Moreover, in contrast to some previous studies, after one week of treatment with doxycycline, a larger proportion (65%) of the chlamydia-negative men than the chlamydia-positive men (40%) was cured, although the difference was not sustained following later treatment.

Adolescent↗