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Biomedical subjects

P M Nathan

Publications and source records attributed to P M Nathan.

6 recordsLinked to original sources
PubMed1994

A randomised, double-blind, parallel group study to compare subcutaneous interferon alpha-2a plus podophyllin with placebo plus podophyllin in the treatment of primary condylomata acuminata.

OBJECTIVES: The primary objective was to determine if six weeks treatment with subcutaneous interferon alpha-2a (IFN) and podophyllin 25% W/V administered twice per week, preceded by IFN alpha-2a three times weekly for one week showed a greater complete response rate in patients with primary condylomata acuminata when assessed at week 10 than treatment with podophyllin and placebo injections in the same schedule. The secondary objective was to compare recurrence rates in complete responders at six months in the two treatment groups. DESIGN: Randomised, double-blind parallel group study. SETTING: Multicentre study in six genitourinary clinics within the U.K. PATIENTS: One hundred and twenty-four patients with primary anogenital warts. MAIN OUTCOME MEASURES: Complete response rate at week 10, and recurrence rate at week 26 in complete responders. RESULTS: At week 10 analysis of the efficacy population showed complete response in 36% (15/42 patients) of IFN-treated group and 26% (11/43 patients) in the placebo group (no significant difference). Analysis of the safety population at week 26 showed persistence of the complete response in 57% (8/14 patients) of the IFN-treated group and 80% (12/15 patients) of the placebo group (no significant difference). Adverse effects were more common in IFN-treated patients, involved particularly application site reaction and malaise but were generally mild. CONCLUSIONS: At the dose and with the regime described treatment with IFN alpha-2a in combination with podophyllin is no more effective in the treatment of primary anogenital warts than podophyllin alone and is associated with more adverse events.

Adolescent↗
PubMedDate not supplied

Screening colposcopy in genitourinary medicine.

A prospective study of new female patients attending the Genitourinary Medicine Department in Doncaster was carried out to look at the value of colposcopic examination at their first attendance. Of the 100 randomized patients studied 41 showed evidence of colposcopically detected cervical abnormality. Twenty-seven patients had colposcopically directed biopsies. These showed evidence of cervical intraepithelial neoplasia (3 cases), flat condyloma (16 cases), exophytic wart (2 cases), chronic inflammation (2 cases) and normal epithelium (4 cases). Colposcopic cervical abnormalities were significantly associated, with a history of anogenital warts, sexual contact with anogenital warts and the presence of anogenital warts at presentation. Despite this, less than half the group showing colposcopic abnormalities had an association with anogenital warts. Demonstration of cervical abnormalities by colposcopy resulted in a greater patient compliance during follow-up. Screening or primary colposcopy may be incorporated into a genitourinary screen at the first visit. The procedure is both acceptable and beneficial to the patient, facilitating the detection of a range of cervical disease and enhancing the doctor-patient relationship.

Adolescent↗
PubMedDate not supplied

A study of the prevalence of male intrameatal warts using meatoscopy in a genitourinary medicine department.

A cross-sectional study is undertaken to determine the prevalence of male intrameatal and distal urethral warts, using meatoscopy. A group of 169 patients presenting for anogenital warts and a group of 74 unselected patients attending the Department for a variety of reasons during the study period, were examined. Twenty-one patients (13.5%) out of 155 patients with anogenital or related warts had external warts at the meatus. Of these 21 cases, 12 (57.1%) had further extension of their warts into the distal urethra. Fifteen other cases of intrameatal and distal urethral warts were detected in the absence of external warts at the meatus. Twenty-three cases out of 107 males with genital warts (21.5%) were found to have intrameatal or distal urethral warts, thus reflecting the common occurrence of these lesions. A highly significant association between the presence of intrameatal/distal urethral warts and the presence of male genital warts was found (P = 0.003). One hundred and fifty-three repeat meatoscopic examinations were carried out, 6 weeks after their first examination. Three new cases of intrameatal/distal urethral warts were found. Intrameatal and distal urethral warts occurred from a depth of 5 mm to 25 mm. One hundred and eighty-three female partners of the study patients were examined. An association between the presence of intrameatal/distal urethral warts and female anogenital warts was found (P = 0.028). No corroborating association between the presence of male and female anogenital warts was found (P = 0.47). This observation may have a bearing on disease transmission and control. The detection of intrameatal/distal urethral warts will be important in achieving successful treatment of male anogenital warts.

Condylomata Acuminata↗
PubMedDate not supplied

Sampling for vaginal candidosis: how good is it?

In defined patient populations attending a genitourinary medicine department, screening for vaginal candidosis resulted in 26.3% positive rate. Microscopy using Gram-stained slide was useful in early diagnosis and resulted in the detection of 64.8% of symptomatic cases. Samples from the anterior fornix proved most sensitive for culture diagnosis while the left lateral vaginal wall proved least sensitive (positive predictive value 0.88 cf 0.81).

Candidiasis, Vulvovaginal↗