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Biomedical subjects

R R Willcox

Publications and source records attributed to R R Willcox.

15 recordsLinked to original sources
PubMed1979

Epidemiological importance of concealed nongonococcal urethritis.

Of the 229 806 new male patients attending venereal disease clinics in England in 1976, 31.9% had recognisable non-specific genital infection (NSGI), which was easily the most common diagnostic category of the sexually transmitted diseases (STDs) and one which had increased more markedly than all the others in the previous 25 years. Many more cases of nongonococcal urethritis (NGU) are concealed under the diagnosis of gonorrhoea, as is clear from the high incidence of post-gonococcal infection following treatment with penicillin. From 44% to 56% of male patients with gonorrhoea can also have non-specific genital infection during the same year. A practical treatment schedule for gonorrhoea which is also effective against simultaneously acquired non-gonococcal urethritis would be of great value.

Adolescent↗
PubMed1977

How suitable are available pharmaceuticals for the treatment of sexually transmitted diseases? 1: Conditions presenting as genital discharges.

The relative prevalence of sexually transmitted diseases and the agents available for the treatment of these diseases commonly presenting as genital discharges-namely, gonorrhoea, candidosis, trichomoniasis, and non-specific genital infection-are reviewed. The many agents that are active against gonorrhoea are listed, but none is ideal. Penicillin, in spite of its allergic side effects, has remained the drug of choice for 25 years because it is cheap, easily obtained, lacks toxicity even in pregnancy, and is effective. Its use is now threatened by the emergence of some strains that are able to produce penicillinase. At present the policy is to obtain the best results from penicillin while these are acceptable, but the clinician in some countries is badly served by the availability of procaine penicillin in aqueous suspension. There is a need for an effective penicillin or cephalosporin that is penicillinase resistant and cheap. Cefuroxime offers considerable hope but it is likely to be expensive in the immediate future.There are many preparations for the local treatment of candidosis. The confidence expressed by the manufacturers in recommending a three-day treatment is, it is hoped, based on a superior product. Nevertheless there is a need for a safe systemically absorbed fungicide which could be used orally, or some substance that could render the vagina an inhospitable environment for the organism.In the treatment of trichomoniasis the pharmaceutical industry in providing substances more than 90% effective in a single dose has done all that can be expected. Any further advances lie in the field of human behaviour rather than pharmaceutical research.In the treatment of non-specific genital infection the needs are more of research than of therapy. More knowledge is required of the cause of the condition and the relative role of contending pathogens, and of the results of treatment of patients and contacts in which Chlamydia or other suspect pathogens have been isolated.

Candidiasis↗
PubMed1977

How suitable are available pharmaceuticals for the treatment of sexually transmitted diseases? (2) Conditions presenting as sores or tumours.

The pharmaceutical industry is not supplying the penicillin preparations that are required for the treatment of syphilis. For those in whom penicillin hypersensitivity is suspected there is a need for a safe injectable alternative that is effective if given once daily or, preferably, at two- or three-day intervals. Existing treatments for chancroid, lymphogranuloma venereum, and granuloma inguinale are described, but even collectively there are few cases and treatments for other sexually transmitted diseases merit priority. Treatments for scabies and pediculosis pubis, although not perfect, are reasonable. There is a need for better local treatment for condylomata acuminata and systemic immunological methods, including those that increase cell-mediated immunity, deserve attention. The same is true for molluscum contagiosum. There is an urgent need for an effective, safe treatment of herpes genitalis that is able to eradicate the virus from the host. If it is proved that the herpes virus is responsible for carcinoma of the cervix this could then be the most serious sexually transmitted disease as in many countries such carcinomas are responsible for approximate seven times more deaths in women than is syphilis in men and women together. The limitations of prophylactic methods in preventing all possibility of infection with one or more of the sexually transmitted diseases are discussed.

Condylomata Acuminata↗
PubMed1977

Which Neisseria?

A case of disseminated gonococcal infection in which the gonococcus was isolated from the blood and genitalia and the meningococcus from the throat is described. A second patient, in whom the meningococcus was isolated from the throat and the gonococcus from the genitals but in whom no organisms were recovered from the blood, had lesions resembling those of a disseminated infection. The results of 150 throat cultures from patients who were examined at a clinic because they had a history of oral sexual intercourse are presented. The meningococcus was isolated nearly six times more often in patients with genital gonorrhoea than in those in whom genital cultures were negative, while the gonococcus was found 2 1/2 times more often in those who carried the meningococcus in the throat than in those who did not. If these findings can be confirmed it could indicate an individual susceptibility to the acquisition of Neisserian organisms that would merit further investigation.

Adult↗
PubMed1976

VD education in developing countries. A comparison with developed countries.

No new method of control of the sexually transmitted diseases is imminent. Reliance has to be placed on existing methods including health education. Health education has a double role, being a primary method in its own right, and--of equal or greater importance--being involved in the enforcement of all of the other tried methods. A comparison is made of the situation in countries with a developed or an underdeveloped venereal disease control service, in respect of organization, statistical reporting, the various agencies treating venereal disease, clinic and diagnostic facilities, personnel concerned in venereal disease management, and other aspects. The vicious circle inherent in developing countries is outlined. A lack of awareness of the extent of the problem and the presence of other serious competing diseases lead to a low budget, thence to poor diagnostic and treatment facilities, and to few cases being seen in the official clinics and hospitals. Thus relatively small numbers of cases are reported and there is consequently a continuing lack of awareness of the problem. A method of cutting through such a circle is suggested, and the importance of health education activities during this period is emphasized.

Developing Countries↗
PubMed1976

Single oral dose of 1-5g. talampicillin in the treatment of gonorrhoea.

81 patients have been treated with single oral doses of 1-5 g. (6 tablets) of talampicillin without probenecid. The failure rate amongst those followed was only 4-2 per cent. No side-effects were reported. These results were superior to those obtained with 2-0g. or equivalent of ampicillin, amoxycillin, or pivampicillin with probenecid. Talampicillin is thus the most potent ampicillin-like antibiotic so far available for the treatment of gonorrhoea and is capable of curing the disease with a smaller single dose without probenecid than is necessary for other preparations.

Administration, Oral↗
PubMed1975

Minocycline in the treatment of non-gonococcal urethritis.

108 male patients with non-gonococcal urethritis have been treated with minocycline given as two 100 mg. tablets initially, followed by one tablet twice a day over a period of 6 days (13 tablets). Of 96 patients followed, re-treatment for non-gonococcal urethritis within 3 months was undertaken in ten (10.4 per cent.). The findings are compared with those previously reported in seven series involving six other tetracyclines and with nine other treatment regimens. All of the tetracyclines proved superior to other agents and the best results combined with simplicity of administration were obtained with minocycline. Two patients complained of soreness of the mouth after 1 week but no other side-effects were reported. Minocycline thus gives excellent results in the treatment of non-gonococcal urethritis. In the dosage used it was also successful against gonorrhoea in seven patients treated. It is therefore particularly useful in cases in which gonorrhoea is suspected but not found in the smears or in which the smears cannot be read immediately.

Follow-Up Studies↗
PubMed1975

Importance of the so-called 'other' sexually-transmitted diseases.

(1) Some data are presented concerning the frequency and potential morbidity of sexually-transmitted organisms other than T. pallidum or N. gonorrhoeae. (2) Most of the diseases with which these organisms are associated are more prevalent than syphilis and some, at least in one sex, are as common as gonorrhoea. A number appear to carry considerable morbidity, which in the case of Type II herpes virus--if it is responsible for cervical cancer--may ultimately cause more fatalities than syphilis. (3) It is concluded: (a) that, if syphilis and gonorrhoea were reduced to the point of representing no public health concern, many other sexually-transmitted conditions would still remain to pose significant problems: and (b) that health education and other methods of prevention should, where possible, be designed to take into consideration the epidemiological implications of the other organisms listed.

Candidiasis↗