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Biomedical subjects

W M McCormack

Publications and source records attributed to W M McCormack.

At least 55 records · Page 3Linked to original sources
PubMed1990

Sexual behavior of college women in 1975, 1986, and 1989.

To compare sexual practices in college women before and after the start of the current epidemics of Chlamydia trachomatis, genital herpesvirus, and human immunodeficiency virus type 1 infection, we surveyed 486 college women who consulted gynecologists at a student health service in 1975, 161 in 1986, and 132 in 1989 at the same university. There were no statistically significant differences in age, age at menarche, or reason for visiting the gynecologist. The percentages of women in this population who were sexually experienced were the same in all three years (88 percent in 1975, 87 percent in 1986, and 87 percent in 1989). Oral contraceptives were used by 55 percent of the women in 1975, 34 percent in 1986, and 42 percent in 1989; the use of condoms as the usual method of birth control increased (6 percent in 1975, 14 percent in 1986, and 25 percent in 1989; P less than 0.001). In 1975, only 12 percent reported the regular use of condoms during sexual intercourse, in some cases in conjunction with other methods of contraception, as compared with 21 percent in 1986 and 41 percent in 1989 (P = 0.0014). No significant differences were found in the three surveys in the number of male sexual partners or the frequency of fellatio, cunnilingus, or anal intercourse. An additional sample of 189 college women who did not consult the health service was surveyed in 1989, and similar sexual behavior was reported by those who were sexually experienced (65 percent). We conclude that in this population there has been little change in sexual practices in response to new and serious epidemics of sexually transmitted diseases, with the exception of an increase in the use of condoms (which still does not reach 50 percent).

Adolescent↗
PubMed1990

Comparison of ofloxacin and ceftriaxone in the treatment of uncomplicated gonorrhea caused by penicillinase-producing and non-penicillinase-producing strains.

Eighty-nine patients with uncomplicated gonorrhea, including 31 patients (34.8%) infected with penicillinase-producing strains of Neisseria gonorrhoeae, were treated with oral ofloxacin (single 400-mg dose) or intramuscular ceftriaxone (250-mg dose). All 47 patients who received ofloxacin and 41 of 42 patients who received ceftriaxone were cured.

Adult↗
PubMed1990

Increase in resistance of Mycoplasma hominis to tetracyclines.

Isolates of Mycoplasma hominis collected from patients in Boston and New York between 1976 and 1989 were studied. Minimal metabolism-inhibiting concentrations (MMCs) were determined by use of a terminal color change-broth dilution method, as well as by an agar inoculum-broth dilution method. Both methods gave comparable results. Tetracycline MMCs for 3 (7.0%) of 43 isolates of M. hominis collected from 1976 to 1979 were 8 micrograms/ml or more, but they were 8 micrograms/ml or more for 11 (20.3%) of 54 isolates collected from 1980 to 1983 (P = 0.083) and 16 (26.6%) of 60 isolates collected from 1984 to 1989 (P = 0.019). Similarly, doxycycline MMCs for 0 of 43 isolates of M. hominis collected from 1976 to 1979 were 8 micrograms/ml or more, but they were 8 micrograms/ml or more for 8 (14.8%) of 54 strains isolated from 1980 to 1983 (P = 0.0082) and 10 (16.6%) of 60 strains isolated from 1984 to 1989 (P = 0.0047). The susceptibility of M. hominis to clindamycin did not change. We conclude that isolates of M. hominis in the northeastern United States have become more resistant to tetracycline and doxycycline over the past decade.

Clindamycin↗
PubMed1990

Overview: sexually transmitted diseases.

Unlike syphilis, gonorrhea, and chlamydial infection, which can cause serious short-term and long-term problems but are themselves curable, the viral STDs I have discussed are incurable and have worrisome long-term complications. The management of these illnesses should emphasize primary prevention, which involves the use of condoms and selectivity in the choice of sexual partners.

Chancroid↗
PubMed1990

Two urogenital sinus syndromes. Interstitial cystitis and focal vulvitis.

Forty-six young women had unusual and presumably noninfectious disorders of unknown etiology involving tissues derived from the embryonic urogenital sinus (urogenital sinus syndromes). Ten women had interstitial cystitis, and 25 had focal vulvitis. Eleven women had both interstitial cystitis and focal vulvitis. The affected groups were similar in demographic and other characteristics. Most were white and in their mid-20s. Both unusual conditions occurred in the same woman more often than could be expected by chance. This observation suggests that some common, perhaps autoimmune mechanism may be involved in the etiology of these syndromes.

Adolescent↗
PubMed1990

The prevalence of dyspareunia.

A questionnaire regarding sexual experience and dyspareunia was sent to 428 women, of whom 324 (75.7%) responded. Ten refused to participate and one had never had heterosexual intercourse, leaving 313 evaluable responders. One hundred twenty-two (39.0%) had never had dyspareunia and 86 (27.5%) had had dyspareunia at some point in their lives which resolved, either spontaneously or with specific treatment. One hundred five women (33.5%) still had dyspareunia at the time of the survey, 51 of whom had had dyspareunia for their entire active sexual lives. Twenty-two (21%) rarely had dyspareunia, 58 (55.2%) occasionally had discomfort, and 25 (23.8%) had dyspareunia frequently or virtually all the time. Frequency of intercourse was not different among any of the groups analyzed, although 49 (48.0%) of the women reported a decrease in sexual frequency and 35 (33.7%) reported an important adverse effect on their relationships as a result of dyspareunia. Most of the women had not discussed their dyspareunia with a health care professional and were unaware of the cause of their problem.

Coitus↗
PubMed1989

Evaluation of difloxacin in the treatment of uncomplicated urethral gonorrhea in men.

Difloxacin is a new quinolone antimicrobial agent with in vitro activity against both Neisseria gonorrhoeae and Chlamydia trachomatis and a long (26-h) half-life. A single oral dose of 200 mg of difloxacin was used to treat 30 men with uncomplicated urethral gonorrhea in an open trial. Of the isolates of N. gonorrhoeae, three produced penicillinase and two were resistant to tetracycline. N. gonorrhoeae was eradicated from all 29 evaluable patients. The geometric mean MIC of difloxacin for 30 pretreatment N. gonorrhoeae isolates was 0.014 (range, less than or equal to 0.0039 to 0.03) microgram/ml. Four (13.3%) of the 30 subjects with gonococcal urethritis also had C. trachomatis recovered from their pretreatment cultures. Treatment with difloxacin was associated with the eradication of C. trachomatis from all four men. In addition, C. trachomatis was isolated from the posttreatment culture of only one man who had a negative culture before treatment. Nineteen patients (65.5%) reported adverse experiences, and 17 of them (58.6%) developed symptoms suggestive of central nervous system dysfunction. An oral dose of 200 mg of difloxacin is effective treatment for uncomplicated urethral gonorrhea and may also eliminate a coexisting infection with C. trachomatis. Side effects may limit the utility of this agent.

Adult↗
PubMed1988

Symptoms associated with vaginal colonization with yeast.

We correlated vulvovaginal symptoms with vaginal cultures for yeast in healthy female college students. Yeasts were isolated from 42 (29.2%) of 144 women. Only four (22%) of 18 women with positive fungal cultures had fungal elements visualized microscopically in vaginal material suspended in 10% potassium hydroxide (potassium hydroxide wet preparations). Symptoms, mainly vulvovaginal itching and irritation, were reported by 28 (67%) of 42 women whose cultures contained yeast and by 22 (22%) of 102 women who were not colonized by yeast (p less than 0.01). We conclude that vaginal colonization by yeasts is commonly associated with vulvovaginal symptoms, often in the absence of positive potassium hydroxide wet preparation results. These data suggest that vaginal specimens from women who have vulvovaginal symptoms and negative potassium hydroxide wet preparation results should be cultured for fungi before the diagnosis of fungal vulvovaginitis is excluded.

Adolescent↗
PubMed1988

Treatment of uncomplicated gonorrhea with single-dose imipenem-cilastatin.

Single 500-mg intramuscular doses of imipenem-cilastatin cured 116 (95%) of 122 men and 9 of 9 women with uncomplicated gonorrhea due to beta-lactamase-negative Neisseria gonorrhoeae. Most co-existing Chlamydia trachomatis infections persisted. Imipenem-cilastatin is effective for uncomplicated gonorrhea in men but has no advantages over other available regimens.

Adult↗
PubMed1987

Measurement of antibody to Mycoplasma hominis by an enzyme-linked immunoassay and detection of class-specific antibody responses in women with postpartum fever.

The standard conditions for detection of human IgG, IgM, and IgA antibodies to Mycoplasma hominis by an enzyme-linked immunosorbent assay (ELISA) were established with the use of a cell lysate antigen and alkaline phosphatase conjugates. Antigen was used at a concentration of 10 micrograms of protein per milliliter, sera were diluted 1:200, and conjugates were diluted 1:500. Agreement between cultured isolation of M. hominis from the lower genital tract and presence of antibody in 207 women was 71%, 82%, and 86% for IgG, IgM, and IgA, respectively. When the ELISA was compared with the mycoplasmacidal assay, an overall agreement of 81% occurred, with the majority of the discrepancies occurring in the ELISA-positive and mycoplasmacidal-negative category. A linear relationship between end point titer and the A400 value (ELISA or absorbance value at 400 nm) at a standard serum dilution was demonstrated for the IgG, IgM, and IgA classes. Although the ELISA was relatively independent of antigen heterogeneity, no single strain detected more than 87% of positive sera, thus suggesting that optimum detection of antibody to M. hominis by the ELISA will require use of antigen pools derived from multiple strains of M. hominis.

Antibodies, Bacterial↗
PubMed1987

Relationship of vaginal pH and Papanicolaou smear results to vaginal flora and pregnancy outcome.

Prematurity is a major cause of perinatal morbidity. Studies have implicated components of the vaginal flora in the etiology of some cases of preterm birth. Current scoring systems do not include factors which directly reflect the vaginal flora. Since Papanicolaou smears and the vaginal pH may be affected by the vaginal flora and are easy tests to perform, we studied their relationship to vaginal flora and pregnancy outcome. Among 231 patients, those with a vaginal pH greater than or equal to 4.4 were significantly more likely to carry Trichomonas vaginalis (P less than 0.03); Bacteroides species (P less than 0.01), and Mycoplasma hominis (P less than 0.001), and to have premature rupture of the membranes (P less than 0.01), and preterm rupture of the membranes (P less than 0.05). Patients with atypia reported on Papanicolaou smear more frequently carried M. hominis (P less than 0.01), and had premature rupture of the membranes (P less than 0.01). Although the high sensitivity and negative predictive value of those tests may make them useful additions to current scoring systems, their low specificity prevents them from being independent predictors of risk.

Female↗
PubMed1987

Effect on birth weight of erythromycin treatment of pregnant women.

To test the hypothesis that treatment with antibiotics prevents low birth weight, pregnant women whose vaginal cultures contained Ureaplasma urealyticum or Mycoplasma hominis (or both) and who gave written informed consent were treated with one of the following: identical looking capsules containing 250 mg of either erythromycin estolate or stearate (active against U urealyticum), or 150 mg of clindamycin hydrochloride (active against M hominis), or placebo, four times daily for six weeks in a randomized double-blind study. Treatment with clindamycin had no effect. Treatment with erythromycin initiated during the second trimester had no effect on mean birth weight or on the frequency of low-birth-weight infants. In contrast, women whose treatment with erythromycin was initiated in the third trimester gave birth to infants with a heavier mean birth weight (3331 g) than infants born to placebo-treated women (3187 g) (P = .042). Similarly, in women whose erythromycin was begun during the third trimester, the birth rate of infants weighing 2500 g or less was 3%, whereas in women treated with placebo, the birth rate for low-birth-weight infants was 12% (P = .047). These data suggest that treatment with erythromycin during the third trimester prevents low birth weight in mycoplasma-colonized pregnant women. Whether the effect is due solely to the action of erythromycin on U urealyticum is uncertain.

Birth Weight↗
PubMed1985

High failure rates in outpatient treatment of salpingitis with either tetracycline alone or penicillin/ampicillin combination.

Eight hundred twenty-five ambulatory women with a clinical diagnosis of salpingitis were randomized to a 10-day course of either penicillin/ampicillin or tetracycline. Forty-four percent of women had gonococcal salpingitis and 56% nongonococcal salpingitis. Overall, both regimens cured equal proportions of women: At 30 days, 81% were cured by penicillin/ampicillin and 82% by tetracycline. However, the proportion of women with gonococcal salpingitis cured by 30 days was significantly greater than that of women with nongonococcal salpingitis. By 30 days, 14% of women with gonococcal salpingitis and 21% of women with nongonococcal salpingitis were not cured by either regimen. These data suggest that both regimens were only marginally acceptable for women with gonococcal salpingitis and that neither regimen was acceptable for nongonococcal salpingitis.

Adolescent↗
PubMed1985

Geographic variation among isolates of Trichomonas vaginalis: demonstration of antigenic heterogeneity by using monoclonal antibodies and the indirect immunofluorescence technique.

Although Trichomonas vaginalis causes one of the most common sexually transmitted diseases, little is known about the antigenic variation of the parasite or about differences between strains in epidemiology or virulence. Variation among isolates of T. vaginalis was investigated by using a panel of monoclonal antibodies, each reactive with different antigens, to test 88 isolates from diverse geographic areas of North America. All isolates of T. vaginalis reacted with at least one of the nine monoclonal antibodies; the individual antibodies reacted with 22%-76% of the isolates. A pool of two broadly reactive antibodies identified all isolates in the study. Four of the most narrowly reactive, or "specific," antibodies demonstrated differences in the antigenic composition of trichomonads isolated from patients in Seattle, Baltimore, and Brooklyn, New York (P less than .005 by chi 2 test). Application of these and other monoclonal antibody probes may facilitate epidemiological studies and provide rapid, reliable methods for direct diagnosis of trichomonads in clinical specimens.

Animals↗
PubMed1985

Infection with Chlamydia trachomatis in female college students.

Chlamydia trachomatis was isolated from genital specimens from 21 (4.9%) of 431 female college students. Antibody to C. trachomatis was found in the genital secretions of 52 (11.9%) of 437 women. Multiple logistic regression analysis showed race, number of sexual partners, and use of barrier methods of contraception to be predictive of infection with C. trachomatis. Logistic regression analysis found race, number of sexual partners, use of barrier methods of contraception, and presence of cervical erythema to be predictive of local chlamydial antibody. White participants were infected less often (12 of 388 (3.1%)) than black participants (9 of 43 (20.9%)) (p less than 0.001) and were less likely to have local chlamydial antibody. None of the sexually inexperienced women were infected or had local antibody. Among the sexually experienced women, chlamydial infection and local chlamydial antibody increased with increasing number of sexual partners only for women who were not using barrier methods of contraception. Sexually experienced women who used barrier methods of contraception (condom, diaphragm) were less likely to be infected (one of 105 (1.0%)) than were sexually experienced women who used other contraceptive measures or who did not use contraception (20 of 276 (7.2%)) (p = 0.031). Women who used barrier methods of contraception also were less likely to have local chlamydial antibody. Women with cervical erythema were more likely to have local chlamydial antibody (4 of 11 (36.4%)) than women without cervical erythema (48 of 426 (11.3%)). Vaginal colonization with other sexually transmitted microorganisms (Mycoplasma hominis, Ureaplasma urealyticum, Trichomonas vaginalis) was noted more often among women with chlamydial infection than among uninfected women.

Adult↗
PubMed1985

Inhibition of growth of Chlamydia trachomatis by nonoxynol-9 in vitro.

We evaluated the ability of the widely used spermicide nonoxynol-9, Conceptrol gel containing nonoxynol-9, and Conceptrol vehicle (without nonoxynol-9) to inhibit the formation of inclusions of Chlamydia trachomatis in cycloheximide-treated McCoy cells. Conceptrol vehicle produced a non-dose-related 40 to 59% reduction of the number of inclusions formed. In contrast, the addition of nonoxynol-9 and Conceptrol gel containing nonoxynol-9 at a concentration of 100 micrograms/ml reduced the number of inclusions by 84 to 95%. Prolongation of contact between nonoxynol-9 and the chlamydial organisms from 90 to 180 min did not result in additional inhibition. Using a higher concentration of chlamydial organisms and diluting the drug-chlamydia mixture before inoculation of the monolayers, we were able to test higher concentrations of nonoxynol-9. At concentrations of 100 to 5,000 micrograms of nonoxynol-9 per ml, a dose-related 19 to 84% reduction of the number of inclusions was noted.

Chlamydia trachomatis↗