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At least 19 recordsLinked to original sources

Gonorrhea.

The gonococcus has become an extremely important organism in obstetrics and gynecology. It is associated with a wide array of clinical syndromes that frequently confront the practitioner. The diagnostic modalities available are many and are rapidly increasing. Therapy likewise is becoming complex as we learn more about the infections associated with this microbe. The basic principles of care still include a high index of suspicion of infection; clinical evaluation of the potentially infected patients; laboratory support of the clinical diagnosis; specifically directed antimicrobial therapy of adequate dosage and duration; treatment of sexual partners; and follow-up test-of-cure evaluation in all patients.

Adolescent↗

Syphilis.

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Adult↗

Epidemiology of sexually transmitted diseases: the global picture.

Sexually transmitted diseases (STD) are now the commonest group of notifiable infectious diseases in most countries, particularly in the age group of 15 to 50 years and in infants. Their control is important considering the high incidence of acute infections, complications and sequelae, their socioeconomic impact, and their role in increasing transmission of the human immunodeficiency virus (HIV). The worldwide incidence of major bacterial and viral STD is estimated at over 125 million cases yearly. STD are hyperendemic in many developing countries. In industrialized countries, the bacterial STD (syphilis, gonorrhoea, chancroid) declined from the peak during the Second World War till up to the late fifties, then increased during the sixties and early seventies, and they have been decreasing again from the late seventies till the present. In the industrialized world, diseases due to Chlamydia trachomatis, genital herpes virus, human papillomaviruses and human immunodeficiency virus are now more important than the classical bacterial ones; both groups remain major health problems in most developing countries. Infection rates are similar in both women and men, but women and infants bear the major burden of complications and serious sequelae. Infertility and ectopic pregnancies are often a consequence of pelvic inflammatory disease, and are preventable. Sexually transmitted diseases in pregnant women can result in prematurity, stillbirth and neonatal infections. In many areas 1-5% of newborns are at risk of gonococcal ophthalmia neonatorum, a blinding disease; congenital syphilis causes up to 25% of perinatal mortality. Genital and anal cancers (especially cervical cancer) are associated with viral sexually transmitted diseases (genital human papillomavirus and herpes virus infections). Urethral stricture and infertility are frequent sequelae in men.

Adolescent↗

Nongonococcal urethritis.

Nongonococcal urethritis (NGU) and its counterparts in women are the most common sexually transmitted disease syndromes in the United States and Western Europe. Chlamydia trachomatis causes 40 to 50 percent of the cases of NGU and is a major cause of mucopurulent cervicitis and urethral infection in women, epididymitis in young men, pelvic inflammatory disease, acute perihepatitis, and neonatal conjunctivitis and pneumonia. Chlamydial infection also has been linked with Reiter's syndrome, infertility, cervical dysplasia, stillbirth, postpartum endometritis, and other syndromes. Tetracycline HCl is the treatment of choice for NGU and related syndromes, and for the sexual partners of infected patients.

Adult↗

Problems and proposals for the surveillance and control of sexually transmitted diseases associated with pelvic inflammatory disease in South America.

In South America, the number of women at risk for gonococcal pelvic inflammatory disease has increased greatly along with the incidence rates for gonorrhea. Further information is needed on the epidemiologic aspects of gonorrhea and PID in order to develop programs for optimal control of sexually transmitted disease (STD). We think that the control of STD, including PID, requires improvement of four basic factors: professional training in STD, management of STD by all levels of health care services, laboratory diagnostic services, and public education in STD.

Adolescent↗

Contraception and women's health.

More and more women all over the world are opting for fertility by choice not by chance. Contraceptive use has a tremendous impact on women's health. The ability to regulate and control fertility is a basic component of health, positively defined as a state of physical, mental and social well-being. Contraception is saving the lives of women around the world from the hazards of unwanted pregnancy. Optimal childbearing is also contributing to infant and child survival. Contraception has a complex relationship to sexually-transmitted diseases. Contraceptive safety is a major public health concern. The risk/benefit assessment will differ for different populations, for different individuals, and even for the same individual at different periods of life. The family planning movement started as a movement by women for women. Women's perspectives and women's concerns should guide the future of contraceptive research and development.

Adolescent↗

Herpesvirus.

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Adolescent↗

Changes in the incidence of acute gonococcal and nongonococcal salpingitis. A five-year study from an urban area of central Sweden.

The incidence of acute gonococcal and nongonococcal salpingitis for a five-year-period (1970--74) was studied retrospectively in an urban area of central Sweden. The investigation was undertaken to see if the reported decrease of gonorrhoea in Sweden had been followed by a change in the incidence of gonococcal salpingitis--the most common complication of gonorrhoea. The study showed that the relative incidence of acute gonococcal salpingitis had decreased even more than urogenital gonorrhoea and these findings thus indicate a real decrease of gonorrhoea. At the same time there were more patients with nongonococcal salpingitis. During the period of the study the gonococcal complement-fixation test (GCFT) gave positive results in 40% to 80% of the patients with gonococcal salpingitis. The yield with this test was only 4% in patients with nongonococcal salpingitis during 1970 but it increased successively and was 23% in 1974. This increase was statistically highly significant (P less than 0.001).

Acute Disease↗

Urethral stricture.

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Equipment and Supplies↗

Prevalence of HIV-1 antibodies in patients with sexually transmitted disease.

Sera from 500 (496 male and 4 female) consecutive patients with sexually transmitted diseases (STD) were examined for the presence of HIV1 antibodies. The serological tests were done using the ELISA (Wellcozyme) and confirmed by the western blot (Biorad). Sixty (12%) of the 500 patients were HIV-1 antibody positive. Seropositivity varied with the type of STD. A positivity rate of 16% seen with genital ulcer disease is significantly higher than the 7% prevalence rate seen in STD patients with urethral discharge. Infection with more than one kind of STD increases seropositivity significantly. Of the potential risk factors identified during the interview it seems that only shaving at barbers' shop is positively associated with seroprevalence. This study suggests that the presence of STDs is associated with an increased HIV-1 seroprevalence. Therefore, any effort to reduce HIV-1 infection should aim at the control of STDs.

Adolescent↗