Journal of the American Venereal Disease Association最新文献

A 4 year survey of a low socioeconomic prenatal population in a large outpatient clinic revealed an incidence of 4.4% gonorrhea by cervical culture. These patients who were culture-positive had a 7.6% perinatal mortality rate compared to a 3.0% perinatal mortality rate among culture-negative patients from the same clinic. The immaturity and prematurity rate was significantly higher in the culture-positive group as was the incidence of premature rupture of the membranes and prolonged premature rupture of membranes.

Cultures were made from the cervix, rectum, and oropharynx of 2,019 women to determine the prevalence of gonorrhea. For patients of similar race and age, the rates of cervical gonorrhea among users of oral contraceptives (10.6/100) or IUD users (9.5/100) were significantly greater than observed with patients using barrier methods, condom-diaphragm-foam (1.7/100). On the other hand, there were no significant differences in rates of rectal or oral infection by method of contraception. Postpartum patients were found to have similar infection rates at all three sites as a comparable group of nonpuerperas. Recommendations for utilization of barrier methods are made for suitable patients, including those in the immediate puerperium.

This paper describes the social characteristics of venereal disease patients aboard a US Navy destroyer. The research team administered questionnaires to 247 crew members at the outset of the ship's 7 month-overseas deployment. When the ship returned to home port, the research staff gathered demographic and occupational information plus disciplinary records, job performance ratings, and complete dispensary visit information for the deployment period. The morbidity data indicated that 48% of the entire crew experienced at least one case of VD, and of these VD patients, 38% had multiple infections. A set of variables that best predicted VD incidence was determined by means of multiple regression analysis. These variables included disciplinary record, pay grade, division or type of job ("blue-collar" versus "white-collar"), and education. Other variables that correlated with VD incidence were age, length of service, marital status, performance ratings, and verbal aptitude scores.

The significance of false-positive FTA-ABS fluorescence in connective tissue diseases and other clinical conditions was evaluated by studying the serum from several groups of patients. In 12% of 67 patients without syphilis, serum with an antinuclear antibody (ANA) titer of 1:32 or greater gave low intensity FTA-ABS test fluorescence. In 20% of 150, patients (2.7% with a history of syphilis), serum with rheumatoid factor (RF) titers of 1:640 or greater demonstrated some reactivity. Only 1.3% of 75 donors of normal blood showed low-grade FTA-ABS fluorescence. In 385 patients with diagnostic problems, 2.1% of the serum demonstrated the beaded pattern. Patterns varied, depending on the treponemal antigen preparation and the duration of serum storage. Also, multiple specimens from the same patient produced different patterns. Furthermore, the beaded pattern could be demonstrated in patients with a history of syphilis, with other medical disorders, and in apparently normal persons.

The Center for Disease Control and cooperating clinics monitored adverse drug reactions in 6,969 patients who were treated for suspected uncomplicated gonorrhea with one of the four 1972 United States Public Health Service (USPHS) recommended regimens and returned for reexamination. Of those patients receiving the aqueous procaine penicillin G (APPG)-probenecid regimen, 2.0% had at least one adverse reaction and 0.18% experienced procaine reactions. No life-threatening reactions occurred. The overall reaction rates for the ampicillin-probenecid, tetracycline and spectinomycin regimens were 0.62%, 5.9%, and 0.61%, respectively. Our findings document the relative safety of the USPHS recommended regimens.

The status of a new treponemal test, the Microhemagglutination Assay for Treponema pallidum Antibodies (MHA-TP) is reviewed and compared with regard to its sensitivity, specificity, and current clinical application to the VDRL slide test, the most widely used non-treponemal test, and to the manual FTA-ABS test, the standard treponemal test. At present, the MHA-TP test seems to combine the simplicity and lower cost of nontreponemal tests and the sensitivity and specificity of treponemal tests, and thus enjoys features of both a screening and verification procedure. However, additional clinical experience with the test is needed before its role in the serologic diagnosis of syphilis can be conclusively determined.

A recent study from our laboratory demonstrated that the gaseous carbon dioxide atmosphere used for growth of Neisseria gonorrhoeae could be replaced by the addition of sodium bicarbonate directly to the growth medium. A comparative growth study was initiated using the Transgrow system and the bicarbonate system, Nei-Carb. The Nei-Carb system displayed several obvsiou advantages over the Transgrow system. It required less incubation space, the bicarbonate concentrations can be regulated more readily than concentration of gaseous CO2, and individual plates can be examined without disturbing the atmosphere of other incubating plates. The preliminary results indicate that the Nei-Carb system can be utilized as a medium for primary isolation of gonococci. For every positive culture detected by the Transgrow system a corresponding positive culture was detected by the Nei-Carb system. Moreover, four strains of N gonorrhoeae grew in the Nei-Carb system that would not grow in the Transgrow system using gaseous CO2. On further examination of these strains it was found that they required a much higher concentration of bicarbonate for growth than did those which grew readily in a gaseous CO2 atmosphere.

In a prospective controlled study of 290 men and women with uncomplicated gonorrhea, carbenicillin was shown to be less than 90% effective. Positive cultures were the basis for initial diagnosis and therapeutic failure in both sexes. Carbenicillin was evaluated in three different schedules: 5gm p.o., 10 gm p.o, and 2gm IM Plus 5GM p.o. The three schedules were equally effective. Eleven of 20 failures in women occurred in infection of the rectum. MICs of carbenicillin ranged from 0.025% to 1.0 mug/ml with a mean of 0.29 mug/ml.

Effective control of a parasitic infestation is aided by a thorough understanding of the parasite and it interaction with the host. The external anatomy of Phthirus pubis and its egg were studied by scanning electron microscopy and the structures visualized were reviewed to determine their function. The pathophysiology of the insect-host interaction and current treatment recommendations were also reviewed.