Sexually transmitted diseases
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Comparative Study
A comparative study of topical analgesia with a lidocaine/prilocaine cream (EMLA) and infiltration anesthesia for laser surgery of genital warts in men.
Treatment of genital warts by laser surgery was performed in 100 male patients under local infiltration (2-6 ml 1% Xylocaine) or topical anesthesia with 2.5-7.5 ml EMLA cream. EMLA cream was applied to the warts ten minutes before the operation. ⋯ The combined pain scores of application and surgery were significantly smaller in the EMLA group. The result suggests that EMLA applied for ten minutes constitutes a less painful treatment and is thus the anesthetic of choice for the laser surgery of genital warts.
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Of 37 female adolescent prostitutes and 63 other females held in the King County, Washington, juvenile detention facility, 81 (81%) complained of vaginal discharge, and only eight (8%) had no genitourinary symptoms. The prevalence of genital infections among prostitutes and nonprostitutes was similar. Neisseria gonorrhoeae was found in 18 (18%) of 98 detainees tested, and Chlamydia trachomatis was found in 17 (20%) of 86 detainees tested; either organism was found in 27 (32%) of 85 tested for both organisms. ⋯ No detainees had syphilis. Sixty-seven (68%) of 98 responding detainees used no contraception. Such populations deserve the attention of public programs for control of sexually transmitted diseases and for family planning.
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The resistance of microbial pathogens to antimicrobial agents is a crucial health-related problem. The inappropriate use of antibiotics in human and veterinary medicine, along with the widespread use of these agents in animal breeding and in agriculture, has favored the selection of multiply resistant microbial strains. The policies employed for the monitoring of such microbial resistance must be reviewed, and new policies designed to retard and combat the emergence of resistance must be implemented.
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Thirty-nine homosexual men seeking treatment for symptomatic proctitis were examined for anorectal gonorrhea by study of gram-stained smears obtained via an anoscope and by a blindly obtained anorectal swab specimen. Anorectal specimens for culture were obtained from all men. ⋯ It was concluded that gram-stained smears obtained through an anoscope can provide rapid diagnosis of most cases of symptomatic anorectal gonorrhea. All patients with symptomatic proctitis should have routine anoscopy and examination of gram-stained smears obtained via anoscopy as part of their diagnostic evaluation.
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One hundred consecutive female patients attending an inner-city clinic for treatment of sexually transmitted diseases were evaluated for the presence of Trichomonas vaginalis by history, physical examination, 0.85% NaCl wet mount, Papanicolaou smear, and culture. Of the 100 women, 54 were found to be harboring the parasite, as determined by one or more positive diagnostic tests. This prevalence corresponds with that reported previously. ⋯ Culture was the most sensitive of diagnostic techniques; 48 (89%) of the 54 patients were identified by this method. The Papanicolaou smear detected 35 infections (65%), and the 0.85% NaCl wet mount, 28 (59%). The simplest and most efficient technique for screening women for infection with T. vaginalis may be the Papanicolaou smear, since it is part of the annual physical examination.