ABSTRACT
During 1999 and 2000, an outbreak of syphilis occurred in Norway: 93 cases were reported to the National Institute of Public Health. This report summarizes a retrospective investigation of the medical records of 60 patients with primary, secondary and early latent syphilis treated during 1999-2000 at the Department of STD at the Ullevål University Hospital in Oslo. Five women and 55 men were treated, mean age 38.6 and 44.9 years, respectively. Of the 60 cases, 14 (23.3%) had primary, 39 (65.0) secondary and seven (11.7%) early latent syphilis. Men who have sex with men (MSM) constituted 78.2% (43/55) of the male patients. Transmission among MSM was related to casual sexual contacts in bathhouses in Oslo. Two cases occurred among men with previously diagnosed HIV infection. Two new cases of HIV were reported. Condom use was inconsistent, and seldom used for oral sex.
Subject(s)
Disease Outbreaks , Syphilis/epidemiology , Adolescent , Adult , Female , Homosexuality, Male , Humans , Male , Middle Aged , Norway/epidemiology , Penicillin G/therapeutic use , Penicillins/therapeutic use , Retrospective Studies , Risk-Taking , Sexual Behavior , Syphilis/drug therapyABSTRACT
OBJECTIVE: To compare the efficacy and safety of azithromycin and doxycycline in the treatment of males with uncomplicated urethritis caused by chlamydia trachomatis. DESIGN: A multicentre, double-blind, randomised treatment study. SUBJECTS: 130 male outpatients with clinical signs and symptoms of urethritis. SETTING: STD clinics at four Norwegian University Hospitals. METHODS: Patients were randomly allocated to 1000 mg azithromycin as single dose or doxycycline 100 mg twice daily for 7 days. Clinical, bacteriological and safety assessments were made at entry and after 1 and 2 weeks. Safety data were also repeated after 4 weeks. RESULTS: Demographic data were similar in both groups. At the week 1 assessment bacteriological eradication was achieved in 44 of 44 evaluable azithromycintreated patients and in 42 of 42 in the doxycycline group. At the week 2 assessment the corresponding figures were 35 of 35 and 34 of 34 respectively. CONCLUSION: Azithromycin 1000 mg single dose was as effective as doxycycline 100 mg twice daily for 7 days in male patients with chlamydial urethritis.
Subject(s)
Chlamydia Infections/drug therapy , Doxycycline/therapeutic use , Erythromycin/analogs & derivatives , Urethritis/drug therapy , Adolescent , Adult , Azithromycin , Drug Administration Schedule , Drug Therapy, Combination/therapeutic use , Erythromycin/therapeutic use , Humans , Male , Treatment OutcomeABSTRACT
Samples from patients with genital condyloma acuminata or with cervical condylomas and/or dysplasia and from women without cytological/clinical evidence of cervical affection were examined by dot blot DNA hybridization or the polymerase chain reaction (PCR). The PCR was much more sensitive than dot blot, more than doubling the human papilloma virus (HPV) findings. HPV DNA, mainly HPV 6/11, was detected in 18 of 19 biopsies of condyloma acuminata, whereas HPV 16 was most frequently detected in the 21 cervices (76%) with condyloma and/or dysplasia. HPV 16 was detected in eight of 103 cervical smears with no signs of infection. The prevalence of HPV 16 in cervical samples was somewhat higher than expected. This suggests that, in Oslo, HPV 16 is a common HPV type in women with cytologically normal cervices. HPV 18 was relatively rare and was detected only in combination with other HPVs.
Subject(s)
Condylomata Acuminata/diagnosis , DNA, Viral/chemistry , Immunoblotting , Papillomaviridae/genetics , Polymerase Chain Reaction , Uterine Cervical Neoplasms/diagnosis , Adult , Base Sequence , Female , Genital Neoplasms, Male/diagnosis , Humans , Male , Molecular Sequence Data , Norway , Prevalence , Vaginal SmearsABSTRACT
A multicenter clinical, double-blind crossover trial was conducted in 65 men and 31 women experiencing recurrent episodes of genital herpes in order to compare the effect of acyclovir in propylenglycol (40% cream) with that of cream alone (placebo). 59.4 of the patients on acyclovir experienced a beneficial effect in relation to the usual clinical course of their herpetic eruptions. The corresponding figure for placebo was 34.4%. These percentages were 76.6 and 33.3 respectively if the treatment started within four hours after appearance of symptoms or skin lesions. Pain and burning lasted less than four days in 70.8% of the patients on acyclovir and in 36.4% of those on placebo cream (p less than 0.001). The average duration until complete healing of all skin lesions was 32 hours shorter for patients on acyclovir. In 42 patients on acyclovir and 31 patients on placebo (p less than 0.001) it was less than four days. As regards duration of symptoms and skin lesions, the effect was significantly better if treatment was started early (e.g. less than 4 h). Slight to moderate side-effects were reported in 13.5% of the patients on both treatment regimens.
Subject(s)
Acyclovir/administration & dosage , Herpes Genitalis/drug therapy , Adult , Clinical Trials as Topic , Double-Blind Method , Female , Humans , Male , Ointments , RecurrenceABSTRACT
A randomised, double-blind, placebo-controlled, crossover study was conducted in 31 male patients with a history of frequently recurrent genital herpes who received consecutively 200 mg acyclovir and matching placebo by mouth four times a day for 12 weeks each. During acyclovir therapy recurrences were completely prevented in 24 (77%) and were reduced in both frequency and duration in the remainder compared with those occurring during treatment with placebo. The incidence and nature of adverse events reported during each treatment period was virtually identical. No long-term effects on recurrence rates were discernible but chronic suppressive therapy can be considered to offer the means of controlling the severe forms of disease experienced by some patients.
Subject(s)
Acyclovir/therapeutic use , Herpes Genitalis/drug therapy , Adult , Clinical Trials as Topic , Double-Blind Method , Drug Administration Schedule , Female , Humans , Male , RecurrenceABSTRACT
747 consecutive patients, 531 men and 216 women, attending the Division of Dermatovenerology, City Health Dept., Oslo, were screened for N. gonorrhoeae (14.5% and 18.5%), C. trachomatis (19.6% and 20.8%), G. vaginalis (0.2% and 6.5%), and C. albicans (1.1% and 21.3%). The prevalence is given in brackets for men and women, respectively. This study was undertaken in order to determine the relative prevalence of these microorganisms with particular reference to G. vaginalis, to determine the importance of concomitant infections, and the possible effect of contraceptive methods (oral contraceptives and IUD) on the prevalence of these microorganisms.
Subject(s)
Sexually Transmitted Diseases/epidemiology , Urethritis/epidemiology , Vaginitis/epidemiology , Adolescent , Adult , Candidiasis, Vulvovaginal/epidemiology , Chlamydia trachomatis , Contraceptives, Oral/administration & dosage , Female , Gardnerella vaginalis , Gonorrhea/epidemiology , Haemophilus Infections/epidemiology , Humans , Intrauterine Devices , Lymphogranuloma Venereum/epidemiology , Male , Norway , Sex Factors , Trichomonas Vaginitis/epidemiologyABSTRACT
A double-blind, randomised trial of acyclovir versus placebo was conducted in 31 patients with initial and 85 patients with recurrent genital herpes. 17 patients with initial and 42 with recurrent disease were treated with 200 mg acyclovir by mouth five times a day for 5 days, and the remaining patients received matching placebo. In patients with initial genital herpes shedding virus acyclovir significantly reduced the duration of viral shedding, itching, and pain, the time to crusting and complete healing, and new lesion formation compared with controls. In patients with recurrence disease acyclovir significantly reduced the duration of viral shedding, time to complete healing, and new lesion formation. The reported incidence of adverse events was similar in both acyclovir and placebo groups. Oral acyclovir is effective and well tolerated in patients with initial and recurrent genital herpes and can be used in outpatient therapy.
Subject(s)
Guanine/analogs & derivatives , Herpes Genitalis/drug therapy , Acyclovir , Administration, Oral , Ambulatory Care , Clinical Trials as Topic , Double-Blind Method , Female , Guanine/administration & dosage , Guanine/therapeutic use , Humans , Male , Random Allocation , RecurrenceABSTRACT
Ninety patients with genital herpes (29 initial and 61 recurrent episodes) were entered into a double-blind randomized trial of oral acyclovir and placebo. Treatment consisted of 200 mg acyclovir five times a day for five days or matching placebo. Therapy was initiated a mean of 2.8 days and 1.0 days after onset of lesions in initial and recurrent infections respectively. The 13 culture-positive patients with initial disease who received acyclovir had a shorter median duration in days of viral shedding (1.0), pain (3.5), combined symptoms (3.5), time to crusting (3.5), and time to complete healing (5.5) than the 11 culture-positive placebo recipients whose scores were 8.0, 4.5, 4.5, 9.0, and 11.0 respectively (p less than 0.05 for all comparisons). Patients with recurrent disease receiving acyclovir also experienced a reduction in the median duration in days of viral shedding (0.5), time to crusting (men only) (3.0), and time to complete healing (5.0), compared with 2.5, 4.0, and 7.0 days, respectively, for control patients (p less than 0.01 for each variable). New lesion formation was effectively prevented by acyclovir in patients with both initial and recurrent infections (p less than 0.05). Oral acyclovir therapy was well-tolerated and shortened the course of both initial and recurrent genital herpes.
