Risk factors for genital lichen sclerosus in men.

BACKGROUND: Lichen sclerosus (LS) is an inflammatory disease of the skin and mucous membranes. Its aetiology is still unknown. OBJECTIVES: To determine risk factors for genital LS in men. METHODS: In a case-control study, 73 patients with LS, consecutively diagnosed at the City Dispensary for Skin and Venereal Diseases in Belgrade, were compared with 219 male patients visiting the same institution because of tinea cruris. Univariate and multivariate logistic regression analyses were used for analysis of data collected. RESULTS: According to multivariate logistic regression analysis, risk factors for male LS were as follows: a personal history of genital injury [odds ratio (OR) 28·1, 95% confidence interval (CI) 5·2-150·8], vitiligo (OR 23·1, 95% CI 2·2-240·2), alopecia areata (OR 8·8, 95% CI 1·1-68·5) and hypercholesterolaemia (OR 3·1, 95% CI 1·1-8·2), and a family history of alopecia areata (OR 24·3, 95% CI 2·1-280·7), diseases of the thyroid gland (OR 9·1, 95% CI 2·3-36·2) and other autoimmune diseases (OR 8·6, 95% CI 1·3-58·6). CONCLUSIONS: The results of the present study are in line with the hypothesis that trauma of the penis is a possible trigger of symptoms in genetically predisposed individuals and that personal and family histories of autoimmune disorders are risk factors for male LS.

Outbreak of early syphilis in an institution for the care of adults with mental disorders.

This paper describes the features of an outbreak of early syphilis in an institution for the care of adults with mental disorders. A case-note review was performed. In the period June to November 2001, 87 cases of syphilis were diagnosed [25 primary, 21 secondary and 41 early latent syphilis in 983 inmates (crude attack rate 8.9%)]. Among them 82 were heterosexual, four were homosexual or bisexual, and for one case sexual preference was not established. About half the cases were known to be promiscuous. The initial case was not identified. Penicillin therapy was administered to all cases and all known or suspected sexual contacts. Sporadic cases of syphilis have, however, continued to emerge from time to time. Institutions for patients with mental disorders are vulnerable to sexually transmitted diseases, and special strategies should be devised for their control.

Personality dimensions of sexually transmitted disease repeaters assessed with the Millon Clinical Multiaxial Inventory.

OBJECTIVE: To assess the personality characteristics of patients with repeated sexually transmitted diseases (STD). METHOD: A case-control study comparing 101 STD repeaters (subjects with a lifetime history of three or more STDs) with 182 controls who had no history of STD. All subjects attended the City Department for Skin and Venereal Diseases in Belgrade (Yugoslavia) from June 1997 to April 1998. Personality characteristics was assessed by the Millon Clinical Multiaxial Inventory (MCMI). RESULTS: The analysis of MCMI test showed that STD repeaters had higher scores on narcissistic, antisocial and paranoid scales. The difference between STD repeaters and the controls was significant on antisocial, psychotic thinking and psychotic delusion scales, although scores on clinical syndromes were low for both cases and controls. Discriminant analysis showed that antisocial personality was predictive for STD repeaters. CONCLUSIONS: This study support the hypothesis that STD repeaters are different from controls in terms of their psychological characteristics. The behaviour of STD repeaters is ego-syntonic, which makes the treatment of their personality difficult and emphasizes the importance of work on primary and secondary prevention of STD.

Risk factors for basal cell carcinoma.

The aim of this study was to assess the risk factors for basal cell carcinoma (BCC). A case-control study, carried out in two towns in Yugoslavia, comprised 200 BCC cases and 399 controls. For statistical analysis, univariate and multivariate logistic regressions were used. The risk factors found for BCC were: freckling before the age 15, seven or more weeks per year spent at the seaside during holidays (lifetime average), outdoor work during summer-time, occupational exposure to organic and non-organic dissolvents and organophosphatic compounds, use of tar for cosmetic purposes, and previous BCC in personal history. Subjects who tended to burn and not to tan after sun exposure also showed a significantly higher risk for BCC. Brown eyes and history of acne had a protective effect. This study confirmed the role of both constitutional and environmental factors in the development of BCC.

Behavioural and social characteristics of subjects with repeated sexually transmitted diseases.

A case-control study was performed in order to assess risk factors for repeated sexually transmitted diseases. The study comprised 101 patients who had had sexually transmitted diseases 3 or more times during their lives and 182 controls who had no history of sexually transmitted disease. The subjects all attended the City Department for Skin and Venereal Diseases in Belgrade, Yugoslavia, from June 1997 to April 1998. According to multivariate logistic regression analysis, sexually transmitted diseases repeaters, in comparison with the controls, were older, more frequently divorced and widowed and without a regular partner, had more sexual partners and more sexual intercourse, and had more frequent sexual contact with people on the same day as meeting them. They also consumed alcohol, used sedatives and were prosecuted for criminal offences more frequently than the controls. The results of this study support the hypothesis that sexually transmitted diseases repeaters are different from their controls in terms of their behavioural and social characteristics.

[Effect of alcohol consumption on recurrence of venereal diseases]. / Uticaj konzumiranja alkohola na ponovno obolevanje od venericnih bolesti.

INTRODUCTION: Sexually transmitted diseases (STDs) comprise a large group of infections caused by different microorganisms including spirochetes, bacteria, chlamydia, mycoplasma, protozoa, fungi, parasites, and viruses. A considerable number of patients with sexually transmitted diseases are STD recurrences. As reported by Marijanovic and Lalosevic, in Belgrade, among patients who visited the City Department of Skin and Venereal Diseases, during 1985 and 1986 because of syphilis or gonorrhea, 22.8% had these diseases two or more times during their lives (male/female ratio 10:1). The aim of this study was to test the hypothesis that there is a relationship between alcohol use and recurrence of STD. MATERIAL AND METHODS: A case-control study was performed in Belgrade population, from June, 1997 to April, 1998. Participants were recruited among patients attending the City Department of Skin and venereal Diseases of Belgrade because of sexually transmitted diseases (syphilis, gonorrhea, nongonoccocal urethritis and genital warts). The case group comprised 101 patients who already had STD two or more times in their personal histories. The control group consisted of 210 patients treated at the same institution for micotic diseases, patients who either never had STD or had it only once (13% of controls) in their personal histories. All participants were men aged 20 to 50 years and all were from Belgrade. Data on demographic characteristics, sexual history and sexual behavior, and data on antisocial behavior were collected from all participants using an anonymous questionnaire. In the present paper only data on alcohol use are presented. In the analysis of data chi 2-test was used. RESULTS: STD recurrence patients in comparison to their controls used alcohol more frequently (56.3%:16.1%), especially hard liquors, and 55.5% of them used alcohol at the time of STD infection. DISCUSSION: In the present study STD recurrence patients consumed alcohol more frequently than their controls, especially hard liquors. In the study of Myliueva et al, 50% of venereal disease patients consumed alcohol now and then and 10% consumed alcohol frequently. Scheidt and Windle found that 60% of alcoholics had at least one sexually transmitted disease as the result of a high number of sexual partners, low use of condoms and practicing sex for drugs or money. Alcohol has a depressive effect on central nervous system, reduces anxiety and increases libido. CONCLUSION: The obtained results support the hypothesis that alcohol use is related to recurrence of STDs.

[Sociopathologic behavior and repeated infection with venereal disease]. / Sociopatoloske pojave i ponovno obolevanje od venericnih bolesti.

INTRODUCTION: The sexually transmitted diseases (STDs) comprise a large group of infections produced by different microorganisms including spirochetes, bacteria, chlamydia, mycoplasme, protozoa, fungi, parasites, and viruses. A considerable number of sexually transmitted diseases patients are STD repeaters. As reported by Marjanovitsh and Laloshevitsh [2], in Belgrade, among patients who during the years 1985 and 1986 visited the City Department for Skin and Veneral Diseases, because of syphilis or gonorrhea, 22.8% had these diseases two or more times during their lives (male/female ratio 10:1). In Richert et al. [6] study over 30% of all patients who in one year visited sexually transmitted diseases clinic in Dade County, Florida, returned with a new infection within 3 years of their index visit. The aim of this study was to test the hypothesis that there is a relationship between antisocial behaviour and repeated STD. MATERIAL AND METHODS: Case-control study was performed in the population of Belgrade, from June 1997 to April 1998. Participants were recruited among patients attending the City Department for Skin and Venereal Diseases of Belgrade because of sexually transmitted diseases (syphilis, gonorrhea, nongonoccocal urethritis and genital warts). The group comprised 101 patients who in their personal histories already had STD two or more times. The control group consisted of 210 patients treated at the same institution for micotic diseases, patients who in their personal histories have never had STD or had it only once (13% of controls). All participants were men aged 20 to 50 years and all were from Belgrade. Data on demographic characteristics, sexual history and sexual behaviour, as well as data on use of sedatives, smoking habit and sport activity, and data on antisocial behaviour (alcohol abuse, prostitution, drug abuse, prosecution for minor and criminal offences) were collected from all participants by an anonymous questionnaire. In the present paper only data on antisocial behaviour are presented. In the analysis of data chi 2 was used. RESULTS: According to the results obtained, STD repeaters in comparison to their controls used more frequently alcohol (17.8%:0.9%) and drug 18.8%:3.8%), had more frequently sex for money (17.8%:2.8%), and were more frequently prosecuted for minor offences (58.4%:24.8%) and criminal offences (24.8%:4.3%). All these differences were statistically significant (p < 0.01). DISCUSSION: In the present study STD repeaters consumed alcohol more frequently than their controls, especially hard liquors, and 55.5% of them had used alcohol at the time of STD infection. In the study of Myliueva et al. [4], 50% of venereal disease patients consumed alcohol now and then and 10% consumed alcohol frequently. Scheidt and Windle [5] found that 60% of alcoholics had at least one sexually transmitted disease as the result of a high number of sexual partners, low use of condoms and practicing sex for drugs or money. Alcohol has depressive effect on the central nervous system, reduces anxiety and increases libido. In this study STD repeaters in comparison with their controls were significantly more frequently drug users (the majority of them inhaled drugs). In several studies conducted in the USA [7, 8] the increase of gonorrhea and syphilis was related to drug use. Upchurch et al. [9] reported that individuals with repeated episodes of gonorrhea were frequently intravenous drug abusers. Drugs are most frequently used by young people, at ages of the highest sexual activity. While most of the subjects developed sexual disinterest and dysfunction with prolonged crack cocaine use, some of them become more sexually promiscuous and consequently contracted sexually transmitted diseases more often. Inciardi /10/ found that 1/3 of men who had exchanged sex for crack (or for money needed to by crack) had 100 or more sex partners during a 30-day period prior to study recruitment. Cleghorn et al. (ABSTRACT TRUNCAT

Incidence of gonorrhea in Belgrade, 1988-1994.

The incidence of gonorrhea in Belgrade decreased 55.5% from 1988 to 1994, but a decreasing trend of gonorrhea incidence actually started many years before. In all age groups gonorrhea incidence was higher in men than women, and the male/female ratio increased with age. The incidence was highest in men and women 20-29 years old. In both sexes the lowest incidence was below 15 years of age and in persons 50 or more years of age. In men, service and industrial workers were the most frequently affected by gonorrhea. In women the disease was commonest among unemployed persons and among workers of the service and industrial sectors. In both sexes gonorrhea infection was commonest in populations who had never married, and in the divorced population.

[Demographic characteristics of patients with gonorrhea in the Belgrade population 1988-1994]. / Demografske karakteristike obolelih od gonoreje u Beogradskoj populaciji za period 1988-1994. godine.

The basic demographic characteristics of the patients with gonorrhea in Belgrade population in the period 1988-1994 were analysed on the basis of the reports of gonorrhea newly diseased to the City Institute for Skin and Venereal Diseases. The decrease of gonorrhea incidence was observed in the period 1988-1992, and the lowest value of 21.2 cases per 100,000 inhabitants was noted in 1992. Gonorrhea incidence increased for 23.8% compared to 1992. The disease is more frequently found in males, aged 20-29, industrial and service workers and unemployed. Unmarried persons had the highest incidence rate of gonorrhea.

Risk factors for gonorrhoea: case-control study.

OBJECTIVE: To define risk factors for gonococcal infection. METHODS: A case-control study comparing 200 gonorrhoea cases with 400 patients with non-gonococcal genitourinary infections and 400 patients with various skin diseases, all of them attending City Department for Skin and Venereal Diseases In Belgrade (Yugoslavia) from October 1993 to December 1994. RESULTS: According to multivariate logistic regression analysis the following factors were significantly related to gonorrhoea in men: education level, sexual contact same day as meeting, condom use, history of prior gonorrhoea, and casual and/or new sex partner in the past month. Age, sexual contact same day as meeting, number of partners in the past year, and frequency of sexual intercourse in the past month were independently, significantly related to gonorrhoea in women. Also, in females, gonorrhoea was significantly more frequent in industrial workers and supported people. CONCLUSION: Since sexual behaviour, low education level, younger ages, and low socioeconomic status were found to be related to gonococcal infection, health education at early age seems to be the most appropriate means of altering high risk behaviour.