sodium-ethylxanthate and Vaginitis

Topics: Adult; Contraceptive Devices, Female; Cystitis; Escherichia coli; Female; Humans; Pyelonephritis; Sex; Urinary Tract Infections; Vaginitis

Owing both to the changing behavior of our society and to the growing awareness of the medical community, sexually transmitted diseases have become more common or more complex over the past 10 years. This article discusses the presentation and management of sexually transmitted disease emergencies and other sexually transmitted disease syndromes with which the emergency room physician is frequently confronted.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Candidiasis; Emergencies; Female; Genital Diseases, Female; Humans; Pelvic Inflammatory Disease; Sex; Sexually Transmitted Diseases; Uterine Cervicitis; Vaginitis

Urinary infections in adult women are extremely common. Yet, dysuria, often a symptom of these infections, can be caused by a number of genitourinary pathogens. Symptomatic urinary infections caused primarily by Escherichia coli or Staphylococcus saprophyticus are best confirmed by demonstrating the presence of 10(2) or more organisms per ml of midstream urine in quantitative cultures. Other causes of dysuria such as vaginitis and urethritis due to venereal disease should be suspected in patients with additional signs and symptoms characteristic of these infections and in young, sexually active females. Effective treatment of urinary infections is achieved with a number of antibiotics; the length of therapy is determined by the location of infection in the urinary tract. Although equal in efficacy to conventional therapy for uncomplicated lower tract infections, single-dose therapy of dysuric women should be limited to patients for whom adequate follow-up can be insured.

Topics: Adult; Anti-Bacterial Agents; Diagnosis, Differential; Emergencies; Female; Humans; Sex; Urinary Tract Infections; Vaginitis

To study incidence and risk factors of heterosexually transmitted HIV infection, we followed a cohort of 343 seronegative women, stable, monogamous partners of infected men whose only risk of acquiring HIV was sexual exposure to the infected partner. Nineteen seroconversions occurred in 529.6 person years (py) of observation, yielding an incidence rate of 3.6 per 100 py. The incidence rate was 7.2 per 100 py among women who did not always use or never used condoms and 1.1 among those who always used them [relative risk (RR) 6.6, 95% confidence interval (CI) 1.9-21.9]. Anal sex was associated with a risk increase in only those women not always using condoms (RR 1.4, 95% CI 0.4-4.8). No seroconversions were observed among 22 women using oral contraceptives. One of the women using intrauterine devices seroconverted. In couples who did not always use condoms, seroconversions occurred more frequently in partners of men with symptomatic diseases, with a low CD4+ cell number (< 400 per mm3) or with a detectable p24 antigen. In couples not always using condoms and where the man had a low CD4+ cell count, the joint presence of blood viral antigens and AIDS symptoms conditioned a fivefold increased risk of seroconversion of the woman (RR 5.4, CI 1.4-20.3). At multivariate analysis, women with longer relationships (> or = 1 year) showed a lower risk of seroconversion (RR 0.3, CI 0.1-0.8), and those partners of men positive for p24 antigen in serum had an increased risk of seroconversion (RR = 4.0, CI 0.1-0.8).

Topics: CD4-Positive T-Lymphocytes; Condoms; Female; HIV Infections; HIV Seropositivity; Humans; Intrauterine Devices; Leukocyte Count; Male; Multivariate Analysis; Risk Factors; Sex; Vaginitis