Diagnosis of some genital-tract infections: part 1. An historical perspective.

Making a prompt and accurate diagnosis of genital tract infections is the key to instituting appropriate treatment and the linchpin of sexually transmitted infection control. We present a brief history, not covering syphilis, of diagnostic events for each of six bacteria and one protozoan from the time of discovery up to the molecular revolution. The latter is touched upon but its impact will form the substance of a further presentation. Here, hindsight is helpful in understanding the way in which progress was made over 135 years, often when microbiology, not even seen as a distinct discipline, had a difficult time in providing what was required in terms of dependable diagnostic techniques. Gram-staining, growth on artificial media, growth in cultured cells, enzyme immunoassays, metabolic and immunofluorescence tests have all had their place and some still do despite the avalanche of the molecular era. Serology to determine the existence of organism-specific antibodies has been important in managing syphilis, but has only sometimes been helpful in supporting a diagnosis for other infections and has rarely been the primary deciding factor.

Human papilloma virus vaccine--more than a vaccine.

PURPOSE OF REVIEW: In February 2006, this journal summarized the scientific and psychosocial data generated about the first generation of prophylactic human papilloma virus vaccines. Since then, the world has held its breath, as the first vaccine to be aimed at the prevention of cancer has made its global debut. We look at this debut in the context of recent findings. RECENT FINDINGS: Many countries have embarked on vaccination programmes to target prevention and media attention has continued unabated. Studies show promising results regarding vaccine acceptance and cost-effectiveness. Who we vaccinate and the quality of campaign materials used now have the potential to alter the very effectiveness of these vaccines as primary preventive tools. With the licensing of Gardasil a new era has started for patients and health professionals alike. Far from a passive new development foisted upon us, it promises to play a pivotal role: to optimize patient information and to advocate strategies we wish health policy makers to achieve. SUMMARY: We aim to summarize how updated information, since this debut, can add to our consultations and help give us a collective voice to address the rising healthcare disparities involved.