Sexually transmitted diseases treatment guidelines, 2015.

These guidelines for the treatment of persons who have or are at risk for sexually transmitted diseases (STDs) were updated by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on April 30-May 2, 2013. The information in this report updates the Sexually Transmitted Diseases Treatment Guidelines, 2010 (MMWR Recomm Rep 2010;59 [No. RR-12]). These updated guidelines discuss 1) alternative treatment regimens for Neisseria gonorrhoeae; 2) the use of nucleic acid amplification tests for the diagnosis of trichomoniasis; 3) alternative treatment options for genital warts; 4) the role of Mycoplasma genitalium in urethritis/cervicitis and treatment-related implications; 5) updated HPV vaccine recommendations and counseling messages; 6) the management of persons who are transgender; 7) annual testing for hepatitis C in persons with HIV infection; 8) updated recommendations for diagnostic evaluation of urethritis; and 9) retesting to detect repeat infection. Physicians and other health-care providers can use these guidelines to assist in the prevention and treatment of STDs.

Estimating the positive predictive value of opportunistic population testing for gonorrhoea as part of the English Chlamydia Screening Programme.

Advances in technology have raised the possibility of including gonorrhoea testing as part of chlamydia screening. In England this is recommended only where the positive predictive value (PPV) of the test is ≥90%. This study assessed the PPV for gonorrhoea testing using routine testing data. Routine data (including gonorrhoea testing) from the Greater Manchester Chlamydia Screening Programme (GMCSP) in 2009/2010, were used to estimate the PPV for gonorrhoea testing. Of those screened, 0.3% (59/18044) of men and 0.4% (174/41873) of women tested positive for gonorrhoea. The PPV was 82.3% in women and 73.6% in men, in those who also tested positive for chlamydia. For women and men testing negative for chlamydia the PPV for a positive gonorrhoea test was incalculable. The low PPV observed in most groups suggests that where population testing for gonorrhoea occurs there is a need for further confirmatory testing of positive results before treatment decisions are made. Clinicians should be aware of screening test result limitations in this context.

Increasing resistance to ciprofloxacin and other antibiotics in Neisseria gonorrhoeae from East Java and Papua, Indonesia, in 2004 - implications for treatment.

We examined gonococci isolated in 2004, in East Java and Papua, Indonesia, to review the suitability of ciprofloxacin-based and other treatment regimens. Gonococci from the two provinces were tested in Sydney for susceptibility to penicillin, tetracycline, spectinomycin, ceftriaxone, ciprofloxacin, gentamicin, azithromycin and rifampicin. Of 163 gonococcal isolates from East Java (91) and Papua (72), 120 (74%) of gonococci, 62 (68%) and 58 (80%) from East Java and Papua, respectively, were penicillinase-producing gonococci and 162 displayed high-level tetracycline resistance. Eighty-seven isolates (53%) were ciprofloxacin resistant, 44 (48%) from East Java and 43 (60%) from Papua. All isolates were sensitive to cefixime/ceftriaxone, spectinomycin and azithromycin. Minimum inhibitory concentrations of gentamicin were in the range 0.05-8 mg/L. Sixty-nine gonococci (42%) showed combined resistance, to penicillin, tetracycline and quinolones. Quinolone resistance has now reached unacceptable levels, and their use for the treatment of gonorrhoea in Indonesia should be reconsidered.

Herbal medicines in Hawaii from tradition to convention.

The stories of kava and chaulmoogra demonstrate the importance of herbal products in ancient and recent Hawaiian medicine. Kava is a psychoactive beverage that has been used ceremonially for millennia throughout the Pacific. It is a nonfermented depressant that causes tranquil intoxication in which thoughts and memory remain clear. Its broad pharmacologic activity led to use in Hawaii to treat skin disorders and later in Germany to treat gonorrhea. Kava is now available outside the Pacific basin as a relaxant, emerging as a popular, albeit deritualized, natural product. In the late 19th century, the main treatment for leprosy was chaulmoogra, extracted from Hydnocarpus seeds. Chaulmoogra had been a traditional treatment for skin diseases in Ayurvedic and Chinese medicine. Chaulmoogra from Asian markets was expensive and usually adulterated so the USDA decided to plant Hydnocarpus in Hawaii. Joseph Rock, a botanist at University of Hawaii, trekked through southeast Asia collecting fresh seeds to plant on Oahu. Rock's trees provided chaulmoogra for leprosy patients on Molokai and elsewhere until it was replaced by dapsone. Chaulmoogra, once the treatment for leprosy worldwide, is now nearly forgotten; kava, once poorly known outside the Pacific, is now a widely-used alternative medicine. Hawaii will probably continue its role in the transition of plants from traditional use to conventional use.

Caracterizaçäo morfológica de piper aduncum L / Morphologic characterization of piper aduncum L

Piper aduncum L. é uma piperácia de grande utilizaçäo na medicina e ampla distribuiçäo no Brasil. É conhecida pelos nomes: Aperta-Ruäo, Aperta-Joäo, Jaborandi do Mato, Pimenta do fruto ganchoso. Entre suas funçöes terapêuticas, é usada popularmente como estimulante hepático e cicatrizante. A planta tem porte arbustivo, com folhas alternas, lanceoladas simples.

Impact of a gonorrhea control program, including selective mass treatment, in female sex workers.

A gonorrhea control program initiated in 1967 in registered female sex workers (FSWs) in the Philippines involved weekly endocervical cultures for Neisseria gonorrhoeae, with treatment of FSWs found infected or named as contacts by US Navy servicemen. Gonorrhea prevalence in FSWs in Olongapo city fell from 11.9% to 4.0% within 4 months, and gonorrhea incidence in servicemen at nearby Subic Bay fell by half. Selective mass treatment (SMT) with oral ampicillin-probenecid or tetracycline was then given to registered FSWs in an attempt to further reduce gonorrhea rates. N. gonorrhoeae was isolated from 105 (4.0%) of 2640 FSWs before SMT and from 43 (1.6%) 1 week later (P < .001). However, gonorrhea incidence among servicemen fell no lower, and gonorrhea prevalence in FSWs quickly returned to higher levels. Thus, after implementation of weekly screening and treatment of FSWs found infected or named as contacts, SMT of FSWs (without increasing condom use or treating regular partners) contributed nothing further to gonorrhea control.

116 cases of gonococcal arthritis treated with acupuncture.

The present parper deseribes the combined treatment of gonococcal arthritis by acupuncture, garlic moxibustion, pricking blood, cupping and drawing hydrarthrus. Dazhui (Du 14), Quchi (LI 11) and Zusanli (St 36) points were selected, plus points along the meridian which were needled as indicated by the affected joint. Results showed that of the 116 cases, 74 were cured, 13 were markedly helped, 11 improved and 11 failed. The total effective rate was 84.5%.

Consumption by semen loss in India and elsewhere.

Using ethnographical data from a rural site of Oriya culture, the purpose of this article is to show that the Indian obsession regarding the harmful consequences of semen loss does not constitute a specific Indian culture-bound preoccupation, but represents a survival example of a much widespread system of beliefs that can be traced for instance in Western culture to the Hippocratic notion of "back consumption" and the classical concept of gonorrhoea. At the core of this system of beliefs are found ancient conceptions of the nature and functions of semen in human life. These conceptions and their cultural influences incidentally inform us about one of the origins of the reprobation of onanism, as well as one possible way, among many others, for traditional thinking to explain the clinical enigma of depressive syndrome.

[Experience in treating chronic urethritis in men by iontophoresis and inductothermy]. / Opyt lecheniia khronicheskikh uretritov u muzhchin ionoforezom i induktotermiei.

A method for therapy of chronic urethritis by exposure to ionized solutions of drugs has been developed (Authors' Certificate of the USSR No. 876138). Active electrode is placed in the flask with the drug, passive one on the external surface of the body as close to the focus of involvement as possible. Ionized solution of the drug (2.5-3.1) is introduced into the urethra via a double-lumen catheter, washes its walls and saturates the mucosa; the solution is aspirated from the urethra through the other lumen of the catheter, thus removing the inflammation products from the urethra. Current density has made up 0.01-0.03 mA/cm2, length of session 12-15 min, 6-8 sessions per course. A device for local therapy of chronic urethritis by a combination of ionophoresis and inductothermy has been suggested (Authors' Certificate of the USSR No. 1084031). This device permits a simultaneous administration of 2 drugs: one from the tube via urethral mucosa, the other from the cuvette outwardly. Current density has made up 0.01-0.03 mA/cm2, with the current of 200 mA in the inductor. Length of inductometry and ionophoresis session is 10-15 min.

Rwandese herbal remedies used against gonorrhoea.

In the course of systematic studies on biologically active substances from medicinal plants of Rwanda (Central Africa) we have screened the indigenous drugs used against gonorrhoea for their antimicrobial activity. From the 25 plants tested, 16 were found to have an activity against Neisseria gonorrhoea and N. meningitidis, 6 against Streptococcus pyogenes and 5 against Staphylococcus aureus. Thus, out of 23 indigenous drugs, 17 remedies (74%) were found to be associated with one or more plants with an activity against gonorrhoea.

[Extragenital gonococcal infections. A review]. / Extragenitale Gonokokken-Infektionen Eine Ubersicht.

In many cases gonorrhea is overlooked and not treated due to an unusual course of the disease. The longer this infection exists the greater is the danger of dissemination of the gonococci. Gonorrhea, if not diagnosed, may cause a series of local and general clinical manifestations, such as: the dermatitis-arthritis syndrome whose pathogenesis is not yet completely clarified: the Fitz-Hugh-Curtis syndrome which is often seen in females with chronic gonococcal adnexitis;gonococcal pharyngitis which nowadays occurs more often due to less conventional sexual practices of contemporary society; gonococcal conjunctivitis which represents the best known extragenital gonococcosis. This paper deals with the clinical manifestations and their treatment.