[Diagnosis and therapy of genitoanal ulcers of infectious etiology]. / Diagnostik und Behandlung genitoanaler Ulzera infektiöser Genese.

BACKGROUND/OBJECTIVES: In this review article the diagnostic and therapeutic principles of genital ulcers of infectious etiology are highlighted. Besides frequent causative infections rare but relevant diseases in the differential diagnosis are discussed in detail. MATERIAL AND METHODS: A Pubmed literature search was carried out, guidelines from different task groups and clinical experiences are presented. RESULTS: Infections with herpes simplex virus (first) and syphilis (second) are still the most common causes of infectious genital ulcers. An endemic occurrence, previously rare in Europe, has been observed in recent years. Particular risk groups, such as men who have sex with men (MSM), sex workers or sex tourists are affected. Even less common locations, such as the mouth or the rectum, lymphogranuloma venereum (LGV) and atypical clinical symptoms (e.g. pelvic pain in pelvic lymphadenopathy with LGV) must be considered in the differential diagnosis. CONCLUSION: In recent years sexually transmitted infections (STI) have shown a significant increase in western industrialized nations. In all cases with unclear findings in the genital and anal areas (and also in the oral cavity) STI diseases must be reconsidered in the differential diagnosis.

High prevalence of HIV and sexually transmitted infections among male sex workers in Abidjan, Cote d'Ivoire: need for services tailored to their needs.

OBJECTIVES: To assess condom use and prevalence of sexually transmitted infections (STI) and HIV among male sex workers (MSW) in Abidjan, Côte d'Ivoire. METHODS: A cross-sectional survey was conducted between October 2007 and January 2008 among MSW attending a sex worker clinic in Abidjan. A short questionnaire was administered in a face-to-face interview, and the participants were asked to provide a urine sample for STI testing and to self-collect transudate of the gingival mucosa for anonymous HIV testing, using a rapid test. A rectal swab for STI testing was taken by a physician. Molecular amplification assays were performed for the detection of Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis. RESULTS: 96 MSW participated in the survey, their median age was 27 years and the median duration of sex work was 5 years. Consistent condom use with clients during the last working day was 86.0%, and consistent condom use with the regular partner during the last week was 81.6%. HIV infection was detected in 50.0% of the participants. The prevalence of N gonorrhoeae was 12.8%, chlamydia infection was present in 3.2% and T vaginalis in 2.1% of the study participants. CONCLUSIONS: HIV and STI rates found in this study confirm the high risk and vulnerability status of MSW in Côte d'Ivoire. There is a definite need for studies exploring risk and risk perceptions among MSW in more depth and for services tailored to their needs, including developing and validating simple algorithms for the diagnosis of STI in MSW and men who have sex with men.

Experience of setting up a genitourinary medicine in-reach clinic in a male prison.

A fortnightly in-reach genitourinary (GU) medicine Service to a medium security male prison has been provided since April 2004. Patients are seen either by referrals from the prison general practitioner (GP), or at an individual's request. Problems have arisen due to a lack of space and time - the health adviser and doctor have to share a room. Since the prisoners have to leave Health Care by 1130 hours, if one inmate has complicated issues, it can result in these not being dealt with, or in patients not being seen as there is no flexibility. There has been an unexpectedly high DNA rate, which is multifactorial. Some prisoners have been moved to another prison since the request to be seen was made, some are on court attendances or have legal visits. Additionally some men choose not to come when sent for on the day. A few men who attend do so mistakenly, thinking that GUM is the dentist. This is particularly a problem where English is not the first language. The attendance of prisoners at the GU medicine service is noted in their prison health record, with relevant information, such as referral for management of hepatitis C. Of the 219 men seen in the first year, 55% had a GU medicine screen. The most common infections were chlamydia 10.5%, warts 12.1% and HCV 9%. The clinic has been well supported by patients and prison staff. High rates of infections are being detected and managed. The men have been happy to be screened, and despite initial concerns all are happy to provide urine specimens for chlamydia screening.

[Health status of individuals dependent on opiates before and after a year of treatment in a methadone maintenance program]. / Stan zdrowia osób uzaleznionych od opiatów przed i po roku leczenia w programie metadonowym.

UNLABELLED: The aim of this study was to compare physical status of opiate dependent patients before and after one year of participation in the methadone maintenance program (MMP). There were investigated all 113 patients (82 male, 31 female) participating in MMP no shortly then one year. There was been used an especially constructed list of physical disorders and illnesses, where severity of them was scored from 0 to 3 points. We found a great influence of a participation in MMP on an use of forbidden substances, what caused that nobody of our patients overdosed drugs. Reducing of intravenous use of drugs and a change of lifestyle caused that nobody from our 67 HIV-negative patients infected with HIV. Thanks MMP was able the systematic and successful treatment of the most common physical illnesses: superficial venous system and skin infections, internal organs mycoses, lowered body mass index, lack of menstruation, and relatively rarer ones: hypertonia, sexually transmitted diseases, tuberculosis etc. The serious problem was liver impairments of different origin, in majority cases. IN CONCLUSION: MMPs should develop in Poland more quickly and more commonly.

Training room management of medical conditions: infectious diseases.

Management of infectious diseases in athletes encompasses a wide range of pathogens, clinical presentations, and treatment options. Certain athletic activities and training regimens may predispose athletes to increased risk of contracting infectious diseases, some of which may limit athletic participation and pose the threat of significant morbidity. The sports medicine physician plays an important role as a first line of defense in preventing, recognizing, and appropriately treating infectious diseases in athletes.

Estudio de la prevalencia del secundarismo sifilítico bucal en dos servicios de estomatología de la ciudad de Buenos Aires / Study of prevalence of oral second-stage Syphilis, in two departments of stomatology, in the city of Buenos Aires

Las manifestaciones bucales del secundarismo sifilítico, son una de las formas clínicas que ermiten el diagnóstico presuntivo de la enfermedad. Estas lesiones son patognomónicas, pero no se han encontrado estudios que relacionen estas lesiones con su distribución y localización en la mucosa bucal. El objetivo de este estudio, es el de distinguir las lesiones bucales observadas, relacionándolas con las adenopatías y los niveles serológicos de V.D.R.L.

Manifestações orais das doenças sexualmente transmissíveis / Oral manifestations of sexually transmitted diseases

O objetivo do presente artigo é descrever a importância da prevenção das doenças sexualmente transmissíveis, através de uma revisão de literatura que elucida os principais aspectos clínicos, meios de diagnóstico e tratamento dessas doenças, que freqüentemente têm manifestações, incluindo as primárias, na cavidade oral.