ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

More cases of primary and secondary syphilis were reported in 1989 than in any year since 1949. Incidence is rising despite four decades of penicillin therapy. The spread of syphilis has been linked to the rising incidence of drug use, especially of crack cocaine. Observations in patients coinfected with human immunodeficiency virus have raised questions about the adequacy of penicillin and prompted a reevaluation of syphilis therapy. Efforts to control the epidemic have brought needed attention to improving health care delivery to persons at risk for syphitis.

ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Subspeciation of gonococci by lectin agglutination and DNA probes has been accomplished. Vaccine candidates include protein I and synthetic peptides made from it. Epidemiologic aspects of gonorrhea are largely unchanged, and the role of gonorrhea in tubal infertility and neonatal eye disease is confirmed. The clinical diagnosis of gonorrhea in women remains difficult, and vancomycin-sensitive gonococci confound culture techniques. Culture-independent diagnostic techniques have been developed with varying degrees of success, and some of these same techniques can be used to identify gonococci from culture.Neisseria gonorrhoeaecontinues to become more resistant to antimicrobial agents via chromosomal mutations and plasmid acquisition. Plasmid-mediated resistance to penicillin and tetracycline is an increasing problem. The third-generation cephalosporins and the quinolones remain effective therapy for uncomplicated infection.

ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Sixty-six types of human papillomaviruses have been identified to date. These viruses are of increasing interest to the scientific and medical communities. There are 14 types that are site specific for the human genitalia. Of highest importance is the epidemiologic and biologic association of certain human papillomavirus types to the development of lower genital tract cancers in women and men. Human papillomaviruses have also been implicated as the sexually transmitted agent responsible for genital condylomas, abnormal Papanicolaou smears, precancerous changes, and invasive squamous and adenocarcinomas of the lower genital tract. Cytologic screening and detection of human papillomavirus-related diseases and their treatment are major concerns of both clinicians and their patients.

ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Clinical features of urinary tract infections in the elderly are well defined but primarily based on data obtained from female subjects. The pathophysiology of urinary tract infections in men is less well characterized. Recent epidemiologic investigations highlight the nearly identical prevalence of bacteriuria in elderly men and women, but women are more frequently persistently bacteriuric with high urinary titers ofEscherichia coli. Sex and age define clinically and bacteriologically distinct populations with serious urinary tract infections. Risk factors for infection may include age-related increases in prevalence of incontinence, onset of nosocomial diarrhea in patients with urinary catheters, and groin skin carriage of Proteeae species. Quinolone antibiotics are useful in the elderly but might interact adversely with concurrently used medications.

ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Urinary tract infections constitute a major cause of morbidity in women of childbearing age and represent the primary cause of nosocomial infections. The most common etiologic organism for urinary tract infections of all types isEscherichia coli. There has been a significant research effort over the last decade to understand whichE. colivirulence factors contribute to disease. The pathogenesis of urinary tract infections involves a complex interaction between the human host and bacteria. The sequence of events includes bacterial adherence and colonization of the uromucosal surface, proliferation, and induction of tissue injury or inflammation. Recent efforts to understand the uropathogenic process have included the following studies: epidemiology of adhesins, the role of adhesins, iron acquisition, urease production, host receptor status, and factors associated with inflammation. These topics are the subject of this review.

ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

There is a growing appreciation for the importance of vaginal flora in the pathogenesis and prevention of urinary tract infections. The survival of uropathogens in the vagina among the wide range of competing flora, and the emergence of these organisms to infect the bladder is not well understood. However, the ability of antimicrobial agents and spermicide to disrupt the flora and make a patient more susceptible to bladder and vaginal infection has been recently recognized. Attempts to restore a protective flora through instillation with carefully selectedLactobacillusstrains does appear to have clinical potential. Alternative methods that utilize immunization have also shown some promisein vivo, but their mechanisms of action, safety, and effectiveness will require more documentation.

ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The onset of urinary tract infections requires careful collection of a urine specimen and use of selective screening and culture techniques. Account must be taken of the patient's status and history. Enterobacteriaceae and gram-positive cocci remain the most commonly isolated uropathogens. The knowledge that bacteria adhere to the uroepithelium has improved our understanding of the pathogenesis but has done little to alter diagnosis and therapy. An examination of host cell responses (leukocyturia, hematuria) and bacteria attached to bladder cells should assist the physician with diagnosis. Treatment of urinary tract infections should depend on culture sensitivity results for the uropathogens. Most urinary tract infections can be treated effectively with antimicrobial agents, and the introduction of broad-spectrum fluoroquinolones has proved useful in eradicating organisms from the urinary tract and prostate. The management of recurrent urinary tract infections involves active eradication of organisms with antibiotics, often given prophylactically. The use of lactobacilli therapy to prevent infection appears to have potential, based on preliminaryin vivoresults, but further studies are required. For catheter-related infections, antimicrobial penetration of bacterial biofilms remains a major problem, as does provision by the laboratory of accurate minimum inhibitory concentrations of antimicrobials required to penetrate the biofilms.

ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The cloning and part-sequencing of the hepatitis C virus has allowed the rapid development of an assay for detecting a serologic marker, anti-C100–3 antibody (anti-hepatitis C virus antibody), to nonstructural regions of the virus. The significance of the finding of a high prevalence of this antibody in a variety of liver diseases remains unclear. The antibody is nonneutralizing; there is no independent confirmatory test, and several steps in the current C100–3 assays lend themselves to false positivity. Evidence continues to accumulate in favor of there being more than one agent to explain parenteral, sporadic, and even enteral forms of non-A, non-B hepatitis, but their interrelations remain unclear. Point mutations in the genomic sequences of certain viruses, including hepatitis B virus, can influence immunogenicity, virulence, and, hence, pathogenicity.

ISSN:0951-7375    

出版商:OVID    

年代:1991

数据来源: OVID