Dermatomycoses ; drug therapy ; Drug Therapy, Combination ; Humans ; Medicine, Chinese Traditional ; Phytotherapy ; Sexually Transmitted Diseases ; drug therapy ; Skin Diseases ; drug therapy ; Skin Diseases, Viral ; drug therapy

OBJECTIVETo study the therapeutic effect of Linbiqing decoction on chronic prostatitis following sexually transmitted disease (CPFSTD).

METHODSLinbiqing decotion was given orally to 36 patients with CPFSTD, and the therapeutic effet was assessed by observing the clinical symptoms and measuring the objective indexes before and after the treatment.

RESULTSFour to eight weeks after the drug administration, the overall effectivity rate was 72.22%, and the scores of NIH-CPSI were decreased significantly.

CONCLUSIONLinbiqing decoction has definite therapeutic effect on CPFSTD, and can be considered as an effective means for the treatment of the disease.

Adult ; Chronic Disease ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Middle Aged ; Phytotherapy ; Prostatitis ; drug therapy ; Sexually Transmitted Diseases ; complications

OBJECTIVESTo validate our revised syndromic algorithms of the management of sexually transmitted diseases and determine their sensitivity, specificity, positive predictive value and cost-effectiveness.

METHODSPatients with either urethral discharge, vaginal discharge or genital ulcer, were selected during their first visits to three urban sexually transmitted disease clinics in Fujian Province, China. They were managed syndromically according to our revised flowcharts. The etiology of the syndromes was detected by laboratory testing. The data were analyzed using EPI INFO V6.0 software.

RESULTSA total of 736 patients were enrolled into the study. In male patients with urethral discharge, the sensitivities for gonococcal and chlamydial infections were 96.7% and 100%, respectively, using the syndromic approach. The total positive predictive value was 73%. In female patients with vaginal discharge, the sensitivity was 90.8%, specificity 46.9%, positive predictive value 50.9%, and negative predictive value 89.3% for the diagnosis of gonorrhea and/or chlamydial infection by syndromic approach. In patients with genital ulcer, the sensitivities were 78.3% and 75.8%, specificities of 83.6% and 42.9%, and positive predictive values of 60.0% and 41.0% for the diagnosis of syphilis and genital herpes, respectively, using the syndromic approach. Cost-effectiveness analysis indicated that the average cost of treatment for a patient with urethral discharge was RMB 46.03 yuan using syndromic management, in comparison with RMB 149.19 yuan by etiological management.

CONCLUSIONSThe syndromic management of urethral discharge was relatively effective and suited clinical application. The specificity and positive predictive value for syndromic management of vaginal discharge are not satisfactory. The revised flowchart of genital ulcer syndrome could be suitable for use in clinical settings. Further validation and revision are needed for syndromic approaches of vaginal discharge and genital ulcer.

Adolescent ; Adult ; Algorithms ; Cost-Benefit Analysis ; Female ; Health Care Costs ; Humans ; Male ; Middle Aged ; Sensitivity and Specificity ; Sexually Transmitted Diseases ; diagnosis ; therapy ; Urethral Diseases ; therapy ; Vaginal Discharge ; therapy

OBJECTIVETo explore the etiologic relationship between sexually transmitted diseases(STDs) and chronic prostatitis (CP), and to evaluate the effect of multiple treatment on CP following STDs.

METHODSSeventy-two cases of CP after STDs were randomly divided into three groups: Group A (treated with levefloxatin), Group B (treated with Levofloxacin, terazosin and microwave), and Group C (treated with levofloxacin, Chinese traditional medicine and microwave), all treated for thirty days. The pathogens related to STDs in the prostatic fluid of all the patients had been examined before treatment. The efficacy was evaluated among the three groups by comparing the count of leukocytes and the scores of NIH-CPSI before and after treatment.

RESULTSThe pathogens related to STDs were found in the prostatic fluid of 7 patients. The count of leukocytes and the scores of NIH-CPSI decreased after treatment in the three groups, more markedly in Groups B and C than in Group A.

CONCLUSIONThere is no strict etiological causality between STDs and CP. Multiple treatments are superior to single antibiotic treatment.

Adult ; Chronic Disease ; Drug Therapy, Combination ; Humans ; Leukocyte Count ; Male ; Microwaves ; therapeutic use ; Middle Aged ; Prostatitis ; blood ; etiology ; therapy ; Sexually Transmitted Diseases ; complications

Department of Medical History, College of Medicine, Yonsei University, Korea.
China ; Communicable Disease Control/*history ; Female ; History, 20th Century ; Humans ; Male ; Pregnancy ; Sexually Transmitted Diseases/*history/prevention & control/therapy ; Social Control, Formal

PURPOSE: Condyloma acuminatum is a common sexually transmitted disease of the external genitalia and anus. Approximately 5% of patients demonstrate urethral involvement. Electrical fulguration or excision using a pediatric resectoscope has been used in the management of such lesions. Holmium(Ho):YAG laser, 5-FU(fluorouracil), or interferon may be helpful in eradicating them. We reviewed the results of intraurethral condyloma acuminatum treatment with Ho:YAG laser and 5-FU solution. MATERIALS AND METHODS: From January 2001 to July 2002, seven patients with intraurethral condylomata acuminata were enrolled in the study. The mean age of the subjects was 19.5(range 25~43) years. Under local anesthesia with 10% lidocaine spray and jelly, all of the intraurethral lesions were removed with the Ho:YAG laser followed by coverage with 10mL of 5% 5-FU solution. Intraurethral injection of 5-FU was performed weekly up to six times. Urethroscopy for detection of recurrence was done 3 months after initial laser therapy. RESULTS: Most patients had multiple intraurethral lesions. Six patients (86%) responded to initial therapy without local recurrence with a mean follow-up of 15.8 (range 9.1-23.2) months. One patient had a recurrence at 2 months. CONCLUSIONS: We believe that the Ho:YAG laser plus 5% 5-FU solution is a useful option for the treatment of intraurethral condyloma acuminatum.
Anal Canal ; Anesthesia, Local ; Condylomata Acuminata ; Fluorouracil* ; Follow-Up Studies ; Genitalia ; Holmium* ; Humans ; Interferons ; Laser Therapy ; Lasers, Solid-State* ; Lidocaine ; Recurrence ; Sexually Transmitted Diseases

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Genital Diseases, Female ; drug therapy ; microbiology ; Humans ; Phytotherapy ; Pregnancy ; Pregnancy Complications, Infectious ; drug therapy ; Sexually Transmitted Diseases, Bacterial ; drug therapy ; Ureaplasma Infections ; drug therapy ; Ureaplasma urealyticum

Administration, Intravaginal ; Administration, Rectal ; Anti-Infective Agents ; administration & dosage ; Female ; HIV Infections ; drug therapy ; prevention & control ; psychology ; Humans ; Male ; Patient Acceptance of Health Care ; Sexually Transmitted Diseases ; drug therapy ; prevention & control ; psychology

It has been increasingly clear that the defence against Mycobacterium leprae(M. leprae) appears mainly to depend on cell-mediated rather than humoral immune mechanism. Nevertheless, the M. leprae is not only capable of producing specific humoral antibody, but also stimulating the formation of a variety of autoantibodies, since mycobacteria are known to exert adjuvant effect. Although the exact role of the autoantibodies in the pathogenesis of leprosy is not known, it is remarkable that the prevalence of autoantibodies has been reported different by several investigators, suggesting the possibility of geographical or racial difference. This study was undertaken to investigate the prevalence of some autoantibodies in Korean patients with leprosy. Eighty patients with leprosy registered at the Department of Dermatology, Seoul National University Hospital entered this study from February, 1977 through October, 1978, The diagnosis was made by clinical, histological, bacteriological and immunological assessments and the patients were classified according to the Ridley-Jopling scale. All patients were under anti leprosy chemotherapy with DDS (Diaminodiphenylsulfone) for various periods at the time of study. Venereal Disease Research Laboratory (VDRL) test was performed in 80 patients and the sera displaying reactive VDRL were subjected to re-examination by Treponema Pallidum Hemagglutinin Assay (TPHA). Rbeumatoid factor was sought by means of latex fixation test in 66 patients. Antinuclear antibody (ANA) was detected by means of latex agglutination reaction in 61 patients using polysterene latex complexed with calf thymus deoxyribonucleoprotein. Cryoprotein was detected as described elsewhere. Four of the 80 patients(5%) showed reactive VDRL, while rheumatoid factor and antinuclear antibody were not detectable in all cases. Cryoprotein was detected in 15 patients (27. 3 %). Compared with other reports on the prevalence of autoantibodies in Caucacian and African patients, we found a much lower frequency. This result may be expained partly by the racial or geographic difference in the pattern of leprosy as suggeste4 by Turk.
Agglutination ; Antibodies, Antinuclear ; Autoantibodies* ; Dermatology ; Diagnosis ; Drug Therapy ; Hemagglutinins ; Humans ; Latex ; Latex Fixation Tests ; Leprosy* ; Mycobacterium ; Prevalence* ; Research Personnel ; Rheumatoid Factor ; Seoul ; Sexually Transmitted Diseases ; Thymus Gland ; Treponema pallidum

Clinical practice guidelines (CPG) are one of the most effective ways to translate evidence of medical improvement into everyday practice. This study evaluated the dissemination and implementation of the Sexually Transmitted Infections-Korean Guidelines (STIKG) by applying the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework. A survey questionnaire was administered to clinicians via the internet. Among the 332 respondents, 190 (57.2%) stated that they were aware of STIKG and 107 (33.2%) implemented STIKG in their practice. The odds that a physician was exposed to STIKG (dissemination) were 2.61 times greater among physicians with previous training or education for any CPG than those who did not. Clinicians who indicated that STIKG were easy to understand were 4.88 times more likely to implement STIKG in their practice than those who found them not so easy. When a clinician's workplace had a supporting system for CPG use, the odds of implementation was 3.76 times higher. Perceived level of effectiveness of STIKG did not significantly influence their implementation. The findings of this study suggest that, ultimately, knowing how to engage clinicians in CPG implementation is as important as how to disseminate such guidelines; moreover, easy-to-use guidelines and institutional support are key factors.
Adult ; Female ; Guideline Adherence/*statistics & numerical data ; *Health Knowledge, Attitudes, Practice ; *Health Plan Implementation ; Humans ; *Information Dissemination ; Male ; Middle Aged ; Physicians ; Practice Patterns, Physicians' ; Public Health Surveillance ; Quality of Health Care ; Sexually Transmitted Diseases/*therapy ; Surveys and Questionnaires