Sexually transmitted diseases in women

Abstract

C trachomatis infection is the most commonly reported STD in the United States, and the majority of women infected are asymptomatic. Screening is recommended for those at high risk, including women who are between 15 and 21 years of age, live in urban areas, are single, or have new or multiple sexual partners. The "gold standard" for diagnosis is chlamydial culture; however, techniques that use DNA and RNA amplification are nearly 100% sensitive and specific and may prove cost-effective. Doxycycline is a recommended first-line therapy, but certain other antibiotics may also be effective. Herpes simplex virus affects more than one third of the world's population. It is diagnosed by observation of shallow, tender ulcerations around the genitalia and by viral isolation using tissue culture. Initial treatment is with antiviral drugs, which may also be necessary episodically or as a suppressive regimen for recurrences. Patient education about prevention of these and other STDs, as well as the impact of such disease on sexual partners, is critical. Physicians should therefore become comfortable questioning and counseling patients about sexual issues and risks for STDs.

Activation of Raf/MEK/ERK/cPLA2 Signaling Pathway Is Essential for Chlamydial Acquisition of Host Glycerophospholipids

“…Infection with chlamydiae has been recognized as a major cause and/or exacerbating factor for various diseases in both humans and animals (1)(2)(3)(4)(5)(6)(7). Despite the wide spectrum of tissue tropisms exhibited by different strains of chlamydiae, a common denominator in chlamydial pathogenesis is the ability of the parasite to invade and then manipulate host cells.…”

“…: 210-567-1169; Fax: 210-567-0293; E-mail: Zhongg@UTHSCSA.EDU. 1 The abbreviations used are: CL, cardiolipin; PE, phosphatidylethanolamine; PG, phosphatidylglycerol; PC, phosphatidylcholine; PI, phosphatidylinositol; PS, phosphatidylserine; MEK, mitogen-activated protein kinase/extracellular signal-regulated kinase kinase; pMEK1/2, phosphorylated MEK1/2; ERK, extracellular signal-regulated kinase; pERK1/2, phosphorylated ERK1/2; ELK-1, a component of the ternary complex that binds the serum response element; pELK-1, phosphorylated ELK-1; MAP, mitogen-activated protein; IFU, inclusion-forming units; cPLA2, Ca 2ϩ -dependent cytosolic phospholipase A2; p-cPLA2, phosphorylated cPLA2; iPLA2, Ca 2ϩ -independent PLA2; AACOCF3, arachidonyltrifluoromethyl ketone; BAPTA, 1,2-bis(2-aminophenoxyl)-ethane-N,N,NЈ,NЈ-tetraacetic acid; BAPTA/AM, BAPTA tetrakis (acetoxymethyl ester). dial uptake of the host glycerophospholipids and chlamydial replication.…”

Audit of outcome following positive chlamydial test results in family planning clinics in Southampton

“…Early detection and treatment prevents upper genital tract infection and its sequelae (pelvic in¯ammatory disease (PID), infertility, ectopic pregnancy and chronic pain problems) 3 . Unfortunately, 70± 90% of chlamydial infection is asymptomatic in women and may persist for months or years; in addition, asymptomatic upper genital tract infection is 3 times more common than symptomatic 4 . Identi® cation of these asymptomatic infections is dependant upon routine or selective screening of at-risk groups of women.…”

“…Identi® cation of these asymptomatic infections is dependant upon routine or selective screening of at-risk groups of women. Sexual intercourse is the common pathway for both reproduction and STIs, therefore women attending family planning clinics (now known as Contraception and Sexual Health Clinics but for the purpose of this paper referred to as FPCs) may exhibit behavioural and demographic characteristics which put them at risk of chlamydia 4 . Hence FPCs provide a good resource for ® rst-line testing for chlamydia 4 .…”

“…Sexual intercourse is the common pathway for both reproduction and STIs, therefore women attending family planning clinics (now known as Contraception and Sexual Health Clinics but for the purpose of this paper referred to as FPCs) may exhibit behavioural and demographic characteristics which put them at risk of chlamydia 4 . Hence FPCs provide a good resource for ® rst-line testing for chlamydia 4 . Unfortunately the management of patients identi® ed with chlamydial infection outside of GUM clinics has caused concern 5 .…”