Non-gonococcal urethritis (NGU), or inflammation of the urethra, is the most common treatable sex... more Non-gonococcal urethritis (NGU), or inflammation of the urethra, is the most common treatable sexually transmitted syndrome in men, with approximately 20-50 % of cases being due to infection with Chlamydia trachomatis and 10-30 % Mycoplasma genitalium. Other causes are Ureaplasma urealyticum, Trichomonas vaginalis, anaerobes, Herpes simplex virus (HSV) and adenovirus. Up to half of the cases are non-specific. Urethritis is characterized by discharge, dysuria and/or urethral discomfort but may be asymptomatic. The diagnosis of urethritis is confirmed by demonstrating an excess of polymorpho-nuclear leucocytes (PMNLs) in a stained smear. An excess of mononuclear leucocytes in the smear indicates a viral etiology. In patients presenting with symptoms of urethritis, the diagnosis should be confirmed by microscopy of a stained smear, ruling out gonorrhea. Nucleid acid amplifications tests (NAAT) for Neisseria gonorrhoeae, C. trachomatis and for M. genitalium. If viral or protozoan aetiol...
epidemiology, diagnosis, clinical features, treatment and prevention of hepatitis B and C with pa... more epidemiology, diagnosis, clinical features, treatment and prevention of hepatitis B and C with particular reference to sexual health clinical practice.
Norway has 5 departments of dermato-venereology. Walk-in examination for venereal diseases is off... more Norway has 5 departments of dermato-venereology. Walk-in examination for venereal diseases is offered at 4 of the departments, situated in Oslo, Bergen, Stavanger and Trondheim. The department in Tromso only accepts patients by appointment. Opening hours vary considerably among the different clinics. The biggest venereal clinic, the Olafia Clinic, in the centre of Oslo, is administrated by Oslo University Hospital, and is a section of a large department including dermatology, infectious diseases and rheumatology. The Olafia Clinic has approximately 25,000 patient consultations per year, roughly the same as the venereology clinic at Bispebjerg Hospital, Copenhagen.
Bakteriell vaginose er den vanligste vaginalinfeksjon i fertil alder. Diagnosen kan baseres på Am... more Bakteriell vaginose er den vanligste vaginalinfeksjon i fertil alder. Diagnosen kan baseres på Amsels kliniske kriterier eller mikroskopi av gramfarget utstryk av vaginalfluor. Amsels kliniske kriterier krever tre av fire følgende: tynnflytende, gråhvit fluor, pH i vaginalutflod > 4,5, fiskelukt ved tilsetting av 10% kaliumhydroksid og clueceller i våtutstryk. Gramfarget utstryk viser at den normale laktobasilldominerte vaginalflora er forandret til laktobasillmanglende flora. Mye tyder på at tilstanden medfører økt risiko for svangerskapskomplikasjoner og postoperative infeksjoner ved obstetriske og gynekologiske inngrep. I vår prospektive undersøkelse av 168 abortsøkere ved Kvinneklinikken, Regionsykehuset i Tromsø, ble det ved undersøkelse av gramfarget preparat påvist bakteriell vaginose hos 24%. Som bifunn ble Chlamydia trachomatis påvist hos 8,4%. På grunn av klinisk sikker eller mistenkt postabortendometritt ble fire pasienter (10,3%) i vaginosegruppen behandlet med antibiotika, mens antibiotikabehandling ble gitt til seks pasienter (5,4%) i gruppen uten bakteriell vaginose.
Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke, 2021
Usha Hartgill er spesialist i hud-og veneriske sykdommer, seksjonsleder og overlege ved Olafiakli... more Usha Hartgill er spesialist i hud-og veneriske sykdommer, seksjonsleder og overlege ved Olafiaklinikken, Seksjon for venerologi, Oslo universitetssykehus. Forfatteren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. KARIANNE NODENES Karianne Nodenes er spesialist i hud-og veneriske sykdommer og overlege ved Olafiaklinikken, Seksjon for venerologi, Oslo universitetssykehus. Forfatteren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. HARALD MOI Harald Moi er spesialist i hud-og veneriske sykdommer med spesialkompetanse i venerologi, pensjonert overlege og professor emeritus ved Universitetet i Oslo. Han er ansvarlig utgiver og medforfatter av flere europeiske retningslinjer for diagnostikk og behandling av seksuelt overførbare infeksjoner. Forfatteren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. Antibiotikaresistent Mycoplasma genitalium har blitt en trussel. Testing og behandling for denne bakterien anbefales nå kun for pasienter med symptomer.
In an epidemiological survey of 2128 women attending a sexually transmitted diseases clinic for t... more In an epidemiological survey of 2128 women attending a sexually transmitted diseases clinic for the first time and 200 attending two primary health clinics, 26% and 27% respectively were found to have bacterial vaginosis. The prevalence increased significantly with age, being diagnosed in 22.8% (326/1431) of women aged 14–24 years, and in 33.3% (232/697) of those aged >25 years. Bacterial vaginosis was associated with gonorrhoea and with chlamydial infection, but was negatively associated with genital papillomavirus infection and yeast infection. Women using barrier contraceptives had a significantly lower prevalence of bacterial vaginosis than those using an intrauterine device or no contraceptive. Women <24 years old using oral contraceptives had a significantly lower prevalence of bacterial vaginosis than those not using contraceptives. Patients without gonorrhoea or chlamydial infection but with vaginal or urethral inflammatory signs had a significantly higher prevalence o...
The incidence and prevalence of dermatitis herpetiformis has never been formally evaluated in any... more The incidence and prevalence of dermatitis herpetiformis has never been formally evaluated in any area of the United States. Several northern European studies have shown prevalence rates ranging from 1.2 per 100,000 to 39.2 per 100,000. The present study was performed to evaluate the incidence and prevalence of dermatitis herpetiformis in Utah. Information from 240 patients diagnosed with dermatitis herpetiformis was compiled from hospital records throughout Utah, as well as the sole private dermatopathologist in the state, and from the university referral center of the state. Criteria for inclusion in the study were a clinical diagnosis of dermatitis herpetiformis plus granular deposition of IgA in dermal papillae by direct immunofluorescence of uninvolved skin, or histopathologic findings consistent with the disease. Clinical diagnosis and response to dapsone alone was considered insufficient for inclusion in the study. On the basis of these criteria, as well as exclusion of non-Utah residents, 188 of the original 240 patients qualified for the study. The prevalence of dermatitis herpetiformis in Utah in 1987 was 11.2 per 100,000. The mean incidence for the years 1978 through 1987 was 0.98 per 100,000 per year. The mean age at onset of symptoms for male patients was 40.1 years, and that for female patients was 36.2 years. The male-female ratio was 1.44:1. This represents the first evaluation of the incidence and prevalence of dermatitis herpetiformis in the United States. These results are similar to those of the previous studies, probably because of Utah&#39;s largely northern European ancestry. This population base, plus a much smaller than average black and Oriental population, is likely to have produced a higher incidence and prevalence in Utah than would be seen in other areas of the United States.
Bacterial vaginosis is the most common vaginal infection during the fertile period. The clinical ... more Bacterial vaginosis is the most common vaginal infection during the fertile period. The clinical diagnosis is based on three of Amsel's four criteria: thin, grey-white discharge, vaginal fluid pH above 4.5, a fishy odour on addition of 10 % potassium hydroxide solution to the vaginal fluid, and the presence of clue cells on a saline wet mount. A probably more sensitive indicator of the diagnosis is based on Gram-stain, where the normal lactobacillus-dominated vaginal flora is changed to the lactobacillus deficient flora of bacterial vaginosis. The condition is probably associated with higher risk of complications in connection with pregnancy and gynaecological surgery. A prospective study of bacterial vaginosis based on microscopy of Gram-stained smears was conducted among 168 women applying for first trimester abortion. The prevalence of bacterial vaginosis was 24 % and of Chlamydia trachomatis 8.4%. Four patients (10.3 %) in the vaginosis group were treated with antibiotics fo...
Author and centre Dr Mohsen Shahmanesh, MD, FRCP, Department of Genitourinary Medicine, Whittall ... more Author and centre Dr Mohsen Shahmanesh, MD, FRCP, Department of Genitourinary Medicine, Whittall Street Clinic, Birmingham, [email protected] Prof Harald Moi, Olafiaklinikken Oslo, Norway, [email protected] Dr Francois Lassau MD, STD Clinic, Hôpital Saint-Louis , Paris, France, [email protected] Assoc. Prof Michel Janier MD PhD, STD Clinic, Hôpital Saint-Louis, Paris, France, [email protected]
Tidsskrift for Den norske legeforening, Sep 6, 2007
Non-gonococcal urethritis/cervicitis (NGU) is now the most common sexually transmitted infection ... more Non-gonococcal urethritis/cervicitis (NGU) is now the most common sexually transmitted infection that is possible to treat. Mycoplasma genitalium is a microorganism about to be established as an aetiological agent of NGU and upper genital infection. The article is based on literature identified through a Pubmed search. There seems to be sufficient evidence to conclude that Mycoplasma genitalium causes sexually transmitted infection. The microbe is associated with non-gonococcal urethritis in both men and women and cervicitis in women. It may also be the cause of upper genital infection in women. M. genitalium seems to cause more severe urethritis and more often lead to symptomatic urethritis/cervicitis than non-chlamydia-non-gonococcal urethritis/cervicitis that is not associated with M. genitalium. For testing, a cervical/vaginal swab should be used for women and first void urine should be collected for both sexes. Nucleic acid amplification tests are used. Azithromycin is more eff...
Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke, 2008
BACKGROUND C. trachomatis is the underlying cause of 20?-?50 % of sexually transmitted urethritis... more BACKGROUND C. trachomatis is the underlying cause of 20?-?50 % of sexually transmitted urethritis cases. Data from the last 10?-?15 years indicate that M. genitalium may be a cause, but the prevalence of M. genitalium in Norwegian patients has not previously been assessed or published. MATERIAL AND METHODS Male patients at the Olafia Clinic in Oslo were examined for non-gonococcal urethritis. First void urine was collected and tested for presence of C. trachomatis and M. genitalium DNA by polymerase chain reaction (PCR). Presence of C. trachomatis or M. genitalium was correlated with microscopic signs of urethritis, quantified by counting polymorphonuclear leucocytes in urethral smears. RESULTS Both C. trachomatis and M.gentialium were found more frequently in patients with microscopic signs of urethritis than in patients without (21.9 % vs 0.7 %, OR = 40, CI = 6?-?295; 8.7 % vs 0.7 %, OR = 14, CI = 1.8?-?102; respectively). The increase in prevalence correlated with the severity of...
Background Mycoplasma genitalium (MG) is an emerging important STI. Failure rates with azithromyc... more Background Mycoplasma genitalium (MG) is an emerging important STI. Failure rates with azithromycin 1 g appear to be increasing. This may be due to the emergence of macrolide antimicrobial resistance as a consequence of extensive use of azithromycin 1 g. An extended regimen of azithromycin 500 mgs on day one then 250 mgs daily for 4 days (5 day regimen) was introduced in the 1990s for treatment of MG and has high efficacy rates (if no pre-existing macrolide resistance) and is less associated with induction of macrolide resistance. There are no comparative trials of the two regimens. View this table: In this window In a new window
Summary: Gonorrhoea is a major public health concern globally. Of particularly grave concern is t... more Summary: Gonorrhoea is a major public health concern globally. Of particularly grave concern is that resistance to the extended-spectrum cephalosporins has emerged during the most recent years. This guideline provides recommendations regarding the diagnosis and treatment of gonorrhoea in Europe. Compared to the outdated 2009 European gonorrhoea guideline, this 2012 European gonorrhoea guideline provides up-to-date guidance on, broader indications for testing and treatment of gonorrhoea; the introduction of dual antimicrobial therapy (ceftriaxone 500 mg and azithromycin 2 g) for uncomplicated gonorrhoea when the antimicrobial sensitivity is unknown; recommendation of test of cure in all gonorrhoea cases to ensure eradication of infection and identify emerging resistance; and recommendations to identify, verify and report failures with recommended treatment regimens. Optimisations of the testing, diagnostics, antimicrobial treatment and follow-up of gonorrhoea patients are crucial in ...
Non-gonococcal urethritis (NGU), or inflammation of the urethra, is the most common treatable sex... more Non-gonococcal urethritis (NGU), or inflammation of the urethra, is the most common treatable sexually transmitted syndrome in men, with approximately 20-50 % of cases being due to infection with Chlamydia trachomatis and 10-30 % Mycoplasma genitalium. Other causes are Ureaplasma urealyticum, Trichomonas vaginalis, anaerobes, Herpes simplex virus (HSV) and adenovirus. Up to half of the cases are non-specific. Urethritis is characterized by discharge, dysuria and/or urethral discomfort but may be asymptomatic. The diagnosis of urethritis is confirmed by demonstrating an excess of polymorpho-nuclear leucocytes (PMNLs) in a stained smear. An excess of mononuclear leucocytes in the smear indicates a viral etiology. In patients presenting with symptoms of urethritis, the diagnosis should be confirmed by microscopy of a stained smear, ruling out gonorrhea. Nucleid acid amplifications tests (NAAT) for Neisseria gonorrhoeae, C. trachomatis and for M. genitalium. If viral or protozoan aetiol...
epidemiology, diagnosis, clinical features, treatment and prevention of hepatitis B and C with pa... more epidemiology, diagnosis, clinical features, treatment and prevention of hepatitis B and C with particular reference to sexual health clinical practice.
Norway has 5 departments of dermato-venereology. Walk-in examination for venereal diseases is off... more Norway has 5 departments of dermato-venereology. Walk-in examination for venereal diseases is offered at 4 of the departments, situated in Oslo, Bergen, Stavanger and Trondheim. The department in Tromso only accepts patients by appointment. Opening hours vary considerably among the different clinics. The biggest venereal clinic, the Olafia Clinic, in the centre of Oslo, is administrated by Oslo University Hospital, and is a section of a large department including dermatology, infectious diseases and rheumatology. The Olafia Clinic has approximately 25,000 patient consultations per year, roughly the same as the venereology clinic at Bispebjerg Hospital, Copenhagen.
Bakteriell vaginose er den vanligste vaginalinfeksjon i fertil alder. Diagnosen kan baseres på Am... more Bakteriell vaginose er den vanligste vaginalinfeksjon i fertil alder. Diagnosen kan baseres på Amsels kliniske kriterier eller mikroskopi av gramfarget utstryk av vaginalfluor. Amsels kliniske kriterier krever tre av fire følgende: tynnflytende, gråhvit fluor, pH i vaginalutflod > 4,5, fiskelukt ved tilsetting av 10% kaliumhydroksid og clueceller i våtutstryk. Gramfarget utstryk viser at den normale laktobasilldominerte vaginalflora er forandret til laktobasillmanglende flora. Mye tyder på at tilstanden medfører økt risiko for svangerskapskomplikasjoner og postoperative infeksjoner ved obstetriske og gynekologiske inngrep. I vår prospektive undersøkelse av 168 abortsøkere ved Kvinneklinikken, Regionsykehuset i Tromsø, ble det ved undersøkelse av gramfarget preparat påvist bakteriell vaginose hos 24%. Som bifunn ble Chlamydia trachomatis påvist hos 8,4%. På grunn av klinisk sikker eller mistenkt postabortendometritt ble fire pasienter (10,3%) i vaginosegruppen behandlet med antibiotika, mens antibiotikabehandling ble gitt til seks pasienter (5,4%) i gruppen uten bakteriell vaginose.
Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke, 2021
Usha Hartgill er spesialist i hud-og veneriske sykdommer, seksjonsleder og overlege ved Olafiakli... more Usha Hartgill er spesialist i hud-og veneriske sykdommer, seksjonsleder og overlege ved Olafiaklinikken, Seksjon for venerologi, Oslo universitetssykehus. Forfatteren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. KARIANNE NODENES Karianne Nodenes er spesialist i hud-og veneriske sykdommer og overlege ved Olafiaklinikken, Seksjon for venerologi, Oslo universitetssykehus. Forfatteren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. HARALD MOI Harald Moi er spesialist i hud-og veneriske sykdommer med spesialkompetanse i venerologi, pensjonert overlege og professor emeritus ved Universitetet i Oslo. Han er ansvarlig utgiver og medforfatter av flere europeiske retningslinjer for diagnostikk og behandling av seksuelt overførbare infeksjoner. Forfatteren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. Antibiotikaresistent Mycoplasma genitalium har blitt en trussel. Testing og behandling for denne bakterien anbefales nå kun for pasienter med symptomer.
In an epidemiological survey of 2128 women attending a sexually transmitted diseases clinic for t... more In an epidemiological survey of 2128 women attending a sexually transmitted diseases clinic for the first time and 200 attending two primary health clinics, 26% and 27% respectively were found to have bacterial vaginosis. The prevalence increased significantly with age, being diagnosed in 22.8% (326/1431) of women aged 14–24 years, and in 33.3% (232/697) of those aged >25 years. Bacterial vaginosis was associated with gonorrhoea and with chlamydial infection, but was negatively associated with genital papillomavirus infection and yeast infection. Women using barrier contraceptives had a significantly lower prevalence of bacterial vaginosis than those using an intrauterine device or no contraceptive. Women <24 years old using oral contraceptives had a significantly lower prevalence of bacterial vaginosis than those not using contraceptives. Patients without gonorrhoea or chlamydial infection but with vaginal or urethral inflammatory signs had a significantly higher prevalence o...
The incidence and prevalence of dermatitis herpetiformis has never been formally evaluated in any... more The incidence and prevalence of dermatitis herpetiformis has never been formally evaluated in any area of the United States. Several northern European studies have shown prevalence rates ranging from 1.2 per 100,000 to 39.2 per 100,000. The present study was performed to evaluate the incidence and prevalence of dermatitis herpetiformis in Utah. Information from 240 patients diagnosed with dermatitis herpetiformis was compiled from hospital records throughout Utah, as well as the sole private dermatopathologist in the state, and from the university referral center of the state. Criteria for inclusion in the study were a clinical diagnosis of dermatitis herpetiformis plus granular deposition of IgA in dermal papillae by direct immunofluorescence of uninvolved skin, or histopathologic findings consistent with the disease. Clinical diagnosis and response to dapsone alone was considered insufficient for inclusion in the study. On the basis of these criteria, as well as exclusion of non-Utah residents, 188 of the original 240 patients qualified for the study. The prevalence of dermatitis herpetiformis in Utah in 1987 was 11.2 per 100,000. The mean incidence for the years 1978 through 1987 was 0.98 per 100,000 per year. The mean age at onset of symptoms for male patients was 40.1 years, and that for female patients was 36.2 years. The male-female ratio was 1.44:1. This represents the first evaluation of the incidence and prevalence of dermatitis herpetiformis in the United States. These results are similar to those of the previous studies, probably because of Utah&#39;s largely northern European ancestry. This population base, plus a much smaller than average black and Oriental population, is likely to have produced a higher incidence and prevalence in Utah than would be seen in other areas of the United States.
Bacterial vaginosis is the most common vaginal infection during the fertile period. The clinical ... more Bacterial vaginosis is the most common vaginal infection during the fertile period. The clinical diagnosis is based on three of Amsel's four criteria: thin, grey-white discharge, vaginal fluid pH above 4.5, a fishy odour on addition of 10 % potassium hydroxide solution to the vaginal fluid, and the presence of clue cells on a saline wet mount. A probably more sensitive indicator of the diagnosis is based on Gram-stain, where the normal lactobacillus-dominated vaginal flora is changed to the lactobacillus deficient flora of bacterial vaginosis. The condition is probably associated with higher risk of complications in connection with pregnancy and gynaecological surgery. A prospective study of bacterial vaginosis based on microscopy of Gram-stained smears was conducted among 168 women applying for first trimester abortion. The prevalence of bacterial vaginosis was 24 % and of Chlamydia trachomatis 8.4%. Four patients (10.3 %) in the vaginosis group were treated with antibiotics fo...
Author and centre Dr Mohsen Shahmanesh, MD, FRCP, Department of Genitourinary Medicine, Whittall ... more Author and centre Dr Mohsen Shahmanesh, MD, FRCP, Department of Genitourinary Medicine, Whittall Street Clinic, Birmingham, [email protected] Prof Harald Moi, Olafiaklinikken Oslo, Norway, [email protected] Dr Francois Lassau MD, STD Clinic, Hôpital Saint-Louis , Paris, France, [email protected] Assoc. Prof Michel Janier MD PhD, STD Clinic, Hôpital Saint-Louis, Paris, France, [email protected]
Tidsskrift for Den norske legeforening, Sep 6, 2007
Non-gonococcal urethritis/cervicitis (NGU) is now the most common sexually transmitted infection ... more Non-gonococcal urethritis/cervicitis (NGU) is now the most common sexually transmitted infection that is possible to treat. Mycoplasma genitalium is a microorganism about to be established as an aetiological agent of NGU and upper genital infection. The article is based on literature identified through a Pubmed search. There seems to be sufficient evidence to conclude that Mycoplasma genitalium causes sexually transmitted infection. The microbe is associated with non-gonococcal urethritis in both men and women and cervicitis in women. It may also be the cause of upper genital infection in women. M. genitalium seems to cause more severe urethritis and more often lead to symptomatic urethritis/cervicitis than non-chlamydia-non-gonococcal urethritis/cervicitis that is not associated with M. genitalium. For testing, a cervical/vaginal swab should be used for women and first void urine should be collected for both sexes. Nucleic acid amplification tests are used. Azithromycin is more eff...
Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke, 2008
BACKGROUND C. trachomatis is the underlying cause of 20?-?50 % of sexually transmitted urethritis... more BACKGROUND C. trachomatis is the underlying cause of 20?-?50 % of sexually transmitted urethritis cases. Data from the last 10?-?15 years indicate that M. genitalium may be a cause, but the prevalence of M. genitalium in Norwegian patients has not previously been assessed or published. MATERIAL AND METHODS Male patients at the Olafia Clinic in Oslo were examined for non-gonococcal urethritis. First void urine was collected and tested for presence of C. trachomatis and M. genitalium DNA by polymerase chain reaction (PCR). Presence of C. trachomatis or M. genitalium was correlated with microscopic signs of urethritis, quantified by counting polymorphonuclear leucocytes in urethral smears. RESULTS Both C. trachomatis and M.gentialium were found more frequently in patients with microscopic signs of urethritis than in patients without (21.9 % vs 0.7 %, OR = 40, CI = 6?-?295; 8.7 % vs 0.7 %, OR = 14, CI = 1.8?-?102; respectively). The increase in prevalence correlated with the severity of...
Background Mycoplasma genitalium (MG) is an emerging important STI. Failure rates with azithromyc... more Background Mycoplasma genitalium (MG) is an emerging important STI. Failure rates with azithromycin 1 g appear to be increasing. This may be due to the emergence of macrolide antimicrobial resistance as a consequence of extensive use of azithromycin 1 g. An extended regimen of azithromycin 500 mgs on day one then 250 mgs daily for 4 days (5 day regimen) was introduced in the 1990s for treatment of MG and has high efficacy rates (if no pre-existing macrolide resistance) and is less associated with induction of macrolide resistance. There are no comparative trials of the two regimens. View this table: In this window In a new window
Summary: Gonorrhoea is a major public health concern globally. Of particularly grave concern is t... more Summary: Gonorrhoea is a major public health concern globally. Of particularly grave concern is that resistance to the extended-spectrum cephalosporins has emerged during the most recent years. This guideline provides recommendations regarding the diagnosis and treatment of gonorrhoea in Europe. Compared to the outdated 2009 European gonorrhoea guideline, this 2012 European gonorrhoea guideline provides up-to-date guidance on, broader indications for testing and treatment of gonorrhoea; the introduction of dual antimicrobial therapy (ceftriaxone 500 mg and azithromycin 2 g) for uncomplicated gonorrhoea when the antimicrobial sensitivity is unknown; recommendation of test of cure in all gonorrhoea cases to ensure eradication of infection and identify emerging resistance; and recommendations to identify, verify and report failures with recommended treatment regimens. Optimisations of the testing, diagnostics, antimicrobial treatment and follow-up of gonorrhoea patients are crucial in ...
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