eLetters

52 e-Letters

published between 2003 and 2006

  • Syphilis and pregnancy in Italy, our experience.
    Roberta Bilenchi

    Dear Editor,

    Syphilis has long been an important risk factor for adverse pregnancy outcome. According to Mullick et al.[1] maternal syphilis is still a major cause of morbidity and mortality in developing countries. Since there has been a resurgence of syphilis in many developed countries[2], women requiring treatment for syphilis during pregnancy are expected to increase in the United States and Western Europe. In...

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  • Optimizing syphilis treatment in patients with HIV
    Charlotte Bell

    Dear Editor,

    We read with interest the paper by Sadiq et al. on CD4 counts and viral loads in patients with early syphilis and HIV.[1] We note that they treated their patients with a single 2.4 MU injection or two weeks of oral doxycycline. In this regard they are in good company.[2]

    Whereas most patients with HIV and early syphilis make a full recovery on this regimen, there are numerous case reports of...

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  • Response to Piyadigamage and Wilson
    Meena Gupta

    Dear Editor,

    We read with interest the article “Improvement in the clinical cure rate of outpatient management of pelvic inflammatory disease following a change in the therapy”.[1]

    In most GUM clinics gonorrhoea is identified by microscopy (x 1000) of Gram stained genital specimens (sensitivity 20%- 51%)[2] and culture (sensitivity 75%-95%).[3] In the above study gonorrhoea was identified in 12% of c...

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  • Chlamydia screening can work if...
    D. Scott LaMontagne

    Dear Editor,

    The engaging editorial by Cassell and Low (STI 2005 Aug; 81(4):285-6) is timely and highlights a critical issue in the debate about the effectiveness of screening as an intervention for genital chlamydial infection. The authors correctly note that ecologic studies are limited in their inference but have a role to play in suggesting areas for further research. The authors hypothesize that targeting only...

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  • Re “Condom effectiveness for prevention of Chlamydia trachomatis infection"
    Lee Warner

    Dear Editor

    Replicating methods and comparing results across studies are critical for the resolution of scientific controversies. In a recent report, Niccolai et al. demonstrated that condoms were effective in preventing chlamydia among STD clinic patients with known exposure to C. trachomatis.(1) We were pleased to see the authors apply the methodology that we first presented for estimating condom effectiveness...

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  • Apocrine glands in inner prepuce doubtful
    Jake H Waskett

    Dear Editor,

    Fleiss et al. make several dubious claims in their article [1], but one is of particular interest. Some authors have now begun to rely upon the assertion that the subpreputial wetness contains lysozyme, and suggest that this may help to protect against HIV.[2,3] Although the epidemiological evidence suggests otherwise,2 our understanding of the mechanisms involved is important, and this claim is wo...

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  • Anal Intraepithelial Neoplasia: the role of high risk HPV
    Atef R Markos

    Dear Editor,

    We read with interest the Fox PA et al. paper (2005, 81;142-6) and welcome the clinical attention to genital pre-cancerous conditions; including Anal Intraepithelial Neoplasia (AIN).

    Their finding of no correlation between high-risk (hr) HPV genotypes and histological or cytological grades of abnormalities, conflicts strongly with general consensus and other studies. Kreuter A et al. identified hr H...

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  • Self-sampling for HPV-detection: factors affecting sensitivity need to be considered
    Veronique Verhoeven

    Dear Editor,

    Ogilvie et al. have published a well-designed meta-analysis of the diagnostic accuracy of self collected vaginal specimens for human papillomavirus (HPV) detection, in which they conclude that self-sampling may be an appropriate alternative for low resource settings or in patients reluctant to undergo pelvic examinations.[1] However, we have a number of remarks on the pooled sensitivities and specificit...

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  • Young, male and infected –victims of chlamydia infection and weak evidence
    Richard Ma

    Dear Editor,

    I was interested to read a survey of Welsh practice nurses on chlamydia testing [1]. The authors must be congratulated for demonstrating a mixed methodology of questionnaires and semi-structured interviews in their study. The response rate to the questionnaire exceeded 70% and together, the methods appeared to have elicited issues which should be considered if chlamydia testing were encouraged in pri...

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  • We need randomised trials to make progress in chlamydia screening in England
    Nicola Low

    Dear Editor,

    In their editorial (Sexually Transmitted Infections 2004;80:331-33) Kevin Fenton and Helen Ward give a positive and detailed overview of the Government's policy on chlamydia screening in England. This could have been balanced by a more critical assessment of the challenges.

    The alarming rise in chlamydia rates in Sweden, where opportunistic screening has been in place nationally since 1988...

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