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Unknown  |  1992-06-06  |  315.8 KB

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ConfidenceProgramDetectionMatch TypeSupport
66% dexvert OS/2 Installation Package (archive/os2InstallPackage) ext Supported
1% dexvert BeOS Installation Package (archive/beOSInstallPackage) ext Unsupported
1% dexvert Newton Package (archive/newtonPackage) ext Unsupported
1% dexvert Independence War 2 mod Package (other/independenceWar2ModPackage) ext Unsupported
100% file data default



hex view
+--------+-------------------------+-------------------------+--------+--------+
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|00002520| 0a 52 65 63 75 72 72 65 | 6e 74 20 56 61 67 69 6e |.Recurre|nt Vagin|
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|00003920| 0a 6d 65 74 72 6f 6e 69 | 64 61 7a 6f 6c 65 20 6f |.metroni|dazole o|
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|00003940| 20 77 6f 6d 65 6e 20 61 | 6e 64 20 74 68 65 69 72 | women a|nd their|
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|000039a0| 63 6c 69 6e 69 63 61 6c | 20 73 69 67 6e 73 2c 20 |clinical| signs, |
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|00003a00| 74 72 65 61 74 65 64 20 | 77 69 74 68 20 6d 65 74 |treated |with met|
|00003a10| 72 6f 6e 69 64 61 7a 6f | 6c 65 20 61 6e 64 20 74 |ronidazo|le and t|
|00003a20| 68 6f 73 65 20 77 68 6f | 20 72 65 63 65 69 76 65 |hose who| receive|
|00003a30| 64 20 70 6c 61 63 65 62 | 6f 2e 20 20 54 72 65 61 |d placeb|o. Trea|
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|00003aa0| 2e 2d 2d 43 2e 45 2e 20 | 44 72 69 73 63 6f 6c 6c |.--C.E. |Driscoll|
|00003ab0| 2c 20 4d 2e 44 2e 0d 0a | 24 55 6e 69 71 75 65 5f |, M.D...|$Unique_|
|00003ac0| 49 44 7b 59 52 42 31 30 | 38 30 34 7d 0d 0a 24 54 |ID{YRB10|804}..$T|
|00003ad0| 69 74 6c 65 7b 49 6e 74 | 72 61 76 65 6e 6f 75 73 |itle{Int|ravenous|
|00003ae0| 20 41 63 79 63 6c 6f 76 | 69 72 20 54 68 65 72 61 | Acyclov|ir Thera|
|00003af0| 70 79 20 6f 66 20 46 69 | 72 73 74 20 45 70 69 73 |py of Fi|rst Epis|
|00003b00| 6f 64 65 73 20 6f 66 20 | 47 65 6e 69 74 61 6c 20 |odes of |Genital |
|00003b10| 48 65 72 70 65 73 3a 20 | 20 41 20 4d 75 6c 74 69 |Herpes: | A Multi|
|00003b20| 63 65 6e 74 65 72 20 44 | 6f 75 62 6c 65 2d 42 6c |center D|ouble-Bl|
|00003b30| 69 6e 64 2c 20 50 6c 61 | 63 65 62 6f 2d 43 6f 6e |ind, Pla|cebo-Con|
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|00003b50| 24 41 75 74 68 6f 72 7b | 50 65 61 63 6f 63 6b 2c |$Author{|Peacock,|
|00003b60| 20 4a 45 20 4a 72 0d 0a | 4b 61 70 6c 6f 77 69 74 | JE Jr..|Kaplowit|
|00003b70| 7a 2c 20 4c 47 0d 0a 53 | 70 61 72 6c 69 6e 67 2c |z, LG..S|parling,|
|00003b80| 20 50 46 0d 0a 44 75 72 | 61 63 6b 2c 20 44 54 0d | PF..Dur|ack, DT.|
|00003b90| 0a 47 6e 61 6e 6e 2c 20 | 4a 57 20 4a 72 0d 0a 57 |.Gnann, |JW Jr..W|
|00003ba0| 68 69 74 6c 65 79 2c 20 | 52 4a 0d 0a 4c 6f 76 65 |hitley, |RJ..Love|
|00003bb0| 74 74 2c 20 4d 0d 0a 42 | 72 79 73 6f 6e 2c 20 59 |tt, M..B|ryson, Y|
|00003bc0| 4a 0d 0a 4b 6c 65 69 6e | 2c 20 52 4a 0d 0a 46 72 |J..Klein|, RJ..Fr|
|00003bd0| 69 65 64 6d 61 6e 2d 4b | 69 65 6e 2c 20 41 45 0d |iedman-K|ien, AE.|
|00003be0| 0a 4b 6e 6f 77 6c 74 6f | 6e 2c 20 47 4d 0d 0a 44 |.Knowlto|n, GM..D|
|00003bf0| 61 76 69 73 2c 20 4c 47 | 7d 0d 0a 24 41 66 66 69 |avis, LG|}..$Affi|
|00003c00| 6c 69 61 74 69 6f 6e 7b | 7d 0d 0a 24 4a 6f 75 72 |liation{|}..$Jour|
|00003c10| 6e 61 6c 7b 41 6d 20 4a | 20 4d 65 64 7d 0d 0a 24 |nal{Am J| Med}..$|
|00003c20| 56 6f 6c 75 6d 65 7b 38 | 35 7d 0d 0a 24 50 61 67 |Volume{8|5}..$Pag|
|00003c30| 65 7b 33 30 31 2d 33 30 | 36 7d 0d 0a 24 44 61 74 |e{301-30|6}..$Dat|
|00003c40| 65 7b 53 65 70 74 65 6d | 62 65 72 20 31 39 38 38 |e{Septem|ber 1988|
|00003c50| 7d 0d 0a 24 59 42 56 6f | 6c 7b 31 39 39 30 20 59 |}..$YBVo|l{1990 Y|
|00003c60| 65 61 72 20 42 6f 6f 6b | 20 6f 66 20 46 61 6d 69 |ear Book| of Fami|
|00003c70| 6c 79 20 50 72 61 63 74 | 69 63 65 7d 0d 0a 24 43 |ly Pract|ice}..$C|
|00003c80| 68 61 70 74 65 72 7b 31 | 32 2d 36 7d 0d 0a 24 59 |hapter{1|2-6}..$Y|
|00003c90| 42 45 64 69 74 6f 72 7b | 44 72 73 2e 20 52 61 6b |BEditor{|Drs. Rak|
|00003ca0| 65 6c 2c 20 41 76 61 6e | 74 2c 20 44 72 69 73 63 |el, Avan|t, Drisc|
|00003cb0| 6f 6c 6c 2c 20 50 72 69 | 63 68 61 72 64 2c 20 61 |oll, Pri|chard, a|
|00003cc0| 6e 64 20 53 6d 69 74 68 | 7d 0d 0a 24 54 61 62 6c |nd Smith|}..$Tabl|
|00003cd0| 65 7b 7d 0d 0a 24 43 6f | 6d 6d 65 6e 74 61 74 6f |e{}..$Co|mmentato|
|00003ce0| 72 7b 43 2e 45 2e 20 44 | 72 69 73 63 6f 6c 6c 2c |r{C.E. D|riscoll,|
|00003cf0| 20 4d 2e 44 2e 7d 0d 0a | 0d 0a 43 6f 70 79 72 69 | M.D.}..|..Copyri|
|00003d00| 67 68 74 20 28 63 29 20 | 59 65 61 72 62 6f 6f 6b |ght (c) |Yearbook|
|00003d10| 20 4d 65 64 69 63 61 6c | 20 50 75 62 6c 69 73 68 | Medical| Publish|
|00003d20| 65 72 73 2c 20 49 6e 63 | 2e 2c 20 31 39 39 30 0d |ers, Inc|., 1990.|
|00003d30| 0a 0d 0a 31 39 39 30 20 | 59 65 61 72 20 42 6f 6f |...1990 |Year Boo|
|00003d40| 6b 20 6f 66 20 46 61 6d | 69 6c 79 20 50 72 61 63 |k of Fam|ily Prac|
|00003d50| 74 69 63 65 20 28 52 29 | 0d 0a 0d 0a 43 68 61 70 |tice (R)|....Chap|
|00003d60| 74 65 72 20 31 32 2d 2d | 47 79 6e 65 63 6f 6c 6f |ter 12--|Gynecolo|
|00003d70| 67 79 0d 0a 0d 0a 49 6e | 66 65 63 74 69 6f 6e 73 |gy....In|fections|
|00003d80| 0d 0a 0d 0a 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |....----|--------|
|00003d90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003da0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003db0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003dc0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003dd0| 2d 2d 0d 0a 49 6e 74 72 | 61 76 65 6e 6f 75 73 20 |--..Intr|avenous |
|00003de0| 41 63 79 63 6c 6f 76 69 | 72 20 54 68 65 72 61 70 |Acyclovi|r Therap|
|00003df0| 79 20 6f 66 20 46 69 72 | 73 74 20 45 70 69 73 6f |y of Fir|st Episo|
|00003e00| 64 65 73 20 6f 66 20 47 | 65 6e 69 74 61 6c 20 48 |des of G|enital H|
|00003e10| 65 72 70 65 73 3a 20 20 | 41 0d 0a 4d 75 6c 74 69 |erpes: |A..Multi|
|00003e20| 63 65 6e 74 65 72 20 44 | 6f 75 62 6c 65 2d 42 6c |center D|ouble-Bl|
|00003e30| 69 6e 64 2c 20 50 6c 61 | 63 65 62 6f 2d 43 6f 6e |ind, Pla|cebo-Con|
|00003e40| 74 72 6f 6c 6c 65 64 20 | 54 72 69 61 6c 0d 0a 0d |trolled |Trial...|
|00003e50| 0a 50 65 61 63 6f 63 6b | 20 4a 45 20 4a 72 3b 20 |.Peacock| JE Jr; |
|00003e60| 4b 61 70 6c 6f 77 69 74 | 7a 20 4c 47 3b 20 53 70 |Kaplowit|z LG; Sp|
|00003e70| 61 72 6c 69 6e 67 20 50 | 46 3b 20 44 75 72 61 63 |arling P|F; Durac|
|00003e80| 6b 20 44 54 3b 20 47 6e | 61 6e 6e 20 4a 57 20 4a |k DT; Gn|ann JW J|
|00003e90| 72 3b 20 57 68 69 74 6c | 65 79 20 52 4a 3b 0d 0a |r; Whitl|ey RJ;..|
|00003ea0| 4c 6f 76 65 74 74 20 4d | 3b 20 42 72 79 73 6f 6e |Lovett M|; Bryson|
|00003eb0| 20 59 4a 3b 20 4b 6c 65 | 69 6e 20 52 4a 3b 20 46 | YJ; Kle|in RJ; F|
|00003ec0| 72 69 65 64 6d 61 6e 2d | 4b 69 65 6e 20 41 45 3b |riedman-|Kien AE;|
|00003ed0| 20 4b 6e 6f 77 6c 74 6f | 6e 20 47 4d 3b 20 44 61 | Knowlto|n GM; Da|
|00003ee0| 76 69 73 20 4c 47 0d 0a | 41 6d 20 4a 20 4d 65 64 |vis LG..|Am J Med|
|00003ef0| 20 38 35 3a 33 30 31 2d | 33 30 36 2c 20 53 65 70 | 85:301-|306, Sep|
|00003f00| 74 65 6d 62 65 72 20 31 | 39 38 38 0d 0a 2d 2d 2d |tember 1|988..---|
|00003f10| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003f20| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003f30| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003f40| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003f50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 0d 0a 0d 0a 41 |--------|---....A|
|00003f60| 62 73 74 72 61 63 74 0d | 0a 0d 0a 20 20 20 20 20 |bstract.|... |
|00003f70| 54 68 65 20 72 65 73 75 | 6c 74 73 20 6f 66 20 61 |The resu|lts of a|
|00003f80| 20 6d 75 6c 74 69 63 65 | 6e 74 65 72 20 64 6f 75 | multice|nter dou|
|00003f90| 62 6c 65 2d 62 6c 69 6e | 64 20 70 6c 61 63 65 62 |ble-blin|d placeb|
|00003fa0| 6f 2d 63 6f 6e 74 72 6f | 6c 6c 65 64 20 74 72 69 |o-contro|lled tri|
|00003fb0| 61 6c 20 6f 66 0d 0a 69 | 6e 74 72 61 76 65 6e 6f |al of..i|ntraveno|
|00003fc0| 75 73 20 61 63 79 63 6c | 6f 76 69 72 20 69 6e 20 |us acycl|ovir in |
|00003fd0| 74 72 65 61 74 6d 65 6e | 74 20 6f 66 20 66 69 72 |treatmen|t of fir|
|00003fe0| 73 74 2d 65 70 69 73 6f | 64 65 20 67 65 6e 69 74 |st-episo|de genit|
|00003ff0| 61 6c 20 68 65 72 70 65 | 73 20 77 65 72 65 0d 0a |al herpe|s were..|
|00004000| 65 76 61 6c 75 61 74 65 | 64 2e 20 20 54 68 65 20 |evaluate|d. The |
|00004010| 73 74 75 64 79 20 69 6e | 76 6f 6c 76 65 64 20 6d |study in|volved m|
|00004020| 61 6c 65 20 61 6e 64 20 | 66 65 6d 61 6c 65 20 70 |ale and |female p|
|00004030| 61 74 69 65 6e 74 73 20 | 31 35 20 79 65 61 72 73 |atients |15 years|
|00004040| 20 6f 72 20 6f 6c 64 65 | 72 20 77 69 74 68 0d 0a | or olde|r with..|
|00004050| 6e 6f 20 68 69 73 74 6f | 72 79 20 6f 66 20 67 65 |no histo|ry of ge|
|00004060| 6e 69 74 61 6c 20 68 65 | 72 70 65 73 20 73 69 6d |nital he|rpes sim|
|00004070| 70 6c 65 78 20 76 69 72 | 75 73 20 28 48 53 56 29 |plex vir|us (HSV)|
|00004080| 20 69 6e 66 65 63 74 69 | 6f 6e 20 61 6e 64 20 64 | infecti|on and d|
|00004090| 69 61 67 6e 6f 73 65 64 | 0d 0a 67 65 6e 69 74 61 |iagnosed|..genita|
|000040a0| 6c 20 68 65 72 70 65 73 | 20 77 69 74 68 20 65 78 |l herpes| with ex|
|000040b0| 74 65 6e 73 69 76 65 20 | 6c 65 73 69 6f 6e 73 20 |tensive |lesions |
|000040c0| 70 72 65 73 65 6e 74 20 | 66 6f 72 20 36 20 64 61 |present |for 6 da|
|000040d0| 79 73 20 6f 72 20 6c 65 | 73 73 2e 20 20 42 65 66 |ys or le|ss. Bef|
|000040e0| 6f 72 65 0d 0a 74 68 65 | 72 61 70 79 20 61 6c 6c |ore..the|rapy all|
|000040f0| 20 6c 65 73 69 6f 6e 73 | 20 77 65 72 65 20 63 75 | lesions| were cu|
|00004100| 6c 74 75 72 65 64 2c 20 | 61 6e 64 20 66 6f 6c 6c |ltured, |and foll|
|00004110| 6f 77 2d 75 70 20 69 6e | 63 6c 75 64 65 64 20 72 |ow-up in|cluded r|
|00004120| 65 63 75 6c 74 75 72 65 | 20 6f 66 20 62 6f 74 68 |eculture| of both|
|00004130| 0d 0a 67 65 6e 69 74 61 | 6c 20 61 6e 64 20 70 65 |..genita|l and pe|
|00004140| 72 69 6e 65 61 6c 20 28 | 67 72 6f 75 70 20 31 29 |rineal (|group 1)|
|00004150| 20 61 6e 64 20 65 78 74 | 72 61 67 65 6e 69 74 61 | and ext|ragenita|
|00004160| 6c 20 6c 65 73 69 6f 6e | 73 20 28 67 72 6f 75 70 |l lesion|s (group|
|00004170| 20 32 29 2e 20 20 41 6c | 73 6f 20 48 53 56 0d 0a | 2). Al|so HSV..|
|00004180| 61 6e 74 69 62 6f 64 69 | 65 73 20 66 72 6f 6d 20 |antibodi|es from |
|00004190| 61 6c 6c 20 70 61 74 69 | 65 6e 74 73 20 77 65 72 |all pati|ents wer|
|000041a0| 65 20 61 73 73 65 73 73 | 65 64 20 61 74 20 65 6e |e assess|ed at en|
|000041b0| 74 72 79 20 74 6f 20 74 | 68 65 20 73 74 75 64 79 |try to t|he study|
|000041c0| 20 61 6e 64 20 6f 6e 20 | 64 61 79 0d 0a 32 31 2e | and on |day..21.|
|000041d0| 20 20 41 63 79 63 6c 6f | 76 69 72 20 74 72 65 61 | Acyclo|vir trea|
|000041e0| 74 6d 65 6e 74 20 77 61 | 73 20 35 20 6d 67 2f 6b |tment wa|s 5 mg/k|
|000041f0| 67 20 69 6e 74 72 61 76 | 65 6e 6f 75 73 6c 79 20 |g intrav|enously |
|00004200| 65 76 65 72 79 20 38 20 | 68 6f 75 72 73 20 66 6f |every 8 |hours fo|
|00004210| 72 20 35 20 64 61 79 73 | 2e 0d 0a 20 20 20 20 20 |r 5 days|... |
|00004220| 50 61 74 69 65 6e 74 73 | 20 72 65 63 65 69 76 69 |Patients| receivi|
|00004230| 6e 67 20 61 63 79 63 6c | 6f 76 69 72 20 68 61 64 |ng acycl|ovir had|
|00004240| 20 73 6c 69 67 68 74 6c | 79 20 73 68 6f 72 74 65 | slightl|y shorte|
|00004250| 72 20 64 75 72 61 74 69 | 6f 6e 20 6f 66 20 70 61 |r durati|on of pa|
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|00004280| 63 65 62 6f 20 28 34 2e | 33 20 64 61 79 73 20 76 |cebo (4.|3 days v|
|00004290| 73 2e 20 34 2e 38 20 64 | 61 79 73 29 2e 20 20 54 |s. 4.8 d|ays). T|
|000042a0| 68 69 73 20 72 65 64 75 | 63 74 69 6f 6e 20 69 6e |his redu|ction in|
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|000042c0| 77 61 73 20 6d 6f 73 74 | 20 70 72 6f 6e 6f 75 6e |was most| pronoun|
|000042d0| 63 65 64 20 69 6e 20 74 | 68 6f 73 65 20 70 61 74 |ced in t|hose pat|
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|00004300| 0d 0a 64 69 73 65 61 73 | 65 20 28 34 2e 32 20 64 |..diseas|e (4.2 d|
|00004310| 61 79 73 20 70 61 69 6e | 20 76 73 2e 20 31 30 2e |ays pain| vs. 10.|
|00004320| 36 20 64 61 79 73 20 69 | 6e 20 70 6c 61 63 65 62 |6 days i|n placeb|
|00004330| 6f 20 67 72 6f 75 70 73 | 29 3b 20 74 68 65 72 65 |o groups|); there|
|00004340| 20 77 61 73 20 6e 6f 0d | 0a 72 65 64 75 63 74 69 | was no.|.reducti|
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|00004df0| 20 42 6f 6f 6b 20 6f 66 | 20 46 61 6d 69 6c 79 20 | Book of| Family |
|00004e00| 50 72 61 63 74 69 63 65 | 7d 0d 0a 24 43 68 61 70 |Practice|}..$Chap|
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|00004e20| 69 74 6f 72 7b 44 72 73 | 2e 20 52 61 6b 65 6c 2c |itor{Drs|. Rakel,|
|00004e30| 20 41 76 61 6e 74 2c 20 | 44 72 69 73 63 6f 6c 6c | Avant, |Driscoll|
|00004e40| 2c 20 50 72 69 63 68 61 | 72 64 2c 20 61 6e 64 20 |, Pricha|rd, and |
|00004e50| 53 6d 69 74 68 7d 0d 0a | 24 54 61 62 6c 65 7b 7d |Smith}..|$Table{}|
|00004e60| 0d 0a 24 43 6f 6d 6d 65 | 6e 74 61 74 6f 72 7b 43 |..$Comme|ntator{C|
|00004e70| 2e 45 2e 20 44 72 69 73 | 63 6f 6c 6c 2c 20 4d 2e |.E. Dris|coll, M.|
|00004e80| 44 2e 7d 0d 0a 0d 0a 43 | 6f 70 79 72 69 67 68 74 |D.}....C|opyright|
|00004e90| 20 28 63 29 20 59 65 61 | 72 62 6f 6f 6b 20 4d 65 | (c) Yea|rbook Me|
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|00004eb0| 2c 20 49 6e 63 2e 2c 20 | 31 39 39 30 0d 0a 0d 0a |, Inc., |1990....|
|00004ec0| 31 39 39 30 20 59 65 61 | 72 20 42 6f 6f 6b 20 6f |1990 Yea|r Book o|
|00004ed0| 66 20 46 61 6d 69 6c 79 | 20 50 72 61 63 74 69 63 |f Family| Practic|
|00004ee0| 65 20 28 52 29 0d 0a 0d | 0a 43 68 61 70 74 65 72 |e (R)...|.Chapter|
|00004ef0| 20 31 32 2d 2d 47 79 6e | 65 63 6f 6c 6f 67 79 0d | 12--Gyn|ecology.|
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|00004f20| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004f30| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004f40| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004f50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 0d |--------|-------.|
|00004f60| 0a 44 69 72 65 63 74 20 | 46 6c 75 6f 72 65 73 63 |.Direct |Fluoresc|
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|00004f90| 76 69 63 61 6c 20 43 68 | 6c 61 6d 79 64 69 61 20 |vical Ch|lamydia |
|00004fa0| 74 72 61 63 68 6f 6d 61 | 74 69 73 3a 0d 0a 46 61 |trachoma|tis:..Fa|
|00004fb0| 63 74 6f 72 73 20 41 66 | 66 65 63 74 69 6e 67 20 |ctors Af|fecting |
|00004fc0| 41 63 63 75 72 61 63 79 | 0d 0a 0d 0a 4c 69 76 65 |Accuracy|....Live|
|00004fd0| 6e 67 6f 6f 64 20 43 48 | 20 49 49 49 3b 20 53 63 |ngood CH| III; Sc|
|00004fe0| 68 6d 69 74 74 20 4a 57 | 3b 20 41 64 64 69 73 6f |hmitt JW|; Addiso|
|00004ff0| 6e 20 57 41 3b 20 57 72 | 65 6e 6e 20 4a 57 3b 20 |n WA; Wr|enn JW; |
|00005000| 4d 61 67 72 75 64 65 72 | 2d 48 61 62 69 62 20 4b |Magruder|-Habib K|
|00005010| 0d 0a 28 44 75 6b 65 20 | 55 6e 69 76 29 0d 0a 4f |..(Duke |Univ)..O|
|00005020| 62 73 74 65 74 20 47 79 | 6e 65 63 6f 6c 20 37 32 |bstet Gy|necol 72|
|00005030| 3a 38 30 33 2d 38 30 39 | 2c 20 4e 6f 76 65 6d 62 |:803-809|, Novemb|
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|00005050| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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|00005070| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005080| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005090| 2d 2d 2d 2d 2d 2d 2d 0d | 0a 0d 0a 41 62 73 74 72 |-------.|...Abstr|
|000050a0| 61 63 74 0d 0a 0d 0a 20 | 20 20 20 20 44 69 72 65 |act.... | Dire|
|000050b0| 63 74 20 66 6c 75 6f 72 | 65 73 63 65 6e 74 20 61 |ct fluor|escent a|
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|000050d0| 69 73 20 61 20 70 72 6f | 6d 69 73 69 6e 67 20 64 |is a pro|mising d|
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|00005ec0| 61 6d 61 2c 20 42 69 72 | 6d 69 6e 67 68 61 6d 7d |ama, Bir|mingham}|
|00005ed0| 0d 0a 24 4a 6f 75 72 6e | 61 6c 7b 41 6d 20 4a 20 |..$Journ|al{Am J |
|00005ee0| 4f 62 73 74 65 74 20 47 | 79 6e 65 63 6f 6c 7d 0d |Obstet G|ynecol}.|
|00005ef0| 0a 24 56 6f 6c 75 6d 65 | 7b 31 36 30 7d 0d 0a 24 |.$Volume|{160}..$|
|00005f00| 50 61 67 65 7b 33 39 36 | 2d 34 30 32 7d 0d 0a 24 |Page{396|-402}..$|
|00005f10| 44 61 74 65 7b 46 65 62 | 72 75 61 72 79 20 31 39 |Date{Feb|ruary 19|
|00005f20| 38 39 7d 0d 0a 24 59 42 | 56 6f 6c 7b 31 39 39 30 |89}..$YB|Vol{1990|
|00005f30| 20 59 65 61 72 20 42 6f | 6f 6b 20 6f 66 20 46 61 | Year Bo|ok of Fa|
|00005f40| 6d 69 6c 79 20 50 72 61 | 63 74 69 63 65 7d 0d 0a |mily Pra|ctice}..|
|00005f50| 24 43 68 61 70 74 65 72 | 7b 31 32 2d 38 7d 0d 0a |$Chapter|{12-8}..|
|00005f60| 24 59 42 45 64 69 74 6f | 72 7b 44 72 73 2e 20 52 |$YBEdito|r{Drs. R|
|00005f70| 61 6b 65 6c 2c 20 41 76 | 61 6e 74 2c 20 44 72 69 |akel, Av|ant, Dri|
|00005f80| 73 63 6f 6c 6c 2c 20 50 | 72 69 63 68 61 72 64 2c |scoll, P|richard,|
|00005f90| 20 61 6e 64 20 53 6d 69 | 74 68 7d 0d 0a 24 54 61 | and Smi|th}..$Ta|
|00005fa0| 62 6c 65 7b 7d 0d 0a 24 | 43 6f 6d 6d 65 6e 74 61 |ble{}..$|Commenta|
|00005fb0| 74 6f 72 7b 43 2e 45 2e | 20 44 72 69 73 63 6f 6c |tor{C.E.| Driscol|
|00005fc0| 6c 2c 20 4d 2e 44 2e 7d | 0d 0a 0d 0a 43 6f 70 79 |l, M.D.}|....Copy|
|00005fd0| 72 69 67 68 74 20 28 63 | 29 20 59 65 61 72 62 6f |right (c|) Yearbo|
|00005fe0| 6f 6b 20 4d 65 64 69 63 | 61 6c 20 50 75 62 6c 69 |ok Medic|al Publi|
|00005ff0| 73 68 65 72 73 2c 20 49 | 6e 63 2e 2c 20 31 39 39 |shers, I|nc., 199|
|00006000| 30 0d 0a 0d 0a 31 39 39 | 30 20 59 65 61 72 20 42 |0....199|0 Year B|
|00006010| 6f 6f 6b 20 6f 66 20 46 | 61 6d 69 6c 79 20 50 72 |ook of F|amily Pr|
|00006020| 61 63 74 69 63 65 20 28 | 52 29 0d 0a 0d 0a 43 68 |actice (|R)....Ch|
|00006030| 61 70 74 65 72 20 31 32 | 2d 2d 47 79 6e 65 63 6f |apter 12|--Gyneco|
|00006040| 6c 6f 67 79 0d 0a 0d 0a | 49 6e 66 65 63 74 69 6f |logy....|Infectio|
|00006050| 6e 73 0d 0a 0d 0a 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |ns....--|--------|
|00006060| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00006070| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00006080| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00006090| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000060a0| 2d 2d 2d 2d 0d 0a 4f 72 | 61 6c 20 43 6f 6e 74 72 |----..Or|al Contr|
|000060b0| 61 63 65 70 74 69 76 65 | 20 55 73 65 20 61 6e 64 |aceptive| Use and|
|000060c0| 20 74 68 65 20 52 69 73 | 6b 20 6f 66 20 43 68 6c | the Ris|k of Chl|
|000060d0| 61 6d 79 64 69 61 6c 20 | 61 6e 64 20 47 6f 6e 6f |amydial |and Gono|
|000060e0| 63 6f 63 63 61 6c 20 49 | 6e 66 65 63 74 69 6f 6e |coccal I|nfection|
|000060f0| 73 0d 0a 0d 0a 4c 6f 75 | 76 20 57 43 3b 20 41 75 |s....Lou|v WC; Au|
|00006100| 73 74 69 6e 20 48 3b 20 | 50 65 72 6c 6d 61 6e 20 |stin H; |Perlman |
|00006110| 4a 3b 20 41 6c 65 78 61 | 6e 64 65 72 20 57 4a 0d |J; Alexa|nder WJ.|
|00006120| 0a 28 55 6e 69 76 20 6f | 66 20 41 6c 61 62 61 6d |.(Univ o|f Alabam|
|00006130| 61 2c 20 42 69 72 6d 69 | 6e 67 68 61 6d 29 0d 0a |a, Birmi|ngham)..|
|00006140| 41 6d 20 4a 20 4f 62 73 | 74 65 74 20 47 79 6e 65 |Am J Obs|tet Gyne|
|00006150| 63 6f 6c 20 31 36 30 3a | 33 39 36 2d 34 30 32 2c |col 160:|396-402,|
|00006160| 20 46 65 62 72 75 61 72 | 79 20 31 39 38 39 0d 0a | Februar|y 1989..|
|00006170| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00006180| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00006190| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000061a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000061b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 0d 0a |--------|------..|
|000061c0| 0d 0a 41 62 73 74 72 61 | 63 74 0d 0a 0d 0a 20 20 |..Abstra|ct.... |
|000061d0| 20 20 20 4f 72 61 6c 20 | 63 6f 6e 74 72 61 63 65 | Oral |contrace|
|000061e0| 70 74 69 76 65 20 75 73 | 65 20 77 61 73 20 72 65 |ptive us|e was re|
|000061f0| 6c 61 74 65 64 20 74 6f | 20 69 6e 66 65 63 74 69 |lated to| infecti|
|00006200| 6f 75 73 20 72 69 73 6b | 20 69 6e 20 61 20 72 61 |ous risk| in a ra|
|00006210| 6e 64 6f 6d 69 7a 65 64 | 0d 0a 74 72 69 61 6c 20 |ndomized|..trial |
|00006220| 6f 66 20 6e 6f 6e 6f 78 | 79 6e 6f 6c 20 39 20 61 |of nonox|ynol 9 a|
|00006230| 73 20 70 72 6f 70 68 79 | 6c 61 78 69 73 20 61 67 |s prophy|laxis ag|
|00006240| 61 69 6e 73 74 20 67 6f | 6e 6f 63 6f 63 63 61 6c |ainst go|nococcal|
|00006250| 20 61 6e 64 20 63 68 6c | 61 6d 79 64 69 61 6c 0d | and chl|amydial.|
|00006260| 0a 69 6e 66 65 63 74 69 | 6f 6e 73 2e 20 20 50 61 |.infecti|ons. Pa|
|00006270| 74 69 65 6e 74 73 20 73 | 65 65 6e 20 69 6e 20 61 |tients s|een in a|
|00006280| 20 73 65 78 75 61 6c 6c | 79 20 74 72 61 6e 73 6d | sexuall|y transm|
|00006290| 69 74 74 65 64 20 64 69 | 73 65 61 73 65 73 20 63 |itted di|seases c|
|000062a0| 6c 69 6e 69 63 20 77 65 | 72 65 0d 0a 69 6e 63 6c |linic we|re..incl|
|000062b0| 75 64 65 64 20 69 6e 20 | 74 68 65 20 73 74 75 64 |uded in |the stud|
|000062c0| 79 20 69 66 20 74 68 65 | 79 20 77 65 72 65 20 61 |y if the|y were a|
|000062d0| 67 65 64 20 31 39 2d 32 | 39 20 79 65 61 72 73 20 |ged 19-2|9 years |
|000062e0| 61 6e 64 20 77 65 72 65 | 20 70 6c 61 6e 6e 69 6e |and were| plannin|
|000062f0| 67 20 74 6f 20 75 73 65 | 0d 0a 63 6f 6e 74 72 61 |g to use|..contra|
|00006300| 63 65 70 74 69 6f 6e 20 | 66 6f 72 20 61 74 20 6c |ception |for at l|
|00006310| 65 61 73 74 20 36 20 6d | 6f 6e 74 68 73 2e 20 20 |east 6 m|onths. |
|00006320| 4f 66 20 38 31 38 20 70 | 61 72 74 69 63 69 70 61 |Of 818 p|articipa|
|00006330| 6e 74 73 2c 20 36 31 37 | 20 75 73 65 64 20 6f 72 |nts, 617| used or|
|00006340| 61 6c 0d 0a 63 6f 6e 74 | 72 61 63 65 70 74 69 76 |al..cont|raceptiv|
|00006350| 65 73 2e 20 20 54 68 65 | 20 6d 65 64 69 61 6e 20 |es. The| median |
|00006360| 61 67 65 20 77 61 73 20 | 32 33 20 79 65 61 72 73 |age was |23 years|
|00006370| 2e 0d 0a 20 20 20 20 20 | 4f 72 61 6c 20 63 6f 6e |... |Oral con|
|00006380| 74 72 61 63 65 70 74 69 | 76 65 20 75 73 65 20 72 |tracepti|ve use r|
|00006390| 61 69 73 65 64 20 74 68 | 65 20 72 61 74 65 20 6f |aised th|e rate o|
|000063a0| 66 20 66 69 72 73 74 20 | 63 68 6c 61 6d 79 64 69 |f first |chlamydi|
|000063b0| 61 6c 20 69 6e 66 65 63 | 74 69 6f 6e 20 62 79 0d |al infec|tion by.|
|000063c0| 0a 38 31 25 20 62 75 74 | 20 6e 6f 74 20 74 68 65 |.81% but| not the|
|000063d0| 20 72 69 73 6b 20 6f 66 | 20 73 65 63 6f 6e 64 20 | risk of| second |
|000063e0| 69 6e 66 65 63 74 69 6f | 6e 73 2e 20 20 52 61 74 |infectio|ns. Rat|
|000063f0| 65 73 20 6f 66 20 67 6f | 6e 6f 63 6f 63 63 61 6c |es of go|nococcal|
+--------+-------------------------+-------------------------+--------+--------+
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