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At least 631 records · Page 35Linked to original sources
PubMed1993

Acute pelvic infection following hysterosalpingography at the Kenyatta National Hospital, Nairobi.

A total of 150 women who had hysterosalpingography (HSG) for investigation of infertility, at the Kenyatta National Hospital over a five month period, were recruited into the study to determine the prevalence of pelvic infection following the procedure. 44.0% of the total study group developed pelvic infection disease (PID) within the first week after the procedure. There were no obvious determining factors. It is possible that most women with infertility have quiescent genital tract infection, prior to HSG, with the latter only facilitating the entry of micro-organisms into the upper genital tract, thus causing pelvic infection or reactivating a pre-existing infections. Further studies should be conducted to determine the microbial patterns of the infection. There should be routine provision of prophylactic antimicrobial agent(s) to all women undergoing HSG in our unit to minimise the risk of developing pelvic infection and further damage to the uterine tubes which will worsen the prognosis.

Adolescent↗
PubMed1994

Transcervical recanalization of strictures in the postoperative fallopian tube.

PURPOSE: To evaluate use of transcervical recanalization in patients with reocclusion of the proximal fallopian tube after failed surgery to reverse sterilization or failed tuboplasty to treat inflammatory disease. MATERIALS AND METHODS: The standard technique for transcervical recanalization was attempted in seven patients after failed reversal surgery and in 12 after failed tuboplasty. Four of seven patients with failed reversal surgery had fistular tracts and one also had a stricture; the remaining three patients and all 12 patients treated after failed tuboplasty and tube reimplantation had strictures at the site of implantation or anastomosis. RESULTS: Transcervical recanalization failed in all patients with fistulas but succeeded in 13 of 15 with stenoses. Three patients became pregnant 1-16 months after recanalization and two after in vitro fertilization and embryo transfer. Reocclusion occurred in two of 10 patients reexamined 6-36 months after recanalization. CONCLUSION: Transcervical recanalization is recommended as an alternative to repeat microsurgical reimplantation or tuboplasty.

Adult↗
PubMed1990

The epidemiology of sexually transmitted diseases in Africa and Latin America.

We review some aspects of the epidemiology of sexually transmitted diseases (STDs) in the developing countries of Africa and Latin America. Apart from their elevated prevalence, they are responsible for important morbidity in mother and child. Stillbirth, premature delivery, conjunctivitis, and respiratory tract morbidity of the neonate are frequently caused by STDs. Sequelae in adult women include pelvic inflammatory disease, ectopic pregnancy, and infertility. The emergence of antimicrobial resistance has complicated the picture in recent times. Genital ulcer disease is very common in developing countries, the most important being chancroid. Both continents are experiencing major epidemics of the acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection with different epidemiological characteristics than in the industrialized world. A link might exist between the high prevalence of STDs and the rapid heterosexual spread of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Clindamycin in the treatment of obstetric and gynecologic infections: a review.

The spectrum of clindamycin's activity includes anaerobes and gram-positive aerobes other than enterococci. No inactivation or incompatibility of clindamycin phosphate has been shown in intravenous solutions usually used clinically. After oral administration, clindamycin is almost completely absorbed, with mean peak serum levels reached in 45 to 60 minutes. Clindamycin is widely distributed in many body fluids and tissues. Its normal half-life is two to three hours, and thus it can be given at six-hour intervals. Because of its excellent coverage against anaerobes, gram-positive cocci, and Chlamydia trachomatis, clindamycin is the preferred antimicrobial agent for serious infections of the female genital tract. Clindamycin plus tobramycin or an aminoglycoside is effective treatment for pelvic inflammatory disease, particularly when a tubo-ovarian abscess is present. In post-cesarean section endometritis, clindamycin plus gentamicin has been shown to be more effective than any other treatment. Clindamycin (alone or with an aminoglycoside) has been used successfully in posthysterectomy vaginal cuff infections and, with an aminoglycoside, in septic abortions. Clindamycin has been well tolerated in studies of animals and human subjects; its most significant side effects develop in the gastrointestinal system.

Abortion, Septic↗
PubMed1997

Human immunodeficiency virus type 1 infection of cells and tissues from the upper and lower human female reproductive tract.

Viable tissue sections and isolated cell cultures from the human fallopian tube, uterus, cervix, and vaginal mucosa were examined for susceptibility to infection with human immunodeficiency virus type 1 (HIV-1). We examined infectivity by using the monocytotropic strain HIV-1(JR-FL) and several primary isolates of HIV-1 obtained from infected neonates. HIV-1 infection was measured by p24 production in short-term culture and by immunofluorescence detection of HIV-1 Nef and p24 proteins by laser scanning confocal microscopy. Three-color immunofluorescence was used to phenotype HIV-infected cells within tissue sections from each site. Our findings indicate that epithelial, stromal, and dendritic cells and cells with CD14+ CD4+, CD14-CD4-, and CD4+ CD14- phenotypes from the female reproductive tract are infectable with HIV-1. Of importance is the finding that tissues from the upper reproductive tract are susceptible to infection with HIV-1. Moreover, tissue samples from women in all stages of the menstrual cycle, including postmenopausal women (inactive), could be infected with HIV-1. Female reproductive tract cells required a minimum of 60 min of exposure to HIV-1 in order for infection to occur, in contrast to peripheral blood lymphocytes, which became infected after being exposed to HIV-1 for only 1 min. These findings demonstrate that HIV-1 can infect cells and tissues from different sites within the female reproductive tract and suggest that multiple cell types, including epithelial cells, may be targets for the initial infection by HIV-1.

Acquired Immunodeficiency Syndrome↗
PubMed1997

The effect of gramicidin, a topical contraceptive and antimicrobial agent with anti-HIV activity, against herpes simplex viruses type 1 and 2 in vitro.

The effect of an anti-HIV compound, gramicidin, previously used as a topical antibiotic and vaginal contraceptive, on the replication of herpes simplex viruses (HSV) type 1 and 2 has been examined. Human WI-38 fibroblasts were inoculated with either HSV type in the presence of serial dilutions of gramicidin and reduction in viral yield was measured by ELISA. The 50% inhibitory dose (IC50) of gramicidin against 3 HSV-1 and 4 HSV-2 isolates was equal to 0.3 microgram/ml and was comparable to the efficacy of the anti-HSV agent acyclovir (ACV). The IC50 of gramicidin required to protect WI-38 from cytolytic effect of HSV was 10 micrograms/ml at day 5 postinfection, indicating that at this time point the activity of gramicidin was inferior than that of ACV. Nevertheless, gramicidin suppressed the replication of ACV-resistant thymidine kinase and DNA polymerase HSV mutants at doses effective against ACV-sensitive strains. The results suggest that the antimicrobial and spermostatic agent, gramicidin, has potential against sexually transmitted diseases (STDs) and for prophylaxis of sex-borne HIV and HSV infections.

Anti-HIV Agents↗
PubMed1976

Cul-de-sac isolates from patients with endometritis-salpingitis-peritonitis and gonococcal endocervicitis.

Neisseria gonorrhoeae was cultured from the cul-de-sac in 11 of 17 patients with bacteriologically documented gonococcal endometritis-salpingitis and identified by Gram stain in one other instance. In five, N. gonorrhoeae was the only isolate. In six other patients, the presence of other aerobic (two) and anaerobic bacteria (three), as well as N. gonorrhoeae, was documented. In the remaining six patients, only aerobic and anaerobic organisms were isolated. The data are interpreted as supporting the concept of anaerobic superinfections following initial infection with N. gonorrhoeae late in the course of this disease entity.

Aerobiosis↗
PubMed1980

Problems and proposals for the surveillance and control of sexually transmitted diseases associated with pelvic inflammatory disease in South America.

In South America, the number of women at risk for gonococcal pelvic inflammatory disease has increased greatly along with the incidence rates for gonorrhea. Further information is needed on the epidemiologic aspects of gonorrhea and PID in order to develop programs for optimal control of sexually transmitted disease (STD). We think that the control of STD, including PID, requires improvement of four basic factors: professional training in STD, management of STD by all levels of health care services, laboratory diagnostic services, and public education in STD.

Adolescent↗
PubMed1988

The use of intrauterine contraceptive devices, pelvic inflammatory disease, and Chlamydia trachomatis infection.

With the same epidemiologic approach taken in a recent study that suggested that oral contraceptive use may not protect against chlamydial pelvic inflammatory disease, the risks of chlamydial pelvic inflammatory disease were evaluated for intrauterine contraceptive device users. Compared with women using no method of contraception, intrauterine contraceptive device users were not found to be at any higher risk of cervical chlamydial infection. Whether this places intrauterine contraceptive device users at no increased risk of chlamydial pelvic inflammatory disease cannot be ascertained from the available data. Further research is needed before any conclusions can be made regarding the risks of chlamydial pelvic inflammatory disease to users of intrauterine contraceptive devices, oral contraceptives, and other contraceptive methods.

Chlamydia Infections↗
PubMed1988

Prophylactic antibiotics for suction curettage abortion: results of a clinical controlled trial.

The prophylactic use of 300 mg doxycycline at the time of an abortion was evaluated in a randomized controlled trial. In the group with negative chlamydia screening results, only two (0.4%) of 502 patients who received prophylactic treatment developed pelvic infection, compared with 15 (3.0%) of 497 patients who received placebos (p = 0.001). The same effectiveness was found in women with positive chlamydia screening results. Vomiting was the major side effect of the medication and could limit its use. A simulation of selective prophylaxis in women with negative chlamydia screening results showed that its selective use in patients with a history of gonorrhea or in nulliparous women with multiple sex partners could be nearly two thirds as effective as general prophylaxis.

Abortion, Induced↗
PubMed1991

Modeling AIDS as a function of other sexually transmitted disease.

The spread of AIDS, as with any sexually transmitted disease, will depend on the pattern of sexual activity. Both the proportion of the population who have high partner exchange rates and the extent to which that proportion interacts with the remainder of the population are likely to be important determinants of the AIDS epidemic. However, it does not seem likely that surveys could obtain sufficiently reliable information of this nature for use in an accurate model of the AIDS epidemic. On the other hand, such information is implicitly contained in the epidemiology of other sexually transmitted diseases (STDs). Therefore a method is suggested of calculating the parameters of a model of the AIDS epidemic by comparing it with the epidemiology of another STD. The result is a model that predicts the likelihood of infection by the AIDS virus as a function of time and an individual's history of STD. It is suggested that further work along these lines may lead to a quantitative approach to assessing the importance of various STDs as cofactors in the spread of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1979

Prostaglandin biosynthesis inhibitors and endometriosis.

Prostaglandins (PGs) may be involved in the development of the symptoms of endometriosis. Therefore 18 patients with pelvic endometriosis were treated in placebo controlled double-blind trial with different prostaglandin biosynthesis inhibitors. These drugs were: acetylsalicylic acid (0.5 g x 3) exerting a weak PG-synthetase inhibition, indomethacin (25 mg x 3) inhibiting PG-synthetase, and as a representative of fenamates, tolfenamic acid (200 mg x 3), which both inhibits PG-synthetase and antagonizes PGs at the target level. The therapeutic effect was evaluated using a specific endometriosis score separately during menstruation and in premenstrum. Prostaglandin biosynthesis inhibitors did not alleviate premenstrual complaints better than placebo. During menstruation tolfenamic acid relieved endometriotic symptoms more effectively than placebo while indomethacin and acetylsalicylic acid did not differ from placebo. A drug which inhibit both the synthesis and action of PGs can thus be used in the alleviation of secondary dysmenorrhea due to endometriosis.

Aspirin↗
PubMed1995

Epidemiologic differences between candidial and trichomonal infections as detected in cytologic smears in Taiwan.

The epidemiologic differences between cytology-detected candidial and trichomonal infections were assessed in 15,933 women attending the 12 district health centres in the Taipei area and a consecutive 1114 patients, visiting venereal disease clinics, whose smears were screened for cervical cancer between July 1991 and December 1992 in Taipei. The Pap smears were examined for the presence of specific organisms, such as trichomonas vaginalis, vaginal candida, herpes simplex virus, human papillomavirus, actinomyces, leptothrix, aspergillu, gardnerella and others. More emphasis was placed on the candidial and trichomonal infection in inflammatory Pap smears. The overall prevalence of candidial and trichomonal infections was 3.40% and 1.88%, respectively. There were striking differences in the prevalence of trichomoniasis ranging from 1.74% in the district health centre population to 3.77% in the venereal disease clinic patients; however, the prevalence of candidial infection remained the same (3.40%) in these two distinct population groups. Indices of socioeconomic status--education and personal hygiene--showed an inverse association with the prevalence of trichomoniasis but a positive correlation with candidiasis. Among participants, younger age (< 20 years old) was independently associated with candidial (OR = 1.95) and trichomonal (OR = 3.87) infections. No sexual behavioural factors were associated with candidial infection in this study; however, having multiple sexual partners (OR = 5.07) was associated with a significantly elevated risk of trichomoniasis, while using condoms was associated with a diminished risk (OR = 0.38). The presence of candidiasis and trichomoniasis was highly associated with abnormal cytologic findings, particularly those indicative of inflammation. There was little evidence that findings suggestive of cervical cancer could be attributed to either candidial or trichomonal infections. These data suggest that trichomoniasis is consistent with venereal transmission of the disease, but transmission by contaminated objects cannot be ruled out because there is an increased relation between trichomoniasis infection and socioeconomic conditions and personal hygiene. Elucidation of such differences may be helpful in designing different strategies to control these infections. Furthermore, the findings can provide a good baseline of prevalence for investigating the relationship between these two pathogens and cervical dysplasia.

Adolescent↗