bluuebunny/crossref_metadata_2025_split huggingface dataset:
Candidiasis During Pregnancy May Result From Isogenic Commensal Strains
Authors: Daniels Wayne , Glover Douglas D. , Essmann Michael , Larsen Bryan 
Published: March 2007

Objective: Our laboratory previously demonstrated that asymptomatic vaginal colonization during pregnancy is a factor predisposing patients to subsequent symptomatic vulvovaginal candidiasis. It is unknown whether symptoms result from strain replacement or a change in host relationship to the original colonizing strain. This study was
undertaken to determine whether Candida albicans isolates from asymptomatic women could be responsible for subsequent symptomatic vaginitis.Methods: We retained isolates of C. albicans from women followed longitudinally through pregnancy, and identified
six pairs of cultures from women who were colonized without symptoms and who later became symptomatic
(average time 14 weeks). We used a random amplification of polymorphic DNA (RAPD) analysis to determine
whether isolates from our study patients were genetically similar or dissimilar.Results: Analysis of these pairs of yeast strains by RAPD revealed that five of the six women had symptoms
apparently due to the same yeast strain that was found initially as a commensal strain. To increase the power of
these observations, we also performed RAPD analysis on six randomly selected yeast strains from other women in
this study who had not become symptomatic to determine whether any of these unrelated strains matched strains
from those women who became symptomatic.Conclusion: Symptomatic yeast vaginitis is usually due to strains of C. albicans already carried in the lower genital
tract, underscoring the need to understand regulation of growth and virulence of the organism in vivo.
Molecular Diagnosis of Human Papillomavirus: Comparison Between Cervical and Vaginal Sampling
Authors: Finan Ramzi R. , Irani-Hakime Noha , Tamim Hala , Almawi Wassim Y. 
Published: March 2007

Background: Human papillomavirus (HPV) is the most significant cause of cervical cancer. In view of the number
of drawbacks associated with endocervical sampling, the gold standard for HPV detection, this study examined the
utility and specificity of vaginal sampling as an alternative for endocervical sampling for the routine detection of HPV.Case study: The study comprised 51 women who tested positive and 54 women who tested negative for
endocervical HPV by polymerase chain reaction (PCR), confirmed by histopathology. At the time of specimen
collection, both (speculum‐assisted) endocervical and vaginal (no speculum) scrapings were isolated from HPV positive
and negativewomen, and HPV DNA was assessed by PCR using the MY09/MY11 primer system;HPV type
was identified by hybridization of PCR products with type‐specific biotinylated DNA probes. Each participant
served as her own control. HPV was detected in vaginal and cervical scrapes from all HPV‐positive but not
HPV‐negative women. In HPV‐positive women the same HPV type was found in vaginal and endocervical scrapings
(positive predictive value = 1.0).Conclusion: Correlation between vaginal and endocervical sampling methods was excellent in detecting the
presence of HPV DNA and for identifying distinct HPV genotypes. Utilization of vaginal testing for routine HPV
detection, and for the long‐term follow‐up of persistent HPV infection, is therefore recommended.
Prevalence of Sexually Transmitted Infections (Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonasvaginalis and Human Papillomavirus) in Female Attendees of aSexually Transmitted Diseases Clinic in Ulaanbaatar, Mongolia
Authors: Garland Suzanne M. , Tabrizi Sepehr N. , Chen Shujun , Byambaa Chultemsuren , Davaajav Khalzan 
Published: March 2007

Background: Epidemiological data suggest that the prevalence of syphilis, gonorrhea and trichomoniasis has
increased in both urban and rural areas of Mongolia. These data are primarily substantiated by notifications of cases
of clinically apparent disease in both rural and urban areas, plus laboratory diagnoses from the AIDS/STD Reference
Center,Ulaanbaatar. In the past 5 years, however, there has been a marked decline in the total number of patients
being screened for sexually transmitted infections (STIs). An assessment of true prevalence of STIs in a female
population attending an urban sexually transmitted diseases (STD) clinic was therefore commenced.Methods: Consecutivewomen attending an STD clinic in Ulaanbaatar had genital samples collected by the insertion
and immediate removal of a tampon, which was then tested for the presence of Neisseria gonorrhoeae ,
Chlamydia trachomatis, human papillomavirus (HPV) and Trichomonas vaginalis , using polymerase chain reaction
(PCR) amplification.Results: A total of 110 women were studied (mean age 26.7 years). Overall, 58 (53%) patients had one or more
pathogens identified; 43 (39%) had a single pathogen, while 15 (14%) had mixed pathogens. C. trachomatis was
found in 15 (14%), N. gonorrhoeae in 12 (11%), T. vaginalis in nine (8%) and HPV in 39 (36%). Among the 39
HPV‐positive patients, oncogenic genotypes (16, 18, 31, 33, 35, 39, 45, 51, 52) were found in 17 (44%) patients.Conclusions: Sexually transmitted infections as defined by PCR were common, and found in 53%of female
attendees of an urban STD clinic in Mongolia. As infections with conventional STIs increase the risk of human
immunodeficiency virus (HIV) transmission, it is imperative that strategies be introduced to reduce the prevalence
of STIs. Furthermore, detection of oncogenic HPV was common, indicating that it is vital that a strategy to reduce
cervical cancer such as a pre‐cancer cervical cytology screening program also be introduced.
A Randomized Trial of Azithromycin Versus Amoxicillin for theTreatment of Chlamydia trachomatis in pregnancy
Authors: Kacmar Jennifer , Cheh Emily , Montagno Andrea , Peipert Jeffrey F. 
Published: March 2007

Objective: To compare the compliance, side effects and efficacy of amoxicillin and azithromycin for the treatment
of Chlamydia trachomatis infection in pregnancy.Methods: This is a randomized single‐blind trial of women diagnosed with C. trachomatis before 33 weeks
gestation.Women were randomly assigned either 500 mg amoxicillin orally three times per day for 7 days or a single
dose of 1 g azithromycin orally. Patientswere interviewed by telephone approximately 3–7 days following therapy
to assess compliance and side effects. Test of cure was performed at a follow‐up visit 4–6 weeks following completion
of therapy.Results: Thirty‐nine patients were randomized with 19 receiving amoxicillin and 20 receiving azithromycin. There
were no differences in baseline data between the two groups, and there were no statistically significant differences
in side effects, compliance or efficacy. In the amoxicillin group 84% of women took all pills, while 100% completed
the single 1 g dose of azithromycin. Side effects were common in both groups (38% overall), with 40% of the
azithromycin group reporting moderate to severe gastrointestinal side effects compared to 17% in the amoxicillin
group (p = 0.11). Of patients who returned for follow‐up test of cure, 3 of 15 (20%) in the amoxicillin group were
positive compared with 1 of 19 (5%) in the azithromycin group (p = 0.3).Conclusions: Side effects of therapy for C. trachomatis in pregnancy are common. Amoxicillin was slightly better
tolerated than azithromycin. Compliance and cure rates with both regimens was high.
Hydatid Cyst of the Uterus
Authors: Başgül A. , Kavak Z. N. , Gökaslan H. , Küllü S. 
Published: March 2007

Background: Hydatidosis is a common zoonosis that affects a large number of humans and animals, especially in
poorly developed countries. The infesting parasite has four forms named Echinococcus granulosis, E. multilocularis ,
E. vogeli and E. oligarthrus (very rare in humans). The most frequently involved organs are liver followed by the lung.
The involvement of the genital tract is rare and the occurrence in the uterus is an extreme rarity.We report a case of
hydatid cyst in the uterus.Case: A 70‐year‐old female with a history of hydatid cysts of the liver, was admitted to hospital after complaining of
low abdominal pains.On physical and gynecological examinations, no pathological finding was detected. However,
the uteruswas significantly large for a postmenopausal patient. Transvaginal sonography (TS) revealed a cystic mass
in the uterus with a size of 7× 6 cm. After further examinations a subtotal hysterectomy was performed. Microscopic
examination showed scolices of Echinococcus granulosis .Conclusion: Hydatid cysts in the genital tract are rare and the occurrence in the uterus is an extreme rarity.Differentiation
between hydatid cyst and malignant disease of the related organ is difficult. To avoid misdiagnosis, a careful
examination of pelvic masses should be carried out in endemic areas for detection of hydatid cysts.
Effect of Adjuvant Imiquimod 5% Cream on SustainedClearance of Anogenital Warts Following Laser Treatment
Authors: Hoyme U. B. , Hagedorn M. , Schindler A.-E. , Schneede P. , Hopfenmüller W. , Schorn K. , Eul A. 
Published: March 2007

Objectives: Imiquimod is an immune response modifier that has demonstrated a good efficacy and relatively low
recurrencerates in comparison to other genitalwart treatment modalities. The primary objective of this open‐label
study was to evaluate the effect on sustained clearance of treated lesions and the safety of patient‐applied topical
imiquimod after laser therapy of external anogenital warts.Methods: After laser treatment of visible external anogenital warts the ablated region(s) were treated with
imiquimod 5% cream three times/week over 12 weeks beginningwhen the wound healing process was completed,
followed by a six‐month treatment‐free observation period for the assessment of sustained clearance of treated
lesions.Results: A total of 211 male and female patients was enrolled in the study. After 12 weeks of treatment, 65.4% of
all patients showed sustained clearance. During the treatment period, 15 patients (7.1% of 211 patients) presented
with recurrent warts in the treated areas, and 58 (27.5%) patients were excluded for other reasons. During
the six‐month follow‐up period, ten additional patients (7.3% of 138 patients) developed wart recurrences. The
application of imiquimod 5% cream was well tolerated. The number of patients with adverse events related to
studymedication declined fromthe first month of treatment until the end of the third month.Most frequently, mild
to moderate itching, burning, pain and erythema were reported.Conclusions: After laser therapy and sufficient wound healing, administration of imiquimod 5% cream three
times/week appears to be safe and to reduce the incidence of wart recurrences.
Can the Diagnosis of Recurrent Vulvovaginal Candidosis BeImproved by Use of Vaginal Lavage Samples and Cultures onChromogenic Agar?
Authors: Novikova N. , Rodrigues A. , Mårdh P.-A. 
Published: March 2007

Objective: To investigate if introital and vaginal flushing samples inoculated on chromogenic agar could increase
the recovery rate and rapid identification of Candida and non‐albicans species, as compared to culture of posterior
vaginal fornix samples on Sabouraud agar and speciation of isolates by biochemical tests.Methods: Samples from the introitus and the posterior vaginal fornix and vaginal lavage samples were collected
from 91 women with a history suggestive of recurrent vulvovaginal candidosis (RVVC), and with a suspected new
attack of the condition. The specimens were cultured on Sabouraud and CHROMagar®
. Speciation of yeast
isolates was made on the chromogenic agar by API 32C®kits and by an atomized system (Vitek®).Results: Forty‐six (51%) women were positive for Candida fromone or more of the samples. The introital cultures
were positive in 43 (47%) women, both on Sabouraud and chromogenic agar. From the posterior vaginal fomix,
42 (46%) women were positive on the Sabouraud and 43 (47%) on chromogenic agar cultures, while the vaginal
lavage cultures yielded Candida on those two media in 40 (44%) and 4l (45%) cases, respectively. Candida albicans
was the most frequent species recovered, from 40 (87%) cases, followed by C. krusei in 4 (9%), C. glabrata in
2 (4%), and C. parapsilosis in one case. There was only onewoman who had a mixed yeast infection, by C. albicans
and C. krusei . There was only one discrepancy in the speciation as demonstrated by mean of chromogenic agar and
API 32C kit.Conclusions: Neither cultures of introital nor of vaginal lavage samples increases the detection rate of Candida in
RVVC cases as compared to cultures of posterior vaginal fornix samples. Use of chromogenic agar is a convenient
and reliable means to detect colonization by Candida and differentiate between C. albicans and non‐albicans
species.
Apoptosis in the Chorion Laeve of Term Patients WithHistologic Chorioamnionitis
Authors: Murtha A. P. , Auten R. , Herbert W. N. P. 
Published: March 2007

Objective: The balance between cell survival and cell death (apoptosis) is critical during development and may
affect organ function. Apoptosis is accelerated in the presence of infection and inflammation in a variety of organ
systems. The objective of this investigation was to determine if apoptosis was increased in the chorion laeve of
term patients with and without histologic chorioamnionitis.Methods: Records of placental pathology were reviewed with respect to the presence/absence of histologic
chorioamnionitis. Sections from formalin‐fixed, paraffin‐embedded fetal membrane rolls were stained using the
TUNEL method. The proportion of apoptotic nuclei was calculated in seven high‐powered fields/section. Those
with and without histologic chorioamnionitis were compared. Datawere analyzed using the Mann—Whitney U test,
with significance defined as p < 0.05.Results: There was no significant difference in demographic or clinical characteristics between the two groups.
The chorion laeve from subjects with histologic chorioamnionitis had significantly more apoptotic nuclei when
compared to those without chorioamnionitis (11.2% vs. 5%, p = 0.02).Conclusion: Apoptosis ismore prevalent in the chorion laeve of fetal membranes with histologic chorioamnionitis.
This finding suggests that infection/inflammation may impact cell survivalwithin fetal membranes. The implications
of these findings warrant further investigation.
Accuracy of Five Different Diagnostic Techniques inMild‐to‐Moderate Pelvic Inflammatory Disease
Authors: Gaitán Hernando , Angel Edith , Diaz Rodrigo , Parada Arturo , Sanchez Lilia , Vargas Cara 
Published: March 2007

Objective: To evaluate the clinical diagnosis of pelvic inflammatory disease (PID) compared with the diagnosis of
PID made by laparoscopy, endometrial biopsy, transvaginal ultrasound, and cervical and endometrial cultures.Study design: A diagnostic performance test study was carried out by cross‐sectional analysis in 61 women. A
group presenting PID (n = 31) was compared with a group (n = 30) presenting another cause for non‐specific
lower abdominal pain (NSLAP). Diagnosis provided by an evaluated method was compared with a standard
diagnosis (by surgical findings, histopathology, and microbiology). The pathologist was unaware of the visual
findings and presumptive diagnoses given by other methods.Results: All clinical and laboratory PID criteria showed low discrimination capacity. Adnexal tenderness showed
the greatest sensitivity. Clinical diagnosis had 87% sensitivity, while laparoscopy had 81% sensitivity and 100%
specificity; transvaginal ultrasound had 30% sensitivity and 67% specificity; and endometrial culture had 83%
sensitivity and 26% specificity.Conclusions: Clinical criteria represent the best diagnostic method for discriminating PID. Laparoscopy showed
the best specificity and is thus useful in those cases having an atypical clinical course for discarding abdominal
pain when caused by another factor. The other diagnostic methods might have limited use.
Lack of an Effect of Protease Inhibitor Use on GlucoseTolerance During Pregnancy
Authors: Dinsmoor Mara J. , Forrest Scott T. 
Published: March 2007

Objective: We hypothesized that HIV‐positivewomen on protease inhibitors (PIs) would be more likely to have an
elevated glucola test result than those not on PIs.Methods: We reviewed our database of all HIV‐positive pregnant women seen at our hospital. Serum glucose
was measured 1 hour following a 50‐g glucola load, at approximately 26–28 weeks of gestation. Statistical
analysis was performed using Student′s t‐test, Fisher′s exact test, and the Mann–Whitney rank sum test.Results: Forty‐one HIV‐infected pregnant women with glucola testing were seen between January 1, 1997 and
March 1, 2000. Fourteen patients were on PIs at the time of glucola. One patient in each group had an abnormal
glucola test result (glucose ≥140 mg/dl); both had normal 3‐hour glucose tolerance tests. The glucola test results
were similar between the PI‐exposed and unexposed, with a mean difference of 5.8 mg/dl (95% confidence
interval 9.2–20.8 mg/dl). Two neonates (both exposed to PI) had hypoglycemia (glucose < 40 mg/dl).Conclusions: The use of PIs does not significantly increase the risk of an elevated glucola result, nor is the
mean glucola result increased in the women on PIs. The finding of hypoglycemia in neonates exposed to PIs
merits further investigation.
Compliance With Protocols for Prevention of Neonatal Group B Streptococcal Sepsis: Practicalities and Limitations
Authors: Gilbert Gwendolyn L. , Hewitt Moira C. , Turner Catherine M. , Leeder Stephen R. 
Published: March 2007

Objective: To compare two protocols for intrapartum antibiotic prophylaxis (IAP) against neonatal group B streptococcal (GBS) sepsis, with respect to staff compliance, in a prospective cohort study in the obstetric units of a community hospital (A) and a university teaching hospital (B).Methods: Cohorts comprised about 500 women attending antenatal clinics at each hospital (total 1096). Women identified as GBS carriers at 26–32 weeks′gestation and those who had intrapartum clinical risk factors (CRF) were eligible for IAP. Compliance was defined as the proportion of women eligible for IAP who received it according to protocol–as determined by audit of case records–and compared between hospitals and according to indication.Results: Overall, 39% of women were eligible for IAP. Indications were GBS carriage alone (21%), CRF alone (13% ) and both (5% ). Compliance was similar for GBS carriers at both hospitals: 78% at Hospital A and 76% at Hospital B. However, because of the poor predictive value of screening before 32 weeks, only 65%of intrapartum GBS carriers actually received IAP. For women with CRF only, compliance was significantly lower at Hospital B than Hospital A (56 vs. 75%; p= 0.03).Conclusions: According to currently recommended protocols, about one‐third of healthy women are eligible for intrapartum antibiotics to prevent neonatal GBS sepsis. In practice, antibiotics are often used inefficiently because of poor compliance with protocols and poor predictive values of selection criteria. Better implementation strategies should improve compliance, but GBS vaccines are needed to replace prophylactic antibiotic use, with its associated disadvantages.
Leukocyte Esterase Activity in Vaginal Fluid of Pregnant andNon‐Pregnant Women With Vaginitis/Vaginosis and in Controls
Authors: Mårdh Per-Anders , Novikova Natalia , Niklasson Ola , Bekassy Zoltan , Skude Lennart 
Published: March 2007

Objectives: To determine the leukocyte esterase (LE) activity in vaginal lavage fluid of women with acute and
recurrent vulvovaginal candidosis (VVC and RVVC respectively), bacterial vaginosis (BV), and in pregnant and
non‐pregnant women without evidence of the three conditions. Also to compare the result of LE tests in women
consulting at different weeks in the cycle and trimesters of pregnancy.The LE activity was correlated to vaginal pH,
number of inflammatory cells in stained vaginal smears, type of predominating vaginal bacteria and presence of
yeast morphotypes.Methods: One hundred and thirteen women with a history of RVVC, i.e. with at least four attacks of the
condition during the previous year and who had consulted with an assumed new attack of the condition, were
studied. Furthermore, we studied 16 women with VVC, 15 women with BV, and 27 women attending for control
of cytological abnormalities, who all presented without evidence of either vaginitis or vaginosis. Finally, 73
pregnant women were investigated. The LE activity in vaginal fluid during different weeks in the cycle of 53 of
the women was measured.Results: In the non‐pregnant women, an increased LE activity was found in 96, 88, 73 and 56% of those
with RVVC, VVC and BV and in the non‐VVC/BV cases, respectively. In 73% of pregnant women in the second
trimester, and 76% of those in the third, the LE test was positive. In all groups of non‐pregnant women tested,
the LE activity correlated with the number of leukocytes in vaginal smears, but it did not in those who were
pregnant. There was no correlation between LE activity and week in cycle. The vaginal pH showed no correlation
to LE activity in any of the groups studied.Conclusions: The use of commercial LE dipsticks has a limited value in the differential diagnosis of RVVC, VVCand
BV. There is no correlation between the LE activity in vaginal secretion on one hand and vaginal pH, week in
the menstrual cycle and trimester in pregnancy on the other. Women with BV often have signs of inflammation
as evidenced by a positive LE test and inflammatory cells in genital smears.
Etiology of Persistent Tubo‐Ovarian Abscess in Nairobi, Kenya
Authors: Cohen Craig R. , Gravelle Lisa , Symekher Samwel , Waiyaki Peter , Stamm Walter E. , Kiehlbauch Julia A. 
Published: March 2007

Objective To study the microbial etiology of tubo‐ovarian abscess (TOA).Methods We recruited 11 women in Nairobi, Kenya who failed antibiotic therapy alone and required
surgical drainage of a presumptive TOA. Pus from the nine abscesses and two pyosalpinges were collected and
cultured for aerobic, facultative and anaerobic microorganisms.Results Eleven women suspected of having a TOA were hospitalized and treated for a median of 6 days (range
3–14 days) prior to surgical drainage of the abscess. Nine (82%) specimens were culture positive. Aerobes
were present in all nine specimens. Seven of the nine positive cultures (78%) were polymicrobial and five of
the polymicrobial cultures contained both anaerobes and aerobes. Anaerobic Gram‐negative bacilli (Prevotella sp.,
Porphyromonas sp. and Bacteroides sp., Escherichia coli ) and Streptococcus sp. ( S. viridans and S. agalactiae) were the
most common microorganisms isolated. Neisseria gonorrhoeae and Chlamydia trachomatis were not isolated by
culture or detected by polymerase chain reaction.Conclusions In Kenya, persistent TOAs are associated with endogenous flora similar to that normally found
in the gastrointestinal tract.
Pregnancy‐Associated Pyogenic Sacroiliitis: Case Report and Review
Authors: Almoujahed Mohammad O. , Khatib Riad , Baran Joseph 
Published: March 2007

Background: Pyogenic sacroiliitis occurs infrequently during the peripartum period.Case: A case at our institution and a review of the literature were analyzed. A total of 15 cases were discovered.
The onset of illness was during pregnancy (40% of cases), within 3 weeks postpartum (40%) or post‐abortion
(20%), and the presentation was usually acute (< 7 days in 67% of cases). Frequent manifestations included
localized pain in the hips or buttock, sacroiliac joint tenderness and fever. Computed tomography or magnetic
resonance imaging revealed joint involvement in all cases tested. Microbiology was confirmed by blood (40%) or
joint aspirate (75%), and most patients were treated with antibiotics. Surgical intervention took place in five cases.
Pretermlabor was reported in only one case. All patients respondedwell to therapy without locomotive disability,
and persistent pain was uncommon.Conclusion: Septic sacroiliitis should be considered in peripartum patients who present with fever and severe
localized pain. Medical management is usually curative, and without an adverse effect on pregnancy.