bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of Repeated Gonorrhea Cultures in the Third Trimester
Authors: Torres Juan G. , Mattox T. Fleming , Pastorek Joseph G. 
Published: March 2007

Objective: With the high cost of health care today, the universal
prophylactic measures recommended, and the availability of effective treatment should
infection occur, the practice of routinely repeating the endocervical gonorrhea (GC) culture
in the third trimester of pregnancy may be unwarranted.Methods: To test this hypothesis, we reviewed charts from patients
who had received routine prenatal care during a 2‐year period at the Lafayette and Opelousas
parish health units. Those charts, which had documented results of both the initial and repeat
GC cultures, were then used for retrospective review. The results ofthe initial GC culture were
compared with that taken in the third trimester. Other data recorded included age, gravidity,
race, and history of gonorrhea, syphilis, or multiple sexual partners.Results: Two hundred fifty charts were available for extraction; 130
of these had documentation of both GC cultures. Of the 130 cultures obtained during
the initial prenatal visit, only 6 (4.6%) were positive. Of the repeat cultures taken during the
third trimester, none were positive. Thirteen patients (10.0%) had a documented history of
GC infection; none of them had positive cultures during the study period.Conclusions: Screening for GC during pregnancy is important and appropriate.
This is commonly accomplished by taking a GC culture during the initial prenatal visit.
Based upon the present study, we found that repeating this culture in the third trimester,
even in a relatively high‐risk population, seems unnecessary, whether the initial culture is
negative or not.
Epidemiology of Sexually Transmitted Diseases Among Pregnant Adolescents
Authors: Gittens Lisa N. , Nichols Rhonda R. , Apuzzio Joseph J. 
Published: March 2007

Objective: The purpose of this study was to determine the
epidemiology of sexually transmitted diseases (STDs) among pregnant adolescents.Methods: Charts of all patients (n = 735) who attended the Maternal and
Infant Care Clinic at University Hospital, Newark, NJ, between July 1, 1991, and June 30,
1992, were reviewed for STDs which included gonorrhea, chlamydia, syphilis, and human
immunodeficiency virus (HIV). At the first prenatal visit, each registrant had endocervical
specimens obtained to detect gonorrhea and chlamydia. A serum sample was obtained
for syphilis screening. HIV testing was made available to all patients and testing was
done on a voluntary basis. The same STD screening that was done at the initial visit was
repeated at 28 and 36 weeks.Results: Twenty‐five percent of patients tested positive for one or
more STDs. The mean patient age was 17.3 years. The mean gestational age at first visit
was 19.5 weeks. The mean number of visits was 7.3. The following STDs were identified:
4.8% of patients tested positive for gonorrhea, 20.9% tested positive for chlamydia,
and 1.7% tested positive for syphilis. Twenty‐one percent of patients had a positive
STD diagnosed at the initial visit. Another 4.8% of patients had an STD diagnosed at some
time after the initial visit when the initial screen was negative for STDs. An additional
1% of patients who initially tested positive for an STD had subsequent screening which
revealed another STD (different organism). Seven patients tested HIV positive.
Sixty‐one percent of patients with STDs agreed to HIV testing. One patient had
HIV coexistent with another STD.Conclusions: Pregnant adolescents are at risk for multiple
STDs. HIV testing should be offered. STD screening should be repeated in the third
trimester in adolescent patients.
Trichomonas vaginalis: Diagnosis and Clinical Characteristics in Pregnancy
Authors: Heine R. Phillip , McGregor James A. , Patterson Elisa , Draper Deborah , French Janice , Jones Ward 
Published: March 2007

Objective: The objectives of this study were to 1) determine the
prevalance and characterize the symptomatology of Trichomonas vaginalis (TV)
infection in pregnant women on entry into prenatal care in an inner‐city population; 2)
compare conventional microscopic methods vs. culture techniques in diagnosing
TV in both symptomatic and asymptomatic pregnant patients; and 3) correlate
wet mount microscopic and microbiologic characteristics of varying manifestations of
trichomoniasis.Methods: One thousand two hundred sixty patients in an inner‐city
population were tested at entry into prenatal care for TV by saline wet mount and culture
techniques. Other tests for lower genital tract infection were also performed.
Vaginal symptoms were ascertained through standardized questioning prior to examination.
Standard microscopic and microbiologic data were also obtained for analysis. Wet
mounts were systematically examined and considered negative if no TV was identified in
10 high powerfields (HPFs). Cultures were inspected from days 4 to 7 or until positive
results were obtained. Results were analyzed using McNemar′s test for correlated proportions,
chi‐squared test, or Fisher exact test where appropriate.Results: Culture and wet mount results were available in 1,175
patients. TV infection was documented by one or both techniques in 110/1,175 (9.4%).
Culture methods detected 105/110 (94.5%) of all patients while wet mount detected
90/110 (73%) (P <0.001). Vaginal symptoms were present in only 20/110 patents
(18.2%). Among asymptomatic patients, culture detected 94% while wet mount
detected 70% (P < 0.001). Among symptomatic patients, wet mount and culture were
both effective and diagnosed 85% and 95% of infections, respectively (P = not significant).
Patients with TV were more likely to have increased vaginal fluid wlaite blood cells (WBCs)
and more severe vaginal flora disruption than uninfected controls. Subgroup analysis
revealed wet mount‐positive/culture‐positive patients were more likely to have vaginal
flora disruption, as evidenced by decreased lactobacilli and elevated vaginal pH, than
wet mount‐negative/culture‐positive subjects. Coexistent infection rates were similar
regardless of wet mount status. Elevated vaginal fluid WBCs were more
common among patients with symptoms.Conclusions: 1) Screening pregnant women for TV based solely
on symptomatology is ineffective in this population; 2) culture techniques detected
more infections than conventional microscopic evaluation; and 3) significant increases
in vaginal fluid WBCs and altered vaginal flora are found in both symptomatic and
asymptomatic TV, suggesting that both infestations have the potential to adversely
affect pregnancy outcome. Studies on the influence of TV on pregnancy outcomes are
ongoing.
Human Papillomaviruses and Papillomatosis Lesions of the Female Lower Genital Tract
Authors: Fu Yu-Liang , Hu Yao-Xiong , Ling Han-Liang , Ye Zhen-Zhong , Liang Tian , Zhang Mei-Gui , Liu Yun-Ke , Kang Biao , Luo Yuan-Ji , He Shu-Ying , Lian Yong-Jian 
Published: March 2007

Objective: The objective of this study was to determine whether human
papillomavirus (HPV) infections are involved in the development of papillomatosis lesions
of the lower female genital tract.Methods: A total of 616 biopsy specimens of genital papillomatous
lesions (307 nodular and 309 papular types) from 598 patients were anaylyzed for the
presence of HPV DNA sequences by polymerase chain reaction (PCR). These specimens
were also examined by histopathological assessment for characteristic HPV‐associated
cytological changes, by immunohistochemical staining for HPV‐associated antigen,
and by electron microscopy for the presence of virions.Results: HPV DNA sequences were found in 97.9% (140 of 143 cases)
and 1.1% (1 of 91 cases) of the nodular and papular papillomatosis cases tested,
respectively. In 18 patients who had both types of papillomatosis lesions, HPV DNA was
invariably found only in nodular tissues. HPV‐associated antigen, koilocytosis, and
virions were found in 53.6% (98 of 183 cases), 70.5% (129 of 183 cases),
and 5.9% (5 of 85 cases) of nodular papillomatosis lesions tested, respectively.Conclusions: These data suggest that nodular papillomatosis was
closely associated with HPV infection, but that papular papillomatosis of the lower
female genital tract may have an etiology other than HPV infection,
Fatal Herpetic Hepatitis in Pregnancy
Authors: Chatelain Stephen , Neumann D. Edward , Alexander Samuel M. 
Published: March 2007

Background: Disseminated herpetic infections during pregnancy have
been reported in the literature.Case: This case presentation describes a pregnant patient who
presented with fever, elevated liver enzymes, and upper abdominal tenderness and
succumbed from fulminant herpetic hepatitis.Conclusion: Early diagnosis and treatment are essential because of the
high mortality rate.
Microbiology of Bartholin′s Duct Abscess
Authors: Mattila Anu , Miettinen Ari , Heinonen Pentti K. 
Published: March 2007

Objective: The aim of the study was to determine the currently most
frequent microbial findings in Bartholin′s duct abscess.Methods: Computerized records of microbial findings of 249 cases
of Bartholin′s duct abscess were retrospectively studied.Results: In 129 cases, only 1 microbe and, in 117 cases, >1 microbe
were recovered. In 3 cases, the flora was recorded as normal for the
lower genital tract. Of all bacteria isolated, 252 were aerobic or facultative and 108 were
anaerobic or microaerophilic. Aerobic or facultative bacteria alone caused 142 (57%) of the
249 cases, Escherichia coli being the most frequent isolate in this group. Anaerobic or
microaerophilic bacteria alone caused 33 cases (13%), Bacteroides species and Prevotella
species being most frequently identified. Both aerobic or facultative and anaerobic or
microaerophilic bacteria were isolated in 70 cases (28%). Candida albicans alone caused
1 case of Bartholin′s duct abscess. The sexually transmitted pathogens Neisseria gonorrhoeae
and Chlamydia trachomatis were both involved in only 2 cases.Conclusions: Bartholin′s duct abscess was mainly caused by
opportunistic bacteria, and sexually transmitted pathogens were only rarely involved in its
pathogenesis. Since potentially pathogenic bacterial species were also frequently isolated,
the use of antibiotics to complement the surgical treatment of Bartholin′s duct abscess
seems advisable, especially in patients with systemic symptoms.
Neurobrucellosis Complicating Pregnancy: A Case Report
Authors: Gloeb D. Jay , Lupi Carla , O′Sullivan Mary Jo 
Published: March 2007

Background: Brucellosis in humans is an infectious disease which may
occur following contact with infected domestic animals or the ingestion of unpasteurized
dairy products. It has rarely been described in pregnancy. The diagnosis, neuropsychiatric
manifestations, and management of brucellosis in a 3rd‐trimester pregnant woman are
discussed.Case: A 24‐year‐old Mexican female, G3P2002,
at 30 weeks gestation
presented with fever, shaking chills, night sweats, a non‐productive cough, weakness,
nausea, vomiting, anorexia, and vague, dull, upper abdominal pain as well as neuropsychiatric
findings. Extensive evaluation revealed serologic and culture evidence of Brucella infection.
Her worsening neuropsychiatric condition necessitated preterm delivery with
satisfactory neonatal and improved maternal outcomes.Conclusion: Bacteriologic infection of pregnant women with
neuropsychiatric manifestations should prompt a careful investigation, and brucellosis
should be considered if there is a travel history possibly compatible with contact with
domestic animals or the ingestion of unpasteurized dairy products.
Chlamydia trachomatis Infections: Implications for Pregnant Adolescents and Their Infants
Authors: Melzer-Lange Marlene , Good Laurie , Hennes Halim 
Published: March 2007

Objective: Chlamydia trachomatis infections are common in pregnant adolescents. Previous studies
have shown that treating pregnant women of all ages with erythromycin prevents transmission of this infection to their
infants. However, there are no published studies on the efficacy of aggressive screening and treatment of C.
trachomatis in pregnant adolescents. This study was undertaken to determine if aggressive screening for C. trachomatis in pregnant adolescents and early treatment with erythromycin can prevent complications in their newborn
infants.Methods: A group of pregnant adolescents enrolled at Teen Pregnancy Service of Milwaukee was
evaluated prospectively for the presence of C. trachomatis infection. Screening was performed during
the 1st and 3rd trimesters by enzyme immunoassay. Adolescents with positive enzyme immunoassays for Chlamydia
were treated with erythromycin for 10 days. Those with negative enzyme immunoassays were enrolled as controls.
All infants born to adolescents in both groups were followed for episodes of conjunctivitis, pneumonia, and wheezing
during their 1st year of life.Results: Ninety mother/infant pairs were followed during the study period. Twenty‐eight mothers
(31%) had positive enzyme assay tests and all received erythromycin therapy. Nasopharyngeal cultures were obtained
from 60 (67%) infants; all were negative. There were no significant differences in general characteristics, development of
conjunctivitis (relative risk 1.27), wheezing (relative risk 0.91), or pneumonia (relative risk 1.12) between infants born to adolescents in either group.Conclusions: We conclude that aggressive screening and treatment of C. trachomatis infection in pregnant adolescents may prevent complications in their offspring.
Penetration of Piperacillin/Tazobactam Into Gynecologic Tissues Following a Single Loading Dose Prior toHysterectomy
Authors: O′Brien William F. , George Shelley 
Published: March 2007

Objective: This study was undertaken to determine plasma and pelvic tissue concentrations of
piperacillin/tazobactam following a single intravenous administration.Methods: Plasma and tissue samples were obtained following administration of 3 g of piperacillin
and 0.375 g of tazobactam. Concentrations of these agents were determined by chromatography.Results: Plasma concentrations (mean ±SD) for piperacillin/tazobactam were 208 ± 87/27 ± 8
and 95 ± 53/14 ± 2, respectively, at 30 and 60 min after the start of the infusion. The 8:1 ratio
between piperacillin and tazobactam in plasma remained constant for up to 96 min. Tissue concentrations
yielded a broader range, but each agent achieved significant penetration in each of the
tissues studied.Conclusions: Piperacillin/tazobactam demonstrates favorable penetration in female genital tract
tissues and Should be considered a potentially effective agent for female pelvic infections.
Prenatal Human Immunodeficiency Virus Testing and Patient Management by Obstetricians in a HighSeroprevalence Community
Authors: Robinson William R. , Fleischer Michael 
Published: March 2007

Objective: In order to determine the practice habits of obstetricians concerning frequency of prenatal
human immunodeficiency virus (HIV) testing and management strategies for HIV‐seropositive obstetric patients, we
conducted a telephone survey of practicing obstetricians over a 3‐month period.Methods: In the New Orleans metropolitan area, 71/104 (68%) obstetricians participated and
completed the survey.Results: Of these obstetricians, 43/71 (60.6%) test all new obstetric patients for HIV; 64/71
(84.5%) routinely ask the patients about risk factors for infection; and 28/71 (39.4%) have actually cared for
an HIV‐positive patient in their practice. Those obstetricians who routinely tested for HIV
were more likely to have personally managed an infected patient and more likely to ask about risk
factors. The number of obstetricians who would manage infected patients without consultative
assistance was 8/71 (11%).Conclusions: We concluded that obstetricians in this community have largely accepted routinely
offered prenatal testing and risk assessment, but they have assumed a relatively small role in risk
reduction counseling and treatment.
Ability of History Taking Alone to Identify Early Pregnancies Among Potential Measles Vaccinees
Authors: Mead Philip B. 
Published: March 2007

Objective: This study was undertaken to determine the ability of history taking alone, compared with
pregnancy testing, to identify early pregnancies among potential female measles vaccinees.Methods: As part of an institution‐wide measles immunization program, 326 female health care
workers (HCWs) who denied being pregnant underwent a urine pregnancy test prior to vaccination.Results: Of the 326 women, 3 had positive pregnancy tests and were ultimately confirmed to be
pregnant. Although all 3 women denied the possibility of pregnancy prior to testing, 2 had been
unable to give an exact date for their last menstrual period (LMP).Conclusions: In this group of 326 northern New England HCWs being immunized against measles
during an outbreak, history taking alone failed to identify 3 pregnancies. If the inability to give an
exact date of the LMP had been included as a discriminator, 2 additional pregnancies could have
been suspected, but 1 pregnancy still would have gone undetected.
Infectious Morbidity After Radical Vulvectomy
Authors: Elg Steven A. , Carson Linda F. , Brooker Doris C. , Carter Jonathan R. , Twiggs Leo B. 
Published: March 2007

Objective: This retrospective investigation describes the infectious morbidity of patients following
radical vulvectomy with or without inguinal lymph node dissection.Methods: The charts of patients undergoing radical vulvectomy between January 1, 1986, and
September 1, 1989, were reviewed for age, weight, cancer type, tumor stage, operative procedure(s), prophylactic
antibiotic and its length of use, febrile morbidity, infection site, culture results, significant medical history, and length
of use and number of drains or catheters used.Results: The study group was composed of 61 patients, 14 of whom underwent a radical vulvectomy
and 47 who also had inguinal lymph node dissection performed. Twenty‐nine patients (48%) had at least 1
postoperative infection. Five patients (8%) had 2 or more postoperative infections. The site and incidence of the
infections were as follows: urinary tract 23%, wound 23%, lymphocyst 3%, lymphatics (lymphangitis)
5%, and bowel (pseudomembranous colitis) 3%. The most common pathogens isolated from both urine and
wound sites were Pseudomonas aeruginosa, enterococcus, and Escherichia coli. A significant decrease in wound
infection was demonstrated when separate incisions were made for inguinal lymph node dissection (P <0.05).
The mean number of days to onset of postoperative infection for wound, urine, lymphatics, lymphocyst, and bowel were
11, 8, 57, 48, and 5, respectively.Conclusions: We conclude that the clinical appearance of post‐radical vulvectomy infections is
delayed when compared with other post‐surgical wound infections. Second, utilizing separate inguinal surgical
incisions may reduce infectious morbidity. Finally, tumor stage and type do not necessarily increase the infectious
morbidity of radical vulvar surgery.
Propensity of Tampons and Barrier Contraceptives to Amplify Staphylococcus aureusToxic Shock Syndrome Toxin‐I
Authors: Tierno Philip M. , Hanna Bruce A. 
Published: March 2007

Objective: Although the incidence of reported cases of toxic shock syndrome (TSS) has declined in
recent years, the disease continues to occur in menstruating women using the newer, less‐absorbent tampons or barrier
contraceptives. Extant tampons and other vaginal devices were tested for the ability to induce TSS toxin‐1 (TSST‐1)
by a TSS strain of Staphylococcus aureus MN8, a known high‐toxin producer. Tested for the first time were 20 varieties
of tampons, including 2 all‐cotton brands newly introduced in the United States, a polyurethane contraceptive sponge,
a latex diaphragm, and a polymer menstrual collection cup.Methods: All products were washed in sterile distilled water prior to use to reduce the effect of
leachable chemicals. Duplicate experiments with unwashed products were also performed. Entire tampons and other
test products were immersed in brain heart infusion broth plus yeast extract (BHIY) and inoculated with S.
aureus MN8, a known TSST‐1 producer. After incubation, the culture supernatants were assayed for TSST‐1 by
gel immunodiffusion.Results: Except for all‐cotton tampons, greater amounts of TSST‐1 were detected in the supernatant
fluid of washed tampons than detected in those which were not washed. While TSST‐1 levels in unwashed non‐cotton
tampons ranged from 0.5 to 8 μg/ml, when these products were washed, TSST‐1 levels increased to 2–32
μg/ml. In all‐cotton tampons, whether washed or not, there was no detectable TSST‐1.Conclusions: The propensity for all‐cotton tampons not to amplify TSST‐1 in vitro suggests they
would lower the risk for tampon‐associated TSS.
Novel Family of Gynecologic Cancer Antigens Detected by Anti‐HIV Antibody
Authors: Rakowicz-Szulczynska Ewa M. , McIntosh David G. , Morris Peter , Smith McClure 
Published: March 2007

Objective: The reactivity of gynecologic cancer proteins with monoclonal antibody (MAb) directed
against the human immunodeficiency virus I (HIV‐I) was tested.Methods: Cytoplasmic and nuclear proteins, extracted from a broad range of gynecologic cancers
obtained during standard surgical procedures, were tested in Western blotting with MAb 5023
developed against the amino acid sequences 308–322 of the envelope protein gp120 of HIV‐I.Results: Three cell membrane proteins, Mrl20,000 (p120), Mr41,000 (p41), and Mr24,000 (p24), and
one chromatin protein, Mr24,000 (p24), were detected by MAb 5023 in invasive, poorly differentiated
cervical squamous‐cell carcinoma; ovarian serous cystadenocarcinoma; poorly and well‐differentiated
endometrial carcinoma; vulvar squamous‐cell carcinoma; and malignant mixed müllerian tumor. The
same antigens were identified in cervical carcinoma cell line SiHa. Neither p120 nor p24 was recognized
by other MAbs directed against the variable loop of gp120. Antigens p120 and p41 were undetectable in
normal ovarian tissue and in biopsy samples of normal vaginal and rectal mucosa. Rectosigmoid cancer
as well as colon carcinoma, lung carcinoma, and melanoma cell lines all tested negative.Conclusions: The identified antigens may represent either the products of human genes (proto‐onc‐ogenes)
or, more likely, the products of an unknown virus specifically expressed in female cancer.