bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of Incident Vulvovaginal Candidiasis inHuman Immunodeficiency Virus‐Positive Women
Authors: Shifrin Emma , Matityahu Debra , Feldman Joseph , Minkoff Howard 
Published: March 2007

Objective: Mucosal infections including vulvovaginal candidiasis are a common problem for women
with human immunodeficiency virus (HIV) infection. Our objective was to determine which factors
predict the development of symptomatic disease among HIV‐infected women.Materials and Methods: In a prospective study from 1991 to 1995, 205 HIV‐positive women were
evaluated every 6 months for occurrences of vulvovaginal candidiasis. Included in the study were
all initially asymptomatic women, whether they were fungal‐culture‐positive or ‐negative at baseline.
Excluded from the study were all women with symptomatic vulvovaginal candidiasis at the
initial visit, those who developed trichomonas vaginitis at any visit, and those who used any antifungal
agents.Results: The risk of the development of vulvovaginal candidiasis did not differ between women
who were asymptomatically colonized at baseline and those who were fungal‐culture‐negative.
However, the risk of developing vulvovaginal candidiasis was increased 6.8 times for women with
CD4 counts less than 200 cells/mm3 at baseline.Conclusions: Fungal culture is not predictive of the development of symptomatic vulvovaginal
candidiasis. Women infected with HIV who have CD4 counts below 200 cells/mm3 should be
monitored more carefully for vulvovaginal candidiasis. Infect. Dis. Obstet. Gynecol. 8:176–180,
2000.
Predictors of Chlamydia trachomatis Infection Among WomenAttending Rural Midwest Family Planning Clinics
Authors: Hilger Tami M. , Smith Elaine M. , Ault Kevin 
Published: March 2007

Objective: To determine predictors of Chlamydia trachomatis infection among women 14–24 years of age
attending family planning clinics throughout a rural Midwestern state.Methods: The study population included 16 756 women between the ages of 14 and 24 years attending family
planning clinics for annual examinations throughout the state of Iowa in 1997. All women under 25 years of age
having annual exams were tested for C. trachomatis during the visit. At the time of exam, both behavioral and
demographic data were collected on all women participating in the study.Results: The majority of women in the study (96%) reported no symptoms of chlamydia. Only 2.5% of all women
had a positive test result. In the multivariate model, the odds ratios were significantly increased among the youngest
age (14–17 years; OR = 2.2), those with mucopurulent cervicitis (OR = 3.4), cervical friability (OR = 2.2),
symptomatic for infection (OR = 1.8), risk history (OR = 1.6), and black race (OR = 1.2) and predictive of a
C. trachomatis infection.Conclusions: Risk factors predictive of C. trachomatis infection among younger aged women attending family
planning clinics in a Midwest rural population are consistent with predictors of infection among women attending
family planning clinics across theUnited States. The overall findings suggest the importance of developing screening
guidelines as a means of lowering chlamydia rates. This may be a particularly difficult task in light of the low rate of
symptoms that would lead a woman to seek medical care, even in younger age women who are at higher risk. In
addition, screening guidelines would be more difficult to implement in a rural setting.
Efficacy of Clindamycin Vaginal Ovule (3‐Day Treatment) vs.Clindamycin Vaginal Cream (7‐Day Treatment) in Bacterial Vaginosis
Authors: Sobel Jack , Peipert Jeffrey F. , McGregor James A. , Livengood Charles , Martin Maureen , Robbins Jill , Wajszczuk Charles P. 
Published: March 2007

Objective: To compare the efficacy and safety of a 3‐day regimen of clindamycin vaginal ovules with a 7‐day
regimen of clindamycin vaginal cream for the treatment of bacterial vaginosis (BV)Methods: Women with a clinical diagnosis of BV were treated with a 3‐day course of clindamycin ovules or a 7‐day
course of clindamycin cream administered intravaginally. Three hundred and eighty‐four patients received study
drug and were included in the evaluable patient population (ovule group, n = 204; cream group, n = 180).
Assessments included pelvic examination and diagnostic testing. Primary efficacy endpoints were a resolution of
two of three diagnostic criteria at the first follow‐up visit and three of three diagnostic criteria at the second.Results: Cure rates in the evaluable patient population were similar between treatment groups: 53.7% (109/204)
for the ovule group and 47.8% (85/180) for the cream group (p = 0.2471, 95% CI– 4.1–16.0%). The most
commonly reported medical event, vulvovaginal pruritus, had similar incidence in both treatment groups.Conclusions: A 3‐day course of clindamycin vaginal ovules is as effective and well‐tolerated as a 7‐day course of
clindamycin vaginal cream in the treatment of BV.
Vaginal Microflora Associated With Bacterial Vaginosis inNonpregnant Women: Reliability of Sialidase Detection
Authors: Smayevsky Jorgelina , Canigia Liliana Fernández , Lanza Alejandra , Bianchini Hebe 
Published: March 2007

Objective: To determine the prevalence of Gardnerella vaginalis, anaerobic bacteria and Mycoplasma hominis in vaginal specimens of women with and without bacterial vaginosis (BV) as well as to determine the sensitivity and specificity of the direct sialidase assay of vaginal fluid as a rapid test for diagnosing this syndrome.Methods: Vaginal cultures were obtained from 109 nonpregnant women (mean age 33 ± 7.1 years), 47 of them with clinical signs of BV (BV+) and 62 of them without BV (BV‐ ). In addition, we determined the vaginal sialidase
activity in both groups, which may serve as a feature of this syndrome.Results: Anaerobic bacteria were isolated in 91% and 18% of the BV+and BV‐ groups, respectively (p < 0.001).
Peptostreptococcus spp., Prevotella bivia and Porphyromonas spp. were strongly associated with BV. P. bivia and
Prevotella spp. represented 44% of all the anaerobes isolated in the BV+ group. All the isolated P. bivia strains presented sialidase activity. G. vaginalis and M. hominis were isolated in 76% and 42% of the BV+ and 1% and 0%
of the BV‐ women, respectively (p < 0.001). Mobiluncus morphotypeswere observed in 34% of the BV+and 0%
of BV‐ women. Sensitivity, specificity, positive predictive value and negative predictive value of sialidase activity
were 81%, 94%, 90% and 86%, respectively.Conclusions: Our data demonstrate a strong association between G. vaginalis, M. hominis, and P. bivia and BV.
Sialidase activity and Gram stain of vaginal fluid represent accurate methods for diagnosing BV.
Antimicrobial Protein Produced by Vaginal Lactobacillusacidophilus that inhibits Gardnerella vaginalis
Authors: Aroutcheva Alla A. , Simoes Jose A. , Faro Sebastian 
Published: March 2007

Objective: To isolate bacteriocin from a vaginal strain of Lactobacillus acidophilus.Methods: L. acidophilus 160 was grown on two media. The first was MRS broth for 18 hours; the cells were
harvested, washed, and placed into a chemically defined medium. The second medium resembled vaginal fluid minus protein. Bacteriocin was precipitated from both media using ammonium sulfate. The growth‐inhibiting
activity of bacteriocin was determined by a bioassay using nine different isolates of Gardnerella vaginalis.Results: MRS broth is not a suitable medium for extracting bacteriocin, because it binds with Tween 80.
Bacteriocin was isolated, without contaminating constituents, from chemically defined medium and identified as a single band by electrophoresis. Bacteriocin has a molecular weight of 3.8 kDa. All nine isolates of Gardnerella were inhibited by the bacteriocin isolated from L. acidophilus 160.Conclusions: Bacteriocin produced by L. acidophilus 160 was isolated from the chemically defined medium
(starvation medium) in a partially pure form. L. acidophilus 160 bacteriocin inhibited growth of all nine isolates of Gardnerella vaginalis.
Septic Shock Resulting in Death After Operative Delivery
Authors: Kavak Zehra Neşe , Başgül Alin 
Published: March 2007

Background: We report a youngwoman who developed septic shock after operative delivery in the 32nd week of
pregnancy.Clinical features, treatment modalities and prognosis of this high‐mortality‐rate disorder are presented
and discussed.Case: A 24‐year‐old woman, gravida 1, para 1, was referred to our clinic in a confused state and immediately
admitted to our emergency unit. She apparently had eclampsia antenatally. Termination of pregnancy with
induction of labor and vacuum extraction had been employed in gestational week 32 of pregnancy. One day after
delivery, her clinical and laboratory parameters worsened, so she was referred to our clinic. After a thorough
physical examination and laboratory evaluation, the patient was diagnosed as having sepsis and disseminated
intravascular coagulation. After blood and urine cultures were taken, aggressive management included volume
repletion, antibiotics and positive inotropic therapy. Because she had persistent fever and unimproved laboratory
values despite these therapies, the uterus and ovaries were thought to be the source of sepsis, and total abdominal
hysterectomy and bilateral salpingo‐oophorectomy were performed. Neither clinical nor laboratory parameters
improved, and the patient died 28 days after delivery as a result of respiratory failure.Conclusion: It is our purpose to emphasize that a rapid and appropriate decision for surgery may prevent the
maternal mortality in obstetric septic shock patients. Successful management depends on early identification and
aggressive treatment.
Adhesion Development and the Expression of Endothelial Nitric Oxide Synthase
Authors: Svinarich David M. , Zaher Fadi M. , Holmdahl Lena , Chegini Nasser , Gonik Bernard , Diamond Michael P. 
Published: March 2007

Objective: This study was conducted to determine whether nitric oxide (NO), a potent vasodilator and inhibitor of thrombus formation, is involved in the formation and maintenance of adhesions.Methods: Skin, subcutaneous tissues, peritoneum and adhesions were collected from surgical patients and total RNA was isolated. Quantitative reverse transcription polymerase chain reaction (QRT‐PCR) was performed to quantitate endothelial nitric oxide synthase (eNOS) and β‐actin mRNA levels.Results: eNOS mRNA levels for skin, subcutaneous tissue, peritoneum and adhesions were ≤ 3.12 × 10-4, ≤ 3.12 × 10-4, 6.24 × 10-4 and 2.5 × 10-3 attomoles/μl, respectively. β‐actin mRNA levels for all tissues were between 1.25 × 10-1 and 6.25 × 10-2 attomoles/μl.Conclusion: eNOS mRNA can be identified in tissue adhesions, and may therefore play a role in adhesion formation and maintenance.
A Multicenter Study of Bacterial Vaginosis in Women With orat Risk for Human Immunodeficiency Virus Infection
Authors: Warren Dora , Klein Robert S. , Sobel Jack , Kieke Burney , Brown William , Schuman Paula , Anderson Jean , Cu-Uvin Susan , Mayer Kenneth , Jamieson Denise J. , Holmberg Scott , Duerr Ann 
Published: March 2007

Background: Bacterial vaginosis is a common gynecologic infection that has been associated with a variety of
gynecologic and obstetric complications, including pelvic inflammatory disease, postabortal infection and premature
delivery. Recent studies suggest that bacterial vaginosis may increase a woman’s risk for human immunodeficiency
virus (HIV). We undertook this study to assess whether the prevalence and characteristics of bacterial
vaginosis differed according to HIV status in high‐risk US women.Methods: Prevalence of bacterial vaginosis was assessed by Gram’s stain and clinical criteria for 854 HIV‐infected
and 434 HIV‐uninfected women enrolled in the HIV Epidemiology Research (HER) Study.Multiple logistic regression
techniques were used to determine whether HIV infection independently predicted bacterial vaginosis.
Results: Almost half (46%) the women had bacterial vaginosis by Gram’s stain. The prevalence of bacterial
vaginosis was 47% in the HIV‐positive women compared with 44% in the HIV‐negativewomen; this difference was
not statistically significant (p = 0.36). After adjustment for other covariates, HIV‐positive women were more likely
than HIV‐negative women to have bacterial vaginosis (odds ratio (OR) 1.31; 95% confidence interval (CI)
1.01‐1.70) by Gram′s stain but not by clinical criteria (OR 1.16; CI 0.87‐1.55). Among HIV‐positive women, use of
antiretroviral drugs was associated with a lower prevalence of bacterial vaginosis (adjusted OR 0.54; Cl
0.38 ‐0.77).Conclusions: In this cross‐sectional analysis of high‐risk US women, HIV infection was positively correlated with
bacterial vaginosis diagnosed by Gram’s stain.
Differentiation Between Women With Vulvovaginal SymptomsWho are Positive or Negative for Candida Species by Culture
Authors: Linhares Iara M. , Witkin Steven S. , Miranda Shirlei D. , Fonseca Angela M. , Pinotti Jose A. , Ledger William J. 
Published: March 2007

Objective: To investigate whether clinical criteria could differentiate between women with vulvovaginitis who
were culture positive or negative for vaginal Candida species.Methods: Vulvovaginal specimens were obtained from 501 women with a vaginal discharge and/or pruritis.
Clinical information and wet mount microscopy findings were obtained. All specimens were sent to a central
laboratory for species identification.Results: A positive culture for Candida species was obtained from 364 (72.7%) of the specimens. C. albicans was
identified in 86.4% of the positive cultures, followed by C. glabrata in 4.5%, C. parapsilosis in 3.9%, C. tropicalis in
2.7% and other Candida species in 1.4%.Women with a positive Candida culture had an increased utilization of oral
contraceptives (26.1% vs. 16.8%, p = 0.02) and antibiotics (8.2% vs. 0.7%, p = 0.001), and were more likely to
be pregnant (9.1% vs. 3.6%, p = 0.04) than the culture‐negative women. Dyspareunia was more frequent in
women without Candida (38.0% vs. 28.3%, p = 0.03) while vaginal erythema (p = 0.01) was more common in
women with a positive Candida culture.Conclusions: Although quantitative differences were observed, the presence of vaginal Candida vulvovaginitis
cannot be definitively identified by clinical criteria.
The Inhibitory Effect of Clindamycin on Lactobacillus in vitro
Authors: Aroutcheva Alla , Simoes Jose A. , Shott Susan , Faro Sebastian 
Published: March 2007

Objective: To evaluate the in vitro effect of varying concentrations of clindamycin on Lactobacillus spp.Methods: Concentrations of clindamycin ranging from 1.95–20 000 mg/ml were studied for their effect on the
growth of six strains of Lactobacillus .Results: Clindamycin concentrations between 1.95–31.25 mg/ml had no statistically significant effect on growth of
lactobacilli (p > 0.05). Concentrations 125 and 250 mg/ml had a bacteriostatic effect. The mean minimum inhibitory
concentration (MIC) for studied Lactobacillus strains was determined as 1000 mg/ml.Conclusion: High concentrations of clindamycin achieved in the vagina by intravaginal application might be
inhibitory for Lactobacillus .
Antimicrobial Susceptibility of Gram‐Negative UropathogensIsolated From Obstetric Patients
Authors: Jamie Whitney E. , Edwards Rodney K. , Duff Patrick 
Published: March 2007

Objective: To evaluate the antimicrobial susceptibility of Gram‐negative uropathogens isolated from pregnant
women.Methods: We performed a snapshot cohort study of women receiving care in the University of Florida prenatal
clinics duringMarch 2000. Subjects with asymptomatic bacteriuria or cystitis were identified and the antimicrobial
susceptibility of each pathogen was recorded. Data were analyzed using chi‐square, Fisher′s exact test and
ninety‐five percent confidence intervals, as appropriate.Results: Ninety‐five positive cultures were identified. Isolates were more often susceptible to trimethoprimsulfamethoxazole
(TMP‐SMX) (87%) and nitrofurantoin (89%) than to ampicillin (72%) (p < 0.03). Escherichia coli
accounted for 71 (75%) cases and was more often susceptible to nitrofurantoin (100%) than to TMP‐SMX (87%)
(p < 0.01). Proteus isolates were all susceptible to TMP‐SMX and resistant to nitrofurantoin (p < 0.01).Conclusions: Both TMP‐SMX and nitrofurantoin are superior to ampicillin for empiric treatment of lower urinary
tract infection in pregnant women. Nitrofurantoin is superior to TMP‐SMX for treatment of infections caused by
E. coli. For suspected or confirmed cases caused by Proteus organisms, TMP‐SMX is the preferred agent.
Does Pre‐ and Postoperative Metronidazole Treatment LowerVaginal Cuff Infection Rate After Abdominal HysterectomyAmong Women With Bacterial Vaginosis?
Authors: Larsson Per-Göran , Carlsson Bodil 
Published: March 2007

Objective: Bacterial vaginosis (BV) is a known risk factor for postoperative infection following abdominal hysterectomy.
Vaginal bacterial flora scored as intermediate has been shown to have the same risk of postoperative
infection as BV.Methods: Women undergoing total abdominal hysterectomy for benign diseases were open‐randomized according
to Zelen to either treatmentwith metronidazole rectally for at least 4 days or no treatment. At the preoperative
gynecological examination a vaginal smear was collected and Gram stained. Women with BV or intermediate flora
were merged to one group called abnormal vaginal flora.Results: In total 213 women were randomized to treatment or no treatment. After exclusion of 71 women, 142
women were eligible for analysis. Among the 59 women diagnosed with abnormal vaginal flora there were no
vaginal cuff infections in the treated arm, comparedwith 27% in the ‘no treatment’ arm (p <0.01). Treatment also
reduced the vaginal cuff infection rate from 9.5 to 2% among the 83 women with lactobacilli flora. However,
this difference was not statistically significant. Treatment had no effect on the rate of wound infections.
Intention‐to‐treat analysis showed a significant reduction in vaginal cuff infections among women randomized
to treatment.Conclusion: Pre‐ and postoperative treatment for at least 4 days with metronidazole rectally reduces
significantly vaginal cuff infection among women with abnormal vaginal flora.
Site‐Specific Prevalence and Cell Densities of Selected Microbesin the Lower Reproductive Tract of Menstruating Tampon Users
Authors: Hochwalt Anne E. , Berg Ronald W. , Meyer Sandy J. , Eusebio Rachelle 
Published: March 2007

Objective: To assess differences in prevalence and cell densities of enterococci, Gram negative enterics (GNEs),
yeast and Staphylococcus aureus among four genital sites and to examine whether the presence of organisms at one
site affected the presence of organisms at other sites.Methods: Swab samples from the perineum, below and above the hymen, and the posterior fornix obtained
from 52 tampon users on menstrual cycle day 3 were analyzed for site‐specific prevalence and cell densities of
microorganisms.Results: Enterococci and GNEs were the most prevalent study organisms at all sites and decreased in prevalence
fromthe perineumto the posterior fornix.Cell densities similarly decreased frombelow the hymen to the posterior
fornix. Yeast were detected at the hymen only; S. aureus frequency was similarly low at all sites. Yeast and S. aureus
site‐specific cell densities were similar. The above‐ and below‐hymen sites were similar in prevalence and cell
density of organisms. An above‐chance association existed between the presence of any study organism below
the hymen and above the hymen and was strongest for GNEs.Conclusions: The pattern of genital colonization with enterococci and GNEs reflects their likely gastrointestinal
source. The absence of significant differences in the prevalence and cell densities of study microflora above and
below the hymen combined with an above‐chance association of the presence of microorganisms at these regions
suggests that the regions above and below the hymen are not different with respect to the presence of the
organisms evaluated in this study.
Varicella Vaccination During Early Pregnancy: A Cause ofin utero Miliary Fetal Tissue Calcifications and Hydrops?
Authors: Apuzzio Joseph , Ganesh Vijaya , Iffy Leslie , Al-Khan Anthony 
Published: March 2007

Background: It is the purpose of this article to describe a suspected association of inadvertent vaccination with
varicella vaccine during early pregnancy with the subsequent development of in utero miliary fetal tissue
calcifications and fetal hydrops detected by sonogram at 15 weeks of gestation.Case: This is a case presentation of a pregnant patient who received varicella vaccination during the same
menstrual cycle that she became pregnant, and is supplemented by a literary review. The fetus developed miliary
fetal tissue calcifications and fetal hydrops detected by a targeted sonogram at 15 weeks gestation.Conclusion: Varicella vaccination during early pregnancy may be a cause of miliary fetal tissue calcifications and
fetal hydrops.
Serotyping Group B Streptococci in a Small CommunityHospital: An Analysis of Distribution and Site of Isolation
Authors: Smith Jennifer M. , Rexroth Jason A. , Chaffin David G. , Jackman Susan H. 
Published: March 2007

Objective: To determine the prevalence and site of isolation of different serotypes of group B streptococcus
(GBS) colonization or infection at a small community hospital.Methods: GBS isolates were obtained from a small community hospital and were then serotyped as la, Ib, II, III, IV,
V or nontypeable. Hospital records were reviewed for patient sex, age and pregnancy status as well as the site of
GBS isolation.Results: GBS serotypes Ia, III and V were most common and accounted for over 60% of the total number of
isolates. Serotype Ia wasmost prevalent in reproductive‐agefemales, while serotypesV and IIIwere most prevalent
in non‐reproductive‐age females and males, respectively. Serotype la was most frequent in both pregnant and
nonpregnantfemales. Serotype IV was more common in this studypopulation than in those from other locations.Conclusions: The GBS serotype distribution in this small community did not differ significantly from distributions
described in larger North American centers. A GBS vaccine designed against multiple serotypes would be
protective for most of this population.