bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prophylactic Antibiotics for Suction Curettage in Incomplete Abortion
Authors: Ramin Kirk D. , Ramin Susan M. , Hemsell Patricia G. , Nobles Brenda J. , Heard Molly C. , Johnson Vivian B. , Hemsell David L. 
Published: March 2007

Objective: The purpose of this study was to investigate the efficacy of 200 mg of prophylactic
doxycycline in preventing pelvic infection after curettage for spontaneous (incomplete) abortion.Methods: A randomized, prospective, double‐blinded study was carried out involving 300 women
with an incomplete abortion who were given either placebo or 200 mg of doxycycline orally 30–60
min prior to curettage. A hematocrit, WBC count, pregnancy test, syphilis serology, Neisseria
gonorrhoeae culture, and Micro Trak (monoclonal antibody test, Syba, San Jose, CA) for Chlamydia
trachomatis were performed. The patients were scheduled for follow‐up 2 weeks later. Antibiotic
administration for any reason as well as the postoperative infection rate in these women was
assessed.Results: Eleven women were excluded from analysis, leaving 289 evaluable. N. gonorrhoeae was
isolated from 6 (2%) women and C. trachomatis from 8 (3%) women, and the syphilis serology was
serofast in 4 (1%) women. Endometritis complicated the procedure in 4 women who received
placebo and in 1 woman who received doxycycline (P = 0.22).Conclusion: Prophylactic doxycycline is not effective in preventing pelvic infection after curettage
for spontaneous (incomplete) abortion.
Enterobiasis of the Ovary in a Patient With Cervical Carcinoma In Situ
Authors: McCabe Kevin , Nahn Patricia A. K. , Sahin Aysegul A. , Mitchell Michele Follen 
Published: March 2007

Background: Enterobiasis occurs throughout the female genital tract and may involve peritoneal
surfaces. It is generally an incidental finding at surgery or at autopsy but occasionally is symptomatic.
Most of the superficial lesions are composed of granulomas with variable fibrosis in which
diagnostic eggs are found, often associated with degenerated adult worms. Multiple histologic sections
may be required to establish the diagnosis in older lesions.Case: A case of enterobiasis of the ovary in a patient with squamous‐cell carcinoma in situ of the
cervix is presented. The features of enterobiasis are discussed.Conclusion: The importance of mistaking such lesions for ovarian cancer is discussed.
Epidemiology and Clinical Outcome of Patients Hospitalized With Pelvic Inflammatory DiseaseComplicated by Tubo‐Ovarian Abscess
Authors: Chan Ying , Parchment Winsome , Skurnick Joan H. , Goldsmith Laura , Apuzzio Joseph J. 
Published: March 2007

Objective: The purpose of this retrospective study was to compare the clinical outcome and characteristics of pelvic inflammatory disease (PID) complicated by tubo‐ovarian abscess (TOA) with PID
without TOA.Methods: Chart reviews were performed for all PID admissions to the University of Medicine and Dentistry of New Jersey‐University Hospital, Newark, NJ, from January 1, 1992, to December 31, 1993.Results: The incidence in this study of TOA based on sonographic evidence of a complex adnexal mass was 18%. The major differences between the patients with and without TOAs were 1) history of hospitalization for PID: 68% (13/19) vs. 29% (25/85); 2) increased erythrocyte sedimentation rate: 82 vs. 41 mm/h; 3) increased WBC count on admission: 16,200 vs. 14,700/ml; 4) failure to respond to initial antibiotic therapy; and 5) longer hospital stay: 7.8 vs. 4.4 days, respectively. Surgical intervention was required in 3 patients: 2 patients who had TOAs and 1 patient who did not have a TOA by clinical examination or by ultrasound.Conclusions: Despite longer hospital stays and blood tests suggesting more severe disease processes, PID complicated by TOA is usually responsive to intravenous (IV) antibiotic therapy without the need for surgical intervention.
Amniotic‐fluid Lactoferrin: A Marker for Subclinical Intraamniotic Infection Prior to 32 Weeks Gestation
Authors: Heller Kimberly A. , Greig Phillip C. , Heine R. Phillip 
Published: March 2007

Objective: Lactoferrin is a glycoprotein released from the secondary granules of activated neutrophils in the setting of infection. The purpose of this study was to determine if amniotic‐fluid (AF) lactoferrin levels are elevated in preterm labor (PTL) patients with subclinical intraamniotic infection (IAI).Methods: AF samples were obtained from 186 pregnant patients with
the following characteristics: group 1 ‐ term, no labor; group 2 ‐ preterm, no labor; group 3 ‐ PTL with IAI; group 4 ‐ PTL without IAI. Lactoferrin levels were measured with an enzyme‐linked immunosorbent assay (ELISA).Results: AF lactoferrin levels were elevated in normal gestation after 31 weeks (P < 0.0001). Lactoferrin levels were also higher in infected PTL patients compared with noninfected PTL patients at gestations ≤31 weeks (P = 0.005). An AF lactoferrin level of >2.5 μg/ml is highly suggestive of infection in PTL patients at <32 weeks, with an overall sensitivity of 82% and a specificity of 83%, when infection is defined as a positive AF culture or positive placental histology.Conclusions: AF lactoferrin levels increase after 31 weeks in normal gestations, but lactoferrin levels >2.5 μg/ml in PTL patients before this gestational age are highly suggestive of IAI. AF lactoferrin levels may be a useful clinical tool for selecting those PTL patients who might benefit from antimicrobial therapy, closer observation, or early delivery.
Preterm Labor and Maternal Hypoxia in Patients With Community-Acquired Pneumonia
Authors: Maccato Maurizio L. , Pinell Phillip , Martens Mark G. , Faro Sebastian 
Published: March 2007

Objective:We sought to determine if preterm labor is associated with the degree of maternal hypoxia in pregnant women with community-acquired pneumonia but no other maternal diseases.Methods:We retrospectively reviewed the medical records of all antepartum patients admitted with a diagnosis of community-acquired pneumonia to an inner-city university hospital between 1983 and 1987. Included in this review were only the patients with radiologically confirmed diagnose of pneumonia and documented arterial blood gases on room air at the time of admission, but no other maternal diseases.Results:A total of 22 cases were identified. There was no maternal mortality, but there were 2 patients (9%) who developed respiratory failure requiring mechanical ventilation. Bacteremia withStreptococcus pneumoniaewas documented in 1 patient (5%). Preterm labor complicated 5 cases (23%) and led to preterm delivery in 3 patients (14%). Terbutaline tocolysis was instituted in 3 patients, but was discontinued in 1 patient who was allowed to deliver because of her worsening condition. Preterm labor was associated with the WBC count on admission, usually > 18,000/mm3, but no statistically significant correlation with the severity of maternal hypoxia was noted. Five patients (23%) were incorrectly diagnosed at the time of admission, 4 with an initial diagnosis of pyelonephritis and 1 with an initial diagnosis of cholecystitis.Conclusions:Community-acquired pneumonia in the antepartum period is responsible for significant maternal and fetal complications even in the absence of other maternal diseases. Preterm labor and delivery remain frequent, and tocolysis should be used cautiously. At the time of admission, the diagnosis may be difficult. The degree of maternal hypoxia on admission does not correlate with the presence of preterm labor.
Vulvar Vestibulitis—A Complex Clinical Entity
Authors: Ledger William J. , Kessler Alan , Leonard Garrick H. , Witkin Steven S. 
Published: March 2007

Objective: This study aims to determine the pathophysiology of vulvar vestibulitis and to evaluate
currently used treatment options.Methods: Two hundred twenty women with vulvar vestibulitis were seen between October 1987
and March 1995. Every patient had vulvar pain when they attempted intercourse, 75% had excessive
vaginal discharge, 36.4% had constant or recurring vulvar burning, and 10.9% had symptoms
suggestive of cystitis. All were cultured for the presence of Candida albicans. One hundred sixty‐one
(73.2%) were also tested for vaginal IgE and prostaglandin E2 (PGE2); 72 (32.7%) had a vulvar biopsy performed as well.Results: A wide range of variants were noted: 53 (24.1%) had a human papilloma virus (HPV)
infection, 25 (11.4%) had a Candida vulvovaginitis, 43 (19.5%) had a vaginal allergy, 15 (6.8%) had
vaginal PGE2 present, 14 (6.4%) had elevated urinary oxalate excretion, and 29 (13.2%) had a
variety of diagnosed variants. In 81 (36.8%) no underlying diagnosis was made. This understates
the numbers and varieties of vulvar vaginal diagnoses, for not all patients received a vaginal fluid
analysis, a vulvar biopsy, or a 24 h urine screen for oxalates. A variety of medical and operative
interventions was used. Symptoms were relieved in 65.9% of patients. The degree of sueeess varied.
Successful outcomes were achieved in 14.3% of patients using a low oxalate diet and calcium citrate
supplementation, 16% with anti‐Candida treatment, 48.1% with antihistamines, 77% with vulvar
injection of interferon, 83% with operative removal of inflamed vulvar tissue, and a posterior
colporrhaphy used to cover the cutaneous defect.Conclusions: The diagnosis of vulvar vestibulitis is easy to make. An etiology for this chronic
condition will not be achieved in every patient. A majority of patients can get relief by a variety of
medical and operative interventions.
Screening for Human Immunodeficiency Virus in Inner City Females With Abnormal Cervical Cytology
Authors: Jennings T. Scott , Dottino Peter , Sperling Rhoda , Beddoe Ann Marie 
Published: March 2007

Objective: This report evaluates the acceptance, results, and predictors of human immunodeficiency
virus (HIV) infection in inner city women referred to a colposcopy clinic for abnormal cervical
cytology.Methods: HIV testing results of 1,908 inner city women referred for abnormal cervical cytology
were analyzed retrospectively with respect to acceptance, race, ethnicity, Pap smear results, sexually
transmitted diseases (STDs), HIV exposures, and final histologic findings.Results: HIV testing was accepted by 50.4% of patients. Women who agreed to screening were
significantly more likely to admit exposure to HIV or to be Hispanic, foreign‐born, or have a history
of multiple STDs. Of those screened, 3.3% were found to be HIV seropositive. Although higher
grades of referral Pap smears were noted in the women found to be HIV seropositive, final histologic
findings were not different. The only predictors of unknown HIV seropositivity were admitted
HIV exposure and external condyloma.Conclusions: Fifty percent of inner city women of unknown HIV status referred for abnormal
cervical cytology will accept HIV serotesting and 3.3% are found to be positive. Most HIV‐seropositive
women can be detected based on either a history of exposure to HIV or the presence
of external condyloma.
Immunohistochemical Characterization of Leukocytic Subpopulations in Chronic Endometritis
Authors: Tawfik Ossama , Venuti Susan , Brown Sharla , Collins Julie 
Published: March 2007

Objective: We analyzed the histologic and immunohistochemical changes in the endometrial leukocytic
subpopulations to determine which of them are characteristic of chronic endometritis.Results: Endometrial biopsies from 25 cases of chronic endometritis and 35 controls were studied.
Characteristic morphologic findings included the presence of a plasma cell infiltrate, and a prominent,
albeit non‐specific, lymphocytic infiltrate in all patients with endometritis. A neutrophilic
infiltrate was also noted in 90% of the patients. Other non‐specific histologic findings included
occasional prominent lymphoid aggregates, stromal edema, hemorrhage, and necrosis and cystic
dilation of some glands in endometria of patients with chronic endometritis. Endometrial immune
cells were investigated immunohistochemically using antibodies to CD3 (pan‐T), CD20 (pan‐B,
L26), and Ham‐56 (macrophage). In control patients, endometrial immune cells were predominantly
composed of CD3 and Ham‐56 positive cells. CD20 positive cells comprised <2% of immune
cells in control patients [mean: <2 cells/high power field (HPF)]. Large numbers of CD20 and CD3
lymphocytes were seen in endometria of patients with chronic endometritis. A semiquantitative
analysis showed that the numbers of CD20 and CD3 positive cells in patients with chronic endometritis
were increased 50‐ and 3‐fold, respectively, when compared to those of control patients
(mean B cells: 49 vs. 2 cells/HPF; mean T cells: 149 vs. 45 cells/HPF). CD20 positive cells were
predominantly seen in subepithelial and periglandular aggregates. CD3 positive cells had a predominant
stromal distribution and an occasional intra‐ or subepithelial localization. There was no
difference in the number and distribution of Ham‐56 positive cells in patients with or without
endometritis.Conclusions: These findings suggest that CD20 cells may have a significant role in the pathogenesis
of chronic endometritis and that immunostaining for B and T lymphocytes could be used in
confirming the diagnosis of endometritis or in diagnosing subclinical or progressing endometritis in
which plasma cells could not be detected or are rarely identified.
Randomized Clinical Trial of Azithromycin vs. Erythromycin for the Treatment of Chlamydia Cervicitis in Pregnancy
Authors: Edwards M. S. , Newman R. B. , Carter S. G. , LeBoeuf F. W. , Menard M. K. , Rainwater K. P. 
Published: March 2007

Objective:The purpose of this study was to prospectively test the null hypothesis that there is no difference in the clinical effectiveness of azithromycin and erythromycin for the treatment of chlamydia cervicitis in pregnancy.Methods:All antepartum obstetrical patients underwent routine screening for chlamydia cervicitis using a DNA probe assay (Gen-Probe Pace, San Diego, CA). Women who tested positive for chlamydia cervicitis were prospectively randomized to receive either azithromycin 1 g orally at enrollment, or erythromycin 500 mg orally 4 times a day for 7 days. Sexual partners were referred to the county health department for evaluation and treatment. A test of cure was repeated in 2 weeks. Results were analyzed by chi-square analysis and Fisher's exact test when indicated.Results:One hundred forty women tested positive for chlamydia cervicitis and agreed to randomization. There were 4 (6.2%) treatment failures in the azithromycin group and 18 (27.7%) in the erythromycin group (P= 0.005). Gastrointestinal side effects were reported by 42 (65.5%) of the women taking erythromycin, but only 12 (19.4%) of those taking azithromycin (P< 0.002). Gastrointestinal side effects and resultant noncompliance were significantly related to treatment failure with erythromycin.Conclusions:The findings of this study support the conclusion that a single dose of azithromycin is a significantly more effective and better tolerated treatment regimen for chlamydia cervicitis in pregnancy than erythromycin which is currently recommended.
Retrospective Analysis of the Serologic Response to the Treatment of Syphilis During Pregnancy
Authors: Galan Henry L. , Montalvo Juan F. , Deaver John 
Published: March 2007

Objective: The purpose of this study was to assess the effect of several maternal variables on the serologic response following the treatment of syphilis in pregnancy.Methods: A 5‐year chart review identified 95 patients coded with syphilis at Hermann Hospital. Inclusion criteria were 1) serologically confirmed syphilis infection during the index pregnancy, 2) complete treatment during the index pregnancy, and 3) minimum of one follow‐up rapid plasma reagin (RPR) titer. Forty‐nine of 95 patients met the inclusion criteria. Treatment response was evaluated by comparing each post‐treatment titer of a patient to her pretreatment titer. Each comparison was considered an “observation.” Each observation was classified as either a positive response (≥4‐fold titer decline) or a negative response (<4‐fold titer decline). Maternal variables assessed included 1) prior history of syphilis untreated or incompletely treated prior to the index pregnancy, 2) gestational age, 3) titer level, 4) unknown duration, 5) positive response at 1 month, 6) positive response at 2 months, 7) positive response at >3 months, and 8) race.Results: A positive response following treatment was significantly more likely if there was no prior history of syphilis or if there was a high initial RPR titer (>32). Only 33/54 (61%) observations at or greater than 3 months had a positive response.Conclusions: Our study suggests that an absence of a history of syphilis and an initial high RPR titer are predictive of a positive response following appropriate treatment. Given the low percentage of observations with a positive response at 3 months, we speculate that we may be undertreating our pregnant patients with syphilis infection.
Cesarean Delivery in Women With Genital Herpes in Washington State, 1989–1991
Authors: Marrazzo Jeanne M. , John Grace C. , Krohn Marijane A. , Corey Lawrence 
Published: March 2007

Objective: The purpose of this study was to determine whether the proportion of cesarean deliveries in pregnant women with a history of genital herpes and no active lesions at birth is higher than that in women with no history of genital herpes, and to determine whether this risk was modified by birth facilities′ underlying prevalence of cesarean delivery.Methods: This was a retrospective survey. Women who gave birth in Washington state from 1989 to 1991 were identified from the state birth records and were classified as having clinical genital herpes during pregnancy (N = 1,094) or history of genital herpes only (N = 4,163) at delivery. Women without genital herpes (N = 5,257) were randomly selected from remaining births.Results: The main outcome measure was primary cesarean delivery, excluding those performed for indications other than genital herpes. Prevalence of primary cesarean delivery was 59.5% in women with clinical herpes during pregnancy and 12.5% in women with history of herpes, both significantly different from prevalence of 11.2% in unexposed women. Age‐adjusted risk for cesarean delivery among women with a history of herpes was 1.13 [95% confidence interval (CI): 0.93, 1.37]. When baseline cesarean delivery prevalence was above 20%, this risk was 1.2 (95% CI: 1.0, 1.4; P = 0.058), compared to 1.1 (95% CI: 0.9, 1.3; P = 0.186) where cesarean delivery prevalence was below 20%.Conclusions: Women with history of genital herpes appear to have a slightly elevated risk of cesarean delivery, particularly in hospital settings with baseline prevalence of primary cesarean delivery above 20%. This rate is somewhat lower than that noted in a previous survey, suggesting that practitioners are following standard guidelines. Evaluations of cesarean delivery for genital herpes in other states should be performed.
Ex Vivo Human Placental Transfer of Anti‐Human Immunodeficiency Virus Compounds
Authors: Bawdon Roger E. 
Published: March 2007

Objective: The transfer of anti‐human immunodeficiency virus (HIV) drugs has been studied in the ex vivo human placental model. There is a paucity of information on the placental transfer of these drugs because of ethical considerations and the expense involved in the use of the non‐human primate model.Methods: The standardized ex vivo human placental model was used in these studies and the clearance index in relationship to antipyrine was used to determine the role of transfer of non‐nucleosides, nucleosides, and a protease inhibitor. Several of the nucleosides and ritonavir were combined with zidovudine (AZT) to determine the effect of the combinations.Results: All non‐nucleosides, nucleosides, and the protease inhibitor were found to cross the human placenta by simple diffusion, although at variable rates. Ritonavir did not diffuse as rapidly as the nucleosides, but some diffusion was noted at peak concentrations.Conclusions: Ex vivo perfusion studies agree with those determined in the non‐human primate model and with data from existing clinical trials.
Ampicillin/Sulbactam Vs. Cefoxitin for the Treatment of Pelvic Inflammatory Disease
Authors: Jemsek Joseph G. , Harrison Frank 
Published: March 2007

Objective:The safety and efficacy of ampicillin plus sulbactam were compared with those of cefoxitin in the treatment of women with pelvic inflammatory disease (PID).Methods:This single-site, randomized, prospective, third-party-blinded, comparative, parallel-treatment study enrolled 93 women with a diagnosis of PID. Patients were treated with either ampicillin/sulbactam (2 g/1 g, administered intravenously [IV], every 6 h) or cefoxitin (2 g, administered IV, every 6 h) for a minimum of 12 doses. Patients with cultures positive forChlamydia trachomatisalso received concurrent oral or IV doxycycline (100 mg twice daily). Patients with cultures negative forC. trachomatisreceived prophylactic oral doxycycline (100 mg twice daily) for 10–14 days after treatment with either ampicillin/sulbactam or cefoxitin was completed.Results:Ninety-three patients were entered in the study: 47 in the ampicillin/sulbactam arm and 46 in the cefoxitin arm. All 93 patients were evaluable for safety; 61 (66%) were evaluable for efficacy. Demographic characteristics were similar for the groups. Of the 27 evaluable ampicillin/sulbactam-treated patients, 67% experienced clinical cure, 30% improved, and 4% failed treatment. Respective values for the 34 cefoxitin-treated patients were 68%, 24%, and 9% (P= 0.67). Pathogens were eradicated in 70% of the women given ampicillin/sulbactam vs. 56% of those who received cefoxitin (P= 0.64).Conclusions:Overall, ampicillin/sulbactam demonstrated clinical and bacteriologic efficacy at least equivalent to that of cefoxitin in the treatment of women with acute PID. The use of ampicillin/sulbactam for this indication may avoid the complex dosing regimens associated with other treatments.