bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blindness in a Woman With Human Immunodeficiency Virus Infection and Syphilis
Authors: Luchi Michael , Beauregard Curtis , Ault Kevin , Hinthorn Daniel 
Published: March 2007

Background: A concomitant infection with human immunodeficiency virus (HIV) may alter the natural history of other infections. Several reports indicate that syphilis may behave more aggressively when HIV infection is present.Case: A woman presented with a rash involving her hands and feet and progressive loss of the vision in her right eye. Her serologic tests for syphilis and HIV infection were positive. A diagnosis of neurosyphilis was confirmed by an analysis of cerebrospinal fluid (CSF). She was treated with high‐dose intravenous (IV) penicillin. Her skin lesions resolved, but her vision did not improve.Conclusion: The incidence of HIV infection among women is rising. A patient with HIV and syphilis may develop neurosyphilis in a much shorter time than a patient without HIV infection.
Human Immunodeficiency Virus Type 1 Counseling and Testing Program in the Prenatal Setting
Authors: Bardeguez Arlene D. , Denny Thomas , Palumbo Paul , Wesley Yvonne , Oleske James , Connor Edward , Weiss Gerson 
Published: March 2007

Objective: The objectives of this study were to ascertain the acceptance rate of human immunodeficiency virus type 1 (HIV‐1) testing in a high‐prevalence area and to describe the sociodemographic
and clinical characteristics of seropositive women diagnosed in the prenatal setting.Methods: A retrospective review was carried out of the prenatal HIV‐1 counseling and testing program at University Hospital, Newark, NJ (1989‐1990).Results: Sixty‐seven percent (741/1,114) of the women offered HIV‐1 counseling services accepted testing and 40 (40/741:5.3%) new cases were identified. Heterosexual contact was the primary exposure (17:52%) of these women, of whom 13 (73%) had negative syphilis serologies. Sixty‐four percent were asymptomatic. The mean absolute CD4 lymphocyte count in seropositive women was 514 ± 305 cells/mm3
. Severe immunosuppression was seen in 7/32 (22%) patients. Seventy‐three percent (24/33) depended on public‐assistance programs for their health‐care services.Conclusions: A voluntary HIV‐1 counseling and testing program is well accepted in the prenatal setting. It can provide early identification of asymptomatic seropositive women and infants at risk and lead to early intervention and therapy.
Septicemia due to Aeromonas hydrophila in aPregnant Woman: A Case Report and Review of the Literature
Authors: Damián Ricardo Figueroa , Zesati Roberto Villagrana , Fernáindez León Sáinchez , García Jose Luis Arredondo 
Published: March 2007

Background: In the late 1960s, the first isolates of Aeromonas were recovered from human specimens. Presently, there is sufficient evidence to suggest that the different isolates of the genus Aeromonas are human pathogens. The most frequent site of infection is the digestive tract, although extraintestinal infection also occurs. In those cases involving septicemia, most infections occur in individuals with underlying diseases. This report presents the case of a pregnant woman with no underlying disease or signs of immunodeficiency who developed A. hydrophila septicemia at 24 weeks gestation.Case: A 20‐year‐old pregnant woman was admitted with a history of 10 days of fever, chills, and diaphoresis. Three days before her hospitalization, she noted jaundice and choluria. Her liver was enlarged and her liver function tests were abnormal, with a moderate elevation of serum aminotransferases and direct serum bilirubin and a high serum alkaline phosphatase. Her blood and bone‐marrow cultures revealed A. hydropkila. She was treated with parenteral ceftriaxone. She experienced a complete remission of her symptoms and laboratory abnormalities after therapy. The remainder of the pregnancy was normal. At 39.2 weeks gestation, she delivered a healthy male infant.Conclusion: An association was noted between pregnancy and
A. hydrophila septicemia in a woman without immunodeficiency or underlying disease, possibly indicating another infectious complication in pregnancy.
Comparative Study of Intravaginal Metronidazole and Triple-Sulfa Therapy for Bacterial Vaginosis
Authors: Sobel Jack D. , Chaim Walter , Thomason Jessica , Livengood Charles , Sweet Richard , McGregor James A. , Eschenbach David , Hillier Sharon , Galask Rudolph , Faro Sebastian , Shangle Elizabeth , Baker David 
Published: March 2007

Objective:We sought to compare the efficacy of metronidazole gel vs. triple-sulfa cream in the treatment of bacterial vaginosis (BV).Methods:In a double-blinded study, 247 women with symptomatic BV were randomly assigned to receive either 5 g of 0.75% metronidazole gel twice daily for 5 days or triple-sulfa cream twice daily for 5 days. There were 205 (96 treated with metronidazole and 109 treated with triple-sulfa) evaluable patients to compare efficacy at the final visit. Approximately 60% of these patients had been previously treated for BV, reflecting the recurrent nature of the disease in this patient population.Results:At the first (12–16 days) return visit, 81/103 (79%) patients in the metronidazole group were cured compared with 80/113 (71%) patients in the triple-sulfa cream group (P= 0.333). At the final (28–35 days) return visit, 63/96 (66%) in the 96 metronidazole group remained cured compared with only 51/109 (47%) in the triple-sulfa group (P= 0.02). An intent-to-treat analysis similarly showed that the cure rate with metronidazole was superior to triple-sulfa (P≤ 0.02). The clinical diagnosis demonstrated a high correlation (88%) with the diagnosis made by an independent assessment by Gram's stain. The side effects reported by the patients using metronidazole gel were infrequent and mild and were similar to those reported with triple-sulfa.Conclusions:Metronidazole gel is a safe, effective, and well-tolerated treatment for BV.
Strategies for Prevention of Varicella Pneumonia: A Cost‐Effectiveness Analysis
Authors: Macones George A. , Ewing Stephanie , Silverman Neil S. 
Published: March 2007

Objective: The objective of this study was to compare the cost‐effectiveness of 3 strategies of serologic
enzyme‐linked immunosorbent assay (ELISA) testing and post‐exposure varicella zoster immune globulin
(VZIG) prophylaxis for the prevention of maternal varicella pneumonia during pregnancy in patients with
negative or uncertain histories of varicella infection.Methods: A decision tree was constructed to compare the following strategies: 1) routine serologic testing
for varicella immunity followed by targeted post‐exposure VZIG prophylaxis, 2) post‐exposure serologic
testing followed by targeted VZIG prophylaxis, and 3) untargeted post‐exposure VZIG administration. The
probabilities for the model were obtained from the medical literature and supplemented by expert opinion.
The costs were obtained by a review of inpatient hospitalizations for varicella pneumonia. All costs were
converted to 1995 dollars.Results: Routine serologic testing followed by targeted post‐exposure VZIG prophylaxis was the most
costly strategy ($37.22/person), with no demonstrable increase in benefit compared with the other 2 strategies.
The disutility of this strategy compared with the others was stable across a wide range of values for
the probabilities and costs utilized in the sensitivity analysis. We were unable to differentiate between the
cost‐effectiveness of the other 2 strategies.Conclusions: Routine serologic testing for varicella immunity in patients with negative or uncertain
histories of varicella infection should not be performed. The remaining options of screening and prophylaxis
appear to be reasonable alternatives for dealing with varicella exposures.
Human Immunodeficiency Virus‐Associated Nephropathy in Pregnancy
Authors: Eriksen Nancy L. , Mastrobattista Joan M. 
Published: March 2007

Background: Human immunodeficiency virus (HIV)‐associated nephropathy typically leads to endstage
renal disease requiring dialysis within 3–4 months. This report describes the prenatal course
of a patient with HIV‐associated nephropathy requiring dialysis during pregnancy.Case: A 23‐year‐old nulliparous, black female presented at 13 weeks gestation with a history of
HIV‐associated nephropathy and anemia. She had a CD4 count of 350/mm3, a total urinary protein
of 1.7 g/day, and a serum creatinine of 4.8 mg/dl. The patient was begun on zidovudine, 500
mg daily, and erythropoietin, 4,000 units weekly. At 23 weeks gestation, when she developed
hypertension, a total urinary protein of 3.4 g/day, and a serum creatinine of 4.4 mg/dl, she was
hospitalized. Her renal function continued to deteriorate, requiring hemodialysis. At 29‐4/7 weeks,
she developed preterm labor, for which she was placed on indomethacin. Four days later, at 30
weeks gestation, she delivered a viable male infant.Conclusion: HIV‐associated nephropathy during pregnancy can be successfully managed with
hemodialysis.
Fusobacterium Chorioamnionitis: Report of Two Cases in Preterm Labor With Intact Amniotic Membranes
Authors: Jazayeri Allahyar , Lantz Michael E. , O′Brien William F. 
Published: March 2007

Background: Preterm labor (PTL) in women with intact membranes may be caused by developing
chorioamnionitis. Fusobacterium displays the ability to cause chorioamnionitis in the presence of
intact amniotic membrane.Case: We report 2 patients with severe Fusobacterium chorioamnionitis which resulted in premature
termination of pregnancy. Both patients presented with PTL and intact membranes. Neither
initially appeared acutely ill. Despite the benign appearance, one woman rapidly deteriorated,
requiring ventilation, pressor support, and surgical evacuation of the uterus.Conclusion: We feel that a Gram′s Stain and proper collection of anaerobic cultures at the time
of amniocentesis should be part of the evaluation of every patient with suspected chorioamnionitis.
Polymerase Chain Reaction Assay With Urine Specimens in the Diagnosis of Acute Chlamydia trachomatis Infection in Women
Authors: Pasternack R. , Mustila A. , Vuorinen P. , Heinonen P. K. , Miettinen A. 
Published: March 2007

Objective: The purpose of this study was to evaluate the benefits achievable by Amplicor polymerase chain reaction (PCR) (F. Hoffmann‐LaRoche Ltd., Basel, Switzerland) with urine specimens in addition to PACE 2 (Gen‐Probe, Inc., San Diego, California) assay with cervical swab specimens in the diagnosis of Chlamydia trachomatis in women.Methods: Cervical and urine specimens from 286 women were tested for C. trachomatis by PACE 2 and Amplicor PCR, respectively. All urine specimens were analyzed undiluted and diluted 1:10 to detect and eliminate possible PCR inhibition. A confirmatory PCR assay using major outer membrane protein‐based primers (MOMP‐PCR) was used on urine specimens that were positive by PCR from women who were negative by PACE 2 with cervical swab specimens.Results: Of the endocervical specimens, 26 were positive by the PACE 2 assay. The PCR with urine was positive in 21 of these patients. When the urine specimens were analyzed diluted 1:10, 4 of the 5 PCR‐negative specimens from PACE 2‐positive patients turned positive by the PCR. Additionally, 4 urine specimens from PACE 2‐negative women were positive by the PCR with
urine, and 3 of them could be confirmed by MOMP‐PCR. Altogether, 29 women were found to be positive for C. trachomatis by either of the two assays.Conclusions: By using the PCR with urine specimens, an 11% increase in sensitivity could be achieved in addition to that obtained by PACE 2 assay with cervical swab specimens. In the present material, however, the increased sensitivity was reversed by the presence of PCR inhibitors in 14% of the female urine specimens. Amplicor PCR with urine specimens can undoubtedly be recommended
for the diagnosis of chlamydial infections in women. However, constant monitoring of the PCR inhibition seems highly advisable to obtain full benefit of the sensitivity of the PCR.
Ultrasound‐guided Transvaginal Aspiration in the Management of Actinomyces Pelvic Abscess
Authors: Anteby Eyal Y. , Rahav Galiya , Hanoch Josef , Shimonovitz Shlomo , Yagel Simcha , Laufer Neri 
Published: March 2007

Background: Increasing reports of intrauterine device (IUD)‐related abdominopelvic actinomycosis
have been described recently. Surgical therapy has been the usual treatment when tubo‐ovarian
abscess is identified.Case: A 38‐year‐old woman suffering from Actinomyces pelvic abscess unresponsive to medical
treatment underwent transvaginal ultrasound‐guided needle aspiration. It resulted in marked improvement
and avoided surgical treatment.Conclusion: Transvaginal needle aspiration of Actinomyces pelvic abscess may be an alternative to
surgical therapy, thereby allowing the preservation of pelvic organs.
Analysis of Lactobacillus Products for Phages and Bacteriocins That Inhibit Vaginal Lactobacilli
Authors: Tao Lin , Pavlova Sylvia I. , Mou Susan M. , Ma Wen-ge , Kiliç Ali O. 
Published: March 2007

Objective: Bacterial vaginosis is associated with an unexplained loss of vaginal lactobacilli. Previously, we have identified certain vaginal lactobacilli‐released phages that can inhibit in vitro other vaginal lactobacilli. However, there is no apparent route for phages to be transmitted among women. The purpose of this study was to identify whether certain Lactobacillus products commonly used by women release phages or bacteriocins that can inhibit vaginal lactobacilli.Methods: From 26 Lactobacillus products (2 acidophilus milks, 20 yogurts, 3 Lactobacillus pills, and 1 vaginal douche mix), lactobacilli were isolated with Rogosa SL agar (Difco, Detroit, MI). From these lactobacilli, phages and bacteriocins were induced with mitomycin C and tested against a collection of vaginal Lactobacillus strains.Results: From the 26 products, 43 Lactobacillus strains were isolated. Strains from 11 yogurts released phages, among which 7 inhibited vaginal lactobacilli. Eleven strains released bacteriocins that inhibited vaginal lactobacilli. While about one‐half of the vaginal strains were lysed by bacteriocins, less than 20% were lysed by phages.Conclusions: Some vaginal lactobacilli were inhibited in vitro by phages or bacteriocins released from Lactobacillus products used by women, implying that vaginal lactobacilli may be reduced naturally due to phages or bacteriocins from the environment.
Chlamydial Lower Genital Tract Infection and Spontaneous Abortion
Authors: Sozio J. , Ness R. B. 
Published: March 2007

Objective:Few previous studies have examined the role that acuteChlamydia trachomatislower genital tract infection plays in the development of spontaneous abortion. This study evaluated cervicalC. trachomatisinfections among 52 women experiencing spontaneous abortion and 59 controls.Methods:Pregnant women at less than 22 weeks of gestation who sought medical care in an emergency department in West Philadelphia were eligible for enrollment. Urine samples from enrolled women were tested for chlamydia using ligase chain reaction DNA amplification. All women were followed up to 22 weeks of pregnancy to ascertain the outcome of spontaneous abortion.Results:The proportion of women with chlamydial infection was 3.8% among spontaneous abortion cases and 8.5% among controls. After adjustment for potentially confounding factors, there was no substantial difference in the rate of chlamydial infection between women with and without spontaneous abortion (odds ratio 1.8, 95% confidence interval 0.3–10.7).Conclusion:These data do not support a relationship between acuteC. trachomatisinfection and the development of spontaneous abortion.
Cutaneous Anergy in Pregnant and NonpregnantWomen With Human Immunodeficiency Virus
Authors: Eriksen N. L. , Helfgott A. W. 
Published: March 2007

Objective: To determine the prevalence of cutaneous anergy in pregnant and nonpregnant women
who are seropositive for human immunodeficiency virus.Methods and materials: The medical records of 159 women seropositive for human immunodeficiency
virus were reviewed. Demographic characteristics and tuberculin skin test results were
abstracted from the chart. Tuberculin skin testing was performed by the Mantoux method (5
tuberculin units of purified protein derivative injected intradermally). Anergy testing was performed
using any two of the three following antigens; tetanus toxoid, mumps, or Candida skin test
antigen. A positive tuberculin test was defined as induration of 5 mm or more, and a positive test for
the other antigens was defined as any amount of induration over the skin test area. Anergy was
defined as any amount of induration to the other antigens. A CD4+T lymphocyte count was
obtained at the time of skin testing. Continuous variables were analyzed using the Mann Whitney—U
test. Categorical data were analyzed with the chi‐square or Fisher′s exact test as appropriate.
A two‐tailed P value <0.05 was considered significant.Results: There were 102 nonpregnant and 57 pregnant women who returned to have their skin
test results read. There was no significant difference in the prevalence of positive, negative or
anergic skin test results between groups. The CD4+T lymphocyte count (mean ± standard deviation)
in patients with anergic results was similar between pregnant (375 ± 256/mm3) and nonpregnant
(358 ± 305/mm3) women (P = 0.64).Conclusion: The prevalence of cutaneous anergy is similar among pregnant and nonpregnant
women seropositive for human immunodeficiency virus.
Congenital Syphilis After Treatment of MaternalSyphilis With a Penicillin Regimen ExceedingCDC Guidelines
Authors: Conover Craig S. , Rend Charles A. , Miller Grayson B. , Schmid George P. 
Published: March 2007

Background: Although congenital syphilis usually occurs as a result of a failure to detect and treat
syphilis in pregnant women, failures of the currently recommended regimen to prevent congenital
syphilis have been reported.Case: This report describes an infant with congenital syphilis despite maternal treatment with a
regimen exceeding current CDC guidelines .Conclusion: Regardless of the regimen used to treat syphilis during pregnancy, clinicians should
recognize the possibility of occasional treatment failures and the importance of adequate follow‐up
of infants at risk for congenital syphilis.
Effect of Gliotoxin on HumanPolymorphonuclear Neutrophils
Authors: Shah D. T. , Jackman S. , Engle J. , Larsen B. 
Published: March 2007

Objectives:Candida albicans is known to produce gliotoxin, which has several prominent biological
effects, including immunosuppression. interference with host defenses may arise from the effects of
this toxin on leukocyte structure and function.Methods: Flow cytometric analysis revealed that polymorphonuclear leukocytes (PMN) were
more sensitive to gliotoxin than were mononuclear cells. Structural and various functional aspects
of PMN exposed to gliotoxin were studied.Results: Gliotoxin at (1 μg/mL) did not affect the viability but did diminish PMN chemotaxis and
reduced their ability to ingest particles. Other functional aberrations included decreased nitroblue
tetrazolium dye reduction, decreased superoxide production, and release of lactoferrin suggesting
by degranulation. Gliotoxin also affected the ability of PMN to kill Escherichia coli.Conclusions: This study suggests a previously unrecognized potential virulence factor of C. albicans
that could contribute to persistence of yeast colonization or recurrence of symptomatic infection
through diminished host resistance.
Chronic Plasma Cell Endometritis in Hysterectomy Specimens of HIV-Infected Women: A Retrospective Analysis
Authors: Kerr-Layton J. A. , Stamm C. A. , Peterson L. S. , Mcgregor J. A. 
Published: March 2007

Objective:Abnormal uterine bleeding is a common and troublesome problem in human immunodeficiency virus (HIV)-infected women. We sought to evaluate endometrial pathology among HIVinfected women requiring hysterectomy to explore if endometritis may be common among these patients.Methods:We performed a retrospective analysis of uterine pathology specimens obtained from HIV-infected and control patients requiring hysterectomy in two urban hospitals between 1988 and 1997 matched for age, surgical indication, and history of gonadotropin-releasing hormone (GnRH) use. Cases were evaluated for the presence of plasma cells and assigned a grade between 0 and 3.Results:Indications included cervical dysplasia (4), carcinoma in situ (2), abnormal uterine bleeding (3), and adnexal mass (3). Some degree of abnormal uterine bleeding occurred in all cases. Plasma cell endometritis was twice as common in HIVoinfected women compared to HIV-negative specimens (11/11 versus 11/22) (P< 0.05). Plasma cell endometritis was also of a higher grade in specimens from HIV-infected women than in controls (P< 0.001).Conclusion:Chronic endometritis was common and of a higher grade among HIV-infected women requiring hysterectomy in our series. Diagnosis and treatment of endometritis should be considered in HIV-infected women with uterine bleeding and/or tenderness. We speculate that antiretroviral and/or antimicrobial treatment for endometritis may effectively treat endometritis and eliminate the need for surgery in some HIV-infected women. We suggest that consideration and treatment of endometritis in HIV-1 infected women being evaluated for possible hysterectomy has the potential to reduce costs and morbidity for patients and providers who may be exposed during surgical procedures.
Performance of a Commercial Polymerase ChainReaction Test for Endocervical Chlamydia trachomatisInfection in a University Hospital Population
Authors: Livengood C. H. , Boggess K. A. , Wrenn J. W. , Murtha A. P. 
Published: March 2007

Objectives: To examine the accuracy of a commercial polymerase chain reaction (PCR) test (Amplicor
CTR,
Roche Diagnostic Systems, Branchburg NJ) for identification of endocervical chlamydial
infections through both laboratory evaluation and among a diverse teaching hospital patient
population.Methods: Testing of reliable threshold inocula and reproducibility were carried out using laboratory
stock organisms. Paired endocervical samples from patients with a wide range of indications
were tested by PCR and an established culture procedure, and discrepant pairs were further
analyzed to determine true results.Results: Laboratory evaluation suggested that one copy of target DNA from a viable organism
consistently yielded a positive result, and test reproducibility was very good, with an overall coefficient
of variation of 15%. Compared to true results in 1,588 paired clinical samples from 1,489
women with a 10% prevalence of infection, the PCR test and culture yielded respective sensitivities
of 87.4% and 78.0%, and negative predictive values of 98.6% and 97.6%. Specificity and positive
predictive value for both tests were 100%. Cost per specimen was nearly identical at $18.84 and
$18.88 respectively. Polymerase inhibitors and organisms lacking target DNA were not found in
false‐negative PCR samples.Conclusion: This commercial PCR test is accurate, cost‐competitive, and much faster than culture
for diagnosis of endocervical chlamydia infections in our population of intermediate prevalence
of chlamydial infection.