bluuebunny/crossref_metadata_2025_split huggingface dataset:
Significance of Gram′s Stain in Rapid Intrapartum Screening for Maternal Carriership ofGroup B Streptococcus
Authors: Adriaanse Albert H. , Muytjens Harry L. , Kollée Louis A. A. , Nijhuis Jan G. , Hoogkamp-Korstanje Jacomina A. A. 
Published: March 2007

Objective: Group B streptococcus (GBS, Streptococcus agalactiae) is an important cause of neonatal sepsis. Prevention is possible by intrapartum screening for maternal GBS carriership and antimicrobial treatment of colonized women with risk factors during labor. The conflicting results of diagnostic performance are reported both for the newly developed rapid GBS antigen tests and Gram′s stain.Methods: The value of Gram′s stain in GBS screening was investigated prospectively in 1,020 women. Intrapartum Gram′s stains of the cervix from these women and of the introitus from 510 of them were compared with cultures of the cervix, introitus, and anorectum in a semiquantitative way.Results: The sensitivities of the cervical and introital Gram′s stains were 25% and 31%, respectively, and the specificities 99% and 98%, respectively. Higher sensitivities (52% and 44%, respectively) were found in heavily colonized parturients. No significant influence of rupture of the membranes was detected. There was a poor correlation between the number of gram‐positive cocci in the Gram′s stain and the growth density.Conclusions: We do not recommend the routine use of the Gram′s stain for intrapartum GBS detection because of both the limited sensitivity and positive predictive value.
Pregnancy Complications Associated With BacterialVaginosis and Their Estimated Costs
Authors: Oleen-Burkey MerriKay A. , Hillier Sharon L. 
Published: March 2007

Objective: This study was undertaken to estimate the annual direct costs of complications associated
with bacterial vaginosis (BV) in pregnant women in the United States.Methods: An economic model was developed from evidence in the published literature linking perinatal complications to BV. The estimates of attributable risks were applied to the estimated population of pregnant women in the United States in 1993. The charge data from a database of hospital utilization information were then used to estimate the direct costs of each pregnancy complication and the total direct costs associated with BV.Results: Under the assumptions of our model, the direct costs of preterm labor, preterm delivery, the attendant low birth weight (LBW), and other perinatal complications associated with BV were estimated at nearly $1.0 billion in 1993. Over 40% of the total cost was associated with preterm delivery and intensive care of LBW infants, while another 24.5% of the cost was related to preterm labor.Conclusions: If the current frequency of BV among pregnant women persists and BV is not
detected and treated during pregnancy, the projected annual costs will reach $1.4 billion by the year
2000. Reducing the heavy economic burden associated with BV in pregnant women will require the
establishment of effective screening and treatment regimens.
Cervicitis as a Clinical Indicator of Gonococcal and Chlamydial Infections in Pregnancy
Authors: Jackson Susan L. , O′Connell Nan G. , Borzelleca Joseph F. , Dinsmoor Mara J. , Soper David E. 
Published: March 2007

Objective: We undertook the present study to attempt to apply clinical indicators predictive of cervical infection in nongravid populations with either Neisseria gonorrhoeae or Chlamydia trachomatis to our pregnant population and to determine the significance of the clinical diagnosis of “cervicitis.”Methods: A retrospective chart review of all pregnant women with a final diagnosis of cervicitis who were seen in the Medical College of Virginia obstetrical emergency room was performed during the period of September 1991 to December 1992.Results: Given the diagnosis of cervicitis in our emergency department, we found that the clinical examination predicted cervical infection with N. gonorrhoeae or C. trachomatis in only 20% of the pregnant women. Gravidas with chlamydial infections were younger (20.1 ± 3.7 years) compared with gravidas not infected (23.2 ± 5.4 years) (P < 0.0001). They were also more likely to have a diagnosis of lower urinary‐tract infection [relative risk (RR) 2.89, 95% confidence interval (CI) 1.42–5.85].Conclusions: The clinical indicators of cervical infection with C. trachomatis and N. gonorrhoeae were unreliable.
Medical Management of Vulvar Vestibulitis: Results of a Sequential Treatment Plan
Authors: Nyirjesy Paul , Halpern Meredith 
Published: March 2007

Objective: The objectives of this study were to assess the efficacy of medical management for vulvar vestibulitis and to examine several historical variables and determine their predictive values as to which treatments will be most successful.Methods: Seventy‐four patients diagnosed with vulvar vestibulitis were evaluated. Each patient was treated using a sequence of consecutive medical therapies for vulvar vestibulitis. These therapies were topical aqueous 4% lidocaine with intercourse, topical corticosteroid therapy, oral amitriptyline, topical low‐dose 5‐fluorouracil (5‐FU) cream, intralesional alpha‐interferon, and a low‐oxalate diet in combination with oral calcium citrate. The patients were followed over 3–30 months and their responses to therapy were assessed. In addition, a statistical analysis was performed to determine the positive predictive values of certain historical variables and specific treatment successes.
Results: Forty‐nine patients reported positive responses to one of the initiated therapies. More specifically, 18.1% of the patients who used lidocaine, 33.8% who used topical corticosteroids, 57.1% who used amitriptyline, 16.7% who used 5‐FU, none who received interferon, and 50% who tried a low‐oxalate diet had positive responses to therapy. No historical variables were predictive of which therapies would have the most successful outcome.Conclusions: Medical management is effective in alleviating the symptoms of vulvar vestibulitis. Various aspects of a patient′s history are not helpful in selecting the therapy that will be most effective.
Pasteurella multocida Bacteremia in a Patient With Ovarian Cancer andChemotherapy‐induced Neutropenia
Authors: Casey A. Catherine , Greenspoon Jeffrey S. , Lagasse Leo D. 
Published: March 2007

Background:Pasteurella multocida is a commensal organism found in the saliva and oropharynx of domestic animals. It causes a variety of human infections ranging from cellulitis to bacteremia and sepsis. The severity of infection is somewhat related to the immunocompetency of the infected host. An immunocompromised host is more likely to suffer a disseminated infection as a result of contact with this organism than an immunocompetent host. This case report and review of the literature are presented to further evaluate the types of infections caused by this organism in oncology patients.Case: A 54‐year‐old woman with epithelial ovarian cancer and a chemotherapy‐induced nadir of her WBC count developed P. multocida bacteremia after she incurred a scratch from her pet cat. She was treated with ceftazidime and then penicillin G with prompt resolution of the bacteremia.Conclusion: This paper summarizes an infectious complication that is likely to become more common as chemotherapy‐induced neutropenia and pet ownership in the elderly become common coincidences. As such, oncologists and infectious disease physicians should keep this organism in mind when selecting antibiotics to treat the febrile, nadiring cancer patient who has known pet contact.
Climatic Factors and the Incidence of Pyelonephritis During Pregnancy
Authors: Busowski John D. , Chez Ronald A. 
Published: March 2007

Objective: Numerous published reports have linked various disease states and pregnancy‐related conditions with meteorologic factors such as weather, humidity, and temperature. The purpose of this study was to determine if temperature and dew point affect the incidence of pyelonephritis during pregnancy.Methods: A retrospective chart review of a 4‐year period from 1989 to 1992 was performed. The records of women who were diagnosed with pyelonephritis during pregnancy were abstracted for the dates of admission. The climatic records of the Tampa Bay area of Florida were obtained from the National Weather Service.Results: The average, minimum, or maximum daily temperature or average daily dew point during the month of admission had no significant effect on the rate of pyelonephritis during pregnancy in the Tampa Bay area.Conclusions: The rate of pyelonephritis during pregnancy per number of deliveries in the Tampa Bay area was not affected by the average, minimum, or maximum daily temperature or average daily dew point.
In Vitro Susceptibility of Ureaplasma urealyticum and Mycoplasma hominis Isolates in Argentina
Authors: Smayevsky Jorgelina , Relloso Silvia , Pundik Mariela , Lanza Alejandra , Weltman Gabriela , Bantar Carlos , Bianchini Hebe 
Published: March 2007

Objective: Our goal was to determine the in vitro susceptibility of Ureaplasma urealyticum and Mycoplasma hominis isolates to several antibiotics in Argentina.Methods: Ninety‐four strains of U. urealyticum and 18 strains of M. hominis isolated from cervical and urethral specimens were studied. Broth microdilution and agar dilution tests for minocycline, tetracycline, erythromycin, ciprofloxacin, and ofloxacin were performed.Results: Both methods proved to be reliable and reproducible for U. urealyticum and M. hominis, with no major differences in results. The U. urealyticurn strains were inhibited by erythromycin at MICs ranging from ≤0.5 to >8 μ/ml. Ofloxacin showed the highest activity against this latter organism. No differences between tetracycline and minocycline MICs were observed with U. urealyticum. Two M. hominis strains displaying high MICs both to tetracycline and to minocycline were detected.Conclusions: The emerging resistance of mycoplasmas to certain antibiotics emphasizes the need to undertake further surveillance studies on the clinical isolates of such organisms.
Randomized Trial of Erythromycin and Azithromycin for Treatment of Chlamydial Infection in Pregnancy
Authors: Rosenn Marc F. , Macones George A. , Silverman Neil S. 
Published: March 2007

Objective: The purpose of this study was to compare erythromycin and azithromycin in the treatment
of chlamydial cervicitis during pregnancy with regard to efficacy, side effects, and compliance.Methods: In a prospective manner, 48 pregnant patients with cervical chlamydial infections diagnosed by routine screening tests were randomly assigned to receive either erythromycin, 500 mg q.i.d. for 7 days (N = 24), or azithromycin, 1 g as a one‐time dose (N = 24). All sexual partners were given prescriptions for doxycycline, 100 mg b.i.d. for 7 days. The treatment efficacy was assessed by follow‐up chlamydia testing 3 weeks after the therapy was completed. The side effects, intolerance to therapy, and overall compliance were evaluated by means of a standardized posttreatment questionnaire.Results: There was no significant difference in cure rates noted between the erythromycin group and the azithromycin group (77% vs. 91%, respectively; P = 0.24). Gastrointestinal side effects were reported more frequently among patients treated with erythromycin compared with patients treated with azithromycin (45% vs. 17%, respectively; P = 0.004). The patients who received erythromycin reported intolerance to therapy secondary to side effects more frequently than patients who received azithromycin (23% vs. 4%, respectively; P = 0.07). Furthermore, the patients in the azithromycin group were more likely to complete their course of therapy as prescribed than the patients in the erythromycin group (100% vs. 61%, respectively; P = 0.002).Conclusions: Azithromycin is efficacious and well tolerated for the treatment of chlamydial cervicitis in pregnancy. Erythromycin, though efficacious, is poorly tolerated, as demonstrated by the number of patients reporting significant side effects during the course of therapy. Since the cost of azithromycin is comparable to that of generic erythromycin, the present study supports the use of azithromycin as an alternative to erythromycin for the treatment of chlamydial cervicitis in pregnancy.
Filariasis of the Breast in a Pregnant Woman Diagnosed by Fine‐needle Aspiration Cytology: A Case Report
Authors: Lau Melanie , Tauchi Pamela , Kim Milton , Liu Francis , Namiki Thomas 
Published: March 2007

Background: Despite increased immigration to the United States from endemic areas, the diagnosis
of microfilariasis in this country remains infrequent. This disease may occasionally present as a breast mass, in the absence of other clinical findings.Case: We report an unusual case of Wuchereria bancrofti diagnosed in a pregnant woman by breast fine‐needle aspiration (FNA) and discuss the clinical implications of filariasis in pregnancy.Conclusion: FNA is safe and reliable in pregnancy. Infants of mothers with breast filariasis should be monitored.
Hepatitis C Virus in Pregnancy: Case Reports and Literature Review
Authors: Joffe Gary M. 
Published: March 2007

Background: Hepatitis C virus (HCV) is now recognized as the cause of 90% of non‐A, non‐B (NANB) hepatitis. This virus is responsible for a large percentage of chronic persistent and chronic active hepatitis in the United States. Parenteral and sexual transmission are well described, so a significant population of pregnant patients is at risk. Vertical transmission of the virus to the fetus is dependent upon the level of maternal viremia.Case: The cases described in the following report demonstrate that fulminant disease may present in pregnancy. They also demonstrate the cofactors promoting the severity of illness, methods of diagnosis, potential treatment, and outcome of the infection.Conclusion: HCV may be encountered in pregnancy. Although most acute‐phase illness will be self limiting, some patients will manifest liver failure during gestation. Because vertical transmission to the fetus is possible, the pediatrician should be informed of the maternal disease. Chronic hepatitis is almost the rule rather than the exception, so patients require close postpartum follow‐up. Interferon, which may alter the course of the chronic disease, has been used on rare occasions in pregnancy.
Randomized Clinical Trial of Intrapartum Clindamycin Cream for Reduction of Group B Streptococcal Maternal and Neonatal Colonization
Authors: Gibbs R. S. , McNabb F. 
Published: March 2007

Objective: In a randomized trial, we sought to determine whether 2% clindamycin cream administered
intravaginally during labor to group B streptococcal‐colonized pregnant women without risk
factors would decrease maternal and neonatal colonization.Methods: The eligible women were randomized to receive either cream or no treatment. Two
hours after treatment or admission, the patients were tested with rectal and vaginal cultures. The
neonates of the study patients were also tested.Results: Of women randomized to cream, 5 of 5 remained positive and 2 (33%) of their 6 neonates
were positive. Of 4 randomized to no treatment, 3 (75%) remained positive and 1 (25%) of 4 neonates
was positive.Conclusions: Intravaginal 2% clindamycin cream was ineffective in reducing colonization with
group B streptococci.
Intraperitoneal Enterobius vermicularis Infection: A Case Report
Authors: Gazvani Mehmet R. , Emery Simon J. 
Published: March 2007

Background: Enterobius vermicularis in an ectopic location usually represents an incidental finding
in tissue specimens in a patient without symptoms. However, the parasite can lead to inflammation
and symptoms in rare cases.Case: A 36‐year‐old woman had an abdominal hysterectomy for menorrhagia, dyspareunia, and
lower abdominal pain. Two small nodules from the posterior aspect of the left broad ligament as
well as the uterus were sent for histologic examination. The pathologic findings confirmed the
diagnosis of “granulomatous peritoneal nodules due to E. vermicularis.” Within the nodules were aggregates of ova of E. vermicularis.Conclusion: This case reminds us that such granulomatous lesions can simulate leiomyoma,
fibroma, endometrioma, and tuberculous or malignant lesions. It is important to be aware of this
resemblance to avoid unnecessary surgical intervention.
Tubo‐Ovarian Abscess Formation in Users of Intrauterine Devices Remote From Insertion: A Report of Three Cases
Authors: Toglia Marc R. , Schaffer Joseph I. 
Published: March 2007

Background: The association between tubo‐ovarian abscess formation and the presence of an intrauterine
device (IUD) is well recognized. It has been suggested that the risk of upper‐genital‐tract
infection is highest during the immediate period following the insertion of an IUD, returning to
baseline by 5 months postinsertion. We present 3 cases of women who, 10–21 years after insertion of
their IUDs, developed tubo‐ovarian abscesses that were not causally related to sexually transmitted
diseases (STDs) or actinomycetes.Cases: Three women, ages 39–47 years, presented to our gynecology service for evaluation of
abdominal pain. One woman had bilateral tubo‐ovarian abscesses and the other 2 had unilateral
tubo‐ovarian abscesses. All 3 were IUD users, with an interval from IUD insertion to presentation
of 10–21 years. In each case, the cervical cultures for gonorrhea and chlamydia were negative at
presentation and the sexual history was not consistent with an STD mode of spread. All 3 women
initially received broad‐spectrum antibiotics, but 2 eventually required definitive surgical therapy.Conclusion: Long‐term users of IUDs remain at risk for serious, indolent pelvic infections. These
women should be counseled by their gynecologists on an ongoing basis as to this persistent risk.
Tubo‐ovarian abscess should be strongly considered in the differential diagnosis of an IUD user
who presents with an adnexal mass, fever, or abdominal pain.
Treatment of Sporadic Acute Puerperal Mastitis
Authors: Hager W. David , Barton John R. 
Published: March 2007

Objective: The purposes of this study were to compare the efficacy of amoxicillin and cephradine for the
treatment of sporadic acute puerperal mastitis (SAPM) and to evaluate the microbiology and clinical
parameters of this infection.Methods: We conducted a prospective, randomized, single‐blinded study comparing amoxicillin, 500 mg
orally q 8 h for 7 days, and cephradine, 500 mg orally q 6 h for 7 days. The diagnostic criteria for SAPM
included a temperature of ≥37.56℃ (≥99.6℉) and erythema and tenderness of the breast(s).Results: Twenty‐seven consecutive outpatients with SAPM were evaluated for admission to the study,
and 25 of these were enrolled. The mean temperature at enrollment was 38.17℃ (100.7℉), with a mean
WBC count of 11,440/μl. The most frequent bacterial isolates from expressed milk were
Staphylococcus aureus (7), staphylococcal species (coagulase negative) (8), and α‐hemolytic streptococci (4). There were
no significant differences between the 2 antibiotic regimens in cure rate, mean days to resolution of
symptoms, or recurrence within 30 days. Both of the treatment failures and 1 of the 3 recurrences within
30 days were amoxicillin‐treated patients whose cultures grew S. aureus.Conclusions: Oral amoxicillin and cephradine appear equally effective in the treatment of SAPM. Staphylococci
were the most frequent isolates from the milk of women with mastitis.
Impact of Anaerobic Growth Conditions on Toxic Shock Syndrome Toxin‐I Production by Staphylococcus aureus
Authors: Lungren Max , Chaisilwattana Pongsakdi , Knoop Floyd C. , Monif Gilles R. G. 
Published: March 2007

Objective: The impact of anaerobic growth conditions on the Staphylococcus aureus toxic shock syndrome
toxin‐1 (TSST‐1) production was studied.Methods: Ten strains of S. aureus derived from patients with toxic shock syndrome (TSS), 10
isolates of S. aureus, and documented TSST‐1‐producing strains recovered from patients with either
staphylococcal septicemia or staphylococcal nongenital abscesses were grown under aerobic and
anaerobic conditions. The bacterial growth was measured using optical density (OD) determinations
at 520 nm. The toxin production was assayed using the TS‐RPLA latex agglutination test.Results: Both TSS and non‐TSS strains of S. aureus grown under aerobic and anaerobic conditions
exhibited comparable OD patterns of growth, and the levels of toxin production remained constant
during the logarithmic phase. Toxin titers developed during the logarithmic growth phase and
peaked after 24 h of incubation. When stationary‐phase isolates grown initially under aerobic
conditions were subjected to strict anaerobic conditions, subsequent toxin titers, compared with
isolates grown in the continued presence of oxygen, were depressed 2‐fold, peaking at a later time.Conclusions: TSST‐1 production is diminished under continued anaerobic conditions.
Intra‐amniotic Infection Caused by Capnocytophaga Species
Authors: Mikamo Hiroshige , Kawazoe Kyoko , Sato Yasumasa , Izumi Koji , Tamaya Teruhiko 
Published: March 2007

Background: Capnocytophaga species are common oral pathogens and infrequent causes of systemic
infection in patients with compromised host. The isolation of this organism suggests an oral source
of infection.Case: A 32‐year‐old woman was admitted at 23 weeks gestation in preterm premature rupture
of the membranes. She subsequently developed signs of clinical intra‐amniotic infection, including
fever, fetal tachycardia, and uterine tenderness. Bacteriologic studies of the amniotic fluid by trans‐abdominal
amniocentesis and subchorionic placental cultures yielded Capnocytophaga species. On
review of the patient′s history, a temporal relation was noted between orogenital contact and onset
of clinical infection. Thorough evaluation of the patient, including dental examination with periodontal
cultures, did not reveal an obvious source of infection. However, significant periodontal
disease was identified in her partner and Capnocytophaga species were isolated from her partner.Conclusion: This case suggests that intra‐amniotic infection may have been due to an ascending
infection after orogenital contact.
Double‐Blind Placebo‐Controlled Treatment Trial of Chlamydia trachomatis Endocervical Infections in Pregnant Women
Authors: Martin David H. , Eschenbach David A. , Cotch Mary Frances , Nugent Robert P. , Rao A. Vijaya , Klebanoff Mark A. , Lou Yu , Rettig Philip J. , Gibbs Ronald S. , Pastorek Joseph G. , Regan Joan A. , Kaslow Richard A. 
Published: March 2007

Objective: The purpose of this study was to determine if treatment of pregnant women with Chlamydia trachomatis infection would lower the incidence of preterm delivery and/or low birth weight.Methods: Pregnant women between the 23rd and 29th weeks of gestation were randomized in double‐blind fashion to receive either erythromycin 333 mg three times daily or an identical placebo. The trial continued until the end of the 35th week of gestation.Results: When the results were examined without regard to study site, erythromycin had little impact on reducing low birth weight (8% vs. 11%, P = 0.4) or preterm delivery (13% vs. 15%, P = 0.7). At the sites with high persistence of C. trachomatis in the placebo‐treated women, low birth weight infants occurred in 9 (8%) of 114 erythromycin‐treated and 18 (17%) of 105 placebo‐treated women (P = 0.04) and delivery <37 weeks occurred in 15 (13%) of 115 erythromycin‐treated and 18 (17%) of 105 placebo‐treated women (P = 0.4).Conclusions: The results of this trial suggest that the risk of low birth weight can be decreased by giving erythromycin to some women with C. trachomatis. Due to the high clearance rate of C. trachomatis in the placebo group, these data do not provide unequivocal evidence that erythromycin use in all C. trachomatis‐infected women prevents low birth weight.