Chlamydia trachomatiscauses a bacterial sexually transmitted infection, Chlamydia, that is often chronic and casues reproductive complications in women. We hypothesized that Chlamydia infection increases local acetylcholine (ACh) production, which regulates the host’s inflammatory response to the infection. Female mice infected with C. muridarumwere sacrificed at days 3, 9, 15, and 21 post-infection, genital tract tissues harvested, and immunohistochemistry performed to enumerate ACh-producing cells. Infection increased the number of ACh-producing cells in cervical tissue at days 3,15, and 21 post-infection (pi), uterine tissue at day 3 and 9 pi, and ovarian tissue day 3, 15, and 21 pi. These findings suggest that C. trachomatis increases ACh production, which may suppress the host’s immunity and aid in establishing chronic infection.

institutochedraui@gmail.com / Objective: To assess predictors of sexual function in mid-aged women. Methods: We analyzed data of 262 healthy sexually active women (40–59 years) who filled out the Female Sexual Functioning Index (FSFI), the Menopause Rating Scale (MRS) and a general questionnaire containing female/partner data. Correlations between these two measures were also analyzed. Results: Significant inverse correlations were found between all FSFI and MRS scores. This was most evident for the MRS urogenital score in relation to FSFI total, pain and lubrication scores. Multiple linear regression analysis determined best model predicting total FSFI index scores that explained a 66% of the variance. In this model, MRS urogenital score was an important predictor of female sexual function (total FSFI scores) with a significant inverse relation. Additionally total FSFI scores displayed a significant positive correlation with female educational level and HT use and an inverse relation with partner age and female parity. Conclusion: Several female/partner factors predicted female sexual function in this mid-aged series. MRS urogenital scores significantly correlated with total FSFI scores.

Objectives: Adherence to National Comprehensive Cancer Network (NCCN) guidelines for ovarian cancer treatment improves patient outcomes. The aim of this study was to assess disparities associated with ovarian cancer treatment in the state of Kentucky and central Appalachia. Methods: Data on patients diagnosed as having ovarian cancer from 2007 through 2011 were extracted from administrative claims-linked Kentucky Cancer Registry data. NCCN compliance was defined by stage, grade, surgical procedure, and chemotherapy. Selection criteria were reviewed carefully to ensure data quality and accuracy. Descriptive analysis, logistic regression, and Cox regression analyses were performed to examine factors associated with guidelines compliance and survival. Results: Most women were age 65 years or older (62.5%), had high grade (65.9%) and advanced stage (61.0%) ovarian cancer. Two-thirds of cases (65.9%) received NCCN-recommended treatment for ovarian cancer. The hazard ratio (HR) of death for women who did not receive NCCN-compliant care was 62% higher compared to the women who did receive NCCN compliant treatment (HR 1.62, 95% CI 1.11-2.35). Results from the logistic regression showed that NCCN-compliant treatment was more likely for: women age 65-74 years compared to age 20-49 (OR=3.32, 95% CI=1.32- 8.32), late stage compared to early stage cancers (OR 0.32, 95% CI 0.20-0.53), receipt of care at tertiary hospitals (OR=1.92, 95% CI=1.10-3.34), and privately insured compared to Medicaid (OR=0.31, 95% CI=0.13-0.77) or Medicare (OR=0.31, 95% CI=0.15-0.66). Conclusions: When the treatment of ovarian cancer did not follow NCCN-recommendations, patients had a significantly higher risk of death. Women were less likely to receive NCCN-compliant care if they were of younger age (20-49 years), had early stage disease, were not privately insured, or had care provided at a non-tertiary hospital.

<p>Chlamydia and gonorrhea are major causes of sexually transmitted infections (STI) in adolescents worldwide. The infections are caused by <em>Chlamydia trachomatis</em> or <em>Neisseria gonorrhoeae, </em>bacteria with clinical manifestations such as urethritis, prostatitis and epididymitis among men, and urethritis, cervicitis and upper genital tract infection (i.e. pelvic inflammatory disease) among women. However, in many cases of genital tract infection, the etiology remains uncertain. In light of this, <em>Mycoplasma genitalium</em> was somewhat accidentally isolated in 1980 after prolonged incubation of urogenital specimens from men with non-gonococcal urethritis. Following the initial isolation in 1980, repeated attempts have been made to recover the extremely fastidious organism from clinical samples by culture techniques, but isolates have been rare and difficult to obtain. With the development of PCR methods in the early 1990s, detection of <em>M. genitalium</em> infection became more feasible.</p><p>The aim in paper <strong>I</strong> was to compare three different PCR assays (conventional and real-time 16S rRNA gene PCR as well as real-time <em>Mycoplasma genitalium</em> adhesin protein (MgPa) gene PCR) for detection of <em>M. genitalium</em>. The study also determined the prevalence of <em>M. genitalium</em>. Clinical specimens collected from STI attendees, 381 men and 298 women, were used to determine the prevalence of <em>M. genitalium</em> and 213 of these specimens were used in the PCR comparative study. The prevalence of <em>M. genitalium</em> infection in men and women was 27/381 (7.1 %) and 23/298 (7.7 %) respectively. In the PCR comparative study, <em>M. genitalium </em>DNA were detected in 61/76 (80.3 %) of true-positive specimen by conventional 16S rRNA gene PCR, in 52/76 (68.4 %) by real-time 16S rRNA gene PCR and in 74/76 (97.4 %) by real-time MgPa gene PCR. Hence, real-time MgPa gene PCR is well suited for clinical diagnosis of <em>M. genitalium</em> in urogenital specimens from men and women.</p><p>The aim in paper <strong>II</strong> was to determine whether a patients’ endocervical swab specimen can be transported in first void urine (FVU) as combined specimens in detection of <em>Mycoplasma genitalium </em>by real-time PCR. The study also compared two different DNA extraction methods (manual Chelex DNA extraction and automated BioRobot M48 DNA extraction) for observation of possible PCR inhibition. Clinical specimens collected from 329 women attending a STI clinic were used in the study. A total of 100 endocervical swab specimens transported in FVU was used in the PCR inhibition analysis. <em>M. genitalium</em> was detected in 25/329 (7.6 %) women. Endocervical swab specimens transported in FVU demonstrate higher sensitivity compared to both FVU alone and specimens transported in 2-SP medium detecting 24/25 (96 %), 22/25 (88 %) and 17/25 (68 %) of <em>M. genitalium</em> positive women, respectively. Automated BioRobot M48 DNA extraction was shown to be superior to manual Chelex extraction leaving no PCR inhibition and slightly higher DNA yield and/or better sensitivity. The results from these two studies are important knowledge in establishing the future diagnostic level of this STI in our county and also nationally.</p>

The human vaginal ecosystem is dominated by Lactobacillus species. An altered vaginal flora can result in symptomatic conditions such as bacterial vaginosis and vulvo-vaginal candidiasis, and urogenital colonisation by uropathogenic bacteria can cause urinary tract infection. The protective role of lactobacilli is gradually being accepted and clinical studies have been carried out in order to evaluate the use of promising probiotic bacteria, which are defined as “live microorganisms which when administered in adequate amounts confer a health benefit on the host”. This thesis includes an investigation into the ecological role of lactobacilli in the genital tract in healthy women, with respect to the relationship to other species and vaginal pH. Furthermore, in order to find different probiotic strains with promising probiotic qualities, Lactobacillus strains were screened in two diverse screening processes. The selected strains were further evaluated in clinical trials. The prevalence of group B streptococci (GBS) and yeast was significantly dependent on the number of vaginal lactobacilli among healthy women. GBS were less frequently found in women with high numbers of vaginal lactobacilli than in women with low numbers and the prevalence of yeast was significantly higher in women with 3-6.99 log10 lactobacilli sample-1 than in women with less than 3 or ≥7 log10 lactobacilli sample-1. Furthermore, the first screening made on 511 strains isolated from the female genital tract resulted in the final selection of a Lactobacillus plantarum, designated LB931. The screening showed that LB931 had a strong technical growth, survived through freeze-thawing, produced substances bactericidal to uropathogenic bacteria and was a rapid and strong producer of hydrogen peroxide. Further characterisation showed that LB931 possessed the properties required for probiotics with the capability to prevent urogenital infections. LB931 could be supplied to the genital tract through the usage of panty liners impregnated with the strain. In the second screening, Lactobacillus fermentum, designated Ess-1, was the only one out of 126 Lactobacillus strains with strong capacity to inhibit Candida albicans and Candida glabrata. Additional characterisation showed that L. fermentum Ess-1 had the properties that are needed to prevent over-growth of Candida in the vulvo-vaginal tract. The result of the case study showed that a high and frequent dosage of Ess-1 is needed and that improved vulvo-vaginal candidiasis specific diagnostic criteria are required. In conclusion, L. plantarum LB931 and L. fermentum Ess-1 are promising probiotic strains to be used in the prevention of recurrent urogenital infections in women and to enhance the normal flora in healthy women.

Includes bibliographical references and index.

Thesis (Ph.D. in Nursing) -- University of Colorado, 2006. / Typescript. Includes bibliographical references (leaves 177-185). Free to UCDHSC affiliates. Online version available via ProQuest Digital Dissertations;

Submitted by isabela.moljf@hotmail.com (isabela.moljf@hotmail.com) on 2017-07-04T10:51:06Z No. of bitstreams: 1 adrianemariabernoderezendeduarte.pdf: 10309233 bytes, checksum: a1e9de941c8313691f0a256a4de6643a (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-08-08T14:29:33Z (GMT) No. of bitstreams: 1 adrianemariabernoderezendeduarte.pdf: 10309233 bytes, checksum: a1e9de941c8313691f0a256a4de6643a (MD5) / Made available in DSpace on 2017-08-08T14:29:33Z (GMT). No. of bitstreams: 1 adrianemariabernoderezendeduarte.pdf: 10309233 bytes, checksum: a1e9de941c8313691f0a256a4de6643a (MD5) Previous issue date: 2012-11-23 / O estudo da prevalência das manifestações urogenitais e seus fatores de risco associados às síndromes genéticas torna-se relevante à medida que abre caminhos para novos campos da epidemiologia, cujas intervenções precoces são decisivas e contribuem para boa evolução clínica, redução da morbimortalidade, qualidade de vida e longevidade.O presente estudo teve como objetivos avaliar a prevalência das manifestações urogenitais em pacientes com Síndrome de Down, bem como a associação entre as manifestações urogenitais encontradas e idade materna e paterna, gênero, tabagismo e álcool consumido pelos pais. Foram avaliados 114 pacientes de um ambulatório público especializado em pacientes com Síndrome de Down (SD) de outubro/2010 a outubro/2011. Utilizou-se questionário semi-estruturado, exames físicos e exames complementares. Foi realizada análise estatística descritiva das variáveis, correlação de Pearson e testes de hipótese. Observou-se incidência elevada de manifestações urogenitais (50,9%), com predomínio no gênero masculino. Dos 40 pacientes do gênero masculino, 26 (65%) apresentaram algum tipo de manifestação urogenital, enquanto das 74 pacientes do gênero feminino, 32 (43,2%) tinham algum tipo de manifestação. Não houve associação entre idade dos pais, nem consumo de álcool e presença de manifestação urogenital. Pais tabagistas apresentaram filhos com uma incidência maior de manifestações urogenitais. A prevalência das manifestações urogenitais nos pacientes com SD estudados foi elevada. Verificou-se forte associação entre o gênero masculino e manifestações urogenitais, bem como, uma forte associação entre tabagismo dos pais e a ocorrência das manifestações urogenitais. Idade dos pais e consumo de álcool não se correlacionaram com presença de manifestações urogenitais. / The study of the prevalence of urogenital manifestations and its risk factors associated with genetic syndromes becomes relevant as it paves the way for new fields of epidemiology, whose early interventions are decisive and contribute to the good clinical evolution, reduction of morbimortality, quality of life and longevity. This study aims to evaluate the prevalence of urogenital manifestations in Down syndrome patients, as well as the association of urogenital manifestations found, along with its variables: age of parents, gender, smoking and alcohol consumed by the parents. 114 patients of a free clinic specialized in Down syndrome (DS) were assessed from October/2010 to October/2011. The instruments used were the following: semi-structured questionnaire, as well as physical and complementary exams. A descriptive statistical analysis of the variables was done, as well as Pearson's correlation and hypothesis testing. A heightened incidence of urogenital manifestations (50.9%) was observed, with a prevalence of male individuals. Of the 40 male patients, 26 (65%) showed some type of urogenital manifestation. Of the 74 female patients, 32 (43.2%) displayed some sort of manifestation. There was no association between the age of parents, nor alcohol consumption, with presence of urogenital manifestation. Parents who smoked had children with a higher incidence of urogenital manifestations. The prevalence of urogenital manifestations in Down Syndrome patients studied was intensified. There was also a strong correlation of males and urogenital manifestations, as well as parents who smoked and the occurrence of such manifestations. Age of the parents and alcohol consumption was not correlated to the presence of urogenital manifestations.

Background: Hypertension during pregnancy is a leading cause of birthing parent mortality and adverse pregnancy outcomes. Since non-metropolitan communities face higher rates of several risk factors for hypertension in pregnancy and shortages in obstetrical services, persons residing in non-metropolitan areas may be at increased risk for adverse outcomes compared to those living in metropolitan areas. Our study objectives were to examine by county of birthing parent residence (1) the prevalence of chronic hypertension (cHTN) and hypertensive disorders of pregnancy (HDP), and (2) the prevalence of adverse birthing parent and neonatal outcomes associated with hypertension. Methods: Using U.S. birth certificate data from 2016 to 2018, we described the prevalence of cHTN and HDP and the association of each with several birthing parent and neonatal outcomes, stratified by non-metropolitan versus metropolitan county of birthing parent residence. Multivariable Poisson regression models were used to calculate adjusted prevalence ratios for birthing parent and neonatal outcomes among individuals with cHTN or HDP who lived in non-metropolitan versus metropolitan U.S. counties. Results: The prevalence of cHTN and HDP for US live births was 2.2% and 7.4%, respectively, among non-metropolitan pregnant individuals and 1.8% and 6.6%, respectively, among metropolitan pregnant individuals. After adjusting for several sociodemographic characteristics among those with HDP, the prevalence ratio for an APGAR score < 7 at 5 minutes (aPR 1.34, 95% CI 1.29-1.38) and neonatal death (aPR 1.36, 95% CI 1.15-1.62) was increased among offspring born to women who resided in non-metropolitan counties. Similar results were seen among those with cHTN. Conclusion: The prevalence of cHTN and HDP is modestly more prevalent in non-metropolitan areas, but most pregnancy outcomes were similar among those residing in non-metropolitan areas compared to metropolitan areas. Further research should investigate the robustness of these findings using alternate definitions of rural and urban areas and the possible link between low APGAR score, low NICU admission, and neonatal death in non-metropolitan counties.

Preeclampsia (PE) is a disorder affecting 2-10% of pregnancies worldwide. Clinical signs include high blood pressure (HBP) and proteinuria in the mother after the 20th week of pregnancy. Currently, the only cure for PE is delivery of the fetus, which is often necessary preterm and thus dangerous for both mother and fetus. Maternal symptoms of PE are caused by excess anti-angiogenic proteins of placental origin called soluble Flt1s (sFlt1s). sFlt1 mRNA isoforms are produced by alternative polyadenylation (APA) of full-length Flt1 (fl-Flt1) pre- mRNA. While fl-Flt1 encodes a transmembrane protein, sFlt1s encode truncated proteins that are soluble. Multiple sFlt1 isoforms exist, and their respective contribution to the pathophysiology of PE is unclear. Furthermore, it is unknown whether there is a genome-wide role for APA in PE. In my thesis research, I developed a polyadenylation site sequencing method, and used this method to simultaneously quantify transcriptome-wide polyadenylation site usage and gene expression levels in normal, early-onset PE, and late-onset PE human placentae. I observed distinct expression profiles amongst the three groups, with differential expression of genes in several functional categories, including angiogenesis. I found that three sFlt1 isoforms account for >94% of all placental FLT1 transcripts, and that increased transcription of the entire FLT1 locus drives upregulation of both fl-Flt1 and sFlt1 in PE. I found that APA does not contribute substantially to PE pathophysiology. I also identified siRNAs that knock down sFlt1 mRNA efficiently in cell lines that pave the way for further development of novel RNAi based therapeutics to alleviate PE.