Bacterial and fungal culturing was conducted on samples taken from the vaginal fornix of 106 cows, of which 42 had vaginitis and 64 had normal vaginas. The diagnosis of vaginitis and non-vaginitis samples was determined by histologic examination. Aerobic, anaerobic, and microaerophilic cultures were done. In addition, cultures were performed for Campylobacter sp., Ureaplasma sp., Mycoplasma sp., Tritrichomonas foetus, and fungi. All 106 samples contained mixed aerobic bacterial cultures. The more frequent aerobic isolates included Acinetobacter lwoffii, Arcanobacterium pyogenes, Escherichia coli, Corynebacterium spp., and Streptococcus spp. These organisms were isolated from both groups of cows, but more frequently from the vaginitis group. Anaerobic isolates included Peptostreptococcus spp., Prevotella spp., and Fusobacterium spp. The fungal isolates included Aspergillus sp., Mucor sp., and Penicillium sp.

Bacterial and fungal culturing was conducted on samples taken from the vaginal fornix of 106 cows, of which 42 had vaginitis and 64 had normal vaginas. The diagnosis of vaginitis and non-vaginitis samples was determined by histologic examination. Aerobic, anaerobic, and microaerophilic cultures were done. In addition, cultures were performed for Campylobacter sp., Ureaplasma sp., Mycoplasma sp., Tritrichomonas foetus, and fungi. All 106 samples contained mixed aerobic bacterial cultures. The more frequent aerobic isolates included Acinetobacter lwoffii, Arcanobacterium pyogenes, Escherichia coli, Corynebacterium spp., and Streptococcus spp. These organisms were isolated from both groups of cows, but more frequently from the vaginitis group. Anaerobic isolates included Peptostreptococcus spp., Prevotella spp., and Fusobacterium spp. The fungal isolates included Aspergillus sp., Mucor sp., and Penicillium sp.

This study was undertaken to determine the clinical significance of detecting candida on Pap smear. Clinical information was obtained from a questionnaire sent to the health care provider whenever candida was identified during the study period. Candida was identified in 309 (3.0%) of the 10,370 Pap smears examined. Completed questionnaires were returned on 137 (44.3%) patients. All 137 smears were reviewed. Ninety-nine (72%) patients were asymptomatic, 29 (21%) had symptoms typical of candida infection, and nine (7%) had nonspecific symptoms. Forty-four (32%) patients had been treated for candida during the original clinic visit. After the Pap smear reported candida, 19 (20%) of the 93 nontreated patients were contacted and treated, while 10 (11%) were scheduled for further evaluation. No action was taken on the remaining 64 (69%) patients. There was a significant association between having initial symptoms and receiving immediate treatment (P < 0.001) and undergoing subsequent treatment or further evaluation after the Pap smear report (P < 0.001). Marked inflammation was statistically associated with symptoms (P = 0.014), but the form or number of candida organisms was not. In conclusion, the identification of Candida on Pap smear does not necessarily indicate a symptomatic infection, although the Pap smear results had a direct impact on the treatment of 21% of patients in this study and served as a confirmation for clinical treatment in another 32% who had received such treatment at the time of the original visit.

El objetivo de esta tesis es determinar la incidencia de rotura prematura de membranas en gestantes con Gardnerella vaginalis diagnosticado mediante la muestra de Papanicolaou durante el control prenatal y cuál es el efecto del tratamiento de esta infección; en el Instituto Nacional Materno Perinatal en el año 2004. Se realizó un estudio Retrospectivo, Comparativo, Descriptivo, en el Instituto Nacional Materno Perinatal en el año 2004. Se incluyeron gestantes con muestra de Papanicolaou que acudieron a la atención prenatal (primera consulta), cumpliendo con los criterios de inclusión y exclusión. La muestra se tomó en forma sistemática, encontrando un total de 308 pacientes, que constituye la población de estudio, de las cuales 154 presentaron Gardnerella vaginalis positivo en muestra de papanicolaou y las otras 154 presentaron papanicolaou negativo a Gardnerella vaginalis. Del estudio podemos concluir con un 95% de confianza que no existe relación entre la presencia de Gardnerella vaginalis y la presencia o ausencia de RPM (p=0.38). Por lo que descriptivamente sólo para esta muestra analizada el 55.2% de presencia de rotura prematura de membranas es mayor al 48.8% de no presencia de rotura prematura de membranas, pero que estadísticamente son similares. Con respecto al tratamiento de esta infección, no es estadísticamente significativo la disminución del riesgo de la rotura prematura de membrana; ya que del total de pacientes con antecedente de Gardnerella vaginalis (154) el 57.8% (89) recibió tratamiento y de estas pacientes sólo el 19.1% presentaron rotura prematura de membranas, en comparación de las que no recibieron algún tipo de tratamiento en el que la incidencia de rotura prematura de membranas fue del 23.07%.

El objetivo de esta tesis es determinar la incidencia de rotura prematura de membranas en gestantes con Gardnerella vaginalis diagnosticado mediante la muestra de Papanicolaou durante el control prenatal y cuál es el efecto del tratamiento de esta infección; en el Instituto Nacional Materno Perinatal en el año 2004. Se realizó un estudio Retrospectivo, Comparativo, Descriptivo, en el Instituto Nacional Materno Perinatal en el año 2004. Se incluyeron gestantes con muestra de Papanicolaou que acudieron a la atención prenatal (primera consulta), cumpliendo con los criterios de inclusión y exclusión. La muestra se tomó en forma sistemática, encontrando un total de 308 pacientes, que constituye la población de estudio, de las cuales 154 presentaron Gardnerella vaginalis positivo en muestra de papanicolaou y las otras 154 presentaron papanicolaou negativo a Gardnerella vaginalis. Del estudio podemos concluir con un 95% de confianza que no existe relación entre la presencia de Gardnerella vaginalis y la presencia o ausencia de RPM (p=0.38). Por lo que descriptivamente sólo para esta muestra analizada el 55.2% de presencia de rotura prematura de membranas es mayor al 48.8% de no presencia de rotura prematura de membranas, pero que estadísticamente son similares. Con respecto al tratamiento de esta infección, no es estadísticamente significativo la disminución del riesgo de la rotura prematura de membrana; ya que del total de pacientes con antecedente de Gardnerella vaginalis (154) el 57.8% (89) recibió tratamiento y de estas pacientes sólo el 19.1% presentaron rotura prematura de membranas, en comparación de las que no recibieron algún tipo de tratamiento en el que la incidencia de rotura prematura de membranas fue del 23.07%.

Made available in DSpace on 2014-06-11T19:33:24Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-03-01Bitstream added on 2014-06-13T21:06:01Z : No. of bitstreams: 1 marconi_c_dr_botfm.pdf: 879832 bytes, checksum: 484596013b636e51071f8123a73dfe3c (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / A vaginose bacteriana (VB) é a alteração de microbiota vaginal mais frequente em mulheres em idade reprodutiva.Inúmeras complicações ginecológicas e obstétricas são associadas à VB, como doença inflamatória pélvica, aumento do risco de aquisição de Doenças Sexualmente Transmissíveis (DSTs), corioamnionite clínica e histológica e baixo peso ao nascimento. A VB se caracteriza pela substituição dos lactobacilos da microbiota vaginal por outras espécies bacterianas, na sua maioria anaeróbias. Estudos recentes demonstraram que várias espécies até então raramente ou nunca isoladas em laboratório são associadas à VB como Atopobium vaginae, Leptotrichia sp. e Megasphaera sp. Essas espécies têm como característica comum a produção de ácido lático. Dessa forma, tem sido observado que mulheres assintomáticas podem apresentar ausência de lactobacilos na microbiota vaginal e predomínio de tais espécies. Portanto, alguns autores sugerem que elas possam contribuir para o equilíbrio do meio vaginal. Tendo em vista que os casos de VB apresentam grande heterogeneidade quanto à composição microbiológica, considera-se que a resposta imune também possa ser variável. A amplificação da resposta imune local na VB é um dos mecanismos que levam a maior suscetibilidade da mucosa vaginal à aquisição de DSTs, dentre as quais a infecção clamidiana que, é bastante frequente em nossa população. Embora estudos tenham demonstrado associação da infecção por Chlamydia trachomatis (CT) com a VB, poucos trabalhos avaliaram o perfil da resposta imune inata local nesses casos. O objetivo deste estudo foi avaliar parâmetros da imunidade inata e atividade de sialidases nos casos de VB em relação a maior ou menor participação das espécies de A. vaginae, Leptotrichia sp. e Megasphaera sp., além de comparar os níveis de citocinas pro-inflamatórias nos casos de VB de acordo com o status... / Bacterial vaginosis (BV) is the most frequent type of abnormal vaginal flora in women in childbearing age. Several gynecological and obstetrical complications are associated with BV, such as pelvic inflammatory disease, increased risk for acquisition of sexually transmitted infections (STIs), clinical and histological chorioamnionitis and low birth weight. Bacterial vaginosis is characterized by the replacement of the vaginal lactobacilli by other bacterial species, mostly anaerobes. Recent studies show that many species, rarely or never isolated by culture, are highly associated with BV, such as Atopobium vaginae, Leptotrichia sp. and Megasphaera sp. In common, these bacteria have the characteristic of producing lactic acid. Study of the vaginal flora of asymptomatic women showed that these species may replace the lactobacilli, dominating the vaginal environment. Thus, some authors suggest that A. vaginae, Leptotrichia sp. and Megasphaera sp. may contribute to a balanced vaginal flora. Considering that BV cases are microbiologically heterogeneous, the immune response is also likely to differ among the women. An imbalanced local immune response is one of the mechanisms leading to increased acquisition of STIs, such as chlamydial infection, which is very frequent in our population. Although studies demonstrated a significant association of BV with Chlamydia trachomatis (CT), few studies evaluated the associated innate immune response. The objective of this study was to evaluate parameters of the innate immunity and sialidase activity in BV, in relation to the larger or samaller participation of A. vaginae, Leptotrichia sp. and Megasphaera sp., and to compare the levels of pro-inflammatory cytokines in BV cases according to the status of CT infection. We evaluated women that presented BV in the period of the study and the control group was composed by women with normal vaginal flora pattern. Vaginal ...

The purpose of this study was to understand how clinicians manage asymptomatic women after Trichomonas has been reported on Papanicolaou (Pap) smears. Clinical information was obtained from questionnaires sent to healthcare providers whenever Trichomonas was identified during the study period. Trichomonas was identified in 173 (1.4%) of 12.547 Pap smears examined. Completed questionnaires were returned on 95 (55%) patients, and 92 patients were included in this study. Sixty-three (68%) patients were asymptomatic, 16 (18%) had symptoms characteristic of infection, and 13 (14%) had nonspecific symptoms. Twenty-six (28%) patients received treatment during the original clinic visits. After the Pap smear reported Trichomonas, 49 (81%) of the 66 patients were contacted and treated. 7 (12%) were contacted and scheduled for further evaluation, and no action was taken on the remaining 10 (17%) patients. There was a significant association between presenting with symptoms and receiving treatment at the time of the original visit (P < 0.001), but not with receiving subsequent treatment. Clinical suspicion of infection was also associated with receiving treatment at the time of the original visit only (P < 0.001). Clinical suspicion of infection correlated with symptoms and results of wet amount smears (P < 0.001). In conclusion, the Pap smear report of Trichomonas identification directly impacted the management of 61% of patients and served as confirmation for clinical management in another 28% who had received treatment at the time of original visit. Despite the fact that most patients were asymptomatic, the majority received treatment and/or evaluation after the Pap smear report was received.

Published Article / The 2012 residents of Huis Welgemoed, a residence for female students at Central University of Technology, Free State Bloemfontein Campus have reported a high prevalence of infections of the vagina and the urinary tract. They assume that this problem is associated with poor hygienic conditions in the toilets of their residence. However, this assumption may not be entirely true, as other factors may also contribute to their problem. Previous studies have shown that there is an evident relation of vaginitis and urinary tract infections (UTI) among students and the practices of personal hygiene or the level of toilet sanitation in their residences. Especially in facilities where the students have complained about the hygiene state of their residence toilets as unsatisfactory. This preliminary study has shown that the residence conforms to the standards set out by the S.A. requirements for toilets in student housing of 1 toilet per 6 students and that the cleaning materials and methods used by staff are adequate. Interestingly, the authors have found that a lack of knowledge around UTI's and VI's regarding basic prevention strategies is most probably the cause of the high incidence of these two types of infections.

El objetivo del estudio fue determinar la prevalencia y evaluar el valor de la detección de Vaginosis Bacteriana entre las 22 - 24 semanas en la predicción de parto pretérmino espontáneo en gestaciones únicas. Se realizó un estudio observacional analítico de tipo cohorte en el Instituto Especializado Materno Perinatal durante enero a diciembre del 2002. Un total de 1218 gestantes cumplieron los criterios de inclusión (perdiéndose 18 al seguimiento); a quienes se tomó una muestra de secreción vaginal para tinción Gram interpretándose los resultados para Vaginosis Bacteriana según los criterios de Nugent. La incidencia de parto pretérmino fue 11,8% y la prevalencia de Vaginosis Bacteriana 37,2%. De las 1200 muestras, 475 tuvieron flora normal (39,6%), 279 flora intermedia (23,2%) y 446 (37,2%) Vaginosis Bacteriana. El antecedente de parto pretérmino, multiparidad y riesgo social alto se asociaron con parto pretérmino espontáneo. No hubo diferencia significativa entre Vaginosis Bacteriana y parto pretérmino < 37 semanas de gestación; observándose en los casos con flora normal, intermedia y Vaginosis Bacteriana, 40 (28,3%), 49 (34,8 %) y 52 (36,9%) partos pretérminos; respectivamente. El parto muy pretérmino (< 33 semanas) se asoció significativamente con el grado de la flora, presentándose 17 (12,1%), 27 (19,1%) y 52 (36,9%) partos muy pretérminos, en los casos con flora normal, intermedia y Vaginosis Bacteriana; respectivamente. Para parto pretérmino espontáneo la Vaginosis Bacteriana tuvo una sensibilidad de 12,8%, una especificidad de 95,3% un valor predictivo positivo de 35,3% y un valor predictivo negativo de 84,3%. Concluimos que la Vaginosis Bacteriana no es predictor de parto pretérmino espontáneo y no recomendamos su uso en la práctica clínica. Palabras Claves: Vaginosis Bacteriana, parto pretérmino espontáneo, predicción.

El objetivo del estudio fue determinar la prevalencia y evaluar el valor de la detección de Vaginosis Bacteriana entre las 22 - 24 semanas en la predicción de parto pretérmino espontáneo en gestaciones únicas. Se realizó un estudio observacional analítico de tipo cohorte en el Instituto Especializado Materno Perinatal durante enero a diciembre del 2002. Un total de 1218 gestantes cumplieron los criterios de inclusión (perdiéndose 18 al seguimiento); a quienes se tomó una muestra de secreción vaginal para tinción Gram interpretándose los resultados para Vaginosis Bacteriana según los criterios de Nugent. La incidencia de parto pretérmino fue 11,8% y la prevalencia de Vaginosis Bacteriana 37,2%. De las 1200 muestras, 475 tuvieron flora normal (39,6%), 279 flora intermedia (23,2%) y 446 (37,2%) Vaginosis Bacteriana. El antecedente de parto pretérmino, multiparidad y riesgo social alto se asociaron con parto pretérmino espontáneo. No hubo diferencia significativa entre Vaginosis Bacteriana y parto pretérmino < 37 semanas de gestación; observándose en los casos con flora normal, intermedia y Vaginosis Bacteriana, 40 (28,3%), 49 (34,8 %) y 52 (36,9%) partos pretérminos; respectivamente. El parto muy pretérmino (< 33 semanas) se asoció significativamente con el grado de la flora, presentándose 17 (12,1%), 27 (19,1%) y 52 (36,9%) partos muy pretérminos, en los casos con flora normal, intermedia y Vaginosis Bacteriana; respectivamente. Para parto pretérmino espontáneo la Vaginosis Bacteriana tuvo una sensibilidad de 12,8%, una especificidad de 95,3% un valor predictivo positivo de 35,3% y un valor predictivo negativo de 84,3%. Concluimos que la Vaginosis Bacteriana no es predictor de parto pretérmino espontáneo y no recomendamos su uso en la práctica clínica. Palabras Claves: Vaginosis Bacteriana, parto pretérmino espontáneo, predicción.