Genital ulcers in women: clinical, microbiologic and histopathologic characteristics

Female genital ulcer is a disease that affects a large number of women, and its etiologic diagnosis can be difficult. The disease may increase the risk of acquiring HIV. Genital ulcer may be present in sexually transmitted diseases (STD) - syphilis, chancroid, genital herpes, donovanosis, lymphogranuloma venereum and other non-STD disorders (NSTD) - Behçet's syndrome, pemphigus, Crohn's disease, erosive lichen planus and others. This study evaluated the clinical-histopathologic-microbiologic characteristics of female genital ulcers. A cross-sectional descriptive prospective study was conducted during a six-month period to investigate the first 53 women without a definitive diagnosis, seeking medical care for genital ulcers at a genital infections outpatient facility in a university hospital. A detailed and specific history was taken, followed by a dermatologic and gynecologic examination. In addition to collecting material from the lesions for microbiologic study, a biopsy of the ulcer was performed for histopathologic investigation. The average age of the patients was 32.7 years, 56.6 percent had junior high school education and higher education. The most frequent etiology was herpetic lesion, followed by auto-immune ulcers. At the time of their first consultation, around 60 percent of the women were using inadequate medication that was inconsistent with the final diagnosis. Histologic diagnosis was conclusive in only 26.4 percent of the patients (14/53). Cure was obtained in 99 percent of the cases after proper therapy. The female genital ulcers studied were equally distributed between sexually transmitted and non-sexually transmitted causes. Herpes was the most frequent type of genital ulcer, affecting women indiscriminately, mostly between the ages of 20 and 40 years. The etiologic diagnosis of herpetic ulcers is difficult to make even when various diagnostic methods are applied. It is imperative that NSTD should be included in the...

Study of the evolution of the placenta and fetal pancreas in the pathophysiology of growth retardation intrauterine due to restricted maternal diet

Intrauterine growth retard (IUGR) continues to be a significant perinatology problem at the end of this century. The nature of the etiologic agent, the time when the attack occurred during pregnancy and its duration affect the type of IUGR. Objective: To study the evolution of fetal pancreas and placenta between the 18th and 2 1st day of pregnancy in rats submitted to maternal protein-calorie restriction. Design: Randomized controlled trial on laboratory animal. Sample: Forty-one normoglycemic pregnant Wistar rats. Intervention: Rats were divided into six experimental groups according to their access to food and date of cesarean section (18th or 21 st day): control with free access to food; diet restricted to 25 per cent introduced on 1 st day of pregnancy; and diet restricted to 25 per cent after the 3rd day of pregnancy. Main measurements: Newborn weight, placenta weight, histopathological study (morphological histochemistry). Results: Maternal protein-calorie malnutrition caused intrauterine growth retard (IUGR) after the 18 th day of pregnancy. Dietary restriction did not interfere with the morphology of the fetal pancreas and theimmunohistochemical study of the placenta showed that glycogen stores were decreased between the 18 th and 21 st day in the control group and in a diet restricted to 25 per cent from the first day of pregnancy. Dietary restriction after the 3rd day of pregnancy led to low placental glycogen concentrations on the 18 th day and disappearance on the 21 st day. Conclusion: The pathophysiology of IUGR due to maternal protein-calorie restriction in rats is related to lower placental weight and low placental glycogen stores.