Effects of anastrozole on Ki-67 antigen expression in the vaginal epithelium of female rats in persistent estrus

OBJECTIVES: Aromatase inhibitors are the first-choice drugs for the treatment of hormone sensitive breast cancer. However, in addition to the scarcity of studies, there are controversies about their effects on vaginal epithelial cell proliferation in rats, especially those in persistent estrus. METHODS: To investigate vaginal epithelial cell proliferation by Ki-67 antigen expression, persistent estrus was induced in 42 randomly selected rats. These rats were randomly divided into 2 groups: group I (control, n=21), which received 0.1 mL of propylene glycol (vehicle) daily, and group II (experimental, n=21), which received 0.5 mg/kg or 0.125 mg/day of anastrozole diluted with 0.1 mL of propylene glycol. RESULTS: Light microscopy showed a higher concentration of cells with brown Ki-67 stained nuclei in the control compared to the experimental group. The mean percentage of Ki-67 stained nuclei per 500 cells in the vaginal epithelium was 68.64±2.64 and 30.46±2.00 [mean±standard error of the mean (SEM)] in the control and experimental groups, respectively (p<0.003). CONCLUSION: This study showed that anastrozole, at the dose and treatment duration selected, significantly decreased cell proliferation in the vaginal mucosa of the rats in persistent estrus.

Risk assessment for preterm delivery using the fetal fibronectin test associated with the measurement of uterine cervix length in symptomatic pregnant women / Avaliação do risco para parto pré-termo utilizando o teste da fibronectina fetal, associado à medida de comprimento de colo uterino, em gestantes sintomáticas

Abstract Objective To analyze the use of the measurement of uterine cervix length (MUCL) and the fetal fibronectin (fFN) rapid test as predictors of preterm delivery (PTD) in symptomatic pregnant women assisted at the Santa Casa de Misericórdia de Sobral Maternity Hospital. Methods This was a prospective and analytic study involving 53 parturients assisted between September of 2015 and July of 2016; the participants were between 24 and 34 weeks of gestational age (GA) and presented complaints related to preterm labor (PTL) prodromes. Vaginal secretion was collected for fFN testing, and the MUCL was obtained via transvaginal ultrasonography. Results A total of 58.49% of the subjects showed MUCL < 25 mm, and 41.51% were positive in the fFNrapid test.Atotal of 48 patients were followed-up until their delivery date, and 54.17% resulted in PTL. The relative risk (RR) for PTD in patients with MUCL < 25 mm was 1.83 (p = 0.09, 0.99-3.36, 95% confidence interval [CI]), with a mean time before delivery of 2.98 weeks. Based on fFN positive results, the RR was 3.50 (p = 0.002, 1.39- 8.79, 95%CI) and themean time until delivery was 1.94weeks. The RRwas 2.70 (p = 0.002, 1.08-6.72, 95%CI) when both tests were used. The RR of PTD within 48 hours, and 7 and 14 days were, respectively, 1.30 (p = 0.11, 95% CI 1.02-1.67), 1.43 (p = 0.12, 95% CI % 0.99-2.06), and 2.03 (p = 0.008, 95% CI 1.26-3.27), when based on the MUCL, and 1.75 (p = 0.0006, 95% CI 1.20-2.53), 2.88 (p = 0.0001, 95% CI, 1.57-5.31), and 3.57 (p = 0.0002, 95% CI 1.63-7.81) when based on positive fFN results. The RR at 48 hours and 7 and 14 days considering both tests was 1.74 (p = 0.0001, 95% CI 1.14-2.64), 2.22 (p = 0.0001, 95% CI 1.22-4.04), and 2.76 (p = 0.0002, 95% CI 1.27-5.96), respectively. Conclusion In symptomatic pregnant women, we concluded that the MUCL < 25 mm associated with positive fFN rapid test indicate increased the risk for PTD. Further studies with larger sample sizes could contribute in supporting the results presented in the current study.

Resumo Objetivo Analisar a utilização da medida do comprimento do colo uterino (MCCU), e do teste da fibronectina fetal (FNf) como preditores do trabalho de parto pré-termo (PPT), em gestantes sintomáticas, atendidas na Maternidade da Santa Casa de Misericórdia de Sobral. Métodos Foi realizado umestudo prospectivo e analítico, envolvendo 53 parturientes atendidas no período de setembro de 2015 a julho de 2016, com idade gestacional (IG) entre 24 e 34 semanas que tiveram queixas relacionadas a pródromos de trabalho de parto prematuro (TPP), sendo realizada coleta de secreção vaginal para FNf e MCCU por via ultrassonográfica transvaginal. Resultados Um total de 58,49% das pacientes tinham MCCU < 25 mm, e 41,51% tiveram teste rápido de fFN positivo. Foi feito o acompanhamento de 48 pacientes, com 54,17% de PPTs. O risco relativo (RR) para PPT com MCCU < 25 mm foi de 1,83 (p = 0,09, 0,99-3,36, intervalo de confiança [IC] 95%), com média de tempo até o parto de 2,98 semanas. Para fFN, o RR foi de 3.50 (p = 0.002, 1.39-8.79, IC 95%) e a média até o parto foi de 1,94 semanas. Quando os dois testes forampositivos, o RR foi de 2,70 (1,08-6,72). Para a MCCU, o RR para PPT em 48 horas, 7 e 14 dias foram 1,30 (p = 0.11, 95% IC 1.02-1.67), 1,43 (p = 0.12, 95% CI % 0.99-2.06) e 2,03 (p = 0.008, 95% IC 1.26-3.27), respectivamente. Para FNf, em 48 horas, 7 e 14 dias foi de 1,75 (p = 0.0006, 95% IC 1.20-2.53, 2,88 (p = 0.0001, 95% IC, 1.57-5.31) e 3,57 (p = 0.0002, 95% IC 1.63-7.81) respectivamente. Com os dois testes, o RR em 48 horas, 7 e 14 dias foi 1,74 (p = 0.0001, 95%IC 1.14-2.64), 2,22 (p = 0.0001, 95% IC 1.22-4.04) e 2,76 (p = 0.0002, 95% IC 1.27-5.96) respectivamente. Conclusão Em mulheres grávidas sintomáticas, concluímos que a MCCU < 25 mm e o teste rápido de FNf positivo indicam aumento do risco de PPT. Outros estudos com tamanhos de amostra maiores podem contribuir para apoiar os resultados apresentados no presente estudo.

Rabdomiosarcoma botrioide del aparato genital femenino en paciente adolescente virgen / Botryoid rhabdomyosarcoma of the female genital apparatus in a virgin adolescent

El rabdomiosarcoma es un tumor complejo y de gran malignidad que se origina en las células del mesénquima embrionario con capacidad para diferenciarse en células musculares esqueléticas. Este es el tumor maligno de tejido blando más frecuente. Representa aproximadamente 3,5 por ciento de los casos de cáncer en niños de 0 a 14 años de edad. La presentación clínica del rabdomiosarcoma embrionario variedad botrioides es, en general, una masa que protruye por la uretra o el introito vaginal, o por la presencia de flujo fétido o sangrado vaginal en niñas menores de 2 años. Se presenta el caso de un rabdomiosarcoma botrioides de la vagina diagnosticado es una paciente de 16 años y virgen. El apoyo diagnóstico con inmunohistoquímica es de vital importancia y la evaluación médica multidisciplinaria precoz y oportuna permitirá siempre establecer un diagnóstico y tratamiento adecuados que mejoren el pronóstico de quienes padecen esta enfermedad(AU)

Rhabdomyosarcoma is a complex tumor of great malignity that originates in the embryonary mesenchymal cells with the capacity of differentiating into skeletal muscle cells. This is the most frequent malignant tumor in the soft tissue. It roughly represents 3.5 percent of cancer in children aged 0 to 14 years. Generally, the clinical presentation of botryoid-type embryonary rhabdomyosarcoma is a mass that protrudes from the urethra or the vaginal introit or the presence of fetid fluid or vaginal bleeding in girls under 2 years-old. This is the case of a 16 years-old virgin female patient diagnosed with botryoid rhabdomyosarcoma of the vagina. The diagnostic support with immunohistochemistry is of vital importance in addition to the early and timely multidisciplinary medical assessment for setting adequate diagnosis and treatment that improve the prognosis of persons suffering this disease(AU)

Analysis of the Ki-67 index in the vaginal epithelium of castrated rats treated with tamoxifen

OBJECTIVES: Vaginal atrophy and breast cancer are common conditions in postmenopausal women and tamoxifen is the standard endocrine treatment for hormone-sensitive tumors. The present study aimed to assess the effect of tamoxifen on Ki-67 protein expression in the vaginal epithelium of castrated rats. MATERIAL AND METHODS: Forty Wistar-Hannover adult, virgin, castrated rats were randomly divided into two groups, group I (control, n=20) and group II (tamoxifen, n=20), receiving 0.5 ml of propylene glycol and 250 µg of tamoxifen diluted in 0.5 ml of propylene glycol, respectively, daily by gavage for 30 days. On the 31st day, the rats were euthanized and their vaginas were removed and fixed in 10% buffered formalin for the immunohistochemical study of Ki-67 protein expression. Data were analyzed by the Levene and Student’s t tests (p<0.05). RESULTS: The mean index of Ki-67 expression in the rat vagina of groups I and II was 4.04±0.96 and 26.86±2.19, respectively (p<0.001). CONCLUSIONS: According to the results of the present study, tamoxifen, at the dose and treatment length used, induced a significant increase in the cell proliferation of the vaginal mucosa in castrated rats, as evaluated by Ki-67 protein expression.

Secreção vaginal anormal: Sensibilidade, especificidade e concordância entre o diagnóstico clínico e citológico / Abnormal vaginal secretion: sensitivity, specificity and concordance between clinical and cytological diagnosis

OBJETIVOS: Estimar a prevalência da vaginose bacteriana (VB), candidíase e tricomoníase e comparar os achados do exame físico da secreção vaginal com o diagnóstico microbiológico, obtido pelo estudo citológico do esfregaço vaginal, pelo do método de Papanicolaou. MÉTODOS: Estudo de corte transversal que incluiu 302 mulheres com idade entre 20 a 87 anos, submetidas à entrevista e exame ginecológico para avaliação da secreção vaginal e coleta de esfregaço citológico, no período de junho de 2012 a maio de 2013. Para avaliar a acurácia das características da secreção vaginal em relação ao diagnóstico microbiológico do esfregaço citológico foi empregado as análises de sensibilidade, especificidade, valor preditivo positivo (VPP) e valor preditivo negativo (VPN), com seus respectivos IC95%. Para avaliar o grau de concordância entre as características clínicas da secreção vaginal e os achados microbiológicos no exame citológico, foi aplicado o índice kappa (k). RESULTADOS: A prevalência da VB, candidíase e tricomoníase foi de 25,5, 9,3 e 2,0%, respectivamente. A sensibilidade, especificidade, valor o VPP e o VPN das características clínicas da secreção vaginal para o diagnóstico citológico de VB foram de 74, 78,6, 54,3, e 89,9%, respectivamente. A sensibilidade, a especificidade, o VPP e o VPN das características clínicas da secreção vaginal para o diagnóstico citológico de candidíase foram de 46,4, 86,2, 25,5 e de 94%, respectivamente. O grau de concordância entre a avaliação clínica da secreção vaginal e o diagnóstico microbiológico de VB, candidíase e tricomoníase, avaliados pelo índice kappa foi de 0,47, 0,23 e 0,28, respectivamente. CONCLUSÃO: A causa mais frequente de secreção vaginal anormal foi VB. A avaliação clínica da secreção vaginal apresentou sensibilidade, VPP e grau de concordância moderado a fraco, comparado ao diagnóstico microbiológico, o que indica a necessidade de avaliação complementar do achado clínico de secreção vaginal anormal. .

PURPOSE: To estimate the prevalence of bacterial vaginosis (BV), candidiasis and trichomoniasis and compare the findings of physical examination of the vaginal secretion with the microbiological diagnosis obtained by cytology study of a vaginal smear using the Papanicolaou method. METHODS: A cross-sectional study of 302 women aged 20 to 87 years, interviewed and submitted to a gynecology test for the evaluation of vaginal secretion and collection of a cytology smear, from June 2012 to May 2013. Sensitivity analyses were carried out and specificity, positive predictive value (PPV) and negative predictive value (NPV) with their respective 95%CI were determined to assess the accuracy of the characteristics of vaginal secretion in relation to the microbiological diagnosis of the cytology smear . The kappa index (k) was used to assess the degree of agreement between the clinical features of vaginal secretion and the microbiological findings obtained by cytology. RESULTS The prevalence of BV, candidiasis and trichomoniasis was 25.5, 9.3 and 2.0%, respectively. The sensitivity, specificity, PPV and NPV of the clinical characteristics of vaginal secretion for the cytological diagnosis of BV were 74, 78.6, 54.3 and 89.9%, respectively. The sensitivity, specificity, PPV and the NPV of the clinical characteristics of vaginal secretion for the cytological diagnosis of candidiasis were 46.4, 86.2, 25.5 and 94%, respectively. The correlation between the clinical evaluation of vaginal secretion and the microbiological diagnosis of BV, candidiasis and trichomoniasis, assessed by the kappa index, was 0.47, 0.23 and 0.28, respectively. CONCLUSION The most common cause of abnormal vaginal secretion was BV. The clinical evaluation of vaginal secretion presented amoderate to weak agreement with the microbiological diagnosis, indicating the need for complementary investigation of the clinical findings of abnormal vaginal secretion. .

Genes responsible for vaginal extracellular matrix metabolism are modulated by women's reproductive cycle and menopause

Objectives To analyze the expression of genes involved in extracellular matrix (ECM) biogenesis and remodeling in vaginal tissue of women with clinically normal pelvic floor support (defined as controls) according to the phase of menstrual cycle and postmenopausal women with and without pelvic organ prolapse (POP). Materials and Methods This study examined the expression of matrix metalloproteinases (MMPs), their tissue inhibitors (TIMPs), and the Lysyl oxidase (LOX) family genes in the anterior vaginal wall of Caucasian women by real-time RT-PCR. Initially, mRNA expression was assessed in premenopausal controls in the secretory (group 1, n = 10) vs. proliferative (group 2, n = 8) phase of menstrual cycle. In addition, we compared premenopausal controls in the proliferative phase (group 2) vs. postmenopausal controls (group 3, n = 5). Finally, we analyzed postmenopausal controls (group 3) vs. postmenopausal women with advanced POP (group 4, n = 13). Results According to the phase of menstrual cycle, MMP1 was significantly reduced (p = 0.003), whereas the expression of TIMP1 and LOXL4 was significantly up-regulated during proliferative phase (both p < 0.01) when compared to the secretory phase in premenopausal control women. Regarding menopausal status/ageing, all MMPs were down-regulated, while TIMP3, TIMP4 and LOXL2 were significantly up-regulated in postmenopausal control women when compared to premenopausal controls (p = 0.005, p = 0.01 and p < 0.001, correspondingly). TIMP4 and LOXL2 mRNA levels were significantly decreased in postmenopausal POP patients compared to asymptomatic postmenopausal controls (p < 0.01 for both). Conclusions Our results indicate that ovarian cycle and age-related changes influence the expression of genes encoding proteins responsible for ECM metabolism in human vagina. Moreover, POP is associated with alteration in vaginal ECM components after menopause. .

Distribution specificity of human fucosyltransferase 5 and its expression and localization in spermatids / 法医学杂志

OBJECTIVE@#To investigate distribution specificity of human fucosyltransferase 5 (FUT5) as well as its expression and localization in spermatids.@*METHODS@#Human semen, vaginal swab, saliva and venous blood from healthy individuals were collected. The spermatids were isolated and the spermatid membrane protein was then extracted. Expression levels of FUT5 from human spermatid membrane, seminal plasma, vaginal fluid, saliva and serum were detected by immunoblotting technique. The expression and localization of FUT5 in spermatids were analyzed by immunofluorescent method.@*RESULTS@#Immunoblotting technique showed that FUT5 was expressed on spermatid membranes and in serum, but not in seminal plasma, vaginal fluid and saliva. The expressed FUT5 on spermatids was mostly localized on head of spermatids by fluorescent microscopy, suggesting that there was certain amount of FUT5 on human spermatid membrane, and the spermatids might be isolated from mixed stains with vaginal fluid by antigen-antibody reaction.@*CONCLUSION@#Human FUT5 shows a characteristic distribution specificity, and this feature may be used for identification of mixed stain involved in criminal sexual offence in future forensic practice.

Expression of estrogen and progesterone receptor genes in endometrium, myometrium and vagina of postmenopausal women treated with estriol / Expresión de los genes receptores de estrógeno y progesterona en el endometrio, miometrio y vagina en mujeres posmenopáusicas tratadas con estriol

CONTEXT AND OBJECTIVE: Estriol is an estrogen with considerably weaker stimulatory effects on endometrial proliferation than estradiol. A study was conducted to determine the level of estrogen receptors (ERs) and progesterone receptors (PRs) in women who received 14-day vaginal estriol therapy, compared with those who did not receive this therapy. ER and PR gene expression was analyzed in the endometrium, myometrium and vagina of postmenopausal women treated with estriol. DESIGN AND SETTING: Analytical cross-sectional study, at the Research Institute of the Polish Mothers' Memorial Hospital, Lodz, Poland. METHODS: Twenty-seven postmenopausal women (57-74 years of age) were included in the study. All of them were waiting for per vaginam hysterectomy or plastic surgery on the vagina and perineum because of uterine prolapse. ER and PR gene expression was determined by means of the technique of reverse transcription polymerase chain reaction (RT-PCR). RESULTS: In the estriol-treated patients, in comparison with the control group, a significant increase in ER gene expression was observed in the endometrium and vagina, while enhanced PR gene expression was found in the endometrium. However, under histological examination of the endometrium, estrogen stimulation of low and medium degree was diagnosed for 21.4 percent and 14.3 percent of the estriol-treated women, respectively. CONCLUSION: The results obtained suggest that the women who received 14 days of treatment with vaginal estriol had higher ER and PR mRNA levels. No difference between these groups regarding endometrial proliferation was observed.

CONTEXTO Y OBJETIVO: El estriol es un estrógeno con un efecto estimulatorio bastante más débil sobre la proliferación endometrial que el estradiol. Se realizó un estudio para determinar los efectos de una terapia vaginal de 14 días con estriol, sobre el nivel de receptores de estrógeno (ER) y receptores de progesterona (PR), comparado con mujeres sin esa terapia. La expresión de los genes de ER y PR se analizó en el endometrio, miometrio y vagina de mujeres posmenopáusicas tratadas con estriol. DISEÑO Y UBICACIÓN: Estudio Transversal analítico, en el Instituto de Investigación del Hospital de la Madre Polaca en Lodz, Polonia. MÉTODOS: Se incluyeron veintisiete mujeres posmenopáusicas (de 57 a 74 años) en el estudio. Todas ellas estaban en espera de una histerectomía per vaginam o de cirugía plástica de la vagina y del perineo debido a un prolapso del útero. La expresión de genes de los receptores ER y PR se estableció por la técnica de RT-PCR. RESULTS: En las pacientes tratadas con estriol en comparación con el grupo de control, se observó un aumento significativo de la expresión del gen de ER en el endometrio y la vagina, mientras que un aumento de la expresión del gen de PR se encontró en el endometrio. De todas formas, en el examen histológico del endometrio, se diagnosticó estimulación estrogénica de bajo y medio grado en el 21.4 por ciento y en el 14.3 por ciento de las mujeres tratadas con estriol, respectivamente. CONCLUSIONES: Los resultados obtenidos sugieren que un tratamiento de 14 días con estriol en pacientes, aunque aumentan el nivel de ER y de PR mRNA, tiene muy poco o ningún efecto sobre la proliferación endometrial.

Satisfaction and tolerability of combination of lactoserum and lactic acid on the external genitalia in Thai women.

OBJECTIVE: The aims of this study were to assess the user satisfaction and tolerability of a combination of lactoserum and lactic acid on the external genitalia of Thai women. MATERIAL AND METHOD: Women who were over 18 years of age who came to gynecologic outpatient unit at Rajavithi Hospital from November 2004 to January 2005, without clinical manifestations of vulvovaginal irritation or infection were included. The exclusion criteria were women who had allergy to a combination of lactoserum and lactic acid, or any of the components of this product. Clinical history was taken and gynaecological examination was performed. Those who met the eligible criteria were assigned to use one bottle of 150 ml combination of lactoserum and lactic acid on the external genitalia. Fisher's Exact test was used to compare the satisfaction between each group. RESULTS: There were 300 patients equally dividing in 3 groups. Average age was 42.2 +/- 9.8 years. The satisfaction percentage was more than 90 percent according to the evaluation criteria. There was no statistically significant difference between products. The tolerability were high percentage, only 3.3% of the patients used these products less than 7 days. 6 patients (2%) experienced discomfort resulting from these products and no statistically significant difference between products. CONCLUSION: The combination of lactoserum and lactic acid demonstrated the high percentage of satisfaction and tolerability. Only 2% of patients experienced discomfort without any serious discomfort effects.

Preparation and in vitro evaluation of liposomal/niosomal delivery systems for antifungal drug clotrimazole.

Clotrimazole, an imidazole derivative antifungal agent is widely used for the treatment of mycotic infections of the genitourinary tract. In order to develop alternative formulation for the vaginal administration of clotrimazole to provide sustained and controlled release of appropriate drug for local vaginal therapy, liposomes/niosomes were evaluated as delivery vehicles. To optimize the preparation of liposomes/niosomes with regards to size and entrapment efficiency, multilamellar liposomes/niosomes containing drug were prepared by lipid hydration method. The ability of the systems to deliver clotrimazole into and through the mucosa was evaluated in vitro using rabbit vaginal mucosa with vertical Franz diffusion cells. The in vitro permeation data showed that the liposomes/niosomes system increased the clotrimazole total penetration through the vaginal mucosa by 1.6, 1.5-fold, the accumulation of clotrimazole into the mucosa was increased by 3.1, 2.3-fold, respectively, as compared with control during 24 hr. These results suggest that the studied liposomes/niosomes systems may be appropriate vesicles for the vaginal mucosa delivery of clotrimazole for local vaginal therapy.

Infecciones neonatales recurrentes por streptococcus agalactiae / Recurrence of neonatal streptococcus agalactiae infections

La infección por streptococcus agalactiae (streptococcus b hemolítico grupo b) es una de las principales causas de sepsis en recién nacidos, pero su recurrencia es extremadamente infrecuente. Consideramos de interés presentar dos casos clínicos de recién nacidos con bacteremia recurrente causada por s agalactiae y analizar los probables mecanismos patogénicos involucrados: reinfección desde una fuente exógena, colonización persistente por s agalactiae, tolerancia a penicilina y recaída desde un foco metastásico latente

Avaliaçäo do emprego de soro humano no meio de Diamond para isolamento e manutençäo de cepas de Trichomonas vaginalis / Evaluation of the use of human serum in Diamond's Medium for the isolation and maintenance of Trichomonas vaginalis

O meio de Diamond vem sendo empregado para o cultivo do Trichomonas vaginalis, Trichomonas tenax e Pentatrichomonas hominis, em sua composiçäo utiliza-se soro de cavalo como fonte de enriquecimento. Neste trabalho, este soro foi substituído pelo soro humano, por facilidade na sua obtençäo em laboratórios de análises clínicas. Os meios de cultura, assim preparados, foram distribuídos em tubos com tampa de rosca, em alíquotas de 8 mL, e os repiques foram feitos a cada 5 dias. As cepas de Trichomonas vaginalis foram inoculadas concomitantemente em meios contendo soro de cavalo e soro humano; resultados satisfatórios foram obtidos no cultivo e manutençäo das cepas, e o número de parasitas dobrou no mesmo período quando foi usado soro humano. Esses dados mostram que o isolamento e a manutençäo desses flagelados podem ser realizados de maneira simples e rotineira nos laboratórios, possibilitando uma melhoria no diagnóstico dessa parasitose e facilidade na manutençäo de cepas para outros estudos.

Shedding of HIV-1 subtype E in semen and cervico-vaginal fluid.

The uneven expansion of HIV-1 subtypes in each transmitted group raises the possibility that some viruses have less/more potential by qualitative/quantitative for heterosexual transmission compared to others. In Thailand, HIV-1 subtype E is mainly spread via heterosexual route and accounts for about 95 per cent of the infected cases. To determine whether high sexual infectivity of HIV-1 subtype E is due to the presence of a virus in genital fluid, we conducted a study to characterize shedding of HIV-1 in seminal and cervico-vaginal fluids of 30 HIV-1 subtype E infected Thai couples by PCR and virus isolation methods. All subjects had no HIV-associated diseases and other sexually transmitted diseases. HIV-1 subtype E DNA was detected in 22/30 (77.33%) of cervico-vaginal and also 22/30 (77.33%) of seminal fluid samples. The isolation rate of HIV-1 from semen and cervico-vaginal secretion was 36.67 per cent and 16.67 per cent, respectively. Number of HIV-1 subtype E DNA copies in the blood is reversely correlated with the number of blood CD4+ T cells, while that in genital fluid was not related to CD4+ T cell count. An increase in shedding of HIV- DNA subtype E in female genital tract compared to other HIV subtypes reported by other investigators might be one reason to explain the rapid spread of subtype E by heterosexual transmission in Thailand.

Determinaçäo do risco para o parto prematuro através da detecçäo da fibronectina fetal na secreçäo cérvico-vaginal e da monitorizaçäo das contraçöes uterinas / Determination of risk for preterm delivery by cervical and vaginal fibronectin detection and by uterine activity monitoring

O objetivo do estudo foi avaliar o aparecimento da fibronectina fetal (fFN) na secreçao cérvico-vaginal e das contraçoes uterinas anormais como métodos preditivos para o parto prematuro. Setenta e duas gestantes foram submetidas, a cada duas semanas, a coletas da secreçao cérvico-vaginal para detectar a presença da fFN e, semanalmente à monitorizaçao das contraçoes uterinas, entre a 24( e a 34( semanas de gestaçao. Foi determinada a correlaçao entre a presença da fFN e o aparecimento de contraçoes uterinas anormais com o parto prematuro em três grupos: grupo l (n=38), gestantes assintomáticas, com risco elevado para o parto prematuro espontâneo; grupo 2 (n=l8), ge stantes de baixo risco para a prematuridade e grupo 3 (n=l6), gestantes com contraçoes uterinas compatíveis com trabalho de parto, com membranas íntegras e em idades gestacionais inferiores a 37 semanas completas. A taxa de parto prematuro espontâneo foi de 21,05 por cento (8/38) no grupo 1; de ll,ll por cento (2/18) no grupo 2 e de 81,25 por cento (l3/16) no grupo 3. No grupo 1, em que todos os testes foram significativos, obtivemos: teste de membrana para a fFN - sensibilidade (S) de 75 por cento; especificidade (E) de 83,33 por cento; valor preditivo positivo (VPP) de 54,54 por cento e valor preditivo negativo (VPN) de 92,59 por cento. O risco relativo (RR) associado ao teste posit ivo foi de 7,36; acurácia, O,81; odds ratio, 1,2 e p=O,0008. O teste de ELISA para a fFN mostrou: S,75 por cento; E, 90 por cento; VPP, 66,66 por cento e VPN, 93,10 por cento. O RR foi de 9,66; acurácia, O,86; odds ratio, 2,0 e p=O,0006. As contraçoes uterinas revelaram: S 50 por cento; E 63,33 por cento; VPP 26,66 por cento e VPN 82,60 por cento. O RR foi de 1,53; acurácia O,60; odds rotio O,36 e p= O,0001471. O teste de membrana e o de ELISA para a detecçao da fFN, quando utilizados entre a 24( e 34( semanas de gravidez, em gestantes assintomáticas com risco elevado para o parto prematuro, constituem melhores mercadores para a prematuridade do que as contraçoes uterinas.

Colonizaçåo vaginal pelo Enterococcus faecalis: prevalência e manifestaçöes citológicas e microbiológicas / Vaginal colonizatin by Enterococcus faecalis: prelance and cytologic and microbiologic findings

Os autores estudaram corrimentos vaginais de 113 pacientes (idade entre 2-52 anos), para investigar a prevalência de Enterococcus faecalis e sua associaçåo com achados citológicos. Cinco faixas etárias foram estudadas: 0-12 anos, 13-18 anos, 19-30 anos, 31-40 anos e maior de 40 anos. A prevalência de Enterococcus faecalis foi maior em pacientes com 0-12 anos (22,8 por cento), 19-30 (40,9 por cento) e 31-40 (22,8 por cento) e menor nas faixas de 13-18 anos (9,0 por cento) e maior de 40 anos (4,5 por cento). A presença de Enterococcus faecalis nas secreçöes vaginais analisadas nåo foi associada com aumento de leucócitos polimorfonucleares, de histiócitos, ou de células epiteliais descamativas. Por outro lado, a colonizaçåo de Sthaphylococcus aureus e de Staphylococcus epidermidis foi menor na presença de Enterococcus faecalis, em pacientes com 0-12 anos (p<0,05) e 19-30 (p<0,05 para a colonizaçåo pelo Staphylococcus aureus e p<0,01 para a colonizaçåo pelo Staphylococcus epidermidis). O mesmo ocorreu com a colonizaçåo de Escherichia coli, em mulheres com 19-30 anos (p<0,05). Os significados destes achados såo discutidos

In vitro adhesiveness of Gardnerella vaginalis strains in relation to the occurrence of clue cells in vaginal discharge.

G. vaginalis was isolated from 52.4 per cent patients with non-specific vaginitis. The haemagglutinating activity of G. vaginalis was strongest with human 'O' red cells and weaker reactions were observed with sheep and chick erythrocytes. Haemagglutinating activity of G. vaginalis with human 'O' cells (1:16 titre) could be correlated with clue cells in vaginal discharge in 73 per cent patients while in lower titres, this correlation was not observed.

Pathology of ovary, uterus, vagina and gonadotrophs of female mice fed on Zn-deficient diet.

Dietary Zn-deficiency in mature female mice for 6 weeks caused a retardation of ovarian growth characterized by lack of vesicular and Grafian follicles, degenerated corpus luteum, distorted cell membranes of granulosa cells with pycnotic nuclei, poor development of theca interna, inordinate accumulation of sudanophilic granules in theca interna and interstitial cells. The vagina and uterus did not exhibit cyclic changes in their cytoarchitecture as a result of the cessation of estrous cycle after 6 weeks of dietary treatment. They displayed wide spread degenerative changes in their myometrial and endometrial layers. The uterine glands appeared collapsed with little or no secretion. The vagina lacked cornification. Their gonadotrophs reacted positive to PAS, identical to the control group observed at diestrous stage. However, they did not display a negative reaction, characteristic of the gonadotrophs at estrous stage of the control group, examined even at an interval of 1 day for 6 days in succession. These results point towards the suspension of steroidogenesis inspite of intact gonadotrophs under Zn-deficiency condition.