[Usefulness of fresh wet mount examination in the diagnosis of vaginal candidiasis]. / Utilidad del examen en fresco para el diagnóstico de candidiasis vaginal.

A prospective study was done at the Clinic for Sexually Transmitted Diseases of the Department of Infectology, Instituto Nacional de Perinatología, Mexico City, in order to validate the fresh wet mount examination as a confirmatory test for vaginal candidiasis. Ninety six patients with cervico-vaginal infection were included, 22 of them had clinical candidiasis (22.9%). The fresh wet mount examination showed the presence of yeast and/or pseudomycelium in all 2 samples (100%). The presence of Candida in the cultures was confirmed in 18 of the 22 specimens (81.8). Negative in 71/96 (73.9%) (Three cultures were not processed). The fresh wet mount examination had a sensitivity of 100% and a specificity of 94.8%. The positive predictive value was 88.8% while the negative predictive value was 100%. It can be concluded that the fresh wet mount examination is very recommendable, useful, economic and easy to practice at the physician's office for the confirmation of vaginal candidiasis.

[Frequency of sexually transmitted diseases in patients at prenatal check-ups]. / Frecuencia de enfermedades transmitidas sexualmente en pacientes en control prenatal.

The sexually transmitted diseases (STD) in pregnant women can result in pregnancy abnormalities, fetal damage or newborn infection. In this study the frequency of STD between the pregnant women of the Instituto Nacional de Perinatología, in 19 months period, was 7.3 per 100 patients in prenatal care; being vulvovaginal candidiasis, bacterial vaginosis, Ureaplasma urealyticum infection, condyloma acuminatum and Chlamydia trachomatis infection the most commonly diagnosed diseases. The 25% of the patients had two or more sexually transmitted infections simultaneously. There were no gonorrhoea cases. The early detection and treatment of the STD in pregnant women must be a common practice in the prenatal care. Primary prevention will reduce the morbidity not only for the offspring but for the pregnant women as well.

[Efficacy and safety of azithromycin in the treatment of female genital Chlamydia trachomatis infections]. / Eficacia y seguridad de azitromicina en el tratamiento de la infección genital femenina por Chlamydia trachomatis.

Genital tract infections by Chlamydia trachomatis associated to sterility and infertility problems as well as perinatal complications have become increasingly frequent. Azithromycin is a new macrolide with a lower activity spectrum than erythromycin and a longer half life as well as less secondary effects. The objective of the study was to evaluate the safety and efficiency of Azithromycin on genital tract infection by C. trachomatis. MATERIAL AND METHODOLOGY. A total of 30 nonpregnant women between the ages of 19 and 35 were studied; 70% had only one sexual partner. In order to insure the presence of C. trachomatis as unique pathogen, cervicovaginal sampling, clinical evaluation and gynecologic exploration were undertaken. One dose of 1 g orally of Azithromycin was administered evaluating microbiologic and clinical remission at days 7-10, 12-16 and 33-37 after treatment. RESULTS. Two patients abandoned the study; global criteria of the evaluation were good to excellent in 17 cases; moderate to sufficient in six and poor in five. None of the cases reported secondary reactions. Results showed that Azithromycin treatment of cervicitis by C. trachomatis is useful with the advantage of unique dose administration.

Bacterial vaginosis associated with G vaginallis / Mobiluncus sp: ultrastructural parameters.

PIP: Physicians at the National Institute of Perinatology in Mexico City, Mexico used a Carl-Zeiss EM 10C electron microscope to examine genital secretion samples from 10 pregnant women (15-38 weeks' gestation) who had been diagnosed with Mobiluncus species and Gardnerella vaginalis infections to illustrate the form and structure of bacteria responsible for bacterial vaginosis. They were concerned that these bacteria induce preterm labor and premature rupture of membranes (PL/PROM). These bacteria have been present in the genital tract of 30% of pregnant women with a thick whitish discharge who have attended the Institute's prenatal outpatient clinic. Physicians noted on the microscope slides that bacteria surrounded vaginal squamous epithelial cells (clue cells). Numerous gardnerella-like bacteria surrounded elongated squamous epithelial cells with many plasma projections. An extensive area of lysis existed around the bacteria in the cytoplasm of many squamous epithelial cells with intact membrane and nonexistent microfilaments. This finding indicated that the bacteria invade and destroy the cells. Plasma membrane projections almost completely surrounded the gardnerella-like bacteria in certain areas. Since this study strengthened the theory that G. vaginalis enters the vaginal squamous epithelial cells, researchers should conduct more studies to determine its role in PL/PROM.^ieng