Evaluation of vaginal microflora in patients infected with HIV.

HIV infection is thought to exacerbate the virulence of normal saprophytic vaginal microflora. We studied the vaginal ecosystem of HIV patients to detect the quantitative and qualitative variation of vaginal microorganisms. 15 patients (5 with AIDS and 10 with ARC) were investigated. Vaginal candidiasis was more frequent in this group than in the control groups. Gardnerella was present in 60% of patients generally in association with anaerobic bacteria and Mycoplasma. Among anaerobia, Bacteroides sp and other Gram-negative rods were the most common bacteria. Neisseria gonorrhoeae was absent in all patients tested. Chlamydia trachomatis was recovered in two out of the 15 HIV-positive patients. Aerobic Gram-negative flora was 100-fold that of the control group and anaerobic Gram-negative flora 10-fold.

[Changes in various immunological parameters in patients with recurrent vaginal candidiasis]. / Alterazione di alcuni parametri immunologici in pazienti affette da candidosi vaginale ricorrente.

An immunological study has been performed in a group of 14 patients suffering from recurring vaginal candidiasis. Cellular immunity has been evaluated by skin test. Mononuclear cells of peripheral blood have been studied by a panel of monoclonal antibodies. Moreover granulocytes phagocytosis and NK activity have been determined. We observed a significant reduction of cellular immunity and phagocytosis comparing to the control group. This association may represent the basis of a compromised immunological response in patients with recurring vaginal candidiasis.

[Pelvic inflammatory disease]. / La malattia infiammatoria pelvica.

At present, PID is considered to be the most severe gynecological infection of young women as well as one of the most important problems of public health involving high social and economical costs. There are two pathogenetic aspects of PID. The primary form results from an ascending infection sustained by the microbic flora of the inferior genital tract, subsequently involving its higher anatomical districts. The secondary form derives from the pelvic diffusion of microorganism primarily involved in extra-genital infections. The analysis of the epidemiological aspects of the disease identifies in the sexual habits, the contraceptive procedures as well as the invasive instrumental practices (iatrogenic factors) the risk factors of the disease. PID has a multimicrobial origin based on a complex interplay between synergic infectious agents, vectors of etiological factors, interferon-gamma and intrauterine devices. The anatomopathological aspects of PID, including Fitz-Hugh-Curtis syndrome are discussed. The literature concerning the diagnosis and the therapy of the disease is extensively analyzed.

[Recurrent vaginitis]. / Le vaginiti recidivanti.

Vaginitis is one of the most frequent infections of the female genital system and, in the United States, represents the main reason for gynecological consultation. Candida albicans, Trichomonas vaginalis and Gardnerella vaginalis are responsible for 90% of cases of vaginal phlogosis. It has been calculated that a percentage varying between 5% and 40% of the female population will suffer, at least once in their lifetime, from an episode of vaginal candidosis. The re-appearance of symptoms after suspension of the antimycotic therapy still represents an unsolved and obscure problem from the etiopathogenetic point of view. The incidence of recurrences in women suffering from various forms of vaginal candidosis, according to the Authors, is between 5% and 25%. Considering the uncertainties existing regarding the clinical and etiopathogenetic definition of recurrent vaginitis we carried out a perspective study, at the General Out-patient Department of the II Obstetrical and Gynecological Clinic of "La Sapienza" Rome University in collaboration with the Bacteriological Laboratory of the III Medical Clinic of "La Sapienza" Rome University, on a group of 60 women suffering from recurrent vaginitis. We included in the study in the period 1 October 1987 - 30 September 1988 60 women reporting to the General Out-Patient Department of the II Obstetrical and Gynecological Clinic of the "La Sapienza" Rome University. These patients complained about the appearance of a leukorrhea or a leukoxanthorrhea in combination with at least one of the following symptoms: burning sensation; itch; dyspareunia; dysuria; recurring cystitis. All the women reported in their case histories having suffered from at least three episodes of recurrent vaginal candidosis in the previous twelve months. Diagnosis had been established on the basis of fresh microscopic examination with determination of the vaginal pH on the occasion of the first episode only; whereas clinical examination only was undertaken on the occasion of the subsequent ones. In 30% of patients (or 18 cases) the diagnosis of the subsequent episodes was "telephonic". In all cases, at each episode, a local therapy with antimycotic drugs had been prescribed. Following the introduction of a sterile speculum sterile swabs were used to remove 2 samples of the fluid present at the level of the posterior vaginal fornix. The first swab was placed in a test-tube containing 2 ml of prereduced transport broth (brain-heart infusion broth oxoid) for the successive aerobe and anaerobe cultures.(ABSTRACT TRUNCATED AT 400 WORDS)

[Recurrent infections of the urogenital tract: preliminary results of a study on the clinical and immunological effects of thymopentin treatment]. / Infezioni ricorrenti a carico dell'apparato uro-genitale: risultati preliminari di uno studio clinico ed immunologico sugli effetti del trattamento con timopentina.

We are carrying on a trial with subcutaneous injections of thymopentin in a group of patients that presented more than 2 infectious episodes of uro-genital tract in the latest 18 months. Microbiological investigations were performed with microscopic and cultural examinations before and after six weeks of treatment with thymopentin (TP5) associated with antibiotic therapy chosen on the basis of cultural response. The follow-up was prolonged to 6 months. The immunological studies were performed at the same moments, by a panel of monoclonal antibodies and by the evaluation of the NK activity and granulocytic phagocytosis. The cellular immunity was studied by skin tests. In our patients, during the follow-up period, we observed a significant reduction of infectious episodes, an increase of NK activity, and a restoration of cellular immunity in hypoergic subjects.

Interference of an alpha 2 component in immunological determinations of pregnancy-specific beta 1 glycoprotein in serum.

Pregnancy-specific beta 1 glycoprotein (SP1-beta) was purified from human retroplacental blood by sequential anion exchange chromatography, gel chromatography and affinity chromatography. The final preparation appeared to be electrophoretically and immunochemically pure and was in particular free from any component with alpha mobility. The preparation was used as immunogen in rabbits as well as tracer and standard for radioimmunoassay and for cross- and rocket-immunoelectrophoresis. It was shown that this radioimmunoassay procedure, allowed quantitative determination of SP1-beta glycoprotein without interference by the alpha component.