UROGENITAL MIXED INFECTIONS IN REPRODUCTIVE AGED WOMEN WITH PELVIC INFLAMMATORY DISEASE.

The purpose of our study was to determine the prevalence of urogenital mixed infections and the sensitivity of mycoplasmas and ureaplasmas to antibiotics in reproductive aged women with pelvic inflammatory disease. 4720 samples of biomaterial were obtained by urethral and cervical canal scrapings in 2360 women of reproductive age with pelvic inflammatory disease (2 samples from each woman). In 2360 samples, Chlamydia trachomatis, Trichomonas vaginalis and Gardnerella vaginalis were determined by multiplex PCR. 2360 samples were examined using the culture method.The cultivation, identification and susceptibility testing of urogenital mycoplasmas and ureaplasmas to 9 antibiotics were conducted with the use of commercial kits. In the study of 2360 samples of biomaterial by PCR, bacterial vaginosis (37.4%) was most often determined in women with PID.Chlamydiatrachomatiswas found in 8.3%, Trichomonasvaginalis- in 1.2% of women with PID. The cultivation and identification of urogenital mycoplasmas and ureaplasmas using biochemical markers revealed: Ureaplasma spp. in 543 women (23.0%) and Mycoplasma hominis in 179 women (0.7% of the total number of women examined). Number of women with mixed infection (positive results for Chlamydia trachomatis, Gardnerella vaginalis, Ureaplasma spp. andMycoplasma hominis) was 112. (4.7% of the total number of women with PID). The study of antibiotic sensitivity showed that most strains of Ureaplasma spp. and Mycoplasma hominis are highly susceptible to tetracycline antibiotics, especially doxycycline.

Early-stage cervical cancer: agreement between ultrasound and histopathological findings with regard to tumor size and extent of local disease.

OBJECTIVES: To determine the agreement between ultrasound and histological examination of the cervix in patients with early stage cervical cancer with regard to tumor size and local extent of the disease. METHODS: Eighteen patients with histologically proven cervical cancer Stage IB1-IIA according to traditional clinical staging (FIGO 1988) who were scheduled for radical surgery underwent a standardized transvaginal ultrasound examination. The maximum tumor length, anteroposterior tumor diameter, tumor width, tumor area, depth of cervical stroma invasion, and the minimal thickness of tumor-free cervical stroma on sagittal and transverse planes through the cervix were measured, and the local extent of the disease within the parametria and vagina were evaluated. The surgical specimens were examined using a specifically devised method of histopathological examination. The results of the ultrasound and histopathological examinations were compared. RESULTS: Limits of agreement were wide and the intraclass correlation coefficient (ICC) was low (0.51-0.58) for three of the four measurements taken to represent the minimal depth of tumor-free cervical stroma, i.e. the results of the measurements taken posteriorly and laterally. However, the limits of agreement were narrower and the ICC values were higher (0.74-0.92) for the depth of cervical stroma invasion and for the tumor size measurements. Histological examination revealed parametrial cancer infiltration in four patients, which was detected during ultrasound examination, with no false-positive results. CONCLUSIONS: Transvaginal sonography is acceptably accurate for evaluation of tumor size and depth of cervical stroma invasion in clinical practice.

Management of amniocentesis in women with oligohydramnios due to membrane rupture: evaluation of a cervical adapter.

Thirty-five pregnant women with gestational age 22-37 completed weeks and with prelabour rupture of the membranes in the preterm period (PROM) volunteered to participate in the study. Sixteen women had a sterile cervical adapter, stopping the leakage of amniotic fluid, applied to the ectocervix for 24 h. The remaining 19 women were managed accordingly to prevailing expectant routine without the cervical adapter. All 35 women were assessed initially and after 24 h by ultrasound to obtain amniotic fluid index (AFI) registered. The results show that the average AFI value in the adapter group almost doubled while it changed insignificantly in the group without adapter. The difference in change between the two groups is significant (p < 0.001). There were no infectious complications in the newborn or in the mother. It is concluded that, in case amniocentesis is indicated to enable improved diagnostic accuracy in women with oligohydramnios due to PROM, application of the cervical adapter designed in this study will increase AFI and facilitate a less complicated amniocentesis.

Morphologic study of the action of lymphoid tissue extracts in peroxidase arthritis.

By means of modelling arthritis by horseradish peroxidase it was possible to reproduce a process corresponding to immune synovitis. A considerable reduction of immunomorphological phenomena in joints, lymphoid tissue, heart, liver and kidneys was favoured by application of lymphoid tissue extracts. Comparison between the extracts of spleen and lymph nodes showed a more pronounced effect of spleen extract.