Erythromycin for chlamydiasis in pregnant women. Assessing adherence to a standard multiday, multidose course.

OBJECTIVE: To assess patient adherence among pregnant women infected with Chlamydia trachomatis given a self-administered, 10-day course of erythromycin prescribed as 500-mg tablets to be taken four times a day for the full 10-day period of treatment. STUDY DESIGN: Study participants (n = 30) were given the standard, 10-day supply of 500-mg tablets of erythromycin and instructed to take one tablet four times daily for 10 days. Patients were blinded to the fact that the Medication Event Monitoring System was being used and that their adherence to this course of drug therapy was being monitored. RESULTS: A 100% cure rate was achieved. The average percentage of therapeutic coverage actually achieved by the study participants declined with the length of erythromycin therapy. Further, as the duration of treatment increased, the longest interval between two successive doses of erythromycin also increased. CONCLUSION: This study demonstrated the importance of assessing both the quantitative and temporal aspects of self-administered oral medication when assessing patient adherence. Moreover, since the length of the course of antibiotic therapy was shown to affect patient adherence, coupled with the 100% cure rate we observed, future research geared toward maximizing adherence while minimizing duration of treatment seems warranted.

Infrared spectroscopy of human tissue. IV. Detection of dysplastic and neoplastic changes of human cervical tissue via infrared microscopy.

Infrared absorption spectra of formalin-fixed, paraffin-embedded human cervical tissue are reported for normal, dysplastic and neoplastic samples. The spectral differences found in this study between these states of the tissues are far less than those observed for single cells by us and others. Nevertheless, we find a direct correspondence between spectral data from tissue sections, obtained from biopsies, and individual exfoliated cells, typically obtained during a pap procedure. We also find that spectra due to dysplastic samples fall about halfway between the spectral features of normal and cancerous samples.

Infrared spectroscopy of human tissue. I. Differentiation and maturation of epithelial cells in the human cervix.

Infrared spectral results for the different epithelial layers of human cervical squamous tissue are reported. The layers, representing different cellular maturation stages, exhibit quite different spectral patterns. Thus, infrared spectroscopy presents a powerful tool to monitor cell maturation and differentiation. Furthermore, a detailed understanding of the spectra of the individual layers of tissue permit a proper interpretation of the state of health of cells exfoliated from such tissue. Part II of this series describes the use of the spectral information presented here to interpret the infrared spectra of exfoliated cells.

Infrared spectroscopy of human tissue. II. A comparative study of spectra of biopsies of cervical squamous epithelium and of exfoliated cervical cells.

A comparison of infrared absorption spectra obtained from the different layers of squamous epithelium from the human cervix, and infrared spectra obtained from exfoliated cervical cells, is presented. Infrared spectroscopy has been shown (in part I of this series) to be a sensitive tool to monitor maturation and differentiation of human cervical cells; therefore, this spectroscopic technique provides new insights into the composition and state of health of exfoliated cells.

First-trimester spontaneous abortions and the incidence of human immunodeficiency virus seropositivity.

OBJECTIVE: To examine the human immunodeficiency virus (HIV) seropositivity rates and HIV risk factors in women with a confirmed diagnosis of first-trimester spontaneous abortion in a community hospital. STUDY DESIGN: Patients admitted with confirmed diagnoses of spontaneous incomplete first-trimester abortions at Lutheran Medical Center, Brooklyn, New York, from September 1991 to September 1992, were asked to anonymously complete an epidemiologic questionnaire, which was used to study HIV risk factors in our study population. Routine blood work done on admission was used to ascertain the incidence of HIV infection. These rates were compared to the maternal HIV infection rates as determined by the New York City Department of Health. RESULTS: Of the 145 patients enrolled in our study, 11% of patients had HIV risk factors. The seropositivity rate was 0.689% in patients with spontaneous incomplete abortions. CONCLUSION: There was no statistically significant difference between the rate of HIV seropositivity in patients with spontaneous incomplete first-trimester abortions and the overall maternal HIV seropositivity rate, 0.56% (P = .36%) at our institution.

Laparoscopic management of ovarian ectopic pregnancy.

Ovarian ectopic pregnancy is a rare entity. Traditional therapy has been laparotomy with oophorectomy and, more recently, with ovarian wedge resection. We report the first case that was diagnosed and treated laparoscopically and retrieved intact. Laparoscopic treatment of ovarian ectopic gestations appears to be a safe and conservative approach in selected patients.