Chlamydial infection of the urinary tract in children and adolescents with hematuria.

Urogenital infection with Chlamydia trachomatis in adults and adolescents is a common sexually transmitted disease. The purpose of this study was to investigate whether isolated microhematuria in children and adolescents is associated with Chlamydia trachomatis infection of the urinary tract. The study group included 37 children and adolescents with isolated nonglomerular microhematuria. Urethral smears for the isolation of Chlamydia trachomatis in cell culture were taken at the time of cystourethroscopy from all patients. Polymerase chain reaction (PCR) for the detection of chlamydial DNA in urine was carried out in 25 of 37 (68%) patients and direct immunofluorescence (DIF) of urine in 16 of 37 (43%) patients. The control group included 33 children and adolescents without hematuria; PCR and DIF of urine were carried out in all controls. Chlamydia trachomatis infection of the urinary tract was confirmed in 8 of 37 (22%) patients in the study group, and in none in the control group (0 of 33, P<0.001). Further studies of larger groups of patients should be conducted, before recommending testing for Chlamydia trachomatis infection of the urinary tract in children and adolescents with unexplained microhematuria.

Transvaginal ultrasound or laparoscopy for oocyte retrieval (experiences in the Ljubljana IVF program).

At present, the less invasive ultrasound-directed techniques are the methods of choice for oocyte retrieval in most in vitro fertilization and embryo transfer (FIVET) centers. Among the ultrasound-direct techniques, the transvaginal follicle aspiration guided by transvaginal ultrasound for oocyte recovery is gaining popularity in many FIVET centers. This study compare cycles outcome following transvaginal ultrasound oocyte retrieval (105 cycles) to laparoscopic oocyte retrieval (218 cycles); no statistically significant difference could be demonstrated between the groups in all parameters evaluated but better clinical results have been obtained in transvaginal ultrasound group. The Authors conclude that transvaginal oocyte recovery represents an improvement and a simplification of the FIVET procedure.

In vitro fertilization and embryo transfer programme in Ljubljana.

Results of the IVF-ET programme from June 1983 to July 1984 are presented. The procedure was performed in 98 women in 127 cycles. Six normally ongoing clinical pregnancies, three early spontaneous abortions and six biochemical pregnancies were achieved. The laparoscopic techniques of oocyte retrieval were used. Ovulation was first stimulated by clomiphene citrate and later on by gonadotropins only. Comparison of these two regimens showed gonadotropin stimulation to be more effective than clomiphene stimulation, considering the respective transfer rate of 73.3% (gonadotropins) and 18.8% (clomiphene).

[Laparoscopic aspiration of oocytes for in vitro fertilization and embryo transfer]. / Laparoskopska aspiracija oocita kod postupka fertilizacije in vitro i transfera embrija.

Within the in vitro fertilization and embryo transfer procedure, 127 laparoscopies were performed in 89 women. The only indication was tubal infertility. There were 116 gonadotropin stimulated cycles and 11 clomiphene citrate stimulated cycles. Because of a limited ovarian access laparoscopic adhesiolysis was necessary in 30%. Egg recovery amounted to 440 oocytes in 92% successful laparoscopies, which represents 4.1 oocytes per laparoscopy. This resulted in 15 pregnancies of which 3 ended with spontaneous abortion, 6 biochemical and 6 ongoing pregnancies. Two pregnancies resulted in the live birth of normal twins, and one in the birth of a healthy girl.

Some biological characteristics of Escherichia coli strains isolated from acute diarrhoeal diseases of infants.

The aim of this study was to evaluate the methods of biological characterization of Escherichia coli strains, in order to use them as screening tests in clinical microbiological laboratories. In two thirds of the 45 E. coli, isolated from acute intestinal infection of infants, different factors of virulence were found. The strains showed prevalently an enterotoxigenic character (66,6%), which was in correlation with the increased permeability (62,2%). Adhesive properties were present in 20% of E. coli independent of their enterotoxigenicity; only 11,1% of the strains had penetrating abilities. The rabbit skin model seems to be accurate and quick for ETEC screening purposes, as is the guinea-pig eye for the EIEC. The mouse intestinal loop has been found sensitive but time-consuming. The infant mouse model is simple and quick, but in this study it has not given optimal results. The Vero cell culture system is simple and easy to perform, but at least for some strains the preparations should be concentrated. The investigation of adhesiveness by haemagglutination is possible to conduct in every small clinical laboratory. Our opinion is, however, that after the isolation of E. coli from different pathological materials, the determination of the antigenic structure of the strains is necessary and later on the additional biological characterization should be performed.