[Mycoplasma hominis and Ureaplasma urealyticum in different gynecologic diseases]. / Mycoplasma hominis y Ureaplasma urealyticum en diferentes patologías ginecológicas.

The incidence of Mycoplasma hominis (M. hominis) y Ureaplasma urealyticum (U. urealyticum) was investigated in 113 endocervical samples obtained from women who were seen for different gynecological pathologies. Forty-seven (42%) patients were positive to these microorganisms; 26 cases (23%) were positive for M. hominis and 21 (19%; p = NS) for U. urealyticum. Average age was 32.1 +/- 7.7 years; the average number of sexual partners was 1.7 +/- 1.1. Eleven of 17 patients with 3 o more sexual partners were positive for Genital Mycoplasma (GM), and U. urealyticum was found more often in this group. A higher incidence of GM was found in women between 26 and 30 years (34%); 57.5% of the patients with positive cultures for GM had begun sexual activity before 20 years of age. M. Hominis was found in 61% of women with no parity and U. urealyticum in 71% of parous women. The cultures were positive in 10 of 14 patients with pelvic inflammatory diseases (PID). A cervical biopsy was taken from 52 cases and the diagnosis of cervical intraepithelial neoplasia (CIN) was made in 49 (94%) but only 24 of them were positive for GM (50%). Thirty-five patients suffered sterility, and 12 (34%) were positive for GM, however all positive cases consulted because of primary sterility. The conclusions obtained from this study are: 1) Near half of the patients was positive for GM and none of the species was predominant over the other. 2) The more sexual partners the higher was the incidence of GM, especially U. Urealyticum. 3) The lower the age of the first sexual intercourse the higher the probability of contamination with these microorganisms. 4) M. hominis was more common in nulliparous women and U. urealyticum was found more often in parous patients; the number of deliveries did not have influence in these findings. 5) A statistical significance between GM and PID was found (p = 0.03). 6) GM have no influence on spontaneous abortion. 7) No statistical significance was found between GM and the beginning and evolution of CIN. 8) No relation statistically significative was found between GM and sterility.

[Cervical intraepithelial neoplasia: Chlamydia trachomatis and other co-factors]. / Neoplasia intraepitelial cervical: Chlamydia trachomatis y otros co-factores.

The incidence of Chlamydia trachomatis (Ct) in patients with diagnosis of Cervical Intraepithelial Neoplasia (CIN) was studied in one hundred eighty patients. The Chlamydiazyme test was performed in all of them. Endocervical samples were taken from 103 patients with CIN and 77 women who sought medical attention for different gynecological reasons (CG). Twenty three tests (12.8%) were positive; 15 of them had CIN (14.6%) and 8 were from the control group (10.4%). It was found a statistical significant difference between NIC III and early intercourse, NIC III and age, NIC and vaginal douches and, among NIC and number of pregnancies and deliveries. There was not a significant difference among Ct and early intercourse, number of sexual partners, pregnancies, deliveries, vaginal douches, oral contraceptives (OC), and vaginal discharge. No statistically significant differences were found between NIC and number of sexual partners, and OC and vaginal discharge. The low incidence of Ct in patients with CIN does not mean that Ct does not play a role in the origin and development of the cervical pathology.

[Incidence of Chlamydia trachomatis in patients with sterility]. / Incidencia de Chlamydia trachomatis en pacientes con esterilidad.

Eighty six women were studied at the Hospital Chiquinquirá in order to determine the role of Chlamydia Trachomatis in infertility. Endocervical samples were taken in 45 infertile women (IG) who concurred to our Gynecologic Endocrinology Clinic and in 41 (CG) who sought medical attention at our General Gynecology Clinic for different reasons. The Chlamydiazyme Test (CT) was performed in all of them. We obtained 12 positive Chlamydiazymes (13.95%), four of them were in the IG (8.89%) and 8 (19.5%) in the CG; this was not statistically significant (p = 0.3). We also found no correlations when positive tests were correlated with sterility (p = 0.5, tube pathology history (p = 0.2), HSG (p = 0.2) and laparoscopic findings (p = 0.1). We did not find an increase in the occurrence of CT in our infertile women as reported by other authors therefore its significance in our study group at this time is uncertain.

Reduced incidence of rabbit endometrial neoplasia with levonorgestrel implant.

To test the hypothesis that progestogens protect against the development of endometrial neoplasia, we placed polydimethylsiloxane implants (levonorgestrel or inert) into the right uterine horn at random in 114 old female rabbits. Cross-sectional uterine biopsy specimens were taken from both horns at the time of implantation and at 6, 12, and 24 months thereafter. Twenty-nine levonorgestrel-treated and 33 controls survived to the completion of the study. The incidence of endometrial neoplasia of 17.2% in the group treated with levonorgestrel was significantly less (p less than 0.05) than the 42.4% incidence observed in the control does. Before the completion of the study, one levonorgestrel-treated doe died and was found to have an endometrial tumor. When the findings of this doe are included in the report, the statistical significance is marginally lost. No endometrial neoplasia was found in the eight does with serum levonorgestrel concentrations greater than 0.12 ng/ml. Only one of the five tumors in the levonorgestrel-treated group occurred in the horn containing the levonorgestrel implant, which suggests that a dose effect is likely. Treatment with levonorgestrel decreases the incidence of endometrial neoplasia in rabbits. This finding gives further credence to the use of progestogen supplementation in women at risk for developing endometrial neoplasia.