A comparison of the incidence of early postoperative infections between patients using synthetic mesh and those undergoing traditional pelvic reconstructive surgical procedures.

New mesh-related complications such as erosion, etc., can result from abnormal postoperative healing due to surgical site infection. The aim of our study was to compare systemic inflammatory responses and the incidence of early infectious complications after reconstructive surgery using synthetic mesh and after traditional vaginal wall repair. In this prospective observational study 99 women with symptomatic pelvic organ prolapse were included; 55 women underwent traditional repair and 44 repair using mesh. After the procedure infectious complications were monitored. The patients who underwent reconstructive surgery using mesh material were more likely to have febrile morbidity in the postoperative period than the patients who had been treated with traditional repair (p=0.031); there was a higher incidence of combination febrile morbidity with elevated C-reactive protein (CRP) > 50 mg/l; p=0.046, and a higher incidence of CRP increase over 30 mg/l; p=0.005. Reconstructive procedures using synthetic mesh are accompanied by a higher incidence of early post-operative infectious complications.

[Modified classification of microscopic evaluation of vulvovaginal infections]. / Modifikovaná klasifikace mikroskopického hodnocení posevních infekcí.

OBJECTIVE: The objective of the study is to examine the role of microscopy using stained smears for diagnosis of vulvovavaginal infections: DESIGN: Description of different scoring systems. SETTINGS: Department of Gynecology and Obstetrics, First Medical Faculty, Charles University; General Teaching Hospital, Prague; Institute of Clinical Chemistry and Laboratory Medicine; Clinical Microbiology and Antibiotic Center, First Medical Faculty, Charles University. MATERIAL AND METHODS: Presentation of our practical skills in microscopic diagnoses of vulvovaginal infections. CONCLUSIONS: Vulvovaginal infections are a common problem which we encounter in daily gynaecological practice. Microscopic examination represents the gold standard in the diagnosis of vulvovaginal infections. However, providing microscopy in an outpatient setting is very time-consuming. The vaginal smear can be sent to a laboratory to stain and to be microscopically examined under oil immersion. For this purpose we recommend taking two smears for Gram and Giemsa stain and combining microscopical examination with cultures for detecting the presence of Candida species and for Trichomonas vaginalis. Where appropriate, it is also necessary to obtain cervical smears for detection of C. trachomatis and N. gonnorhoeae infection.

[Current possibilities for diagnosis of vulvovaginal infection]. / Soucasné moznosti diagnostiky vulvovaginálních infekcí.

OBJECTIVE OF THE STUDY: The objective of the study was to describe current possibilities of proper diagnosis of vulvovaginal infections. DESIGN: Review article. SETTINGS: Department of Gynecology and Obstetrics, First Medical Faculty, Charles University and the General Teaching Hospital, Prague, Institute of Clinical Chemistry and Laboratory Medicine, Clinical microbiology and antibiotic center, First Medical Faculty, Charles University and General Teaching Hospital in Prague. MATERIAL AND METHODS: Presentation of literature review information and our practical skills in diagnosing vulvovaginal infections. CONCLUSIONS: Vulvovaginal infections are a common problem which we encounter in daily gynaecological practice. Most women with those conditions need only basic investigation and treatment. However, in order to offer the appropriate care for those women it is necessary to understand the basic pathophysiology of vulvovaginal disorders. A fundamental step is to make the correct diagnosis. All too often our decisions are influenced by clinical dogmas which are even found repeatedly in gynaecological textbooks. Microscopic examination represents the gold standard in the diagnosis of vulvovaginal infections.

Iron enhancement of experimental infection of mice by Tritrichomonas foetus.

The ability of a microbial invader to acquire iron from its vertebrate host has been recognized as an important virulence mechanism in some pathogenic bacteria. We examined the involvement of similar mechanisms in an experimental infection of mice by a protozoan pathogen of cattle, Tritrichomonas foetus. In a series of experiments, outbred ICR mice were inoculated intraperitoneally with two strains of T. foetus, the moderately virulent KV-1 (approximately 5% mortality rate) and the highly virulent LUB-1MIP (approximately 80% mortality rate). Treatment of mice with ferric ammonium citrate (FeAC) (100 mg/kg per day intraperitoneally) increased the mortality rate caused by the KV-1 infection up to the level determined for the highly virulent strain. The treatment effect was dose dependent and required early administration of FeAC after inoculation of parasites and its continued supply for at least 3 subsequent days. Daily sampling of peritoneal exudate showed that the infection-enhancing effect of iron overload was associated with a stimulation of parasite multiplication, which in the case of KV-1 infection was strongly suppressed in untreated mice. Consistent with these findings, the strain of lower virulence (KV-1) showed considerably lower efficiency accumulating radiolabeled iron from transferrin and a low-molecular source [Fe(III)nitrilotriacetic acid] in vitro. The results indicate an involvement of iron uptake mechanisms by the parasite as a virulence factor in T. foetus infection.