[The Dynamics of General Morbidity of Salpingoophoritis as a Problem of the Regional Health Care].

The article presents the results of studying dynamics of total morbidity of salpingoophoritis in the Belgorod oblast in 2009-2014 testifying negative tendencies. The maximal increasing of of total morbidity of salpingoophoritis among female adolescents and adult women in oblast rural districts was established. The obtained data can be used as a basis for developing target regional programs directed to improvement of functioning of specialized obstetrician gynecological service.

Primary Immunoprevention of Epithelial Ovarian Carcinoma by Vaccination against the Extracellular Domain of Anti-Müllerian Hormone Receptor II.

Epithelial ovarian carcinoma (EOC) is the most prevalent form of ovarian cancer in the United States, representing approximately 85% of all cases and causing more deaths than any other gynecologic malignancy. We propose that optimized control of EOC requires the incorporation of a vaccine capable of inducing safe and effective preemptive immunity in cancer-free women. In addition, we hypothesize that ovarian-specific self-proteins that are "retired" from autoimmune-inducing expression levels as ovaries age but are expressed at high levels in emerging EOC may serve as vaccine targets for mediating safe and effective primary immunoprevention. Here, we show that expression of the extracellular domain of anti-Müllerian hormone receptor II (AMHR2-ED) in normal tissues is confined exclusively to the human ovary, drops to nonautoimmune inducing levels in postmenopausal ovaries, and is at high levels in approximately 90% of human EOC. We found that AMHR2-ED vaccination significantly inhibits growth of murine EOC and enhances overall survival without inducing oophoritis in aged female mice. The observed inhibition of EOC growth was mediated substantially by induction of AMHR2-ED-specific IgG antibodies that agonize receptor signaling of a Bax/caspase-3-dependent proapoptotic cascade. Our results indicate that AMHR2-ED vaccination may be particularly useful in providing safe and effective preemptive immunity against EOC in women at high genetic or familial risk who have the greatest need for a preventive vaccine and ultimately in cancer-free postmenopausal women who account for 75% of all EOC cases. Cancer Prev Res; 10(11); 612-24. ©2017 AACRSee related editorial by Shoemaker et al., p. 607.

Estimating true hospital morbidity of complications associated with mumps outbreak, England, 2004/05.

Mumps outbreaks in highly vaccinated populations continue to be reported globally. Therefore, quantifying the burden of mumps morbidity accurately will be necessary to better assess the impact of mumps vaccination programmes. We aim to estimate the true morbidity resulting from mumps complications in terms of hospitalised orchitis, meningitis, oophoritis and pancreatitis in England during the outbreak in 2004/05. This outbreak in England led to a clear increase in hospitalisations coded to mumps for complications of orchitis in those born in the 1970s and 1980s and possibly for meningitis in those born in the 1980s. A simple statistical model, based on analysing time trends for diagnosed complications in hospital databases with routine laboratory surveillance data, found that the actual morbidity was much higher. There were 2.5 times (166 cases) more mumps orchitis cases in the 1970s cohort and 2.0 times (708 cases) more mumps orchitis cases in the 1980s cohort than complications coded to mumps in hospital databases. Our study demonstrated that the mumps outbreak in England 2004/05 resulted in a substantial increase in hospitalised mumps complications, and the model we used can improve the ascertainment of morbidity from a mumps outbreak.

Tubo-ovarian abscess during therapy of chronic hepatitis C with pegylated interferon and ribavirin.

BACKGROUND: Serious infections are rare complications of standard treatment in chronic hepatitis C with pegylated interferon alpha (Peg IFN) and ribavirin. CASE: We report two cases of life-threatening tubo-ovarian abscess (TOA) in women older than 40 year of age. No casual risk factors of TOA could be identified in them. In one case septic shock and acute renal failure occured. TOA was caused by endogenic bacteria (Porphyromonas asaccharolytica in the first case and Streptococcus intermedius in the latter). Surgical treatment and interruption of IFN therapy was necessary in both cases. CONCLUSIONS: Serious gynecological infections may have the significant negative influence on chronic hepatitis C therapy outcome. Because of the risk of TOA developing during IFN therapy gynecological care is needed in chronic hepatitis C management.

Reduction in hospitalized women with pelvic inflammatory disease in Oslo over the past decade.

BACKGROUND: A tuboovarian abscess (TOA) is a common complication of pelvic inflammatory disease (PID), occurring world-wide in 15-30% of women with PID. The aim of the study was to identify changes during the last 10 years in the number of women hospitalized with PID in Oslo, as well as a change regarding the frequencies of the subdiagnoses salpingitis and tuboovarian abscess. METHODS: We performed a review of computerized diagnosis lists and manual check of the medical records of women hospitalized with PID in Oslo. The years 1990-92 and 2000-02 were included, resulting in information from two time periods 10 years apart. Cases were registered as salpingitis, oophoritis or tuboovarian abscess. Medical and demographic variables from the medical records of women diagnosed during 4 out of the 6 years were described in detail. RESULTS: We identified 523 women with the diagnosis of PID hospitalized during 1990-92 and 2000-02. There was a 35% reduction in hospitalized cases of salpingitis over the period of 10 years, but the number of cases of tuboovarian abscesses among women admitted for PID remained unchanged from 1990-92 to 2000-02. We found low frequencies of Chlamydia trachomatis and Neisseria gonorrhoea infections, although documented bacteriological sampling was insufficient. CONCLUSIONS: Fewer patients were hospitalized in Oslo for PID during the time period of 2000-02 compared with 10 years earlier, but a higher percentage of patients had developed TOA compared with the first time period (43% compared with 26%, p = 0.013), indicating a changing clinical panorama of PID.

Etiology of persistent tubo-ovarian abscess in Nairobi, Kenya.

OBJECTIVE: To study the microbial etiology of tubo-ovarian abscess (TOA). METHODS: We recruited 11 women in Nairobi, Kenya who failed antibiotic therapy alone and required surgical drainage of a presumptive TOA. Pus from the nine abscesses and two pyosalpinges were collected and cultured for aerobic, facultative and anaerobic microorganisms. RESULTS: Eleven women suspected of having a TOA were hospitalized and treated for a median of 6 days (range 3-14 days) prior to surgical drainage of the abscess. Nine (82%) specimens were culture positive. Aerobes were present in all nine specimens. Seven of the nine positive cultures (78%) were polymicrobial and five of the polymicrobial cultures contained both anaerobes and aerobes. Anaerobic Gram-negative bacilli (Prevotella sp., Porphyromonas sp. and Bacteroides sp., Escherichia coli) and Streptococcus sp. (S. viridans and S. agalactiae) were the most common microorganisms isolated. Neisseria gonorrhoeae and Chlamydia trachomatis were not isolated by culture or detected by polymerase chain reaction. CONCLUSIONS: In Kenya, persistent TOAs are associated with endogenous flora similar to that normally found in the gastrointestinal tract.

Gynaecological tuberculosis in Victoria: a 20-year survey.

A review of the 181 cases of gynaecological tuberculosis notified in Victoria between the years 1961 and 1980 is made. The incidence of the disease is gradually falling and is currently 0.16 per 100,000. The majority of affected women were found to be immigrants to Australia with Southern European patients predominating. Nearly 46% of the women presented with infertility, while 43% were investigated for various symptoms. Twenty-one patients had children before the diagnosis was made, but only 4 conceived after treatment. A comparison with overseas studies is made.