[THE ROLE OF NO AND MEXIDOL IN CONTRACTILITY OF OVARIAN AND CERVICAL PARTS OF UTERUS UNDER THE CONDITION OF IMMUNE-MEDIATED INJURY IN MICE].

Contractility of ovarian (OP) and cervical parts (CP) of uterus under the condition of immune-mediated injury which was induced by immunization with bovine serum albumin (BSA) was investigated. It was shown that under the activation of energy-synthesizing function of mitochondria with Mexidol the frequency of reductions in both uterine parts decreased, the amplitude and contractility index in the OP and CP as well as the duration of the active state in CP increased. Mexidol under the condition of immunization with BSA leads to the decrease in amplitude in 2,6 time and contractility index in 2,2 time in OP and to the increase of them in CP. It was shown that contractility features of ovarian and cervical parts of uterine under the condition of BSA- induced immunization were caused by changes of mitochondria functional state and were associated with nitric oxide.

Effect of ultrasound-guided aspiration of hydrosalpingeal fluid during oocyte retrieval on the outcomes of in vitro fertilisation-embryo transfer: a randomised controlled trial (NCT01040351).

OBJECTIVE: To determine whether the ultrasound-guided aspiration of hydrosalpingeal fluid at the time of oocyte retrieval can improve the outcomes of in vitro fertilisation-embryo transfer (IVF-ET). PATIENTS: One hundred and ten women with ultrasound-visible hydrosalpinges were randomised to two groups based on computer generated randomisation list. Fifty-four women underwent ultrasound-guided aspiration of hydrosalpingeal fluid prior to IVF-ET and 53 women underwent IVF-ET without any prior intervention. RESULTS: Patients who underwent aspiration of hydrosalpinges demonstrated a significantly increased implantation, clinical pregnancy rates. Among the patients in the aspiration group, the implantation rate and pregnancy rates were higher in the subgroup of patients with no reaccumulation of hydrosalpingeal fluid within the first 2 weeks after aspiration compared to patients with reaccumulation of hydrosalpingeal fluid within the first 2 weeks after aspiration, but this difference failed to reach statistical significance. Furthermore, no pregnancies occurred in the four patients with uterine fluid collection detected during IVF-ET cycles. CONCLUSION: The aspiration of hydrosalpingeal fluid at the time of oocyte retrieval is simple, safe and effective procedure for treatment of patients with ultrasound-visible hydrosalpinges particularly those without rapid reaccumulation of hydrosalpingeal fluid after aspiration or uterine fluid collection during the IVF-ET cycles.

[Escherichia coli salpingitis and peritonitis in layer chickens: an overview]. / Escherichia coli-salpingitis en -peritonitis bij leghennen: een overzicht.

Escherichia coli can induce salpingitis and/or peritonitis, a major cause of mortality in layer hens, but also other localized and systemic infections. E. coli infections have also been described in turkeys, geese, and ducks and are thought to be the cause of significant economic losses. However little is known about the real economic impact of the disease in layer chickens. The pathogenesis of E. coli salpingitis and peritonitis has not been elucidated yet. Three routes of infection have been discussed in the literature: ascending faecal contamination from the cloaca, bacterial translocation from the respiratory tract (air sac and lungs) and bacterial translocation from the intestinal lumen. Only one study has reported the occurrence of ascending faecal contamination from the cloaca to the oviduct and subsequently to the peritoneum. Regarding bacterial translocation, the only models available are for mammals, and these have not been applied to chickens so far Animal models could prove valuable to elucidate the pathogenesis of E. coli-induced salpingitis and peritonitis, and for assessing the value of preventive and curative intervention strategies. Little is known about risk factors for E. coli salpingitis and peritonitis. In contrast to colibacillosis in broilers, recent research has failed to demonstrate an association between several pathogens of the respiratory tract and the occurrence of E. coli pathology in layer chickens. The distance between poultry farms and the hen density in the cages were recently proposed as important risk factors for outbreaks ofcolibacillosis in flocks of layer hens, while in the past hormonal factors were implicated. The latter is an area of research that deserves more attention. Several methods for the molecular typing of E. coli have been described and might prove useful to study the epidemiology ofE. coli outbreaks in poultry, about which little is known. The presumptive diagnosis E. coli salpingitis and peritonitis is rather simple to establish, based on the anamnesis, clinical symptoms, and macroscopic findings at post-mortem. However; bacteriological analysis is required to establish a definite diagnosis because other pathogens can also cause salpingitis and peritonitis in layer hens. Antibiotics, chosen on the basis of sensitivity testing and their pharmacokinetic properties can be used as therapy; however residues in eggs may occur. Autovaccines are often used as prevention because in practice effective protection is only achieved against homologous E. coli serotypes.

DNA immunization with pgp3 gene of Chlamydia trachomatis inhibits the spread of chlamydial infection from the lower to the upper genital tract in C3H/HeN mice.

Chlamydia trachomatis pgp3 DNA immunized (no. 300) and non-immunized (no. 300) C3H/HeN mice were infected by vaginal inoculation with infectious C. trachomatis serotype D elementary bodies (EBs) and the spread of infection to the salpinges was assessed by cell culture isolation from tissue homogenates 7, 14, 21, 28, 35 and 42 days post-infection (p.i.). Overall, the pgp3-DNA immunization prevented salpinx infection in 94 (56%) mice, if compared with the 168 positive animals found among the non-immunized animals (P < 0.001). A group of negative control animals (i.e. mice immunized with plasmid DNA containing an irrelevant insert) was not protected, whereas all the mice of a positive immune control group (mice that had resolved a primary genital C. trachomatis infection) were resistant to re-infection. Pgp3 DNA immunization induced both humoral and mucosal anti-pgp3 antibodies.

A peptide of Chlamydia trachomatis shown to be a primary T-cell epitope in vitro induces cell-mediated immunity in vivo.

Chlamydiae are a major cause of infertility and preventable blindness and there is currently no effective vaccine in humans or rodents against these organisms. We have previously shown that a peptide of 12 amino acids (termed TINKP) from a conserved region of the major outer membrane protein (MOMP) of Chlamydia trachomatis (C. trachomatis) is a primary T-cell epitope in humans. Here we showed that when dendritic cells (DC) from C3H or BALB/c mice were pulsed in vitro with the peptide they stimulated proliferation of syngeneic T cells in vitro indicating that the peptide is also a primary T-cell epitope in mice. Since the skin is a rich source of DC, we immunized mice from each strain with an intradermal injection of the peptide. Humoral and cell-mediated immunity to peptide, MOMP or whole elementary bodies (EB) of C. trachomatis (F/NI1/GU) were assessed. No antibody response to TINKP was observed. However, immunized mice showed recall responses to all three chlamydial antigens. T-cell-mediated immunity in the absence of antibody was induced by a single injection of the peptide intradermally. C. trachomatis isolated from the human genital tract causes salpingitis in mice. Preliminary studies in susceptible C3H mice indicated that intradermal injection of peptide conferred some protection against the development of salpingitis. Thus, a primary T-cell epitope identified by in vitro stimulation using DC can also initiate cell-mediated immunity in vivo and this approach may be useful in the development of vaccines.

Noncontraceptive benefits of oral contraceptives.

The noncontraceptive health benefits of oral contraceptives were initially summarized a decade ago. Studies conducted in the last decade confirmed the findings of earlier studies with high-dose oral contraceptives and extended them to low-dose formulations. Among the noncontraceptive health benefits first cited were reductions in menorrhagia, irregular menses, endometrial cancer, ovarian cancer, functional ovarian cysts, benign breast disease, dysmenorrhea, premenstrual tension and iron-deficiency anemia. In addition, women who used oral contraceptives were less likely to develop rheumatoid arthritis or acute salpingitis, particularly moderate or severe forms, than were women using no method of contraception. Despite the fact that such benefits were identified more than 10 years ago and despite their inclusion in oral contraceptive labeling, women today are largely unaware of the noncontraceptive health benefits associated with oral contraceptive use.

Noncontraceptive benefits of oral contraceptive agents. Patients should know the positive effects.

Physicians' role as teachers and counselors includes the responsibility to provide detailed and accurate information on the risks and benefits of therapy whenever a prescription is written. Inaccurate or overly negative communication, particularly from the mass media, may confuse patients trying to make an informed decision regarding use of oral contraceptives. Patients have the right to be informed of possible prevention of life-threatening disease and improvement of quality of life as a result of oral contraceptive therapy.

Heterotypic protection of mice against chlamydial salpingitis and colonization of the lower genital tract with a human serovar F isolate of Chlamydia trachomatis by prior immunization with recombinant serovar L1 major outer-membrane protein.

Intrauterine infection of mice with a human genital tract isolate of Chlamydia trachomatis (serovar F) resulted in salpingitis. In some cases, oviduct damage was sufficient to cause infertility due to lumenal blockage. Parenteral immunization with a purified, heterologous, recombinant major outer-membrane (rMOMP) preparation reduced the proportion of animals developing severe salpingitis by 77% compared with mock-immunized controls, but failed to reduce chlamydial colonization of the lower genital tract. In contrast, mice immunized with rMOMP directly into the Peyer's patches to stimulate mucosal immunity shed fewer chlamydiae from the vagina than controls, but showed little reduction in oviduct damage. No consistent correlation was observed between antibody levels to rMOMP in immunized mice and reduced lower genital tract colonization. Immunization with rMOMP via the presacral space, a route previously shown to stimulate mucosal immunity in the genital tract, produced high levels of circulating anti-rMOMP IgG but only traces of anti-rMOMP IgA in vaginal secretions. There was no difference in the severity of salpingitis in these animals compared with mock-immunized controls. Immunization with rMOMP conferred no protection against infertility resulting from direct inoculation of chlamydiae into the oviducts.

[Recurrent extra-uterine pregnancies. 63 cases treated at the Hospital Center of Libreville from 1985 to 1989]. / Les grossesses extra-utérines récidivantes. A propos de 63 cas survenus au Centre Hospitalier de Libreville de 1985 à 1989.

Ectopic implantation of the fertilised ovum, whether for the first time or as a recurrence, is not uncommon in this department. In a study in the Libreville Hospital group from 1985 to 1989, the authors found 828 cases of ectopic pregnancy (EP) including 63 recurrences, i.e. 7.61 per cent. These recurrences most often involved young women (26 per cent of cases) and nullipara (30%). The chief common etiology for the first occurrence remained tubal infection (57.28 per cent of cases). Treatment consisted most often of radical macrosurgery because of the advanced state of tubal disease, thus leading to the permanent sterilisation of 48 patients, i.e. 71.2 per cent of recurrences. Nineteen patients had a history of previous conservative surgery, including 8 homolateral recurrences (43 per cent). Reducing the incidence of such pathology essentially involves the prevention of gynecological infections, and in particular sexually transmitted diseases, as well as the possibility of early diagnosis of EP. Despite the fact that it seriously compromises the subsequent fertility of these young patients, total salpingectomy remains the treatment of choice for avoiding recurrences.

The effect of a single oral dose of azithromycin on chlamydial salpingitis in mice.

Progesterone-treated C3H mice were inoculated under the ovarian bursa with a human Chlamydia trachomatis strain, serovar E, and treated variously from one week before inoculation to two weeks afterwards with a single oral dose of azithromycin. At autopsy, all 27 control mice, not given azithromycin, had histological evidence of salpingitis. Any tubal inflammation in the 139 mice which had received greater than or equal to 60 mg azithromycin/kg was always less severe than that in control mice killed on the same day. This was true also for three of the six mice given azithromycin 25 mg/kg. Salpingitis was prevented in all 38 mice given greater than or equal to 60 mg of azithromycin on the day chlamydiae were inoculated. Inflammation was found in only 35% of mice given 60-80 mg/kg of drug from two to ten days after inoculation and was less severe than in untreated control mice. This dose given later was not as effective in preventing disease. Doses of 200-240 and 100-180 mg/kg given up to a week before inoculation reduced the proportion of mice with salpingitis to 33% and 77%, respectively, while no reduction occurred with 60-80 mg/kg, although lesions were less severe than in control mice. Chlamydiae were not detected in any part of the genital tract when greater than or equal to 60 mg/kg of azithromycin were given on the day of inoculation and were rarely detected when the drug was given a week before or up to 12 days after inoculation. Re-isolation of organisms was not always associated with histological evidence of disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Cervical dilatation with Lamicel in first trimester therapeutic abortion.

Preoperative treatment with Lamicel tent for first trimester therapeutic abortion was evaluated in an open randomized trial and compared with no treatment. Measured by the lowest Hegar moved through the internal os without resistance, the Lamicel group had significantly higher cervical dilatation than the control group (8.2 mm vs. 5.8 mm; P less than 0.001). One perforation was observed in the Lamicel (n = 270) group compared to six in the control group (n = 359) (not significant). There was no difference between the groups in the frequency of readmissions to the hospital. During one year of clinical experience with pretreatment of elective abortion with Lamicel per- and postoperative complication rates were not reduced.

Induced abortion: Chlamydia trachomatis and postabortal complications. A cost benefit analysis.

The overall prevalence of Chlamydia trachomatis among 873 abortion-seeking women was 9.3% during 1985. Significantly higher age-specific prevalences of C. trachomatis occurred among younger women (p less than 0.001). None of 17 women treated for C. trachomatis before the abortion was carried out, was readmitted to the hospital. Of 64 Chlamydia-positive women, who commenced treatment within the first 2 weeks after the abortion was carried out, 14.1% were readmitted to the hospital, compared with 5.7% of Chlamydia-negative women (p less than 0.02). Postabortal salpingitis was verified at readmission among 10.9% of Chlamydia-positive women and 3.2% of Chlamydia-negative women (p less than 0.01). An analysis of screening of all abortion-seeking women is estimated to be worthwhile when the prevalence of C. trachomatis exceeds 4.3%. We recommend screening for Chlamydia trachomatis of all abortion-seeking women, 30 years or younger, at the pre-abortion visit, provided that treatment can be completed before the abortion is carried out.

[Prevention of infection with metronidazole in abortion induced by PGF2 alpha]. / Infektionsprophylaxe mit Metronidazol bei der Abortinduktion mit PGF2 alpha.

The influence of prophylactic treatment with metronidazole on infectious morbity after induced abortion by intermittent intrauterine extraamniotic application of PGF2 alpha was studied in 255 primigravidae. The rate of inflammatory complications was decreased significantly by oral and rectal application of Vagimid.

Patient cost in the treatment of postsurgical female pelvic infection.

Soft tissue female pelvic infections, that is, postpartum endomyometritis, pelvic cellulitis, and salpingitis, are frequently polymicrobial, involving aerobic and anaerobic bacteria. The most common antibiotic regimen employed for the treatment of these patients is clindamycin and an aminoglycoside. Single-agent therapy, utilizing the newer beta-lactams, is more economical, potentially less toxic, and as effective.

Salpingitis and pelvic inflammatory disease.

Chlamydia trachomatis is becoming an increasingly important etiologic agent. The physician must also be aware of other nongonococcal causes of pelvic inflammatory disease, such as Mycoplasma, Ureaplasma, coliforms and anaerobes. Epidemiologic characteristics of the various microorganisms differ, with the frequency of nongonococcal disease higher in older women. Intrauterine devices increase the potential for pelvic inflammatory disease. The rising incidence of nongonococcal and dual infections has led to therapeutic and preventive techniques aimed at multiple etiologies.

[Prevention of Chlamydia trachomatis infections in women]. / Réflexion sur la prévention des infections à Chlamydia trachomatis chez la femme.

Over the past several years, the incidence of chronic salpingitis has increased relentlessly, with its accompanying pelvic pain, ectopic pregnancies, and tubal sterility. Chlamydia are a frequent etiologic agent. Preventing these infections is difficult, nevertheless proper care will be given by recalling four key words: avoidance, diagnosis, education, and treatment. It is important to discourage early sexual activity and multiple sexual partners, to encourage the use of condoms, and avoid the use of an intrauterine device in adolescents. Atypical presentations of salpingitis must be recognized and treated effectively, thus preventing the spread of infection. Education on venereal diseases should be presented in secondary schools, during military service, and other similar groups, but especially during physician visits for contraception.

PIP: Chlamydia are a frequent etiologic agent in the chronic salpingitis that has become more and more of a problem in recent years, with its accompanying pelvic pain, ectopic pregnancies, and tubal sterility. Although public health officials, obstetricians and gynecologists, and sexually transmitted disease specialists all agree that prevention would be preferrable to treatment of the resulting tubal lesions and possible neonatal complications, the change of habits necessary for prevention will be difficult to achieve. Infection can be avoided by discouraging early initiation of sexual activity in adolescents, who are apparently particularly susceptible to chlamydial infection, and by discouraging multiple sexual partners since the risk increases appreciably for those having over 3 partners. Condoms and local spermicides with a benzalkonium chloride base offer protection but are poorly accepted by adolescents. IUDs should not be used by adolescents because of the risk of infection. Diagnosis of chlamydia is difficult because about 60% of cases in women are asymptomatic. Persons at high risk because of their patterns of sexual activity should be examined regularly for chlamydia, and tests should be scrupulously performed at all stages and sent to a competent laboratory. All sexual contacts of the chlamydia patient and all their sexual contacts should be treated. An early diagnosis of tubal involvement is difficult but should be pursued through laparoscopy and taking the necessary samples. The public should be educated about the existence, gravity, consequences, and contagiousness of sexually transmitted diseases in such institutions as schools and the military service. Treatment of chlamydia includes early and intensive antibiotic therapy, complete rest, and prolonged use of corticotherapy. An oral contraceptive can be prescribed to prevent development of functional ovarian cysts. Laparoscopic control is essential to ensure that the cure was effective. Return of the infection is associated with a very poor prognosis.