Evaluation of proposed cytomorphologic criteria for the diagnosis of Chlamydia trachomatis in Papanicolaou smears.

To evaluate the proposed cytomorphologic criteria for the cervical cytologic diagnosis of Chlamydia trachomatis infection, a study was made of 171 endocervical smears. All cytomorphologic elements that could be ascribed to Chlamydia trachomatis infection were correlated with the diagnostic confirmation of this microorganism by monoclonal antibody (MAb) staining. The presence of Chlamydia trachomatis was detected in 21 samples (12.28%) by MAb staining. Comparing the cytomorphologic results with the MAb results, the sensitivities and specificities of the Papanicolaou smear diagnoses were 19% and 86% using the cytologic criteria proposed by Gupta and coworkers, 38% and 87% using the criteria proposed by Kiviat and coworkers and 23% and 91% using the criteria proposed by Shiina. In view of (1) its low sensitivity, (2) the subjective elements and individual variations in the proposed cytologic criteria, (3) the similarity with Trichomonas vaginalis-produced exudates and (4) the implications of a misdiagnosis of a sexually transmitted disease, it is concluded that cervical cytology is not useful for ascertaining the presence of Chlamydia trachomatis.

[The herpes simplex virus and immunoglobulins in the amniotic fluid in pregnant women with genital herpes and a follow-up over several years: 3 clinical cases]. / Investigación de virus herpes simplex e inmunoglobulinas en líquido amniótico en embarazadas con herpes genital y seguimiento por varios años: 3 casos clínicos.

The presence of herpes simplex virus and immunoglobulin in the amniotic fluid in three pregnant women with herpetic genital virus are investigated. The mothers and their children are followed for several years.

[Attitude and knowledge on AIDS at a maternity unit in Santiago de Chile]. / Actitudes y conocimientos sobre el SIDA en una maternidad de Santiago de Chile.

An inquest to determine the degree of knowledge they have, was done among 27 physicians (obstetricians-gynecologist), 36 midwives and 47 assistants of infirmary in a maternity of Santiago. The following items where included: definition of concept, general knowledge, ways of transmission, prevention and treatment, communication and educational means, recommendations, comments, suggestions and specific knowledge. We proved that even though the general knowledge is apparently good for physicians, midwives and assistants of infirmary, they don't have adequate knowledge of the mechanisms of transmission of AIDS, of its prevention and no specific knowledge. They do have wrong ideas upon the topic. This lack is evident in assistants of infirmary and in a less degree in midwives and physicians. Considering that the group to be studied works in the specific health area dealing with gynecology and obstetrics, it is expected that they have a high grade of knowledge in relation with AIDS, due to the fact that they are a group of high risk in getting the disease and that they are a multiplicator factor of education among the population. This makes necessary to give periodic training courses and to reinforce the knowledge of such personnel.

[Seroprevalence of AIDS in Chilean male and female prostitutes. II. Male prostitution]. / Seroprevalencia de SIDA en prostitutas masculinas y femeninas chilenas.1. Prostitución masculina.

ELISA test to detect HIV-1 antibodies was performed to 65 homosexuals and homosexual male prostitutes in a Sexually Transmitted Diseases (STD) Clinic in Santiago de Chile together with a survey about risk factors. It was found that 40 of them (62%) practice prostitution with a rate of 1.5% clients per day. All the studied group presented dissemination of HIV risk factors like low frequency usage of condom, patients hide their homosexual condition, they have donated blood, they do not manifest an attitude towards changing their behaviors and have had intercourse with the opposite sex. We found 1 (1.54%) seropositive confirmed by Western blot in a homosexual who does not practice prostitution.

[Sexually transmitted microorganisms and immunoglobulins in the amniotic fluid in mothers who carry sexually transmitted diseases]. / Germenes de transmisión sexual e inmunoglobulinas en el líquido amniótico, en madres portadoras de enfermedades de transmisión sexual.

Fetal behaviour as an intrauterine patient is unknown. In the diagnosis of sexually transmitted diseases (STD) and in the criteria for treatment only the mother is considered leaving the fetus out. The presence of immunoglobulin M in the amniotic fluid is an indicator of fetal infection and could allow an accurate diagnosis of fetal disease or treatment, if the measurement is related to the presence or absence of organism in the amniotic fluid. In this way, the study of fetal behaviour under these conditions could be done. The objective of this research was to determine the presence of STD organism in the amniotic fluid of the STD infected pregnant women and to evaluate the prevalence and evolution of these pathologies in the fetus. No STD organism, nor immunoglobulin M were found in the 13 samples of amniotic fluid (8 pre and 5 post-treatment) of infected pregnant women. The presence of microorganisms and its relation to immunoglobulin M was not observed. More cases are needed to arrive to a conclusion regarding fetal immunology and to a better understanding of antibacterial properties of the amniotic fluid. We concluded that no contamination in the amniotic fluid or fetal infection was found in pregnant women with STD.

[Diagnosis of sexually transmitted diseases in Chilean pregnant adolescents]. / Diagnóstico de enfermedades de transmisión sexual en adolescentes embarazadas chilenas.

We searched in 100 healthy pregnant women by isolation, the presence of Neisseria gonorrhoeae, Herpes simplex, Mycoplasma hominis, Ureaplasma urealyticum and Chlamydia trachomatis. Blood was also taken for examination of specific antibodies to these microorganisms. We studied only for antibodies titled Cytomegalovirus (CMV), Treponema pallidum and Human Immunodeficiency Virus, and Condyloma acuminatum by cervical cytology. In 85 adolescents we found 5 (6%) patients with C. trachomatis, four of these patients had another microorganism added, one with N. gonorrhoeae, M. hominis and U. Urealyticum, one with U. urealyticum and the last two with M. hominis and U. urealyticum, In relation to Mycoplasmas 69 (81%) out of 85 had Mycoplasmas, 4 (5%) had M. hominis, 46 (54%) U. urealyticum and 19 (22%) patients had both. The seropositivity to CMV was 96.25%. We didn't find any other microorganism. We concluded that the rate of STD in chilean pregnant adolescent women is high, especially with no traditional bacteria.