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Biomedical subjects

D Taylor-Robinson

Publications and source records attributed to D Taylor-Robinson.

At least 73 records · Page 4Linked to original sources
PubMed1998

Safety study of nonoxynol-9 as a vaginal microbicide: evidence of adverse effects.

Nonoxynol-9 (N-9) is virucidal in vitro, and is therefore a candidate microbicide for preventing sexual transmission of HIV. However, the activity of N-9 is nonspecific, suggesting that virucidal levels may produce adverse effects including epithelial disruption, inflammation of the genital mucosa, or both. A randomized placebo controlled trial of daily use of 100 mg of N-9 took place for 1 week in 40 female volunteers. Outcome measures included symptoms, colposcopic and histologic changes in the genital tract, and impact on vaginal flora. Genital irritation was reported by 10 of the N-9 and 5 of the placebo group. Colposcopy showed erythema in 9 of the N-9 group and 2 of the placebo group. Histologic inflammation was found in 7 of the N-9 group and 2 of the placebo group. Inflammatory changes were characterized by patchy infiltration of the lamina propria predominantly with CD8+ lymphocytes and macrophages, in the absence of epithelial disruption. A transient reduction in numbers of lactobacilli was observed in 9 of the 15 women using N-9, and 6 of 18 women using placebo. N-9 used for 7 days in a standard spermicidal dose was associated with increased irritation, colposcopic and histologic evidence of inflammation and was more frequently associated with reduction in numbers of lactobacilli during gel use. The clinical significance of the recruitment of cells susceptible to HIV infection to the genital mucosa is unknown but raises concerns about the suitability of N-9 as a microbicide when given in this dose.

Administration, Intravaginal↗
PubMed1998

Chlamydia pneumoniae in vascular tissue.

This review summarizes the evidence for the presence of Chlamydia pneumoniae organisms in atherosclerotic lesions. A total of 17 publications are mentioned concerning this topic. In all but two, both from the same group, evidence is presented by means of various techniques for the existence of the organisms in atherosclerotic tissue. Thus, they have been found in the aorta and in coronary, carotid, pulmonary, femoral and iliac arteries. In the first study in the UK, the aorta, femoral and iliac arteries were found to be positive for C. pneumoniae. In a recent study on autopsy specimens undertaken in conjunction with South African investigators, 71% of atheromatous arteries were positive for C. pneumoniae compared with only 9% of non-atheromatous arteries. Interestingly, the organisms were detected in 67% of the vessels showing only early atherosclerotic lesions (fatty streaks). The relationship between the age of the subject and the probability of detecting C. pneumoniae organisms is discussed; the youngest subjects with arteries positive for these organisms were aged 15 and 20 years. It is concluded that the presence of chlamydiae within atherosclerotic lesions is now beyond doubt, but as yet there is no conclusive evidence for a causal role in atherosclerosis.

Arteriosclerosis↗
PubMed1998

Effect on normal vaginal flora of three intravaginal microbicidal agents potentially active against human immunodeficiency virus type 1.

The effect on normal vaginal flora of three intravaginal microbicides potentially active against human immunodeficiency virus type 1 was examined. Volunteers received dextrin sulfate (D2S), nonoxynol-9 (N-9), or docusate sodium in separate placebo-controlled studies. High vaginal swabs were obtained for bacterial culture before and after microbicide application. D2S did not affect the vaginal flora. However, lactobacilli decreased by > or = 10(2) cfu/mL in 9 (56%) of 16 women given N-9 and in 5 (63%) of 8 women given docusate sodium. Women using N-9 were also significantly more likely to become colonized abnormally (usually with aerobic gram-negative rods) than were those using placebo, as were women using docusate sodium. Women with reduced lactobacilli were less likely to regain normal flora than were those whose lactobacilli were unaffected. However, coliform colonization occurred whether lactobacilli produced H2O2 or not. Continuous use of N-9 could induce susceptibility to urinary and gynecological infection. It is essential that potential microbicides are examined for activity against normal vaginal flora.

Adult↗
PubMed1998

Chlamydia pneumoniae in atheroma: consideration of criteria for causality.

AIMS: (1) To seek evidence of the existence of Chlamydia pneumoniae in a spectrum of atheromatous lesions in different types of arteries from individuals of different ages, using a polymerase chain reaction (PCR) assay supported by electron microscopy and immunocytochemistry; (2) to use electron microscopy to examine interactions between C pneumoniae and the cells present in the arterial tissue; (3) to assess the extent to which the data fulfil the criteria for causality. METHODS: At necropsy examination, 35 arterial specimens were taken from 25 subjects. The grade of atheroma was determined macroscopically and microscopically and the tissues coded and examined by the three techniques. RESULTS: Of the 35 specimens, 24 had macroscopic or microscopic atheromatous lesions of varying degree. Twenty two of the 35 specimens were examined by electron microscopy, C pneumoniae-like bodies being found in 11 (50%); seven specimens were examined by the immunocytochemical method, positive staining being detected in three; and all specimens were examined by the PCR technique, 15 (43%) being PCR positive. Overall, of the 24 specimens with lesions, 17 (71%) were positive by at least one of the three tests, whereas of the 11 specimens without lesions, only one was positive. The positive specimens comprised 10 of 19 aortas, three of six iliac arteries, and one coronary and one pulmonary artery. C pneumoniae was detected in four of six specimens in which there were early changes and in a 20 year old subject. Concerning the 25 subjects, of 17 who had atheromatous arteries, 14 (82%) were C pneumoniae positive and of the eight who had normal arteries, none was positive. CONCLUSIONS: There is a strong correlation between C pneumoniae and arterial atheromatous lesions. The organism may contribute to the disease process by damaging smooth muscle cells.

Adult↗
PubMed1998

Sensitivity of the ligase chain reaction assay for detecting Chlamydia trachomatis in vaginal swabs from women who are infected at other sites.

OBJECTIVE: To assess the sensitivity of the ligase chain reaction (LCR) assay for Chlamydia trachomatis in vaginal swabs from women who were positive in cervical samples and/or urines. SUBJECTS: 413 women attending the genitourinary medicine clinic, St. Mary's Hospital, Paddington. METHODS: The LCR assay was used to test vaginal swabs from 46 women who were C trachomatis positive at one or both of the other sites by direct fluorescent antibody (DFA) staining, by an enzyme immunoassay (EIA), or by the LCR assay. RESULTS: The LCR assay of vaginal swabs had the following sensitivity values using confirmed positive results: 93% (41/44) compared with DFA staining of cervical deposits, 93% (41/44) compared with the LCR assay of cervical samples, 93% (28/30) compared with an EIA for cervical samples, 91% (39/43) compared with DFA staining of urine deposits, and 93% (39/42) compared with the LCR assay of urine. Four women had vaginal swab samples negative by the LCR assay; one was positive only in the urine and two had cervical samples containing a small number of chlamydial elementary bodies. CONCLUSION: Testing vaginal swabs by the LCR assay is a sensitive method of detecting chlamydial infection; the results suggest that this procedure could be used as an alternative to examining urines in a screening programme for chlamydial infection in the community.

Chlamydia Infections↗
PubMed1998

Quantification of Chlamydia trachomatis in cervical and urine specimens from women attending a genitourinary medicine clinic: implications for screening strategies.

Population screening and intervention programmes can reduce the prevalence and incidence of infection with Chlamydia trachomatis, especially if sensitive molecular diagnostic tests are used. However, diagnostic tests that perform well on genitourinary medicine (GUM) clinic populations may be less useful for screening, particularly if the majority of infected subjects are asymptomatic and their samples contain fewer organisms. We have compared the extent of low organism load in cervical and urine samples from symptomatic and asymptomatic chlamydia-positive women, by using a direct fluorescent antibody staining method and counting the chlamydial elementary bodies (EBs). We have investigated the ability of an enzyme immunoassay (EIA; MicroTrak) and a DNA amplification (ligase chain reaction; LCR) assay to detect low numbers of organisms in cervical samples and the ability of the LCR assay to detect low numbers of organisms in urine. A low organism load (< 10 EBs) was seen by direct fluorescent antibody (DFA) staining in about 30% of cervical samples and in about 75% of urines from chlamydia-positive women; the proportions in symptomatic women were not significantly different from those in asymptomatic women. The EIA identified only 16% of cervical samples that contained < 10 EBs by DFA staining; the LCR identified 100% of cervical samples and 93% of urine samples that contained < 10 EBs by DFA staining. The findings suggest that the ability of chlamydial diagnostic tests to identify positive women should be similar among patients attending a GUM clinic and those taking part in a population screening programme, and that sensitive molecular assays such as the LCR should identify subjects with a low organism load in both groups.

Chlamydia Infections↗