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G R Monif

Publications and source records attributed to G R Monif.

At least 19 recordsLinked to original sources
PubMed1999

The great douching debate: to douche, or not to douche.

It has been implied douching causes chlamydial infection, acute salpingitis, ectopic pregnancy, and reduced fertility. However, the incriminating articles do not represent a vast accumulation of data from diverging sources; rather, most reflect repetitive analysis of data from a limited population base by an institutionally interrelated group of investigators. The conclusions reached were reintroduced periodically into the literature in different journals. An equally plausible alternate hypothesis is that douching is a marker for increased probability of one or more sexually transmitted diseases and their sequelae. Review of microbiologic rather than epidemiologic data published on douching revealed that douching with a preparation containing acetic acid caused a small reduction in total bacterial counts. Most of that change was attributable to washing. When povidone-iodine was present, significant reductions occurred, but these were short-lived. The first bacteria to recover are usually the lactobacilli, which might explain partial efficacy of prolonged douching with commercial preparations of povidone-iodine.

Chlamydia Infections↗
PubMed1998

Female genital tract bacterial coisolates with Candida albicans in patients without clinical vaginitis.

OBJECTIVE: In vitro, Candida albicans has demonstrated the ability to inhibit replication of selected bacteria. Little information exists on the impact of C. albicans on the vaginal bacterial flora in vivo. The purpose of this study is to identify the coexisting bacterial flora when C. albicans is isolated from vaginal cultures submitted to a hospital-based testing facility for reasons other than vulvovaginitis. METHODOLOGY: All specimens (240) received from ambulatory care clinics over a six-month period were cultured for aerobic and anaerobic bacteria and Candida species. Those specimens submitted for cervicitis, vaginitis, or vaginal discharge and those from which yeasts other than C. albicans were isolated were eliminated. To control for sample biases, a subgroup composed of all pregnant women for whom cultures were done as screening procedures was similarly studied. Chi-square analyses, comparing the prevalence of individual bacteria isolated with and without the presence of C. albicans, were done for all study populations using SPSS for Windows software (1994). RESULTS: Two hundred and forty consecutive specimens were bacteriologically analyzed. Of the 220 vaginal samples used in the study, C. albicans was isolated in 44 instances (20%). Neither the presence of the lactobacilli nor the presence of Gardnerella vaginalis markedly influenced the isolation rate of C. albicans. The group B streptococci had a greater probability of coisolation when C. albicans was present (27.3% verses 16%), but this was not statistically significant (P < 0.8). Dissociation between the presence of C. albicans and the coisolation of Peptostreptococcus species and anaerobic gram-positive cocci and/or bacilli was noted (P < 0.0819), while the incidence of gram-positive aerobic bacilli was reduced in the presence of C. albicans (30/176 [17.1%] versus 6/44 [13.6%]), this reduced incidence was not statistically significant. Isolation data of the subgroup of pregnant women supported these observations. CONCLUSION: Within the limitations of the study, statistically, the data suggests that an inverse relationship exists between the presence of C. albicans and recovery of Peptostreptococcus and anaerobic gram-positive cocci and bacilli.

Bacteria↗
PubMed1993

Chlamydia trachomatis in patients who used oral contraceptives and had intermenstrual spotting.

OBJECTIVE: To identify the incidence of positive assays for direct antigen detection of Chlamydia trachomatis in oral contraceptive (OC) users with and without intermenstrual spotting and in women seeking contraception. METHODS: We studied 65 women who had used OCs for more than 3 months and who presented with intermenstrual spotting for which no readily demonstrable cause could be identified. They were compared with 65 matched controls who were taking OCs without intermenstrual spotting and who had chlamydia testing because of one or more risk factors, and 65 matched controls seeking contraception. The incidence of positive tests for each group was compared by chi 2 test for independence using the Yates formula. The strength of the relationship was analyzed by determining the Craemer phi coefficient. RESULTS: Nineteen of the 65 women (29.2%) taking OCs for more than 3 months and experiencing bleeding had positive tests, in contrast to seven of 65 matched controls (10.7%) who were also on OCs and who had had chlamydia testing because of vaginitis or new or multiple sexual consorts, and four of 65 women (6.1%) who were screened for C trachomatis before initiation of contraception. The significance level for the chi 2 statistic was P < .01. CONCLUSION: Intermenstrual bleeding in women previously well regulated on OCs appears to be an added marker for chlamydial infection.

Adult↗
PubMed1991

Intrapartum bacteriuria and postpartum endometritis.

Ten gravidas with bacteriuria in the immediate antepartum period subsequently delivered vaginally and did not receive antibiotic therapy. Four of these women developed postpartum endometritis and in three of them, the same Enterobacteriaceae recovered from the urine was present in the endometrial cultures. Of the 1233 study subjects whose screening urine cultures were negative and who delivered vaginally, 27 (2.2%) developed endometritis. Intrapartum bacteriuria was significantly associated with postpartum endometritis in women delivering vaginally (P less than .001). Monitoring for asymptomatic bacteriuria and eradicating it in pregnancy should diminish the occurrence of endometritis and possible endomyometritis in the postpartum period.

Bacteriuria↗
PubMed1989

Potential use of C-reactive protein determinations in obstetrics and gynecology.

C-reactive protein (CRP) is an acute-phase protein synthesized by the liver during the course of a large number of diseases. During gestation and parturition, progressively increasing numbers of gravida develop elevated levels up to 32, 48 to 80 per cent, respectively). These elevations in pregnancy, the nonspecificity of the test, and the inability to function as a reliable marker of fetal and/or maternal infectious morbidity have obscured the pragmatic utility of CRP determinations in both obstetrics and gynecology. Because of its biophysical kinetics, C-reactive protein determinations are best used as a monitoring parameter after the documentation of infection rather than as a diagnostic indicator of infection. They can provide valuable end titration points for termination of parenteral antibiotic therapy.

C-Reactive Protein↗
PubMed1989

In vitro sensitivity of Candida (Torulopsis) glabrata to clotrimazole.

Vulvovaginitis caused by Candida (Torulopsis) glabrata is often refractory to intravaginal imidazole therapy. Clotrimazole achieves its fungistatic activity for Candida albicans and C. glabrata by inhibiting different steps in intermediary cell metabolism. For C. glabrata, alkylation precedes dimethylation. The possibility that this altered sequence might account for the relative therapeutic nonresponsiveness was studied by determining comparative minimal inhibitory concentrations (MICs) of clotrimazole. In vitro analyses of ten strains of C. glabrata and 30 control strains of C. albicans performed using both agar and broth dilution tests revealed that four-fold lower MICs were consistently demonstrable with C. glabrata, irrespective of inoculum size. The data suggest that clinical difficulties encountered in the therapy of torulopsis vulvovaginitis probably represent the inability of intravaginal medication to eradicate urethral/urinary bladder colonization and subsequent reinfection rather than true therapeutic failures.

Candida↗
PubMed1989

How rare is congenital herpes simplex? A literature review.

Using three criteria--(1) herpetic infection and altered organogenesis of inflammatory etiology that antedates dissolution of the fetal membranes, (2) documented herpetic infection present at birth and within 24 hours of rupture of the fetal membranes, and (3) evidence of viral herpetic placentitis the induction of which antedates rupture of the membranes--15 cases of congenital transplacental herpes simplex were identified in the literature. Disease occurring early in gestation produces a cluster of congenital malformations that is clinically indistinguishable from that produced by the cytomegalovirus. Disease manifesting after the shortest recognized incubation period for the induction of the disease in experimental animals does not necessarily preclude transplacental acquisition. Various factors mask the perception of congenital transplacental herpes simplex as a valid disease entity.

Cohort Studies↗