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Biomedical subjects

J Paavonen

Publications and source records attributed to J Paavonen.

At least 199 records · Page 11Linked to original sources
PubMed1984

Single dose of tinidazole in the treatment of vaginal discharge.

Seventy-nine unselected women whose main symptom was abnormal vaginal discharge were seen at the Department of Obstetrics and Gynecology at Helsinki University Central Hospital between October 1980 and September 1981. All patients and their current sex partners were randomly treated either with a 2-gram single dose of tinidazole or with identical placebos. Those excluded were 9 patients who did not attend the follow-up examination, 15 who had specific cervicovaginal infections (6 with chlamydial infection, 4 with trichomoniasis and 5 with yeast infection), and 22 with normal Döderlein flora seen on vaginal Pap smear. Response to the treatment was analysed among the remaining 33 women, of whom 17 received tinidazole and 16 placebo. The symptoms and signs that best discriminated between those who had normal Döderlein flora and those who had non-Döderlein flora were malodour, other than white colour of the discharge, and the presence of clue cells on Pap smear. When these findings were used to evaluate the response to treatment, tinidazole proved to be more effective than placebo. Disappearance of clue cells best (p less than 0.01) discriminated between tinidazole and placebo.

Adult↗
PubMed1984

[Vasa praevia].

Explore the source record for details and available documents.

Adult↗
PubMed1983

Solid-phase enzyme immunoassay for Chlamydial antibodies.

An enzyme immunoassay (EIA) for chlamydial immunoglobulin G antibodies was developed by using microtiter wells coated with partially purified reticulate bodies of Chlamydia trachomatis serotype L2, grown in McCoy cells, and uninfected McCoy cells as a control. Duplicate testing of a single serum dilution, 1:500, was found to be sufficient. A good correlation between positive reactions was observed in a comparative study of 421 patient sera with the EIA and an inclusion immunofluorescence test. A good correlation between positive reactions was also observed in a comparative study of 140 patient sera with EIA and microimmunofluorescence tests in which chlamydial elementary or reticulate bodies were used as antigens. Sera of 77 healthy control individuals with low titers in inclusion immunofluorescence or complement fixation tests gave negative results in the EIA. Immunoblotting experiments showed that the major antigenic component in the EIA antigen was a protein with an Mr of 39,000.

Antibodies, Bacterial↗
PubMed1983

Physiology and ecology of the vagina.

The human vagina is lined by stratified squamous epithelium which has no glands. Major components of the vaginal secretions are transudate through the vaginal walls, desquamating epithelial cells, cervical mucus, fluids from the upper genital tract, and leukocytes. Estrogens and sexual stimulation are examples of factors which increase vaginal fluid. Major organic constituents of the vaginal fluid are proteins, carbohydrates, and fatty acids. Organic acids arise as metabolic byproducts of vaginal bacterial flora, cause the vaginal odor, and show cyclic changes except in oral contraceptive users. Qualitative and quantitative studies in humans as well as animal model studies have confirmed that the vaginal flora is a dynamic and closely interrelated system. Lactobacilli are most prevalent, but many other facultative and anaerobic organisms are present. An inverse relationship exists between the concentration of lactobacilli and other bacteria such as anaerobes. Aerobic bacteria decrease premenstrually whereas anaerobes, in general, remain at constant levels. During menarche, pregnancy, postpartum period, menopause, and postoperative trauma, dramatic changes occur in the microbial flora. The role of an IUD in causing changes in the microbial flora is under great scrutiny at the present time. Overall, disturbances in the vaginal ecosystem may have a potential impact on many diseases, and thus deserve careful studies.

Adolescent↗
PubMed1982

Isolation of Chlamydia trachomatis in Untreated MMC-E mouse epithelial cells.

The susceptibility of the epithelial mouse embryo cell line MMC-E to infection with Chlamydia trachomatis was studied by using chlamydiae from both laboratory strain L2 and clinical specimens. MMC-E cells were sensitive to infection with C. trachomatis without any pre- or posttreatments, and their susceptibility for isolation was comparable to that of the conventionally used irradiated McCoy cells.

Animals↗
PubMed1982

Chlamydia trachomatis in cervicitis and urethritis in women.

In the Scandinavian countries today, Chlamydia trachomatis seems to be the most important cause of sexually transmitted diseases. Although C. trachomatis is most prevalent in symptomatic women and in persons visiting venereal disease clinics, the asymptomatic carrier rate, particularly in young women, appears to be surprisingly high. In addition to young age and level of sexual activity, the use of oral contraceptives and the presence of cervical ectopy are important risk factors for chlamydial infection. Chlamydial cervicitis often is characterized by a hypertrophic follicular appearance, with severe edema, erythema, friability, and endocervical mucopurulent discharge. On colposcopy, an atypical transformation zone is frequently observed. Papanicolaou smears taken from C. trachomatis culture-positive patients often reveal benign atypias and dyskaryotic changes. C. trachomatis, therefore, being a venereally transmitted intracellular organism, may well play a role in the development of cervical intraepithelial neoplasia (CIN). Future studies on patients with cytological atypias, therefore, also should include tests for C. trachomatis. Prospective studies are needed to determine the natural history and outcome of C. trachomatis-associated atypias and their behavior after adequate therapy. A large proportion of C. trachomatis-infected women also are culture-positive from the urethra. The demonstration that C. trachomatis is a common causative agent of acute urethral syndrome (also called abacterial urethritis, dysuria-pyuria syndrome) in women has been a valuable contribution. The diagnosis of pyuria in a patient with abacterial dysuria is of critical importance, since it suggests a chlamydial etiology and thus is a potentially treatable condition.

Adolescent↗
PubMed1982

Routine cytology as a diagnostic aid in chlamydial cervicitis.

The cytological abnormalities seen in connection with cervical inflammation due to Chlamydia trachomatis are briefly reviewed. Severe inflammatory changes and the occurrence of metaplastic cells and tissue repair cells, which are indicative of severe tissue damage, are common findings in chlamydial cervicitis. However, these changes may also be found in inflammatory states not caused by Chlamydia. Differentiation between the intracytoplasmic inclusions pathognomonic of chlamydial infection and the inflammatory degenerative cytoplasmic formations currently seen in exfoliated cervical cells cannot confidently be made from Papanicolaou-stained specimens. Routine cytology, therefore, is not the proper method for diagnosing chlamydial infection.

Cervix Uteri↗
PubMed1982

Infertility as a sequela of chlamydial pelvic inflammatory disease.

The sensitivity of clinical criteria for the diagnosis of pelvic inflammatory disease (PID) is low, particularly with regard to chlamydial PID. Chlamydia trachomatis infection of the fallopian tubes ranges from the clinically severe to the silent, subclinical PID which can result in tubal scarring and subsequent infertility. In the treatment of PID, therefore, this organism should be considered. The diagnosis of chlamydial PID should be based both on isolation of the agent from the infected site--the endometrium, the fallopian tubes, or the peritoneum--and, preferably, on the further demonstration of a significant antibody response to C. trachomatis as well. Cultures for C. trachomatis from the cervix and the urethra can, if positive, offer presumptive evidence of etiology. Moreover, such evidence is of importance in motivating examination and treatment of sexual partner(s).

Age Factors↗
PubMed1982

Colposcopic and histologic findings in cervical chlamydial infection.

Colposcopic and histologic findings in 41 patients with Chlamydia trachomatis-associated cervicitis and in age-matched controls with nonspecific cervicitis are presented. Colposcopy showed exophytic follicular cervicitis in 30 patients in the chlamydia group and in none in the control group. Atypical transformation zone occurred significantly more often in the chlamydia group. Directed biopsy specimens revealed cervical intraepithelial neoplasia in 10 cases in the chlamydial group but in only 1 case in the control group. In 4 patients with chlamydial cervicitis lymphoid follicles were observed in histologic specimens.

Adult↗
PubMed1981

Serological evidence for the role of Bacteroides fragilis and enterobacteriaceae in the pathogenesis of acute pelvic inflammatory disease.

Pelvic inflammatory disease (PID) is classically divided into gonococcal and non-gonococcal forms depending on whether or not gonococcus is isolated from the lower genital tract. Chlamydia trachomatis seems to be another major pathogen in PID. In an attempt to determine the role of facultative enteric bacteria and anaerobic Bacteroides fragilis in the pathogenesis of PID antibodies to the enterobacterial common antigen (ECA) and B. fragilis capsular polysaccharide were measured in paired sera of 101 consecutive patients with PID. Significant ECA and B. fragilis antibody tires were each found in about a third of the patients whether or not the lower-genital-tract culture yielded gonococci or C. trachomatis. These results support the concept that PID is a polymicrobial infection in which both anaerobes and aerobic enteric bacteria, as well as gonococci and C. trachomatis, have an important role.

Acute Disease↗
PubMed1980

Chlamydia trachomatis in acute salpingitis.

Of the 228 hospitalized patients who had acute salpingitis, 69 (30%) harbored Chlamydia trachomatis in the lower genital tract (LGT). The mean antichlamydial IgG immunofluorescence antibody titer was 264 in sera from the C. trachomatis culture-positive patients but only 49 in culture-negative patients. In paired sera obtained from 167 of the patients, 32% of the culture-positive patients and 13% of the culture-negative patients showed significant titer change. Patients with abscess formation had higher mean antichlamydial antibody titer than the group with no abscess (192 vs. 53), although there was no difference between the groups in positive chlamydial cultures from the LGT (33% vs. 29%). Overall, this study indicates that C. trachomatis is a common etiologic agent in acute salpingitis, emphasizing the need to treat chlamydial cervicitis before this complication develops.

Adolescent↗
PubMed1980

Intrauterine contraceptive device use in patients with acute salpingitis.

The frequency of intrauterine contraceptive device (IUD) use among 144 hospitalized women with acute salpingitis was compared with that of 229 control women, who were symptomless sexual partners of men examined for non-gonococcal urethritis. The relative risk for salpingitis was higher for IUD than in the group of basal level of disease (p < 0.02). This was mostly caused by the high relative risk in the women with no deliveries. Oral contraceptives showed a contrary picture, the relative risk was significantly lower than on the basal level (p < 0.01). Non-gonococcal and gonococcal infections were equally represented in salpingitis patients with IUDs. The severity of the infection in IUD users did not differ from that of non-IUD users.

Adult↗
PubMed1980

Treatment of nongonococcal urethritis with trimethoprim-sulphadiazine and with placebo. A double-blind partner-controlled study.

The effect of sulphadiazine and trimethoprim (T-S) was compared with that of a placebo in the treatment of 75 men with nongonococcal urethritis (NGU) and their female sexual partners. Forty (53%) men and 30 (40%) women had positive culture results for Chlamydia trachomatis before treatment was started. Thirty-four patients of each sex received active treatment. Of these, 19 men and 15 women had positive culture results for C trachomatis before treatment with T-S and one of each sex had a positive culture result after treatment. C trachomatis had been isolated in 21 men and 15 women before treatment with placebo. At follow up four weeks after treatment had been started, 16 men and 15 women still harboured C trachomatis. Five of the chlamydia-positive patients treated with placebo developed complications (epididymitis, arthritis, or salpingitis) so the trial was discontinued.

Chlamydia Infections↗