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PubMed1985

Towards control of chlamydial infections.

Chlamydia trachomatis causes more sexually transmissible diseases in the United States than any other organism. Complications of chlamydial urethritis and cervicitis include epididymitis, salpingitis and neonatal pneumonia. Chlamydial infections can be easily treated but, until recently, they have been difficult to diagnose. Presumptive antichlamydial therapy for symptomatic/high-risk individuals was the first step taken towards control. With new methods of diagnosis becoming available, detection in asymptomatic women is the next critical step. Key populations for screening include clinics for family planning, abortion, student health, adolescent care and prenatal care. This article outlines the biology, diseases, diagnosis and treatment of C. trachomatis.

Antibodies, Monoclonal↗
PubMedDate not supplied

Infertility as a consequence of chlamydial infection of the upper genital tract in female mice.

The effect of infection with Chalmydia trachomatis (mouse pneumonitis biovar) on the fertility of female mice was examined. Mice were inoculated into one ovarian bursa with approximately 10(4) inclusion-forming units of C. trachomatis and were mated five to 16 days later. At sacrifice all mice showed salpingitis or hydrosalpinx in the inoculated oviduct and implantations were found only in the uterine horn contiguous with the noninoculated oviduct. Animals inoculated with tissue culture supernate showed no tubal pathology and had implantations evenly distributed in both uterine horns. Intrauterine inoculation of Chlamydia five to 36 days before mating also resulted in tubal pathology and infertility. Intrauterine inoculation of C. trachomatis one to two days after mating (one to two days before expected nidation) had no effect on the number or distribution of implantation sites as compared with controls. These results demonstrate that chlamydial infection of the upper reproductive tract of mice prior to mating can result in infertility.

Animals↗
PubMedDate not supplied

Neisseria meningitidis in specimens from urogenital sites. Is increased awareness necessary?

Neisseria meningitidis serogroups B type 2 and Y were isolated from urogenital specimens from three heterosexual patients. The first patient was a young man with the clinical signs and microscopic findings of a typical gonococcal urethritis. The second was a middle-aged woman with cervicitis, in whom neither Neisseria gonorrhoeae nor Chlamydia trachomatis were demonstrated by culture. In the third patient, a young woman, N. meningitidis was associated with cervicitis, acute salpingitis, and peritonitis. The patients' clinical symptoms responded quickly to antibiotic treatment. Meningococci of the same serogroup/serotype as the index cases were demonstrated in two of the sexual consorts in pharyngeal specimens but not in genitourinary specimens. Orogenital sexual practice seemed to be the most likely route of transmission. During the period of this study (August 1989-March 1990), the three meningococcal strains observed at the authors' laboratory represented 20% of the total number of urogenital isolates of pathogenic Neisseria. A greater awareness of this problem from medical, diagnostic, epidemiologic, and legal viewpoints is therefore needed.

Adult↗
PubMedDate not supplied

Chlamydia trachomatis, infertility, and population growth in sub-Saharan Africa.

In sub-Saharan Africa, Neisseria gonorrhoeae and Chlamydia trachomatis are common infections. These pathogens are also the major causes of post-salpingitis tubal infertility, and infertility is a frequent problem in this region. A mathematical model, recently devised to estimate the effect of gonococcal infection on population growth, was used to estimate the potential effect of chlamydial infection on population growth. The model predictions for chlamydial infection were compared with those previously reported for gonococcal infection. The model predicts that both infections may be exerting severe effects on population growth at realistic prevalence rates of infection. The model also predicts that N. gonorrhoeae produces a steeper reduction in population growth than does C. trachomatis because its transmission dynamics result in a higher force of infection (incidence rate) at any given prevalence of infection. Large scale changes in the epidemiology of these infections can be expected to occur in sub-Saharan Africa because of improved sexually transmitted disease (STD) diagnosis and treatment services as a component of AIDS prevention. Changes in the epidemiology of gonococcal and chlamydial infection are predicted to result in accelerated population growth unless STD control programs are linked to effective contraception programs.

Africa↗
PubMed1980

Experimental infection of the upper genital tract of female grivet monkeys with Mycoplasma fermentans.

Mycoplasma fermentans inoculated directly into the uterine tubes of female grivet monkeys produced a self-limiting acute salpingitis and parametritis. The inflammation was accompanied by a significant rise in titre of specific indirect haemagglutinating antibodies. Inoculation of M. fermentans into the uterine cavity through the cervical canal without dilatation of the cervix produced practically no signs of inflammation and no antibody response. However, when the intrauterine inoculation of mycoplasmas was followed by currettage of the endometrium, in animals whose uterine tubes had been closed by ligatures, pronounced upper genital-tract inflammation developed, together with a significant antibody response.

Animals↗
PubMed1978

The percentage of granulocyte-like cells in human oviduct epithelium.

The ratio of granulocyte-like cells to epithelial cells was examined in the fimbriae, ampullary, and isthmic regions of oviducts obtained from normal women of reproductive age, from postpartum women, from menopausal women, from women on combined oral contraceptives and from women with adnexal pathology. Only patients on oral contraceptives had a significantly high percentage of granulocyte-like cells as did one patient with acute salpingitis.

Contraceptives, Oral, Combined↗
PubMed1982

Effect of estradiol on chlamydial genital infection of female guinea pigs.

Female guinea pigs were treated daily with 1 mg of beta-estradiol-3-benzoate intramuscularly beginning 14 days before intravaginal inoculation with the chlamydial agent of guinea pig inclusion conjunctivitis and continuing during the course of the infection. Treatment with estradiol was found to markedly influence the course of genital infection with the chlamydial agent of guinea pig inclusion conjunctivitis, producing infections of greater intensity and longer duration than those in control animals. Moreover, pathogenesis was altered in that ascending infection was observed, resulting in endometritis, cystic salpingitis, and cystitis. Infection in the controls was limited to the cervix and vagina. Estradiol treatment increased the apparent number of infected cells in the cervix and vagina as detected by histopathology and immunofluorescent staining. Humoral and cell-mediated immune responses to the chlamydial agent of guinea pig inclusion conjunctivitis were comparable in estradiol-treated and untreated animals. These data indicate that hormonal manipulation may have profound effects on the course of chlamydial genital infections.

Animals↗
PubMed1993

Analysis of the immune response in mice following intrauterine infection with the Chlamydia trachomatis mouse pneumonitis biovar.

A Swiss Webster white mouse model of salpingitis was used to characterize the immune response following an intrauterine infection with the Chlamydia trachomatis mouse pneumonitis biovar. Western blot (immunoblot) analyses of the serum samples showed that the immunodominant bands corresponded to molecular masses of 72, 60, 42, and 28 kDa and to the lipopolysaccharide. Antibodies to the 60-kDa heat shock protein and to the 60-kDa cysteine-rich protein were detected at 2 and 3 weeks postinfection, respectively. Neutralization was observed in an in vitro assay with serum samples as early as the 3rd day postinfection and remained high for the 7 weeks of observation. The mice were mated in the 7th week following infection. Of the infected experimental mice, 71.4% were found to be either unilaterally or bilaterally infertile, whereas only 27.4% of the noninfected control mice were found to be infertile.

Animals↗
PubMed1976

Prostitution in Sheffield.

Prostitution in Sheffield, a city with over half a million population, has been reviewed in its legal, social work, and medical aspects. The years studied were 1960-73. The medical studies were confined to the years 1968-72. Prosecutions for soliciting increased steadily during the study period. The trend was more marked locally than nationally and was associated both with increased police activity and, more recently, with the pursuit of a socially-aware sentencing, probationary, and social work policy. During the 5-year medical study, sixty prostitutes were seen. Using gonorrhoea as an index they were found to hazard the health of both themselves and others. Recurrent infection was the rule amongst them and 40 per cent. suffered salpingitis. In epidemiological terms our findings show that the vector role of prostitutes continues undiminished. The alleged decline in their role is relative only and not real. They accounted for one in six of locally acquired gonococcal infections in heterosexual men. The study indicates the need for the regular monitoring of the social phenomenon or prostitution and for the detailed study of all its aspects on a national basis.

England↗
PubMed1979

Chlamydia trachomatis infection of the Fallopian tubes. Histological findings in two patients.

In two patients with acute salpingitis, C. trachomatis was isolated from the cervix. In one of the patients, the organism was also recovered from the Fallopian tubes, and in the other, chlamydial inclusions were found in Giemsa-stained tubal epithelial cells. A significant change in micro-immunofluorescence antibodies to C. trachomatis occurred in both patients during the course of the disease. The Fallopian tubes of both patients were removed and studied by conventional histological techniques and, in the case of one of them, by transmission electron microscopy.

Adult↗
PubMed1981

Sexually transmitted diseases in tropical Africa. A review of the present situation.

At present very little information is available on the prevalence and pattern of sexually transmitted diseases (STDs) in many countries of tropical Africa. The available evidence does, however, suggest that these diseases are highly prevalent and that a considerable reservoir of infection exists among the female population. Gonorrhoea is probably the most commonly recognised STD in tropical Africa, frequently causing epididymitis and urethral stricture in men and salpingitis and pelvic inflammatory disease in women. The prevalence of a infectious syphilis is still high, particularly the late manifestations of the disease. The prevalence of the other STDs is also high. Thus, the problem is clearly very serious and the need for improving facilities for diagnosis and treatment urgent; some attempt also must be made to initiate control measures.

Africa↗
PubMed1984

Induction by human serum of resistance to serum in Neisseria gonorrhoeae: A clinical survey of patients with gonorrhoea.

Serum from 74 female and 170 male patients with gonorrhoea and from 72 male and 123 female controls was tested for its ability to induce in gonococci resistance to complement mediated killing by human serum. We confirmed two findings of a previous survey: firstly, a higher percentage of serum samples from women suffering their first infection than from female controls induced high resistance; secondly, no serum sample taken from infected women with complications (mainly salpingitis) induced high resistance. The number of serum samples from female patients with repeat infection was too small for conclusions to be drawn. In men, however, there were no significant differences between patients and controls, or between patients with first or repeat infection, in the percentage whose serum induced high resistance. The pattern of these results on the induction of resistance to serum correlates with the general clinical aspects of gonococcal infections; namely, wide clinical differences in symptoms in women contrasting with a more uniform pattern in men.

Blood Bactericidal Activity↗
PubMed1985

Pelvic inflammatory disease in patients infected with Chlamydia trachomatis: in vitro cell mediated immune response to chlamydial antigens.

Blood samples were obtained from 11 women with laparoscopically confirmed acute salpingitis who yielded positive cultures of Chlamydia trachomatis from the cervix. Four patients also had perihepatitis. Lymphocyte transformation assays, using C trachomatis serovars I and L2 as antigens, showed that the patients' lymphocytes responded to antigenic stimulation more strongly than the lymphocytes of age matched controls. Responses to the I and L2 antigens correlated strongly, but greater responses were obtained to the L2 antigen. No correlation was found between the response in the lymphocyte transformation assay and the degree of the inflammatory changes of the fallopian tubes, the presence of perihepatitis, or the titres of humoral antibodies to C trachomatis as measured by microimmunofluorescence. Sequential transformation assays, however, showed that patients with perihepatitis tended to have a more sustained response.

Adolescent↗
PubMed1998

Observations on the significance of diagnostic findings in egg-binding of Psittaciformes.

Clinical examination of 2192 psittacine birds of both sexes revealed a prevalence of 2.74 per cent (60 birds) of egg-binding. Domesticated species easily bred in captivity were the most commonly affected; the prevalence in cockatiels (15.75 per cent), and in budgerigars (5.73 per cent). An accurate diagnosis was possible in all cases by means of an evaluation of the case history, a visual examination, palpation and radiographic and ultrasonographic examinations. The case history alone was typical in 60 per cent of the cases, and reliable diagnosis was reached with the help of a visual examination in 70 per cent of the cases. Radiographic examination provided a definitive diagnosis in 30 per cent of the cases, especially in those with shelled eggs. Medullary bone proved to be a radiographic indication of laminated and thin-shelled eggs. However, laminated and thin-shelled eggs could only be differentiated definitively from abdominal masses, salpingitis and cystic degeneration by means of ultrasonography.

Animals↗
PubMed1994

Selective tubal sterilization in rabbits: experience with a hydrogel combined with a sclerosing agent.

PURPOSE: To test a method of nonsurgical sterilization. MATERIALS AND METHODS: A hydrogel that forms an in situ plug by phase inversion of a polymer solution was placed into fallopian tubes of eight rabbits by means of transvaginal rabbits by means of transvaginal fluoroscopic fallopian tube catheterization. The rabbits were bred, and the presence of embryos was confirmed with palpation and at autopsy. RESULTS: Seven of the eight rabbits became pregnant. Six of these rabbits contained embryos in the control uterus but not in the uterus on the side of the hydrogel injection. The seventh rabbit had embryos in both uteri, but the hydrogel had been expelled. All seven tubes that contained hydrogel showed evidence of acute and chronic salpingitis and a foreign-body reaction. The tube from which hydrogel had been expelled and the eight control tubes were not inflamed. CONCLUSION: Transcervical catheter methods of tubal occlusion and sterilization are promising, but a non-reactive material is needed.

Acrylonitrile↗
PubMed1980

A comparison of two different dosages of pivampicillin and doxycycline in patients with gynaecological infections.

The efficacy of 500 mg pivampicillin twice daily, 350 mg pivampicillin 3-times daily and 100 mg doxycycline daily was compared in 106 patients with salpingitis, parametritis or endometritis. Both the pivampicillin regimens were equally effective. The average duration of therapy needed to produce a satisfactory clinical response was shorter with pivampicillin (14 days) than with doxycycline (21 days). Pivampicillin improved the patients' gynaecological status in 90% of the subjects treated compared to only 70% of patients given doxycycline. Fewer relapses were recorded in women given pivampicillin (4%) than in subjects treated with doxycycline (15%). Gonococci were isolated from 10% of vaginal swabs. The involvement of Chlamydia and Mycoplasma was not studied. However, the high cure rate indicated that, if present, they did not pose a therapeutic problem. Side-effects, mainly dyspepsia, were observed in 2 patients in each group. The twice-daily administration of pivampicillin is recommended, since it is more practical and increases patient compliance.

Adult↗
PubMed1983

Estrone and dehydroepiandrosterone sulfatase activities in normal and pathological human endometrium biopsies.

The properties of estrone (E1) and dehydroepiandrosterone (DHEA) sulfatase activities are reported. Endometrial biopsy specimens were obtained using a Novak curette. Cycle stage was assessed from histological dating of endometrium, plasma estradiol and progesterone levels, and patient history. Both sulfatases are membrane-bound enzymes. The optimum pHs in Tris-HCl buffer were 6.5 for E1 sulfatase and 7.3 for DHEA sulfatase. Lowest activities and different optimum pHs were obtained with imidazole, maleate, or acetate buffers. DHEA sulfatase is more sensitive to thermal inactivation than E1 sulfatase. From kinetic studies, apparent Km values of 3.1 microM for E1 sulfatase and 5.7 microM for DHEA sulfatase were calculated. Noncompetitive inhibition of E1 sulfatase by DHEA sulfate and of DHEA sulfatase by E1 sulfate were demonstrated. The effects of inorganic ions and unconjugated steroids were also tested. These results are consistent with two different activities hydrolyzing E1 or DHEA sulfates. Neither activity varies during normal menstrual cycles nor is not correlated to plasma progesterone or 17 beta-estradiol levels. An isolated increase in E1 sulfatase occurred in the proliferative phase of irregular menstrual cycles, postantibiotic-treated salpingitis, or hyperplastic endometrium.

Dehydroepiandrosterone↗