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PubMed2005

[Adnexitis and pelvic inflammatory disease].

Pelvic inflammatory disease and upper genital tract infection describe inflammatory changes in the upper female genital tract of any combination: endometritis, salpingitis, tubo-ovarian abscess, peritonitis in the small pelvis. The International Infectious Disease Society for Obstetrics and Gynecology recommends a revision of the CDC guidelines taking into account the type of germ or the triggering agent and the seriousness of the disease. Infections with Chlamydia trachomatis and Neisseria gonorrhoeae are increasing worldwide. They are one of the main causes of tubal sterility, chronic abdominal pain and ectopic pregnancies. More than 30% of the infections are subclinical and asymptomatic. Therefore it is most recommendable to generally screen young, sexually active women with any of the risks mentioned above. Antibiotic therapy should be started as early as possible, in case of doubt even probatively, and should cover a broad spectrum of germs. C. trachomatis and N. gonorrhoeae should be treated according to resistance testing. In uncomplicated cases, hospitalization is unnecessary, ambulant therapy is sufficient.

Anti-Bacterial Agents↗

PubMed1983

Concentrations of ceftriaxone in serum and gynecological tissues.

31 patients received an intravenous 15-min injection of 2 g ceftriaxone at various times before abdominal or vaginal hysterectomy. Ceftriaxone concentrations in salpinges were significantly higher than in myometrium and endometrium. Tissue concentrations of 20 micrograms/g could be maintained for at least 5 h. Due to its high tissue concentrations maintained for the whole operative procedure, ceftriaxone does seem to be one of the antibiotics of choice for single-dose prophylaxis of postoperative infections in gynecology.

Adult↗

PubMed1990

Comparison of ceftriaxone (1 x 1 g/day) versus cefotaxime (3 x 1 g/day) for gynecologic and obstetric infections. A randomized clinical trial.

A prospective, randomized clinical trial was conducted to compare the efficacy and tolerance of a single dose of 1 g ceftriaxone i.v. daily with 3 doses of 1 g cefotaxime i.v. daily for obstetric and gynecologic infections. Both agents are characterized by a wide spectrum and potent activity. Furthermore, ceftriaxone has an outstanding serum half-life of 8 h. 41 patients with pelvic inflammatory disease, pelvic or wound infections after vaginal or abdominal hysterectomy, endomyometritis and urinary-tract infection were included. Patients were monitored clinically by routine laboratory methods (erythrocyte sedimentation rate, white blood cell count and cross-reacting protein) and bacteriologically. Clinical parameters of infection were fever, local pain and/or tenderness, a sactosalpinx or pyosalpinx at palpation and cervical secretion. Clinical cure was achieved in 77.3% in the ceftriaxone and in 78.9% in the cefotaxime group, improvement in 3 (13.6%) and 4 patients (21.0%), respectively. 2 clinical failures were seen in the ceftriaxone group. One was a severe pelvic infection following vaginal hysterectomy, which responded to the addition of metronidazole, the other was due to a chlamydial salpingitis, which was cured with a 10-day course of doxycycline. Both antibiotics were well tolerated. Our results suggest that for obstetric and gynecologic infections a single 1-gram dose of ceftriaxone is equally effective as three 1-gram doses of cefotaxime.

Cefotaxime↗

PubMed1983

A clinicopathological study of IUD users with special reference to endometrial patterns and endometritis.

A group of 65 IUD users was studied during a period of 165 years of use, with a mean of 2.6 +/- 1.7 years per woman. The main complaint which differed significantly from the 120 controls was the occurrence of spotting in 33.8% of IUD users. Normal endometrial mucosae were found in 36.9% of IUD users and 38.7% of controls. Chronic endometritis was evidenced in 35.4% of IUD users versus 12.5% of controls; the former were asymptomatic in 25.0% of the cases. 39.1% of them had normal endometrial synchrony. Chronic endometritis occurred 2.2 +/- 1.3 years after insertion of the device. Endometritis was always symptomatic in controls; only 13.3% of them exhibited endometrial synchrony. The fundamental mechanism(s) responsible for the contraceptive efficiency of intrauterine contraceptive devices (IUD) remains a subject of controversy and a field of investigation. The most recent studies are essentially directed towards the biochemical analysis of uterine fluid [1]. Nevertheless, the presence of an inflammatory process, either morphologically or biochemically detectable, seems to be one of the fundamental modifications induced by the IUD. Since a certain reluctance to use IUDs has been observed in some countries, which has been ascribed mainly to contradictory reports on the risk of pelvic inflammatory disease (PID) in women wearing such devices [2], we found it interesting to intend to objectivate and reevaluate the influence of IUD on chronic aspecific endometritis, a possible precursor state of salpingitis and PID.

Adult↗

PubMed1986

Pathology of the canine and feline uterine tube.

Lesions of the uterine tube were described in 37 dogs and nine cats. Of the 52 lesions noted, 18 were developmental abnormalities; four paramesonephric remnants, and 14 mesonephric remnants. Uterine tube cysts were seen in 16 animals, and seven animals had salpingitis. One dog had hyperplastic changes of the infundibular mucosa, and one cat and one dog demonstrated adenomyosis. There were three primary benign uterine tube neoplasms, one adenocarcinoma, two metastatic neoplasms in the uterine tube, and two bursal lipomas, all in dogs. With the exception of neoplasia of the uterine tube, most lesions were unlikely to affect the reproductive performance of these animals and/or were incidental or secondary to disorders elsewhere in the reproductive tract.

Animals↗

PubMed2004

Current problems of perinatal Chlamydia trachomatis infections.

Chlamydia trachomatis has been recognized as a pathogen of trachoma, nongonococcal urethritis, salpingitis, endocervicitis, pelvic inflammatory disease, inclusion conjunctivitis of neonates, follicular conjunctivitis of adults, infantile pneumonia and associated conditions. Chlamydial infections during pregnancy may also cause a variety of perinatal complications. Different antigenic strains of C. trachomatis from endocervical, nasopharyngeal and conjunctival origins have been associated with different clinical conditions. Control programs emphasizing early diagnosis, targeted screening, and effective treatment will lead to an eventual decline in the incidence of perinatal chlamydial infection. This review focuses on current problems of perinatal C. trachomatis infections in the aspects of microbiological and immunological pathogenesis.

Journal Article↗

PubMed1987

Accelerated growth and abnormal glucose tolerance in young female rats exposed to fetal hyperinsulinemia.

This study was designed to evaluate the relationship between fetal macrosomia and postnatal growth as well as the glucose homeostasis in young female rats. We produced fetal macrosomia by fetal insulin injection at 20 1/2 days of gestation. The control subjects were injected with saline. The weights were recorded weekly from birth up to 12 wk. Only the female rats were studied. At 4, 6, 10, and 12 wk of age, oral glucose tolerance tests were performed. Also, at wk 6, 10, and 12, peri-renal-ovarian-salpingeal fat weights, the RNA, DNA, and protein contents of the abdominal muscle were determined. One-hundred seventeen control and 78 macrosomic rats were studied. The macrosomic rats showed a higher body weight (10-12%) than the control rats from birth up to 8 wk, but at 10 and 12 wk their weights were similar. The fat weights reflected the body weights, i.e. a higher fat weight in the macrosomic rats during the period of accelerated growth (from birth up to 8 wk), and a similar fat weight when the body weight of the two groups were similar at 10 and 12 wk. At 4 and 6 wk of age, the plasma glucose level measured in response to the oral glucose loading were similar in both groups. However, at 10 and 12 wk of age, the macrosomic rats had significantly higher fasting plasma glucose levels and exhibited consistently higher plasma glucose levels for the 3.5-h period of postglucose administration compared to the control rats. The plasma insulin levels rose significantly following glucose challenge. However, the values were similar in both groups at 10 and 12 wk.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed2002

Mycoplasma genitalium -- an up-date.

Mycoplasma genitalium was first isolated from men with non-gonococcal urethritis (NGU) more than 20 years ago. Use of polymerase chain reaction technology has shown it to be a cause of acute NGU and probably chronic NGU, almost independently of Chlamydia trachomatis, but there is no substantial evidence that it causes acute or chronic prostatitis. In women, M. genitalium is not associated with bacterial vaginosis, but it is strongly associated with cervicitis and endometritis and serologically with salpingitis and tubal factor infertility. Further studies may show M. genitalium to be associated, perhaps causally, with epididymoorchitis, neonatal disease and reactive arthritis. Furthermore, its potential for enhancing HIV transmission needs to be explored. M. genitalium is susceptible to various broad-spectrum antibiotics, but M. genitalium-associated diseases are probably best treated with azithromycin.

Anti-Bacterial Agents↗

PubMedDate not supplied

[Gonorrhea].

Gonorrhea is a common bacterial infection caused by Neisseria gonorrhoeae, a Gram-negative diplococcus that is transmitted almost exclusively by sexual contact or perinatally. It primarily affects the mucous membranes of the lower genital tract and less frequently those of the rectum, oropharynx, and conjunctivae. Ascending genital infection in women leads to the predominant complication, acute salpingitis, one of the most common causes of female infertility in the world. Since the 1990s, a remarkable surge of information ensued regarding the pathogenesis of gonorrhea and its agent. Gonorrhea has proven difficult to control in most populations and remains a prime example of the influence that social, behavioral, and demographic factors can have on the epidemiology of an infectious disease. The management of gonorrhea and other sexually transmitted infections requires both treatment of the patient as an individual and of his or her sexual partner(s) as a public health measure to interrupt the onward spread of infection and prevent long-term complications.

Female↗

PubMed2003

The occurrence of avian influenza A subtype H6N2 in commercial layer flocks in Southern California (2000-02): clinicopathologic findings.

Between February 2000 and February 2002, the California Animal Health and Food Safety Laboratory System diagnosed 26 cases of low-pathogenic H6N2 avian influenza from 12 commercial egg-laying farms. The most common gross and histologic lesions observed in infected chickens were fibrinous yolk peritonitis, salpingitis, oophoritis, and nephritis. Edema of the mesentery of the oviduct and pale, swollen kidneys were also observed. Mortality in infected flocks ranged from 0.25% to 3%, and egg production dropped 7% to 40%.

Animals↗

PubMed1997

National surveillance of poultry diseases in Lebanon.

From 1992 to mid-1996, a national survey of poultry diseases in Lebanon was conducted. This surveillance included meat breeder, layer breeder, commercial layer and chicken broiler flocks. The history, signs, lesions and laboratory tests of poultry were used in the diagnosis of prevalent poultry diseases. Culture techniques were used to screen for bacterial diseases; serological techniques and, to a lesser extent, culture techniques were used to diagnose viral diseases; and both serological and culture techniques were used to diagnose Mycoplasma infections. The outbreaks of diseases detected in broiler breeder flocks and the number of such flocks experiencing these diseases were as follows: femoral head necrosis (6), egg-drop syndrome (3), reovirus-associated malabsorption syndrome (3), synovitis (Mycoplasma synoviae infection) (7), swollen head syndrome (SHS) (3), tenosynovitis (viral arthritis) (1), lymphoid leukosis (3), avian encephalomyelitis (1), fowl pox (1) and aortic rupture (1). The disease outbreaks detected in layer breeders were as follows: SHS (2), bumble foot (2), egg-drop syndrome (3) and avian infectious bronchitis (IB) (1). The disease outbreaks detected in commercial layer flocks were as follows: egg-drop syndrome (5), avian infectious laryngotracheitis (2), avian IB (nephrogenic strain) (1), malabsorption (1), avian tuberculosis (Mycobacterium avium) (1), Marek's disease (1), fowl pox (1), Salmonella enterica subsp. enterica Enteritidis infection (1), salpingitis (1) and Heterakis gallinae infestation (1). The disease outbreaks detected in broiler flocks were as follows: colibacillosis (40), infectious bursal disease (Gumboro disease) (15), malabsorption syndrome (8), avian infectious laryngotracheitis (8), paratyphoids (salmonellosis) (7), femoral head necrosis (8), SHS (6), avian mycoplasmosis (Mycoplasma gallisepticum infection) (6), synovitis (7), avian IB (6), botulism (1), avian encephalomyelitis (1) and gangrenous dermatitis (1). Diseases which occurred and which were reported for the first time in Lebanon were as follows: bumble foot, femoral head necrosis, avian IB (nephrogenic strain), malabsorption syndrome and SHS. This surveillance helped to establish baseline data concerning the predominant poultry diseases in Lebanon. Such information is a prerequisite for future regional and international collaboration to identify the source of the aetiological agents and to control their spread to neighbouring countries.

Adenoviridae Infections↗

PubMed2000

Fowl typhoid and pullorum disease.

Fowl typhoid (FT) and pullorum disease (PD) are septicaemic diseases, primarily of chickens and turkeys, caused by Gram negative bacteria, Salmonella Gallinarum and S. Pullorum, respectively. Clinical signs in chicks and poults include anorexia, diarrhoea, dehydration, weakness and high mortality. In mature fowl, FT and PD are manifested by decreased egg production, fertility, hatchability and anorexia, and increased mortality. Gross and microscopic lesions due to FT and PD in chicks and poults include hepatitis, splenitis, typhlitis, omphalitis, myocarditis, ventriculitis, pneumonia, synovitis, peritonitis and ophthalmitis. In mature fowl, lesions include oophoritis, salpingitis, orchitis, peritonitis and perihepatitis. Transovarian infection resulting in infection of the egg and subsequently the chick or poult is one of the most important modes of transmission of these two diseases. Salmonella Gallinarum and S. Pullorum can be isolated by use of selective and non-selective media. Salmonella Pullorum produces rapid decarboxylation of ornithine whereas S. Gallinarum does not, an important biochemical difference between the two bacteria. Both FT and PD can be detected serologically by use of a macroscopic tube agglutination test, rapid serum test, stained antigen whole blood test or microagglutination test. Both diseases can be controlled and eradicated by use of serological testing and elimination of positive birds. Vaccines may be used to control the disease and antibiotics for the treatment of FT and PD. Although FT and PD are widely distributed throughout the world, the diseases have been eradicated from commercial poultry in developed countries such as the United States of America, Canada and most countries of Western Europe. Both S. Gallinarum and S. Pullorum are highly adapted to the host species, and therefore are of little public health significance.

Animals↗

PubMed1991

Organic vs functional obstruction of the fallopian tubes: differentiation with prostaglandin antagonist- and beta 2-agonist-mediated hysterosalpingography and selective ostial salpingography.

In order to determine the prevalence and cause of functional vs organic obstruction of the fallopian tubes, hysterosalpingography was repeated after pharmacologic manipulation with a prostaglandin antagonist (aspirin) and/or a beta 2-agonist (terbutaline) in 100 patients in whom the fallopian tubes did not fill with contrast medium on the initial hysterosalpingogram. Selective ostial salpingography was performed in those in whom the fallopian tubes did not fill on the second hysterosalpingogram. Patients referred from three infertility clinics were included in the study if they could be rescheduled for a second hysterosalpingogram after at least 1 week of preparation with aspirin. Hysterosalpingograms obtained after administration of aspirin showed normal filling in 21 of 100 patients with initially obstructed tubes; the tubes filled in four more patients after administration of terbutaline. Selective ostial salpingography opacified the tubes in another 36 patients in whom the tubes had so far failed to fill. On the basis of the radiographic appearance and sometimes laparoscopic observation, initial nonfilling was attributed to spasma and debris in 49 patients, submucosal fibroids in six, synechiae in three, salpingitis isthmica nodosa in two, and septated uterus in one. Hysterosalpingography, after pharmacologic manipulation with aspirin and/or selective ostial salpingography, revealed false-positive and functional tube obstructions in 61 of 100 patients. Moreover, the radiologic appearance improved categorization of organic obstructions.

Adrenergic beta-Agonists↗

PubMed1993

Behçet's disease: a review and a report of 12 cases from Sweden.

In a retrospective study of 12 patients with Behçet's disease, more than half were found to originate from the Near East, where the prevalence of the disease is known to be high. The immigrant patients were all males, whereas 3 of the 5 patients with Swedish ancestry were females. Certain differences emerged between the two groups, including different sex ratio and absence of HLA B5 association and pathergy skin reaction among the Swedish patients. Moreover, serious neurological and ocular symptoms showing no tendency to recede with age afflicted all the Swedish female patients. Urogenital symptoms were, besides ulcers, common in both groups, including prostatitis, urethritis, orchitis, chronic sterile cystitis and relapsing salpingitis. Although the maternal does not allow statistical inferences, the estimated prevalence was higher than expected among both Swedish and immigrant patients. Recent studies, including the diagnostic criteria proposed by the "International Study Group for Behçet's disease", are discussed in relation to previously used criteria as well as present findings. The sensitivity and specificity of the first mentioned criteria and the ones proposed by Mason & Barnes seemed equal.

Adult↗

PubMed2006

Laparoscopic application of PGE2 to re-establish oviducal patency and fertility in infertile mares: a preliminary study.

REASONS FOR PERFORMING STUDY: Mares are occasionally encountered that consistently fail to conceive when inseminated, naturally or artificially, with fertile stallion semen in the absence of any identifiable pathology of either the structure or function of their reproductive tract. HYPOTHESIS: Temporary blockage of the oviducts by accumulations of naturally occurring oviducal masses may be preventing oviducal transport of the embryo to the uterus. METHODS: Mares, with known reproductive histories, that had exhibited inexplicable failure of conception were treated by laparoscopically guided administration of PGE2-laced triacetin gel directly onto the surface of their oviducts. RESULTS: Fifteen mares age 10-21 years that had exhibited inexplicable failure of conception during 1-4 years were treated, of which 14 (93%) conceived within the same or subsequent breeding season. CONCLUSIONS: The high success rate of this treatment supports the tentative diagnosis of oviducal obstruction in these mares and indicates that blockage of the mare's oviducts may occur in the form of a moveable accumulation of debris rather than from permanent fibrous adhesions resulting from salpingitis. POTENTIAL RELEVANCE: This laparoscopic application of PGE2 to the oviducts constitutes a sound and practical method of restoring fertility in mares suffering oviducal obstruction and further studies involving the procedure are warranted.

Animals↗

PubMed1981

Effects of estrogen deficiency in women castrated when young.

In earlier studies on the effects of castration, most of the women had been operated on late in the reproductive period of life. In the present material all the 142 women had been oophorectomized between the ages of 15 and 30 years because of advanced salpingitis. Not only the tubes but also the ovaries had been radically removed. The series was analyzed in respect of causes of death, survival, morbidity, osteoporosis and hormonal state. Complete oophorectomy was found to be followed by (i) a significant increase in the frequency of coronary heart diseases; (ii) an increase in serum cholesterol and triglyceride levels, most significantly in those aged below 60-65 years; (iii) an increase incidence of fractures; (iv) in increased frequency of nervous disorders of psychological rather than endocrinological origin.

Adult↗

PubMed1982

Penetration of lymecycline (tetracycline) into the tissues of the Fallopian tube.

On the basis of a comparison of different methods used to determine the concentration of active lymecycline in Fallopian tube tissue, a method was adopted which allowed the determination of lymecycline in serosa and mucosa tissue of the Fallopian tube in 16 women undergoing hysterectomy. A difference in the concentration of active drug was found in serosa (greater than 1.7 mg/kg tissue) and mucosa (greater than 0.8 mg/kg tissue) in 16 patients on lymecycline therapy for 24 hours. These figures were fairly constant for the 7.5 hours following the administration. The figures are discussed in relation to the MIC values of the commonly found microorganisms in salpingitis.

Adult↗

PubMed1989

Serum CA 125 levels in patients with a provisional diagnosis of pelvic inflammatory disease. Clinical and theoretical implications.

In 50 patients with a provisional diagnosis of pelvic inflammatory disease (PID), CA 125 concentrations in serum were measured before laparoscopy and during hospitalization, using an enzyme immunoassay. The findings at laparoscopy were graded on the basis of the extent of inflammatory peritoneal involvement (grades 0-3; normal observations having a score of 0). On admission, 66% of the patients had serum CA 125 concentrations in excess of the cut-off value of 16 U/ml (range: 20-1300 U/ml). The serum CA 125 concentration before laparoscopy correlated with the extent of inflammatory peritoneal involvement (eta = 0.74). The predictive value of an elevated serum CA 125 level to indicate the presence of salpingitis (grades 1-3) was 97%. However, the predictive value of a normal CA 125 level indicating normal observations at laparoscopy (grade 0) was only 47%. During treatment and follow-up, the serum CA 125 concentration returned gradually to normal levels. It was concluded that the finding of an elevated serum CA 125 level confirms the diagnosis of peritoneal involvement in patients with a clinical diagnosis of PID.

Adolescent↗