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PubMed1980

Halophilic vibrios from human tissue infections on the pacific coast of Australia.

Inshore sea waters harbour a variety of halophilic bacteria which increase in the warmer seasons. Ten Vibrio alginolyticus, 3 V. parahaemolyticus and 3 lactose-fermenting (L +) strains of vibrio were isolated in 3 yr from wound and ear infections, salpingitis and sputum in 2 coastal towns; 14 isolations were in summer. Clinically the cases resembled ordinary pyogenic infections. The API 20E kit and determination of NaCl tolerance permitted identification of the strains with reasonable confidence. Only a few characteristics were essential for presumptive identification.

Adult↗

PubMed1990

Haemophilus isolated from unusual anatomical sites.

During a 15-year period Haemophilus species were isolated from unusual anatomical sites in 80 patients, mostly adults. The origin of specimens was pus and swabs from suppurative lesions, fluids from serosal cavities and gall bladder, gut content, and blood in cases with a supposed tissue focus. In 17 patients Haemophilus species were isolated in pure culture, in 63 patients in conjunction with other bacteria. 17 patients had gynaecological complaints: bartholinitis, salpingitis, and vaginal discharge. 22 patients had gastrointestinal complaints, comprising 17 with appendicitis, peritonitis following perforation of gastric ulcer, gall-duct infections, and an abscess in the stomach wall, and 5 patients with colonization of the gut. 41 patients had soft tissue and bone infections.

Adolescent↗

PubMed1980

Techniques for culturing and determining antimicrobial susceptibility of Chlamydia trachomatis.

The application of cell culture techniques to the study of chlamydiae have led to isolation of C. trachomatis from a variety of syndromes, among which are nongonococcal urethritis, post-gonococcal urethritis, cervicitis, acute salpingitis, neonatal conjunctivitis, and pneumonia of infants. The methods currently employed fo chlamydia isolation are described, as well as the conditions which affect the infectivity of these organisms to cells in vitro. Cell culture methods applicable to the study of the effect of antibacterial drugs on C. trachomatis are also presented.

Anti-Bacterial Agents↗

PubMed1987

Contraception in general practice analyzed by a computerized medical record.

By a computerized medical record 174 patients who consulted a general practitioner regularly for contraceptive advice through 51 months were selected. There were 67 patients aged 25.9 +/- 4.0 (mean +/- SD), using Lynestrenol 0.75 mg and etinyloestradiol 375 micrograms or Levonorgestrel 0.150 mg and etinyloestradiol 30 micrograms. Eleven patients aged 27.2 +/- 5.3 using Noretisteron 0.3 mg and 96 patients aged 33.3 +/- 6.0 using intrauterine contraceptive device (IUCD). As judged by the Pearl index, the Pill-users unwantedly and unexpectedly became pregnant more often than IUCD-users. Acute salpingitis was encountered in six Pill-users, and in one with IUCD. There was more often purulent vaginal discharge and metrorrhagia in the Pill-group, but the hemoglobin values were similar. The importance of these findings remain to be established, but they suggest that the IUCD may be more reliable than the Pill, perhaps due to a better compliance. Eight IUCD patients did not return for changing the device in due time after 36 months of use. Four out of 13 patients with cervical dysplasia did not return for prescribed controls of the cervical smear. The computerized medical record seems to be a powerful tool for the monitoring of high risk patients and clinical research in general practice.

Adolescent↗

PubMed1996

Chlamydia trachomatis screening in family planning centers: a review of cost/benefit evaluations in different countries.

Chlamydia trachomatis is a primary cause of acute or silent salpingitis leading to infertility and ectopic pregnancy. The C. trachomatis epidemic, undiscovered in most cases, spreads, mostly in adolescents, during the years following the onset of sexual activity. As opposed to gonococcal infection which has greatly decreased, C. trachomatis cervical and urethral infection is common in young occidentals. More then 30 different studies covering 200-12,000 subjects screened in family planning centers, college women and men, students and military recruits in different parts of the USA, in Scandinavian countries and France, indicate a prevalence of 5-20% (mean 10%) in apparently healthy young females < 25 years and 5-10% in males. Female prevalence is strongly related to age, being highest (15-20%) in women < 20 years old. Several cost-benefit analyses show that the total cost of the general screening in young populations, which can easily be carried out for women in family planning centers, could save twice the cost of treatment for pelvic inflammatory disease caused by C. trachomatis and six times the total cost of C. trachomatis epidemics if late sequelae are taken into account (tubal infertility treatment, ectopic pregnancy). There is a debate among authors concerning the relative merits of total screening versus selective screening in family planning centers, the most common opinion being to do a total screening of women < 20 years old and selective screening of women 20-30 years of age with at least one risk factor, the most common risk factors being more than one partner in a year, purulent, cervical discharge, failure to use condoms and use of a contraceptive pill. Although the data clearly show that C. trachomatis screening is cost-effective, conducting of the diagnostic laboratory tests used in such screening programs should be carefully evaluated relative to cost, feasibility, specificity and sensitivity and should be adapted to the presumed prevalence in screened populations.

Adolescent↗

PubMed1997

Hormonal contraception and pelvic inflammatory disease.

Estrogen-progestogen contraception (OC) is significantly associated with a high prevalence of Chlamydia trachomatis in the lower genital tracts of young women. In contrast, pelvic inflammatory disease is less frequent and is associated with milder pelvic lesions in OC users than in non-users. A recent study suggests that OC use can be associated with silent endometritis and salpingitis. The usual clinical, biological and laparoscopic signs of acute and chronic pelvic inflammatory disease are described. As shown tby several cost-benefit analyses, C. trachomatis detection in family planning centers is cost-effective and the eradication of bacteria is obtained in 90% of cases by a new treatment: azithromycin (1 g for 1 day). Although the data clearly show that C. trachomatis screening is cost-effective, selection of the diagnostic laboratory tests used in such screening programs should be carefully evaluated relative to cost, feasibility, specificity and sensitivity, and should be adapted to the presumed prevalence in screened populations. A systematic screening is indicated in populations susceptible to a prevalence of 5% or more.

Acute Disease↗

PubMed2004

Fitz-Hugh-Curtis syndrome: a diagnosis to consider in women with right upper quadrant pain.

Fitz-Hugh-Curtis syndrome--inflammation of the liver capsule associated with genital tract infection--occurs in up to one fourth of patients with pelvic inflammatory disease (PID). Classically presenting as sharp, pleuritic right upper quadrant pain, usually but not always accompanied by signs of salpingitis, it can mimic many other common disorders such as cholecystitis and pyelonephritis.

Abdominal Pain↗

PubMed2004

Nodular histiocytic hyperplasia of the endometrium.

A case of nodular histiocytic hyperplasia of the endometrium is described. A 45-year-old Japanese woman was found to have an enlarged uterus during her annual checkup. Hysterectomy and bilateral salpingo-oophorectomy specimens revealed uterine leiomyomas, adenomyosis, and acute salpingitis. A 5-mm, well-demarcated, elevated endometrial nodule (an incidental finding) was present and consisted of round or polygonal histiocytic cells with eccentric nuclei and pale or granular cytoplasm. The nuclei were ovoid, reniform, or crescent-shaped and had fine chromatin and inconspicuous nucleoli, and the cytoplasm contained single or multiple vacuoles. Immunohistochemically, the histiocytic cells were positive for vimentin, CD68, and lysozyme and were negative for cytokeratin, S100 protein, estrogen and progesterone receptors, and CD10. Nodular histiocytic hyperplasia in the endometrium is considered to be a reactive process. Differentiation from neoplasms, including signet-ring cell carcinoma, in curettage specimens is critical to avoid unnecessary surgical resection.

Diagnosis, Differential↗

PubMed2005

Immunohistochemical detection of glucose transporter GLUT1 in benign and malignant fallopian tube epithelia, with comparison to ovarian carcinomas.

CONTEXT: Enhanced expression of GLUT1, a facilitative glucose transporter found on red blood cells, blood-brain barrier, and perineurium, has been described in a large spectrum of epithelial malignancies. OBJECTIVE: We present an immunohistochemical survey of GLUT1 expression in benign and malignant fallopian tube epithelia, and compare serous carcinomas of the fallopian tube and ovary. DESIGN: One hundred two routinely fixed and processed archival specimens (36 benign fallopian tubes, 29 primary tubal adenocarcinomas, and 37 primary ovarian adenocarcinomas) were immunostained with rabbit anti-GLUT1 and developed with streptavidin-biotin/diaminobenzidine. Only distinct membrane staining was scored positively (1+ to 3+). RESULTS: Benign tubes (n = 36) were either negatively stained (58.3%) or displayed rare weak staining (0.5+ to 1+, rarely 2+; 41.7%); of the latter, 4 specimens showed chronic salpingitis, and 6 showed hyperplasia (epithelial tufting and stratification). A case of florid hyperplasia with atypia in a BRCA1-positive patient was GLUT1 negative. Twenty-three (79.3%) of 29 tubal carcinomas were positively stained. Staining ranged from focal/scattered foci (n = 15) to multifocal/extensive (n = 8). Of the 6 nonstaining tubal carcinomas, 3 were undifferentiated. Nineteen tubal carcinoma sections showed residual benign epithelium, which was consistently nonstaining. Very frequently, GLUT1 staining intensified in cells furthest from stroma/ stromal capillaries and/or bordering necrotic zones. On average, GLUT1 staining in primary fallopian tube cancers was less extensive than in primary ovarian adenocarcinomas. CONCLUSIONS: GLUT1 immunostaining of fallopian tube adenocarcinomas was substantially stronger and more extensive than staining of benign tubal epithelium, consistent with previously described findings in carcinomas versus benign tissues from many primary sites. The frequent localization of GLUT1 positivity to regions most distal from stroma/stromal capillaries is consistent with known activation of GLUT1 expression by hypoxia-sensing cellular pathways and may constitute a survival advantage under hypoxic conditions present in malignancy. The difference in extent of GLUT1 staining between primary tubal and primary ovarian serous adenocarcinomas is discussed.

Adenocarcinoma↗

PubMed1991

[Vasitis nodosa: report of two cases].

Two cases of vasitis nodosa are reported hereon. The two patients were 47 and 40 year old males with desire of refertility. They were performed vasectomy 23 and 10 years ago. They were subjected to vaso-vasostomy. During the operations, spindle shaped nodules were found in the vas deferens at the site of the previous vasectomy. Histologically, they showed focal proliferation of epithelial components forming glands, where a plentiful number of sperms were present, and this was also associated with proliferative change of smooth muscle bundles of vas deferens. Some foci of spermatic granulomas were also found. This condition was similar those of salpingitis isthmica nodosa in the fallopian tube. Vasitis nodosa should be differentiated from metastatic adenocarcinoma histologically. This condition may lead to re-canalization.

Adult↗

PubMed1981

Endometritis related to Chlamydia trachomatis infection.

A 23-year-old woman had endometritis due to Chlamydia trachomatis infection. Chlamydia trachomatis was cultured from endometrial tissue obtained by biopsy, and elevated levels of serum antibodies, including IgM antibodies, to C. trachomatis were found. Cervical secretions were also positive for antibody. After treatment with tetracycline, endometrial cultures for C. trachomatis were negative and endometrial inflammation disappeared. Chlamydia trachomatis has been implicated in salpingitis, cervicitis, urethritis, and peritonitis, This case shows that endometritis may also result from C. trachomatis infection and in such instances may be a contributing factor in infertility.

Adult↗

PubMed1981

Pathology of the female reproductive tract in the koala, Phascolarctos cinereus (Goldfuss), from Victoria, Australia.

Lesions occurred in the female genital tract of 10 of 16 (63%) koalas, Phascolarctos cinereus, examined in Victoria. Inflammation of the uterine horns was seen in all 10 affected koalas; six of these had vaginitis and eight also had salpingitis. Cystic dilation of the ovarian bursa, occasionally with hydrosalpinx, was seen in six koalas with concurrent inflammatory lesions of the lower tract. Cystic lesions were considered to have developed as chronic sequelae to previous inflammation in the ovarian bursa. Lesions were not found in the ovaries. Lesions in the urinary tract lesions were noted in four koalas with genital tract pathology. The significance of these findings in relation to the reproductive success of the koala population on Phillip Island is discussed.

Animals↗

PubMed1986

Percutaneous drainage of pelvic abscesses: management of the tubo-ovarian abscess.

Percutaneous drainage of 35 pelvic abscesses secondary to pelvic inflammatory salpingitis are reported. Two methods of drainage were used: simple aspiration and catheter drainage. The success rate of aspiration drainage was 94 per cent, while catheter drainage yielded a 77 per cent success rate. The differences between pelvic abscess drainage and other types of percutaneous drainage are presented. The role of percutaneous drainage in the treatment of pelvic inflammatory disease is also discussed.

Abscess↗

PubMed1998

Syndromic management of sexually transmitted diseases. Part 4--The management of lower abdominal pain in women.

The symptom of lower abdominal pain in women is extremely common and does not always indicate the presence of serious illness. However, women with certain serious conditions such as pelvic inflammatory disease (PID), acute appendicitis, ectopic pregnancy and other complications of pregnancy may present initially with this symptom. Therefore, in managing women with lower abdominal pain care should be taken to exclude any serious condition before dismissing the patient. PID is a condition in which there is infection of the reproductive tract of women above the internal os of the cervix. This usually occurs as a result of an ascending cervical infection caused by Neisseria gonorrhoeae, Chlamydia trachomatis and anaerobic bacteria. The immediate and long term effects of PID include salpingitis, pelvic abscess, peritonitis, infertility and predisposition to tubal ectopic pregnancy. Women with lower abdominal pain should be assessed carefully and if PID is the cause they should be treated for gonococcal, chlamydial and anaerobic bacterial infection. Other gynaecological and surgical causes of lower abdominal pain and the immediate complications of PID require urgent referral to a specialist. PID is associated with significant morbidity and mortality.

Abdominal Pain↗

PubMedDate not supplied

Characteristics of H7N2 (nonpathogenic) avian influenza virus infections in commercial layers, in Pennsylvania, 1997-98.

Between January 1997 and March 1998, 11 cases of H7N2 avian influenza (nonpathogenic) were diagnosed at the Laboratory of Avian Medicine and Pathology, Kenneth Square, PA. These cases involved either commercial leghorn laying hens or leghorn pullets raised in Pennsylvania. Grossly and histologically, the most striking lesion associated with disease was salpingitis, usually with edema and occasionally with oviduct necrosis. Fluid, fibrinous, and egg yolk material in the peritoneum (egg yolk peritonitis) as well as pulmonary congestion and pulmonary edema were also frequently seen. Oviduct lesions have rarely been described in association with avian influenza infections in previous outbreaks. Mortality in affected houses was mild to moderate (less than 4% total mortality during the outbreak), with concurrent mild to moderate egg production declines (2%-4% at the time of disease onset).

Animals↗

PubMed1976

First oviduct transplants.

The first four cases of oviduct transplantation are described. In the first case, it consisted in the substitution of an oviduct that could not be recanalized after previous sterilization; two further patients had undergone salpingectomy for ectopic pregnancy, and one had been salpingectiomized for salpingitis. Donor oviducts preserved in liquid nitrogen at--196 degrees C were used as grafts. Rejection was prevented by countersensitization according to Theurer, also a first instance of the use of this method to be recorded in the literature.

Adult↗

PubMed1998

Primary fallopian tube carcinoma. Histopathology of 46 cases.

Here we report on histopathological findings from 46 cases of primary Fallopian tube carcinoma (PFTC) which were diagnosed and/or consulted in the Department of Pathology, University Medical School of Wrocław between 1982 and 1997. PFTCs can be classified according to the WHO International Classification of Ovarian Tumors. Reexamination of glass slides revealed at least five histological types of PFTC. Our results indicated better prognosis in patients with primary Fallopian tube endometrioid carcinoma rather than with serous carcinoma. Patients with PFTC expressing urothelial differentiation also show better prognosis. These findings confirm greater usefulness of primary ovarian carcinoma classification in the evaluation of the primary salpingeal carcinomas. The problems encountered in diagnosis, prognosis and therapy of PFTC are discussed.

Adult↗

PubMed1999

[The frequency of illnesses attended and its relationship with the maintenance of the family doctor's skill].

OBJECTIVE: To describe the incidence of health problems dealt with less often in primary care medical consultations, and to discuss its relationship with the maintenance of professional skill, with in-work training and case-load planning. DESIGN: A prospective observational study based on a year's recording. SETTING: The clinics of 44 primary care doctors from 10 autonomous communities. PATIENTS: 418,98 people were attended. INTERVENTIONS: The unit of analysis was the care episode. The incidence per 1000 people attended, in total and by demographic mean, of the less common health complaints (incidence less than 1/1000) was calculated. RESULTS: Primary care doctors attended at greater frequency than 1/1000 all diseases of eyes, ears, mastoids (except salpingitis) and menstrual disorders codifiable under the classification CIPSAP; almost all the respiratory, skin and locomotive diseases, and more than half of the circulatory, genito-urinary, digestive and endocrine-metabolic diseases. Incidence was less than 1/1000 in all the malignant tumours and contagious diseases, except viral hepatitis and tuberculosis in the urban setting. CONCLUSIONS: Primary care doctors do not often attend certain serious diseases, which are nevertheless present in many differential diagnoses (malignant tumours). This should be borne in mind in the training strategies aimed at maintaining doctor's diagnostic skills.

Clinical Competence↗