An Attempt to Classify Gram-Stained Vaginal Smears with a Nugent Score of 4 into Four Bacterial Morphotypes at First Prenatal Visit

ObjectivesThe study aimed to test if there was an association between prevalent bacterial vaginosis (BV) and women reporting that their partner had other partners at the same time (partner concurrency). This association has not been assessed in a longitudinal cohort.MethodsThe Longitudinal Study of Vaginal Flora recruited a cohort of 3620 non-pregnant women aged 15–44 years who presented for routine primary healthcare at 12 clinics in Birmingham, Alabama. Behavioural questionnaires and vaginal smears were obtained quarterly for a year and BV was defined by a Nugent score 7 or higher as well as Amsel criteria. Mixed effects logistic regression was used to assess the relationship between prevalent BV and reporting that one's partner had other partners in the preceding 3–6 months time interval.ResultsNugent score prevalent BV was associated with both reporting that one's partner definitely (adjusted OR (aOR) 1.5; 95% CI 1.2 to 1.8) and possibly (aOR 1.5; 95% CI 1.2 to 1.8) engaged in partner concurrency in the preceding 3–6 months time period. Prevalent BV diagnosed by Amsel criteria was similar.ConclusionsA diagnosis of prevalent BV was associated with reporting that one's partner possibly or definitely engaged in partner concurrency.

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Sex, thrush and bacterial vaginosis

International Journal of STD & AIDS ◽

10.1258/0956462971918850 ◽

1997 ◽

Vol 8 (10) ◽

pp. 603-608 ◽

Cited By ~ 48

Author(s):

P E Hay ◽

A Ugwumadu ◽

J Chowns

Keyword(s):

Bacterial Vaginosis ◽

Sexual Intercourse ◽

Vaginal Flora ◽

Unprotected Intercourse ◽

Women Of Childbearing Age ◽

Childbearing Age ◽

Vaginal Smears ◽

Unprotected Sexual Intercourse ◽

Nugent Score ◽

Intermediate Pattern

Summary: Bacterial vaginosis (BV) is the most common cause of vaginal discharge in women of childbearing age. In some women it shows a relapsing and remitting course with apparently spontaneous onset and resolution. There are intermediate patterns of vaginal flora in which lactobacilli and other species co-exist. We asked women with recurrent BV to prepare vaginal smears daily, and to record symptoms, time of menstruation, sexual activity and use of douches or medication. We Gram-stained the smears and assigned a Nugent score for BV, and noted the presence of candida, pus cells, sperm and blood. Eighteen women collected daily vaginal smears for up to 10 months. Forty months of slides were collected in total. Bacterial vaginosis arose spontaneously on 23 occasions. We saw candida arise 11 times. Bacterial vaginosis appeared after candida on 9 of these 11 episodes. We saw BV regress spontaneously 13 times. Nine of these resolutions occurred within 48 h of unprotected sexual intercourse: BV only arose on one occasion within 48 h of unprotected intercourse. The intermediate pattern was seen for up to 10 days, and occurred as BV began or resolved in some women, and sometimes resolved without developing into BV. Bacterial vaginosis arose most often in the first 7 days of a menstrual cycle, and resolved spontaneously most often in mid-cycle. In women with recurrent BV, BV arises most often around the time of menstruation and resolves spontaneously in mid-cycle. Recurrences often follow an episode of candidiasis, and BV often regresses after unprotected sexual intercourse.

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Diagnosis of bacterial vaginosis on self-collected vaginal tampon specimens

International Journal of STD & AIDS ◽

10.1258/095646202760159693 ◽

2002 ◽

Vol 13 (8) ◽

pp. 559-563 ◽

Cited By ~ 4

Author(s):

P D J Sturm ◽

P Moodley ◽

G Nzimande ◽

R Balkistan ◽

C Connolly ◽

...

Keyword(s):

Bacterial Vaginosis ◽

Sexually Transmitted Infections ◽

Population Based ◽

Reference Standard ◽

Vaginal Smears ◽

Nugent Score ◽

Sexually Transmitted ◽

Speculum Examination ◽

Stis And Hiv ◽

Amsel Criteria

A vaginal tampon specimen was previously shown to be suitable for the molecular diagnosis of non-ulcerative sexually transmitted infections (STIs). Different tampon fluid preparations were evaluated for the diagnosis of bacterial vaginosis (BV). Women with pregnancy related problems were enrolled. Two observers evaluated the different tampon fluid preparations and vaginal smears collected during speculum examination using the Nugent score. Using the Amsel criteria, 21% of the 84 women enrolled were diagnosed with BV. Results of the tampon fluid preparations and vaginal smears showed excellent agreement for both observers (Spearman >0.80). The overall sensitivity and specificity was 91.7% (95% CI: 81.6-96.5) and 79.3% (95% CI: 67.2-87.8), respectively, using the Amsel criteria as reference standard. The tampon provides a specimen for the combined diagnosis of non-ulcerative STIs and BV. This non-invasively collected specimen may facilitate self-initiated testing and population-based studies as well as longitudinal studies that are necessary to gain insight in the epidemiology of BV related to STIs and HIV.

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High-speed brightfield 3-D imaging and 3-D image analysis of thick and overlapped cell clusters in cytological preparations

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100168827 ◽

1994 ◽

Vol 52 ◽

pp. 218-219

Author(s):

Robert W. Mackin

Keyword(s):

Image Analysis ◽

High Speed ◽

Three Dimensional ◽

Image Data ◽

Ccd Camera ◽

Objective Lens ◽

Array Processor ◽

Vaginal Smears ◽

Low Contrast ◽

Computer Controlled

This paper presents two advances towards the automated three-dimensional (3-D) analysis of thick and heavily-overlapped regions in cytological preparations such as cervical/vaginal smears. First, a high speed 3-D brightfield microscope has been developed, allowing the acquisition of image data at speeds approaching 30 optical slices per second. Second, algorithms have been developed to detect and segment nuclei in spite of the extremely high image variability and low contrast typical of such regions. The analysis of such regions is inherently a 3-D problem that cannot be solved reliably with conventional 2-D imaging and image analysis methods.High-Speed 3-D imaging of the specimen is accomplished by moving the specimen axially relative to the objective lens of a standard microscope (Zeiss) at a speed of 30 steps per second, where the stepsize is adjustable from 0.2 - 5μm. The specimen is mounted on a computer-controlled, piezoelectric microstage (Burleigh PZS-100, 68/μm displacement). At each step, an optical slice is acquired using a CCD camera (SONY XC-11/71 IP, Dalsa CA-D1-0256, and CA-D2-0512 have been used) connected to a 4-node array processor system based on the Intel i860 chip.

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ABSENCE OF COMPENSATORY OVARIAN HYPERTROPHY IN RATS WITH ANTERIOR HYPOTHALAMIC LESIONS

Acta Endocrinologica ◽

10.1530/acta.0.0360180 ◽

1961 ◽

Vol 36 (2) ◽

pp. 180-184 ◽

Cited By ~ 21

Author(s):

Béla Flerkó ◽

Vera Bárdos

Keyword(s):

Essential Role ◽

Ovarian Tissue ◽

Vaginal Smear ◽

Corpora Lutea ◽

Vaginal Smears ◽

Hypothalamic Area ◽

Unilateral Ovariectomy ◽

Hypothalamic Lesions ◽

Oestrogen Level ◽

Stimulation Of

ABSTRACT Absence of compensatory ovarian hypertrophy in »constant oestrus rats« from lesions in the anterior hypothalamic area suggests that nervous elements localized in this region play an essential role in the stimulation of gonadotrophin output by diminution of the blood oestrogen level. The constant vaginal oestrus after unilateral ovariectomy in the majority of animals was, however, repeatedly interrupted by vaginal smears of a dioestrous type. The appearance of a dioestrous vaginal smear in the »hypothalamic constant oestrus rats« is often associated with some luteinisation. It is assumed that diminution of the blood oestrogen level by reduction of ovarian tissue in these animals may bring about a release of LH sufficient to cause formation of corpora lutea.

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ANDROST-5-ENE-3β,17β-DIOL IN OVARY OF POST-MENOPAUSAL HYPEROESTROGENIC WOMEN

Acta Endocrinologica ◽

10.1530/acta.0.0580364 ◽

1968 ◽

Vol 58 (3) ◽

pp. 364-376 ◽

Cited By ~ 5

Author(s):

S. Pesonen ◽

M. Ikonen ◽

B-J. Procopé ◽

A. Saure

Keyword(s):

Ovarian Tissue ◽

Cortical Layer ◽

Vaginal Smears ◽

Incubation Experiments ◽

Cell Groups ◽

Post Menopause ◽

Reducing Activity ◽

Post Menopausal ◽

One Year

ABSTRACT The ovaries of ten patients, at least one year after the post-menopause, were incubated with two Δ5-C19-steroids and also studied histochemically. All these patients had post-menopausal uterine bleeding and increased oestrogen excretion of the urine. The urinary estimations of gonadotrophins, 17-KS, 17-OHCS and pregnanediol were carried out on all patients. Vaginal smears were read according to Papanicolaou, and the endometrium and ovaries were studied histologically. The incubation experiments indicate the presence of Δ5-3β-hydroxysteroid-dehydrogenase. When androst-5-ene-3β,17β-diol was used as precursor the formation of testosterone occurred without any concomitant production of DHA and/or androstenedione. This seems to indicate the possible role of the Δ5-pathway in the formation of testosterone by post-menopausal ovarian tissue. The histochemical reactions indicated a reducing activity on NADH, lactate and glucose-6-phosphate, in certain corpora albicantia, atretic follicles and in diffuse thecoma regions in the cortical layer of the ovary. Steroid-3β-ol-dehydrogenase and β-hydroxybutyrate-dehydrogenase were found only at the edges of certain corpora albicantia, in some individual stroma cell groups and in some atretic follicles. Our studies, both biochemical and histochemical, suggest that the observed increase in the urinary oestrogens of the patients studied might in part at least, be of ovarian origin. This opinion is also supported by the postoperative oestrogen values.

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PHYSIOLOGICAL EFFECTS OF THE PINEAL GLAND IN ANDROGEN-STERILIZED FEMALE RATS

Acta Endocrinologica ◽

10.1530/acta.0.0630667 ◽

1970 ◽

Vol 63 (4) ◽

pp. 667-678 ◽

Cited By ~ 4

Author(s):

Russel J. Reiter

Keyword(s):

Pineal Gland ◽

Reproductive Organs ◽

Female Rats ◽

Inhibitory Influence ◽

Light Deprivation ◽

Vaginal Smears ◽

Adult Rats ◽

Androgen Treatment ◽

Postnatal Treatment ◽

Cervical Ganglia

ABSTRACT The influence of early androgen treatment, light deprivation (by blinding), pinealectomy and superior cervical ganglionectomy on the reproductive system of female rats was tested. Early postnatal treatment of rats with testosterone propionate caused adult rats to exhibit the characteristic signs of androgen sterilization; these included polyfollicular ovaries, normal-sized uteri and persistent vaginal cornification. If early androgentreated rats also were blinded the ovaries were smaller in size and contained fewer follicles, the uteri were greatly reduced in size and the incidence of vaginal oestrus was decreased by approximately 50% If in addition to blinding, androgen-sterilized animals were subjected to either removal of the pineal gland or superior cervical ganglia, the reproductive organs and the vaginal smears were indistinguishable from those of testosterone-treated rats with eyes. These data indicate that the inhibitory influence of blinding on the pituitary-ovarian axis was mediated through the sympathetic nervous system and the pineal gland. The restraining influence of light deprivation on the growth of the reproductive organs was not permanent as illustrated by the fact that if these animals were kept to 120 days of age the ovaries and uteri grew to the same level as those of pinealectomized control rats.

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