The phagocytotic activity of monocytes from diabetic patients and healthy controls was studied. It was found that the number of phagocytizing cells from diabetic patients was significantly reduced in comparison with that from control individuals. However, the number of bacteria phagocytized per cell was similar in both groups. Plasma from healthy controls added to diabetic monocytes did not cause any significant change in their phagocytotic capacity. Addition of insulin to the plasma of diabetic patients failed to alter the number of phagocytizing diabetic monocytes. Similarly, addition of glucose to control plasma did not affect the number of control monocytes capable of phagocytosis. Protein synthesis was increased during phagocytosis in both control and diabetic cells. The importance of monocytes in the defense mechanism of the organism is discussed.
A study was made of the cervical and upper vaginal flora in menopausal women, in an attempt to determine whether such women are predisposed to infections when undergoing gynecologic operations. The series comprised 72 women (age range, 44-80 years) classified as follows: a) 35 with a natural menopause, b) 18 with a surgical menopause induced by abdominal panhysterectomy, and c) 19 postmenopausal women after vaginal hysterectomy performed for genital prolapse. The vaginal flora of these menopausal women consisted predominantly of Gram-positive bacteria which, together with the Gram-negative bacteria, conformed to the normal pattern of microorganisms in the vagina. Such bacteria also are found in women of child-bearing age, but occasionally they can be pathogenic. Despite the inherent biohormonal changes of the memopause, expressed especially by the low estrogen level, 26.4 percent of the cultures in our study were sterile, even after major vaginal operations. Thus, the pattern of the vaginal flora, even though occasionally pathogen, should not be a contraindication to gynecologic surgical procedures in postmenopausal women. Even when vaginal cultures show the presence of these bacteria, it does not seem necessary to use prophylactic antibiotic and hormonal therapy routinely. Rather, it should be given selectively, depending upon the local state of the tissues and upon the postoperative course.
Staphylococcus epidermidis (SE) is the leading pathogen of prosthetic valve endocarditis. At the same time it is a very rare cause of native valve endocarditis and it follows a clinical course and outcome similar to Streptococcal viridans endocarditis. We report here the case of a 41year-old man with a community acquired SE endocarditis of a native aortic valve. Despite early surgical intervention, the case followed an acute and fatal course.
Summary
From 200 women with term pregnancy and intact membranes at the beginning of labor we collected vaginal smears for Candida albicans cultures. From their newborns we collected, immediately after birth, tracheal aspirates and cultured them for C. albicans.
Our results differ from those reported in the literature. From the 400 patients (200 mothers; 200 newborns), only in 17 (8.5%) vaginal smears, and only in 13 (6.5%) tracheal aspirates was C. albicans isolated. Other authors reported a percentage of 27 to 30 % positive vaginal cultures and 23.8 % infected newborns from mothers with vaginal candidiasis.
We have no explanation for the different results obtained, although none of the examined women has received antimycotic treatment during their pregnancy. It is probable that the newborn in our series have swallowed the C. albicans cells during passage through the infected vagina. None of the babies in our series presented signs of congenital infection either immediately after birth or during the first month of life.
In the light of our results, we consider unnecessary the initiation of prophylactic treatment of the mother during the third trimester of pregnancy, in order to avoid severe C. albicans infections in their children.
Zusammenfassung
Kulturen zum Nachweis von Candida albicans wurden von vaginalen Abstrichen bei 200 Frauen, mit ganzen Fruchthäuten, bei der Aufnahme im Geburtssaal angelegt. Vom Trachealaspirat der Neugeborenen dieser Mütter wurden auch Kulturen hergestellt.
Während andere Autoren 27–30 % positive Vaginalkulturen bei Schwangeren und bei deren Neugeborenen 23,8 % Candida‐lnfektionen angaben, fanden wir nur 17 (8,5 %) positive Pilzkulturen und im Trachealaspirat nur 13 (6,5 %).
Obgleich keine unserer Patientinnen eine antimykotische Therapie in der Schwanger‐schaft erhielt, können wir keine Erklärung für unsere Resultate finden. Es ist anzuneh‐men, daß die Neugeborenen beim passieren des infizierten Geburtskanals die Candida‐Zellen aspiriert haben. Keines unserer Neugeborenen wies irgendwelche Zeichen einer kongenitalen Candidose, audi nicht einen Monat nach der Geburt, auf.
Bewußt schlagen mehrere Autoren eine prophylakcische antimykotische Therapie im dritten Schwangerschaftstrimester vor, um Infektionen der Neugeborenen zu verhüten.
Auf Grund unserer Resultate sehen wir soldi eine Therapie für nicht angebracht.
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