The hypothesis of higher‐level relationships among extinct and extant hymenopterans presented by Rasnitsyn in 1988 is widely cited but the evidence has never been presented in the form of a character matrix or analysed cladistically. We review Rasnitsyn’s morphological work and derive a character matrix for fossil and recent hymenopterans from it. Parsimony analyses of this matrix under equal weights and implied weights show that there is little support for Rasnitsyn’s biphyletic hypothesis, postulating a sister‐group relationship between tenthredinoids and macroxyelines. Instead, the data favour the conventional view that Hymenoptera excluding the Xyelidae are monophyletic. Higher‐level symphytan relationships are well resolved and, except for the basal branchings, largely agree with the tree presented by Rasnitsyn. There is little convincing support for any major divisions of the Apocrita but the Microhymenoptera and the Ichneumonoidea + Aculeata appear as monophyletic groups in some analyses and require only a few extra steps in the others. The Evaniomorpha appear as a paraphyletic grade of basal apocritan lineages and enforcing monophyly of this grouping requires a considerable increase in tree length. The Ceraphronoidea are placed in the Proctotrupomorpha, close to Chalcidoidea and Platygastroidea. This signal is not entirely due to loss characters that may have evolved independently in these taxa in response to a general reduction in size. The analyses suggest that the Proctotrupomorpha may be monophyletic if the ceraphronoids are included. The Chrysidoidea are resolved in good agreement with relationships proposed by Brothers and Carpenter in 1993 but in conflict with the tree presented by Rasnitsyn. Rasnitsyn’s data are largely uninformative about relationships among the Aculeata sensu stricto. The results are compared with those of other recent analyses of higher‐level hymenopteran relationships.

The expected 4-week cure rate after conventional treatment of bacterial vaginosis are only 65-70%. In an attempt to improve the cure rate by adding probiotic lactobacilli we performed a double-blind placebo-controlled study of adjuvant lactobacilli treatment after an open treatment with vaginal clindamycin ovules. Women with bacterial vaginosis as defined by Amsel's criteria were treated with clindamycin ovules. Vaginal smears were collected and analysed according to Nugent's criteria. During the following menstruation period the women used, as an adjuvant treatment, either lactobacilli-prepared tampons or placebo tampons. The lactobacilli tampons were loaded with a mixture of freeze-dried L. fermentum, L. casei var. rhamnosus and L. gasseri. The cure rate was recorded after the second menstruation period. There was no improvement in the cure rate after treatment with lactobacilli-containing tampons compared to placebo tampons; the cure rates as defined by Amsel's criteria were 56% and 62%, respectively, and 55% and 63%, as defined by Nugent's criteria. This is the first study to report cure rates for women with 'intermediate' wet smear ratings according to Nugent's classification and this group had an overall cure rate of 44%. The cure rate of treatment of bacterial vaginosis was not improved by using lactobacilli-prepared tampons for one menstruation.

Preoperative treatment for at least three days with clindamycin cream significantly reduced the risk for developing signs of post-abortion infection only among women with preoperative abnormal vaginal flora (BV and intermediate flora).

Papanicolaou-stained cervicovaginal smears (Pap smears) are used to screen for cervical cancer. Since there is a lack of consensus in published reports respecting the efficacy of Pap-stained smears in BV diagnostics, there is a need to validate their use for diagnosis of BV. Slides from the international BV00 workshop were Pap stained and independently analyzed by four investigators under a phase-contrast microscope. All workshop slides--whether Pap-stained, Gram-stained or rehydrated air-dried smears--were scored according to the same Nugent classification. The diagnostic accuracy of Pap smears for diagnosis of BV had a sensitivity of 0.85 and a specificity of 0.92, with a positive and negative predictive value of 0.84 and 0.93, respectively. The interobserver weighted kappa index was 0.86 for Pap-stained smears compared to 0.81 for Gram-stained smears, and 0.70 for rehydrated air-dried smears using the mean Nugent score as the criterion standard. Provided that the samples are taken from equivalent locations (the vaginal fornix) and analyzed according to the same scoring criteria, there is no discernable difference in the diagnostic accuracy of the three smear-staining methods. The Pap-stained vaginal smears can be used as a wholly adequate alternative to Gram-stained smears for BV diagnosis.

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