Treatment with ulipristal acetate for 13 weeks effectively controlled excessive bleeding due to uterine fibroids and reduced the size of the fibroids. (Funded by PregLem; ClinicalTrials.gov number, NCT00755755.).
Nucleic Acid Amplification Tests (NAATs) for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) have become routine. These methods are validated for use with urogenital samples and have a faster turn-around-time for results with automation. Testing of non-validated samples is common which raises concerns about assay performance. In Australia, the 2005 Public Health Laboratory Network (PHLN) guideline recommends repeat testing of all initial positive GC NAAT results with a suitable alternate NAAT assay. In this study, results from > 70,000 patient samples from 2 laboratories were reviewed in accordance with the PHLN recommendations. The laboratories used the APTIMA Combo 2 (AC2) and APTIMA Neisseria gonorrhoeae (AGC) assays with the PANTHER instrument.72,253 AC2 results were available for analysis which included 1,174 (1.68%) initially AC2 reactive (positive or equivocal) samples which also had results for the AGC assay used as the confirmatory assay. For the reactive samples, the agreement between the AC2 and AGC assays occurred in 97.19% of samples; 1135 were positive in both assays and 6 were equivocal in both assays. Sample types tested included those with manufacturer's validation claims; urine, ThinPrep, vaginal, endocervical and urethral swabs and non-validated samples including throat, rectal, eye and joint fluids. Samples from throat swabs showed the highest numbers of discordant results followed by rectal swab samples. The percentage agreement of results obtained from all sample types was excellent, with an overall PPV of > 99%.Without confirmatory testing, false positive results would have been reported for 13 samples representing 0.02% of all samples tested. This study demonstrates that the initial AC2 results can be accepted with high confidence. Background Bacterial vaginosis (BV) is the most common cause of vaginal discharge in women. Since BV is associated with significant morbidity, accurate tools for diagnosing the disease are important. The Amsel criteria (AC) and Nugent score (NS) are currently used for BV diagnosis. Recently, a number of PCR-based tests providing objective, sensitive and specific BV detection have been described. This study aimed to evaluate a newly developed BV test based on quantitative detection of Gardnerella vaginalis, Atopobium vaginae, Lactobacillus spp. and total Bacteria using multiplex PCR. Methods PCR criteria were elaborated based on the relative counts of the targeted bacteria to classify vaginal microflora as BV, no BV or intermediate. Vaginal samples for the test evaluation were obtained from 274 patients addressing a gynaecologist for routine examination. All participants were of reproductive age, not pregnant and not menstruating at the time of enrollment. BV was diagnosed using the AC and NS. Results According to the NS results, 66 patients were BV positive, 156 were BV negative, and 52 were classified as intermediate. All patients positive by the NS were positive by the AC, and all patients negative by the NS were negative by the AC. Among 66 BV posi...
Predicting the outcome of in vitro fertilization is of great importance when deciding on the use of this method. The purpose of the study was to determine the echographic and morphological criteria for the readiness of the endometrium for implantation to increase the effectiveness of IVF. The case-control method was used to select and examine 250 women, divided into 3 groups: group 1 (main group, IVF 1, n=87) included infertile women planning IVF for the first time, group 2 (comparison group, IVF 2, n=83) - women with unsuccessful previous IVF attempts; in group 3 (control group, n=80) - women with a history of physiological pregnancy that successfully ended in natural childbirth. An ultrasound examination of the pelvic organs and morphological examination of the biopsy of the uterine mucosa in a significant part of women from the IVF 1 and IVF 2 groups revealed signs of chronic endometritis, which is the cause of infertility. According to 2D echography and Doppler ultrasound data, the echographic criteria for the readiness of the endometrium for IVF are determined: the thickness of the endometrium is more than 8 mm, the correspondence of the endometrial echostructure to the phase of the menstrual cycle, the uniformity of the M-echo, the absence of hyper- and hypoechoic inclusions, and the absence of hemodynamic disturbances in the uterine vessels and in the vascular basin of the pelvis in the second phase of the menstrual cycle. The morphological criteria of the readiness of the endometrium for implantation, in our opinion, include the absence of inflammatory changes in the endometrium (focal and diffuse lymphoid cell infiltrates, plasma cells in the stroma), as well as sclerotic changes in the walls of the spiral arteries. Under these conditions, the prognosis of the effectiveness of the IVF program is favorable.
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