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Gilles R. G. Monif, MD

Gilles R. G. Monif, MD

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The human papilloma viruses (HPVs) are among the widespread sexually transmitted pathogens infecting women. Like HIV, HPV–s

The CDC recommends that sexually active adolescent girls be screened for Chlamydia trachomatis infection at least annually and that all sexually active women aged 20 to 25 years and women aged 25 years or older who have risk factors also receive an annual screening.1 How well are these screening practices being observed and what are the implications?

Third-degree perineal lacerations reputedly occur in
2.2% to 19% of vaginal deliveries in the United
States.1,2 Breakdown of a third- or fourth-degree
perineal repair can lead to incontinence of stool or flatus,
rectovaginal fistula, or sexual dysfunction.3,4 Infection at
the operative site occurs in up to 12% of cases,5 and a key
factor in successful anal sphincter repair is the absence of

A new study confirmed the value of real-time polymerase chain reaction (PCR) assay as a rapid method of screening for group B streptococci (GBS) colonization during parturition.1 Using real-time automated PCR assay, DNA amplification testing, and standard culture, Edwards and colleagues1 comparatively looked at the detection of GBS colonization in women who were in the 35th to 37th week of pregnancy and in women who were about to give birth. A true-positive result was defined as a positive molecular test and a positive culture finding. Compared with culture, the sensitivity rate of PCR was 91.1%, the specificity was 96.0%, the predictive value was 87.8%, the negative predictive value was 97.1%, and the accuracy was 94.8%. As anticipated, PCR assay was more sensitive than DNA amplification testing (91.1% vs 79.3%). Neither specificity, positive predictive value, nor detection of GBS prevalence was statistically divergent.

Accurate diagnosis of nonviral
infectious diseases of
the vagina is largely contingent
on the clinician’s ability
to do a sophisticated wet
mount/potassium hydroxide (KOH)
preparation examination—more specifically
what is termed a “level II wet
mount examination” (Table). Clinical
assessment in conjunction with a proper
wet mount/KOH analysis will usually
identify the causative organism or
suggest exclusion of diagnostic possibilities

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