Objective: This study was performed to determine the prevalence of GBS and to identify GBS colonisation risk factors in a multicultural population of pregnant women in The Netherlands. We calculated predictive values of cultures in pregnancy for intrapartum GBS carriage. Study design: From a total of 1702 women visiting several antenatal outpatient departments, rectovaginal swabs were collected at 35-37 weeks' gestation. In 761 women swabs were repeated at time of delivery. Carriage of GBS late in third trimester and at time of delivery was analysed in relation to age, parity, ethnicity and socio-economic status. Results: Twenty-one percent was GBS carrier late in pregnancy. Compared to Europeans, African women were at a higher risk (29%, RR 1.4, CI 1.1-1.7) and Asian women were at lower risk (13%, RR 0.6, CI 0.4-0.8) for GBS carriage. No differences in colonisation were found between women with respect to age, parity or socio-economic background. Positive predictive value of GBS carriage at 35-37 weeks' gestation for carriage at time of parturition was 79% and negative predictive value was 93%. Conclusions: It was not possible to identify a group of pregnant women at high risk for GBS colonisation. Predictive values of antenatal genital group B streptococci cultures at 35-37 weeks' gestation for intrapartum GBS carriage are lower than previously reported. # 2005 Published by Elsevier Ireland Ltd.

Inclusion of oropharyngeal and anorectal tests in the STD screening protocol increases the prevalence of chlamydia and gonorrhea in women. Screening of anatomical sites based on sexual history is preferred over a symptom-based protocol.

BackgroundSexually transmitted infection (STI) screening programmes are implemented in many countries to decrease burden of STI and to improve sexual health. Screening for Chlamydia trachomatis and Neisseria gonorrhoeae has a prominent role in these protocols. Most of the screening programmes concerning men having sex with men (MSM) are based on opportunistic urethral testing. In The Netherlands, a history-based approach is used. The aim of this study is to evaluate the protocol of screening anatomic sites for C. trachomatis and N. gonorrhoeae infection based on sexual history in MSM in routine practice in The Netherlands.MethodsAll MSM visiting the clinic for STI in The Hague are routinely asked about their sexual practice during consulting. As per protocol, tests for urogenital, oropharyngeal and anorectal infection are obtained based on reported site(s) of sexual contact. All consultations are entered into a database as part of the national STI monitoring system. Data of an 18 months period were retrieved from this database and analysed.ResultsA total of 1455 consultations in MSM were registered during the study period. The prevalence of C. trachomatis and N. gonorrhoeae per anatomic site was: urethral infection 4.0% respectively and 2.8%, oropharynx 1.5% and 4.2%, and anorectum 8.2% and 6.0%. The majority of chlamydia cases (72%) involved a single anatomic site, which was especially manifest for anorectal infections (79%), while 42% of gonorrhoea cases were single site. Twenty-six percent of MSM with anorectal chlamydia and 17% with anorectal gonorrhoea reported symptoms of proctitis; none of the oropharyngeal infections were symptomatic. Most cases of anorectal infection (83%) and oropharyngeal infection (100%) would have remained undiagnosed with a symptom-based protocol.ConclusionsThe current strategy of sexual-history based screening of multiple anatomic sites for chlamydia and gonorrhoea in MSM is a useful and valid guideline which is to be preferred over a symptom-based screening protocol.

Infectious ileocecitits caused by yersinia, campylobacter, and salmonella -clinical, radiological and us findings Puylaert, J.B.C.M.; van der Zant, F.M.; Mutsaers, J.A.E.M. Published in: European Radiology DOI:10.1007/s003300050098Link to publication Citation for published version (APA): Puylaert, J. B. C. M., van der Zant, F. M., & Mutsaers, J. A. E. M. (1997). Infectious ileocecitits caused by yersinia, campylobacter, and salmonella -clinical, radiological and us findings. European Radiology, 7(1), 3-9. https://doi.org/10.1007/s003300050098 General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: https://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. Download date: 20 Jun 2019 IntroductionIt is well known that the bacteria Yersinia enterocolitica, Campylobacter jejuni, and Salmonella enteritidis are important causes of diarrhea in humans. It is less known that the same microorganisms may also cause an appendicitis-mimicking syndrome, in which case the infection is confined to the ileocecal area [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. In these patients right lower abdominal pain is the predominant symptom, whereas diarrhea is absent or only mild. Due to this symptomatology, this otherwise innocuous and self-limiting bowel infection may lead to an unnecessary laparotomy for suspected appendicitis.The use of US with graded compression has greatly enhanced the diagnostic accuracy in patients with acute right lower abdominal pain [21][22][23][24]. In patients with the above-described appendicitis-mimicking syndrome due to Yersinia, Campylobacter, or Salmonella, a fairly characteristic US pattern can be demonstrated. This enables a rapid diagnosis and therewith exclusion of appendicitis [25][26][27][28][29][30][31]. In view of the constant clinical and morphological features and its common bacterial origin, the condition has been named bacterial ileocecitis (Table 1) [19]. Because analogous clinical, sonographic, and barium findings have also been described in viral, fungal, protozoan, and helminthic infections of the ileocecal area, the term infectious ileocecitis may be more appropriate [32][33][34][35][36].This article reflects a 9-year experience with infectious ileocecitis caused by Yersinia, Campylobacter, and Salmonella and describes its clinical, microbiological, epidemiological, radiolog...

Cyclooxygenase (COX) catalyzes the first committed step in the synthesis of prostanoids, a large family of arachidonic acid metabolites comprising prostaglandins, prostacyclin and thromboxanes. The COX enzyme is a major target of nonsteroidal antiinflammatory drugs. Two isoforms of COX enzymes have been identified: the constitutively expressed COX-1 and the inducible, highly regulated COX-2. Recently, COX has been found to be expressed in different areas of the brain, and inhibitors of COX enzyme(s), particularly the COX-2 inhibitors, may attenuate inflammation associated with brain disorders. Although COX-1 is constitutively expressed in different areas of brain, there has been a conceptual neglect of the role of COX-1 inhibitors in various neurodegenerative and neuropsychiatric disorders. The present review summarizes the current understanding of COX expression in the central nervous system and the effects of COX inhibitors (both nonselective and selective COX-2 inhibitors) in epilepsy. It is speculated that COX inhibition will be a useful ameliorative adjunct in the management of epilepsy and related disorders.