Pelvic actinomycosis associated with the use of intrauterine devices. Diagnostic and therapeutic criteria.

The association between IUD use and the occurrence of pelvic infections caused by actinomyces was investigated in 221 IUD users at a University of Turin clinic. Pelvic actinomycosis is chronic and progressive, and diagnostic error and/or inappropriate treatment often lead symptoms to persist for years. Each study participant had a Papanicolaou smear both before IUD insertion and during IUD use. No Pap smear was positive for actinomyces before IUD insertion; however, during IUD use, this microorganism was identified in 30 patients (14\%). There was no correlation between infection and socioeconomic status, a history of prior abortion, or IUD size. There was no significant difference between infection rates in nulliparae (12\%) and primiparae (14\%). Infection was found in 8\% of Papanicolaou class I patients and in 15\% of class II subjects. The mean duration of IUD use in women with positive Actinomyces vaginal smears was 32.1 months compared with 23.2 months for patients with negative findings. Finally, the risk of infection was higher among acceptors of plastic rather than copper IUDs. These findings confirm the association between IUD use and pelvic actinomycosis; a review of the literature reveals 395 such cases. When actinomycotic infection is discovered, immediate removal of the IUD is necessary and targetted antibiotic treatment should be commenced

[Anesthesia and resuscitation in major interventions in gynecologic surgery].

A number of biohumoral parameters have been looked at pre-, intra- and post-operatively in patients subjected to radical hysterectomy according to Wertheim, with lymphadenectomy according to Meigs or Valle, in the Obstetric and Gynaecology Clinic of Turin University. Patients' ages were between 26 and 60. On the basis of the premise that during and after every surgical operation metabolic type changes relating to the quality and quantity of organic fluids, serous proteins and electrolytes, haemoglobin, clotting times and bilirubin production are observed, a treatment that enables prophylaxis to be carried out and cuts complications to the minimum is recommended

[Hormonal regulation of uterine contraction].

A personal method has been used to study spontaneous kinetic activity of the uterus in 50 women during puerperium following miscarriage between the VIIIth and XIIth weeks. Modifications induced were evaluated in several sessions (510 recordings) and at various periods of time, following administration of: 50 mg of 17B oestradiol, 200 mg natural progesterone, 500 mg of natural progesterone, 250 mg of 17 hydroxyprogesterone caproate and 500 mg of 17 hydroxyprogesterone caproate. In the case of some of the patients, hysterotonometry was evaluated following intravenous oxytocin loading. The results pointed to an activation of the uterine pacemaker after oestrogenic loading, and a clear-cut progestinic block of contractile activity