Causative Role of Sexually Transmitted Infections in the Development of Chronic Cystitis Complicated with Leukoplakia of the Bladder

The objective of this study was the investigation of the influence of chlamydial, mycoplasmal and trichomonas infection on the development of urinary bladder leukoplakia. The article presents the results of the examination of women with chronic cystitis complicated with leukoplakia of the bladder, and associated with concomitant sexually transmitted infections, including the results of culture analysis of the cervical canal content and urinary bladder biopsy samples, as well as molecular-biological analyses confirming the presence of sexually transmitted infections, pathomorphological characteristics of tissue samples from leukoplakia foci typical for different types of infectious agents. In this study, 60 women with chronic cystitis, complicated with leukoplakia of the bladder and associated with concomitant sexually transmitted infections were examined. Using PCR diagnostics, Mycoplasma hominis and Chlamydia albicans were found to be the most frequently occurring agents, followed by Ureaplasma urealyticum, Chlamydia trachomatis and Trichomonas vaginalis. The results of culture analyses demonstrated that M. hominis and U. urealyticum were prevalent in patients with chronic urinary tract inflammatory processes, followed by Tr. vaginalis. Candida fungi show practically the same frequency of occurrence. The pathomorphological examination of the foci of leukoplakia in the urinary bladder (in 30 subjects) demonstrated metaplasia of the transitional epithelium to the stratified pavement squamous epithelium with inflammatory cellular infiltration of the lamina propria in all types of infections. The intensity of the urothelial transformation and stromal inflammatory processes were determined by the type of predominant infection. Pathomorphological characteristics of the foci of leukoplakia correlate with the etiology of chronic inflammation and are relevant for etiological diagnosis and treatment

Causative Role of Ureaplasma Urealyticum and other Sexually Transmitted Infections in the Urethral Meatus Polyp Development in Women

The objective of this study was the investigation of the influence of ureaplasmal infection on the development of urethral meatus polyps in women. The article presents the results of the examination of women with chronic cystitis and urethritis over a 0.5- to 5-year duration, complicated by the presence of urethral meatus polyps and associated with concomitant Ureaplasma urealyticum and other sexually transmitted infections (STI). This was based on the culture analysis of the cervical and urethral content, and PCR-diagnostics of STI, as well as a complex pathomorphologic study of the resected polyps, including electron microscopy. In this study, 98 women between 45 and 60 years (52.5±4.9 years) were examined, who had undergone radiowave resection of the polyps: 52 women were infected by STI, including Ureaplasma urealyticum, Mycoplasma genitalium, Mycoplasma hominis, Chlamydia trachomatis and Trichomonas vaginalis, while the remaining 46 women had been diagnosed as not having STI. According to the culture results in the women with STI, U. urealyticum was identified as a monoinfection in 69% of cases, while in the remaining 31% of cases it was evident in the form of mixed infections, mainly in association with Mycoplasma hominis (17.5%) and Trichomonas vaginalis (13.5%). Pathomorphological examination of the urethral meatus polyps of the women with U. urealyticum and other STI demonstrated the proliferative character of the remodeling of the surface epithelium with hyperplasia, acanthosis, and keratinization of the stratified squamous epithelium and synchronous changes in the underlying connective tissue - impaired microcirculation and the diffuse inflammatory cell infiltrates with transepithelial leukopedesis. Using electron microscopy in the fibroblasts and plasma cells of the resected polyps the markers of U. urealyticum were detected in patients with negative results of the bacteriological diagnostic methods

Vitamin D Status Among Children With Juvenile Idiopathic Arthritis: A Multicenter Prospective, Non-randomized, Comparative Study

BackgroundJuvenile idiopathic arthritis (JIA) is a chronic autoimmune disease characterized by destructive and inflammatory damage to the joints. The aim in this study was to compare vitamin D levels between children and adolescents, 1–18 years of age, with juvenile idiopathic arthritis (JIA) and a health control group of peers. We considered effects of endogenous, exogenous, and genetic factors on measured differences in vitamin D levels among children with JIA.MethodsOur findings are based on a study sample of 150 patients with various variants of JIA and 277 healthy children. The blood level of vitamin D was assessed by calcidiol level. The following factors were included in our analysis: age and sex; level of insolation in three regions of country (center, south, north); assessment of dietary intake of vitamin D; effect of prophylactic doses of cholecalciferol; a relationship between the TaqI, FokI, and BsmI polymorphisms of the VDR gene and serum 25(OH)D concentration.ResultsWe identified a high frequency of low vitamin D among children with JIA, prevalence of 66%, with the medial level of vitamin D being within the range of “insufficient” vitamin D. We also show that the dietary intake of vitamin D by children with JIA is well below expected norms, and that prophylactic doses of vitamin D supplementation (cholecalciferol) at a dose of 500–1,000 IU/day and 1,500–2,000 IU/day do not meet the vitamin D needs of children with JIA. Of importance, we show that vitamin D levels among children with JIA are not affected by clinical therapies to manage the disease nor by the present of VDR genetic variants.ConclusionProphylactic administration of cholecalciferol and season of year play a determining role in the development of vitamin D deficiency and insufficiency