Granulomatosis in the pulmonary system leads to chronic coughs, palpitations, atypical chest pain, pulmonary hypertension, cor pulmonale, and ultimately death. Praziquantel (PZQ) effectively treats all forms of schistosomiasis, sellectchem is inexpensive, and only requires 2 to 3 doses for 1 day. Although it has minimal side effects, it cannot prevent future infections. Female genital schistosomiasis (FGS) is predominantly caused by S haematobium. Women suffer severe morbidity and mortality during their reproductive years due to FGS. As the eggs penetrate the urinary system, they migrate to the female genital region and form granulomas in the uterus, fallopian tube, and ovaries, leading to the development of uterine enlargement, menstrual disorders, cervicitis, and infertility.
The most effective way to decrease the spread of schistosomiasis is through prevention. Interventions that focus on mass treatments of PZQ (without diagnosis) decrease the prevalence of this disease, and in some cases, mass treatment has reduced the infection rate by as much as 15%.
Oppegaard KS, Lieng M, Berg A, et al. , BJOG 2010;117:53�C61 [PubMed]. Cervical ripening is usually thought of in the context of pregnancy. Enhancing cervical dilatation prior to uterine evacuation or the induction of labor is well documented but little is known about ��ripening�� in postmenopausal women. When access to the uterus is required to investigate pathology via a hysteroscope, cervical dilatation is desirable to allow the atraumatic passage of a 10 mm diameter operating instrument.
Damage from a grasping vulsellum or tenaculum to the anterior lip or forcible expansion with Hegar dilators to the cervical canal can be reduced by preoperative preparation. Oppegaard and colleagues from Denmark studied the use of misoprostol prior to hysteroscopic evaluation in postmenopausal women. All patients were undergoing endometrial investigation and had received 2 weeks of treatment with 25 ��g of vaginally delivered estradiol and were then allocated to 1000 ��g misoprostol or placebo. The operators were blind to the immediate pretreatment, which was self-administered by the patients the evening before. The misoprostol was effective in that it allowed less force to be used in dilating the cervix. The method was acceptable to the patients, inexpensive, with minimal side effects.
Childhood Outcomes After Prescription of Antibiotics to Pregnant Women With Preterm Rupture of the Membranes: 7-Year Follow-Up of the ORACLE I Trial Kenyon S, Pike K, Jones DR, et al. , Lancet 2008;372:1310�C1318 [PubMed]. Childhood Outcomes After Prescription of Antibiotics GSK-3 to Pregnant Women With Spontaneous Preterm Labor: 7-Year Follow-Up of the ORACLE II Trial Kenyon S, Pike K, Jones DR, et al. , Lancet 2008;372:1319�C1327 [PubMed]. The ORACLE trial originally studied the use of antibiotics or placebo in the management of preterm labor and preterm rupture of the membranes.