- Reliability of Symptom-Based Diagnosis of Uncomplicated Cystitis. [Journal Article]
- UIUrol Int 2018 Nov 12; :1-13
- CONCLUSIONS: The severity of the symptom is even more essential than just its presence for an accurate diagnosis. The ACSS is an accurate tool and may be recommended for clinical practice and studies for diagnosis of AC in women. Further studies and unification of terms are need.
- Spondylodiscitis after minimally invasive recto- and colpo-sacropexy: Report of a case and systematic review of the literature. [Journal Article]
- JMJ Minim Access Surg 2018 Nov 09
- CONCLUSIONS: Although a rare complication, surgeons performing rectopexy and colpopexy must be aware of the potential risk of SD Careful suture or tack placement into the anterior longitudinal ligament at the level of the promontory while avoiding the disc space is of paramount importance. Prompt diagnosis and multidisciplinary management are the cornerstones of a successful treatment.
- Brachial Plexus Birth Injury in Elective Versus Emergent Caesarean Section: A Cohort Study. [Journal Article]
- JOJ Obstet Gynaecol Can 2018 Nov 07
- CONCLUSIONS: Emergent CS is a moderate risk factor for BPBI compared with elective CS. Intrauterine positioning with a trial of labour may provide an antenatal etiology in these distinct cases.
- Follow-up postoperative calls to reduce common postoperative complaints among urogynecology patients. [Journal Article]
- IUInt Urogynecol J 2018 Nov 09
- CONCLUSIONS: The implementation of the FPC policy resulted in fewer patient-initiated calls. As such, there were significant reductions in postoperative complaints of constipation, vaginal bleeding, incomplete bladder emptying, and inquiries into laboratory results and disability paperwork.
- Challenges facing a woman wishing to report intimate partner violence in Belize. [Journal Article]
- BCBMJ Case Rep 2018 Nov 01; 2018
- We present a case of a 29-year-old woman who presented to a volunteer-run primary care facility in Southern Belize. Her initial presentation was vaginal itching and white discharge; she also requeste...
We present a case of a 29-year-old woman who presented to a volunteer-run primary care facility in Southern Belize. Her initial presentation was vaginal itching and white discharge; she also requested insertion of a sub-dermal contraceptive implant. During the insertion, marks suspicious for deliberate self-harm were noticed on the patient's arm, and on further exploration she revealed she was being physically and emotionally abused by her husband. With some encouragement, she requested help in taking further action to preserve her safety; however, in Belize clinicians have no power to assist in cases involving adults. Therefore, the victim should self-present to a police station, resulting in a significant potential barrier to reporting intimate partner violence (IPV). Here we discuss this barrier further, as well as other barriers that exist to reporting IPV, and discuss possible policy changes that may improve the situation in Belize.
- Associations of birth mode with cord blood cytokines, white blood cells, and newborn intestinal bifidobacteria. [Journal Article]
- PlosPLoS One 2018; 13(11):e0205962
- The associations of Cesarean delivery with offspring metabolic and immune-mediated diseases are believed to derive from lack of mother-to-newborn transmission of specific microbes at birth. Bifidobac...
The associations of Cesarean delivery with offspring metabolic and immune-mediated diseases are believed to derive from lack of mother-to-newborn transmission of specific microbes at birth. Bifidobacterium spp., in particular, has been hypothesized to play a health-promoting role, yet little is known about how delivery mode modifies colonization of the newborn by this group of microbes. The aim of this research was to examine the presence of Bifidobacterium in meconium and in the transitional stool, and to assess cytokine levels and hematological parameters in the venous cord blood of infants born by elective, pre-labor Cesarean section vs. vaginal delivery in Southern Brazil. We recruited 89 mother-newborn pairs (23 vaginal delivery and 66 elective cesarean delivery), obtained demographic information from a structured questionnaire and clinical information from medical records. We obtained umbilical cord venous blood and meconium samples following delivery and the transitional stool (the first defecation after meconium) before discharge. We determined plasma levels of IL-1β, IL-10, IL-6, GM-CSF, IL-5, IFN-γ, TNF-α, IL-2, IL-4 and IL-8 in the cord blood, and presence of stool Bifidobacterium by real time PCR. Compared to vaginally-delivered neonates, Cesarean-delivered neonates had a lower leukocyte count (p = 0.037), lower hemoglobin (p = 0.04), and lower levels of the cytokine GM-CSF (p = 0.009) in the cord blood. Moreover, Bifidobacterium was detected less often in the transitional stool of Cesarean-delivered neonates compared to vaginally-delivered neonates (p = 0.001). The results indicate that pre-labor Cesarean birth may be associated with microbial and hematological alterations in the neonate. The clinical significance of these findings remains to be determined in larger prospective birth cohort studies.
- An Update on the Roles of Non-albicansCandida Species in Vulvovaginitis. [Review]
- JFJ Fungi (Basel) 2018 Oct 31; 4(4)
- Candida species are one of the commonest causes of vaginitis in healthy women of reproductive age. Vulvovaginal candidiasis (VVC) is characterized by vulvovaginal itching, redness and discharge. Cand...
Candida species are one of the commonest causes of vaginitis in healthy women of reproductive age. Vulvovaginal candidiasis (VVC) is characterized by vulvovaginal itching, redness and discharge. Candida albicans, which is a common genito-urinary tract commensal, has been the prominent species and remains the most common fungal agent isolated from clinical samples of patients diagnosed with VVC. In recent times, however, there has been a notable shift in the etiology of candidiasis with non-albicans Candida (NAC) species gaining prominence. The NAC species now account for approximately 10% to as high as 45% of VVC cases in some studies. This is associated with treatment challenges and a slightly different clinical picture. NAC species vaginitis is milder in presentation, often occur in patients with underlying chronic medical conditions and symptoms tend to be more recurrent or chronic compared with C. albicans vaginitis. C. glabrata is the most common cause of NAC-VVC. C. tropicalis, C. krusei, C. parapsilosis, and C. guilliermondii are the other commonly implicated species. Treatment failure is common in NAC-VVC, since some of these species are intrinsically resistant or show low susceptibilities to commonly used antifungal agents. This article reviews the etiology, pathogenesis, clinical features, diagnosis, and management of NAC vulvovaginitis.
- Treatment of Vaginal Shortening and Narrowing With Autologous Buccal Mucosa Graft Augmentation Without Vaginal Mold. [Journal Article]
- FPFemale Pelvic Med Reconstr Surg 2018 Oct 31
- Vaginal foreshortening can occur after hysterectomy leading to inability to engage successfully in vaginal intercourse resulting in decreased quality of life. Vaginal elongation using autologous bucc...
Vaginal foreshortening can occur after hysterectomy leading to inability to engage successfully in vaginal intercourse resulting in decreased quality of life. Vaginal elongation using autologous buccal mucosal graft with mold and postoperative bed rest has been reported extensively for vaginal stenosis and foreshortening, but graft without mold has never been described. A 61-year-old woman 5 years after robotic-assisted hysterectomy with foreshortened vagina and vaginal stricture sought care secondary to the inability to have sexual intercourse. Her vagina was successfully repaired with autologous buccal mucosal grafting without the use of a vaginal mold facilitating a next-day discharge and ultimately ability to resume intercourse. Vaginal shortening and narrowing after hysterectomy can be repaired using autologous buccal mucosal grafting without the need for a vaginal mold or 5 to 7 days of bed rest.
- [Current diagnosis and treatment of sexually transmitted infections]. [Review]
- UUrologe A 2018 Oct 30
- CONCLUSIONS: Due to the increasing incidence of STIs, the recognition and evidence-based treatment of these infections is essential to avoid ascending infections, long-term consequences, and further transmissions. It is important to assure the infectious material before initiating therapy to be able to switch from the initially initiated calculated therapy (also considering the local resistance situation) to a test-appropriate therapy.
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- Symptomatic Sexually Transmitted Infections in Brazil's Emerging Rural Populations. [Journal Article]
- JAJ Assoc Nurses AIDS Care 2018 Nov - Dec; 29(6):942-948
- We used a cross-sectional study in 2011 to estimate prevalence and risk behaviors for self-reported symptomatic sexually transmitted infections (STI) in rural settlers in Midwestern Brazil. There wer...
We used a cross-sectional study in 2011 to estimate prevalence and risk behaviors for self-reported symptomatic sexually transmitted infections (STI) in rural settlers in Midwestern Brazil. There were 353 individuals recruited who had been living in the settlement for more than 6 months. The endpoint variable was having reported vaginal discharge, urethral discharge, genital ulcers, or anogenital warts in the previous 12 months. Univariate and multivariate Poisson regressions were performed to identify STI correlates. A prevalence of 22.4% of self-reported symptomatic STI was found. Being female, homosexual, and/or having lived in camps were associated with self-report of STI (p < .05). The high prevalence of self-reported symptomatic STI among settlers suggested that this was a key population in the epidemiology of STI in rural regions and demands the strengthening of health promotion actions in this vulnerable population, especially for women, homosexuals, and those who previously lived in camps.