- Adverse effect analysis of high-intensity focused ultrasound in the treatment of benign uterine diseases. [Journal Article]
- IJInt J Hyperthermia 2018 May 24; :1-6
- CONCLUSIONS: Based on the results with low rate of major adverse effects from multiple centers, we concluded that HIFU is safe in treating patients with benign uterine diseases. With development of this technique and more experience on the part of the physicians, the rates of the major adverse effects will be further lowered.
- Selective arterial embolisation for intractable vaginal haemorrhage in genital tract malignancies. [Journal Article]
- EJEur J Gynaecol Oncol 2016; 37(5):736-740
- CONCLUSIONS: Since the introduction of SAE the authors have avoided emergency radiotherapy, surgery, and repeat vaginal packing in patients with intractable vaginal bleeding due to gynaecological cancer. Patients were discharged to their appropriate treatment pathways in a timely manner. The authors recommend the application of SAE.
- Genital tuberculosis in postmenopausal women with variable clinical presentations: A report of 3 cases. [Journal Article]
- CRCase Rep Womens Health 2018; 18:e00059
- Genital tuberculosis is usually diagnosed in young women being assessed for infertility. After menopause it usually presents with symptoms resembling endometrial malignancy, such as postmenopausal bl...
Genital tuberculosis is usually diagnosed in young women being assessed for infertility. After menopause it usually presents with symptoms resembling endometrial malignancy, such as postmenopausal bleeding, persistent vaginal discharge and pyometra. The diagnosis is made by detection of acid-fast bacilli on microscopy or bacteriological culture and/or presence of epithelioid granuloma on biopsy. Anti-tubercular therapy involves the use of rifampicin, isoniazid, pyrazinamide and ethambutol. Surgery is indicated if a pelvic mass and recurrence of pain or bleeding persist after 9 months of treatment. Three cases of genital tuberculosis in postmenopausal women with different clinical presentations are reported. The first woman presented with ascites and weight loss. The second had postmenopausal bleeding with a pipelle biopsy suggestive of endometrial intraepithelial neoplasia. The third presented with weight loss and a palpable abdominal mass. Pelvic malignancy was initially suspected but a diagnosis of tuberculosis was made following pre-operative endometrial biopsy, bacteriological culture and intra-operative frozen section. All three women responded to anti-tubercular therapy.
- The prevalence of neonatal jaundice and risk factors in healthy term neonates at National District Hospital in Bloemfontein. [Journal Article]
- AJAfr J Prim Health Care Fam Med 2018 Apr 12; 10(1):e1-e6
- CONCLUSIONS: More than half (55.2%) of healthy term neonates developed neonatal jaundice. As it is difficult to clinically diagnose neonatal jaundice in darker pigmented babies, it is recommended that the bilirubin level of all babies should be checked with a non-invasive bilirubin meter before discharge from hospital or maternity unit as well as during the first clinic visit on day 3 after birth.
- Delivery and its complications among women of Somali, Kurdish, and Russian origin, and women in the general population in Finland. [Journal Article]
- BBirth 2018 May 20
- CONCLUSIONS: Delivery complications were more common among migrant Somali women than among women in the general Finnish population. Somali women represent a high-risk group calling for special attention and care.
- Common Sexually Transmitted Infections in Women. [Review]
- NCNurs Clin North Am 2018; 53(2):189-202
- The spread of sexually transmitted infections (STIs) remains a significant public health issue in the United States. Social, economic, and behavioral implications affecting the spread of STIs have be...
The spread of sexually transmitted infections (STIs) remains a significant public health issue in the United States. Social, economic, and behavioral implications affecting the spread of STIs have been identified. The most important social factor in the United States is the stigma associated with discussing sex and STI screening. In this article, specific recommendations for women are included regarding screening, diagnosing, and treating common vaginal and cervical infections. Screening women for infections of the vagina and cervix is essential because untreated infections may result in complications that have current and long-term health consequences and impact quality of life.
- Molecular Diagnosis of Bacterial Vaginosis: an Update. [Journal Article]
- JCJ Clin Microbiol 2018 May 16
- Bacterial vaginosis (BV) is the most common cause of vaginal discharge in reproductive age women. BV has been associated with poor reproductive outcomes like preterm delivery, acquisition of sexually...
Bacterial vaginosis (BV) is the most common cause of vaginal discharge in reproductive age women. BV has been associated with poor reproductive outcomes like preterm delivery, acquisition of sexually transmitted infections including HIV, and pelvic inflammatory disease. BV represents acquisition of a diverse community of anaerobic and facultative bacteria and a reduction in lactobacilli. It can be diagnosed using several tests ranging from clinical indicators, point-of-care tests, and molecular assays. Molecular technologies are objective, able to detect fastidious bacteria, allow quantitation, and are ideal for self-collected vaginal swabs. This paper reviews currently available BV diagnostic tests in the US.
- [Cost-effectiveness analysis of spontaneous vaginal delivery and elective cesarean for normal risk pregnant women in the Brazilian Unified National Health System]. [Journal Article]
- CSCad Saude Publica 2018 May 10; 34(5):e00022517
- The purpose of this study was to conduct a cost-effectiveness analysis of spontaneous vaginal delivery and elective cesarean (with no clinical indication) for normal risk pregnant women, from the per...
The purpose of this study was to conduct a cost-effectiveness analysis of spontaneous vaginal delivery and elective cesarean (with no clinical indication) for normal risk pregnant women, from the perspective of the Brazilian Unified National Health System. An analytical decision model was developed and included the choice of delivery mode and clinical consequences for mothers and newborns, from admission for delivery to hospital discharge. The reference population consisted of normal risk pregnant women with singleton, at-term gestations in cephalic position, subdivided into primiparas and multiparas with prior uterine scar. Cost data were obtained from three public maternity hospitals (two in Rio de Janeiro, one in Belo Horizonte, Minas Gerais State, Brazil). Direct costs were identified with human resources, hospital inputs, and capital and administrative costs. Effectiveness measures were identified, based on the scientific literature. The study showed that vaginal delivery was more efficient for primiparas, at lower cost (BRL 1,709.58; USD 518.05) than cesarean (BRL 2,245.86; USD 680.56) and greater effectiveness for three of the four target outcomes. For multiparas with prior uterine scar, repeat cesarean was cost-effective for the outcomes averted maternal morbidity, averted uterine rupture, averted neonatal ICU, and averted neonatal death, but the result was not supported by probabilistic sensitivity analysis. For maternal death as the outcome, there was no difference in effectiveness, and labor showed the lowest cost. This study can contribute to the management of perinatal care, expanding measures that encourage adequate delivery according to the population's characteristics.
- Streptococcus agalactiae carriage among pregnant women living in Rio de Janeiro, Brazil, over a period of eight years. [Journal Article]
- PlosPLoS One 2018; 13(5):e0196925
- Group B Streptococcus (GBS) carriage by pregnant women is the primary risk factor for early-onset GBS neonatal sepsis. Intrapartum antibiotic prophylaxis (IAP) can prevent this transmission route, an...
Group B Streptococcus (GBS) carriage by pregnant women is the primary risk factor for early-onset GBS neonatal sepsis. Intrapartum antibiotic prophylaxis (IAP) can prevent this transmission route, and two main approaches are recommended to base the selection of pregnant women to be submitted to IAP: the risk-based and the culture-based strategies. In Brazil, compliance to such recommendations is poor, and not much is known about GBS carriage. In the present study, 3,647 pregnant women living in Rio de Janeiro State, Brazil, were screened for GBS anogenital colonization, over a period of 8 years (2008-2015). GBS was detected in 956 (26.2%) of them, and presence of vaginal discharge was the only trait associated with a higher risk for GBS colonization. Serotypes Ia (257; 37.3%) and II (137; 19.9%) were the most frequent among 689 (72.1% of the total) GBS isolates evaluated, followed by NT isolates (84; 12.1%), serotype Ib (77; 11.1%), V (63; 9.1%), III (47; 6.8%) and IV (24; 3.5%). Estimated coverage of major serotype-based GBS vaccines currently under clinical trials would vary from 65.2% to 84.3%. All 689 isolates tested were susceptible to ampicillin and vancomycin. Resistance to chloramphenicol, clindamycin, erythromycin, levofloxacin, and tetracycline was observed in 5% (35), 2% (14), 14% (97), 5% (35) and 86% (592) of the isolates, respectively. No significant fluctuations in colonization rates, serotype distribution and antimicrobial susceptibility profiles were observed throughout the period of time investigated. The culture-based approach for IAP recommendation showed to be the best choice for the population investigated when compared to the risk-based, since the first did not increase the number of pregnant women submitted to antibiotic therapy and covered a larger number of women who were actually colonized by GBS. The fact the not all isolates were available for additional characterization, and serotype IX antiserum was not available for testing represent limitations of this study. Nevertheless, to the best of our knowledge, this is the largest investigation on GBS carriage among pregnant women in Brazil up to date, and results are useful for improving GBS prevention and treatment strategies.
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- Symptom-Based Versus Laboratory-Based Diagnosis of Five Sexually Transmitted Infections in Female Sex Workers in Iran. [Journal Article]
- ABAIDS Behav 2018 May 09
- Among 1337 Iranian adult female sex workers in 2015, we assessed the diagnostic value of 4 self-reported sexually transmitted infection (STIs) symptoms for detecting laboratory-confirmed gonorrhea, c...
Among 1337 Iranian adult female sex workers in 2015, we assessed the diagnostic value of 4 self-reported sexually transmitted infection (STIs) symptoms for detecting laboratory-confirmed gonorrhea, chlamydia, trichomoniasis, human papillomavirus (HPV), and syphilis. While 37.7% reported vaginal discharge (VD), 25.9% reported pain or burning (P/B), 3.0% reported genital ulcers (GU), and 1.4% reported genital warts (GW), the prevalence of laboratory-confirmed syphilis, gonorrhea, chlamydia, trichomoniasis, and HPV was 0.4, 1.3, 6.0, 11.9, and 41.9%, respectively. The sensitivity of VD was 40.3% for detecting tricomoniasis, 37.5% for chlamydia, and 37.5% for gonorrhea. The sensitivity of P/B ranged from 12.5% for gonorrhea to 25.2% for trichomoniasis. The sensitivity of GU and GW was very low for 5 STIs. The sensitivity of all symptoms combined was also lower than 50%. Among asymptomatic participants, 41.2% tested positive for HPV, 11.8% for trichomoniasis, and less than 6.6% for other STIs. Symptom-based case management and surveillance of STIs can lead to misclassification of a large proportion of cases.