ABSTRACT
Introducción: La infección por Chlamydia trachomatis es la ITS bacteriana más frecuente del mundo. En el cervix se presenta mayormente de forma asintomática y afecta especialmente a mujeres jóvenes y adolescentes. Puede producir daño permanente en el tracto reproductor femenino, se asocia a parto prematuro, infecciones neonatales transmitidas vía vertical y mayor riesgo de adquirir otras ITS como VIH Y VPH. Por estos motivos se han establecido estrategias de tamizaje para detectar y tratar precozmente la infección asintomática por C. trachomatis en diferentes países. En nuestro país no contamos con un programa nacional de tamizaje. Objetivo: Determinar la prevalencia de infección asintomática por Chlamydia trachomatis en mujeres entre 12 y 21 años de la Provincia de Osorno, Región de Los Lagos, Chile. Pacientes y Métodos: Se desarrolló un estudio de diseño transversal con una cohorte única de mujeres adolescentes y jóvenes consultantes en el Policlínico de Alto Riesgo Obstétrico y de Ginecología Infantil y Adolescente, del Hospital Base de Osorno, entre enero de 2019 y enero 2020. Se determinó el estado de infección asintomática mediante RPC en tiempo real para C. trachomatis. Se realizó una encuesta a fin de determinar características demográficas, hábitos y conductas sexuales de las pacientes estudiadas. Resultados: Fueron reclutadas 124 mujeres entre 12 a 21 años de edad, de las cuales, 36 (29,3%) se encontraban embarazadas al momento del estudio. La prevalencia de infección asintomática por C. trachomatis fue de 14/124 (11,3%). En las mujeres gestantes se encontraron 6/36 (16,7%) casos positivos de infección por C. trachomatis y 8/88 (9,1%) en las no gestantes. Existe una mayor frecuencia de infección asintomática a menor edad de inicio de actividad sexual (33,3% en aquellas que inician entre 11-12 años vs. 16,2% en las que inician entre 1314 años, 7,4% entre 15-16 y 8% entre 17-21 años; p < 0,05). Esta tendencia no fue observada al comparar el estado de infección con el tiempo de vida sexual activa. Sólo 15,7% de las pacientes utilizó preservativo en todas sus relaciones sexuales. Discusión: La infección asintomática por C. trachomatis es frecuente en las mujeres adolescentes y jóvenes sexualmente activas. Las pacientes con inicio más temprano de la actividad sexual coital (bajo 13 años de edad) podrían estar en mayor riesgo. Se requiere con urgencia establecer la frecuencia nacional de infección para desarrollar una estrategia sanitaria para su pesquisa y manejo oportuno en nuestro país.
Background: Chlamydia trachomatis infection is the world most common bacterial STI. At uterine cervix it presents mostly asymptomatically and especially affects young women and adolescents. It can cause permanent damage to the female reproductive tract and is associated with premature birth, connatal infections and increased risk of acquiring other STIs such as HIV and HPV. For these reasons, other countries have established screening strategies to detect and treat asymptomatic C. trachomatis infection. Our country don't have a national screening program. Aim: To determine the prevalence of C. trachomatis asymptomatic infection in adolescent and young women in Osorno province, Los Lagos Region, Chile. Methods: A crosssectional study was performed in adolescent and young women who consult at Hospital Base Osorno in the MaternoFetal and PediatricAdolescent Gynecology ambulatory clinics, between January 2019 and January 2020. The status of asymptomatic infection was determined by PCR for C. trachomatis. A survey was carried out to determine the demographic characteristics, habits and sexual behaviors. Results: 124 women between 12 and 21 years of age were recruited, of which 36 (29,3%) were pregnant at the time of the study. The prevalence of asymptomatic infection by C. trachomatis was 11.3.%. In pregnant women, there were 6/36 (16.7%) positive cases for C. trachomatis and 8/88 (9.1%) in nonpregnant women. We found a higher frequency of asymptomatic infection at younger age of first sexual intercourse (33% in adolescents at 11-12 years old vs. 16.2% at 13-14, 7.4% at 15-16 and 8% at 17-21; p<0.05). Only 15.7% of the patients utilized condoms in all their intercourses. Discussion: Asymptomatic C. trachomatis infection is common in adolescent and young women, with a higher risk in those who onset sexual activity at an early age (less than 13 years old). It is urgently required to determine the national frequency of asymptomatic C. trachomatis infection to develop a national strategy for screening and timely treatment.
ABSTRACT
OBJECTIVES: To evaluate the accuracy of magnetic resonance imaging measurements of cartilage tissue-mimicking phantoms and to determine a combination of magnetic resonance imaging parameters to optimize accuracy while minimizing scan time. METHOD: Edge dimensions from 4 rectangular agar phantoms ranging from 10.5 to 14.5 mm in length and 1.25 to 5.5 mm in width were independently measured by two readers using a steel ruler. Coronal T1 spin echo (T1 SE), fast spoiled gradient-recalled echo (FSPGR) and multiplanar gradient-recalled echo (GRE MPGR) sequences were used to obtain phantom images on a 1.5-T scanner. RESULTS: Inter- and intra-reader reliability were high for both direct measurements and for magnetic resonance imaging measurements of phantoms. Statistically significant differences were noted between the mean direct measurements and the mean magnetic resonance imaging measurements for phantom 1 when using a GRE MPGR sequence (512x512 pixels, 1.5-mm slice thickness, 5:49 min scan time), while borderline differences were noted for T1 SE sequences with the following parameters: 320x320 pixels, 1.5-mm slice thickness, 6:11 min scan time; 320x320 pixels, 4-mm slice thickness, 6:11 min scan time; and 512x512 pixels, 1.5-mm slice thickness, 9:48 min scan time. Borderline differences were also noted when using a FSPGR sequence with 512x512 pixels, a 1.5-mm slice thickness and a 3:36 min scan time. CONCLUSIONS: FSPGR sequences, regardless of the magnetic resonance imaging parameter combination used, provided accurate measurements. The GRE MPGR sequence using 512x512 pixels, a 1.5-mm slice thickness and a 5:49 min scan time and, to a lesser degree, all tested T1 SE sequences produced suboptimal accuracy when measuring the widest phantom.
Subject(s)
Cartilage/diagnostic imaging , Dimensional Measurement Accuracy , Magnetic Resonance Imaging/methods , Phantoms, Imaging , Observer Variation , Radiographic Image Interpretation, Computer-Assisted , Reference Values , Reproducibility of Results , Signal-To-Noise Ratio , Time FactorsABSTRACT
Because of the continued importance of correct condom-use in controlling the HIV epidemic and the limited availability of tools for assessing correct condom-use, methods for assessing condom-application skills, especially when direct observation is not feasible, are needed. Accordingly, in the context of a high-risk population (The Bahamas) for HIV, a 17-item scale—the Condom-use Skills Checklist (CUSC)—was developed for use among young adolescents and adults. The rationale and approach to developing the scale and some measures of internal consistency, construct validity, and criterion-related validity have been described. It is concluded that the scale offers a reasonable alternative to direct observation among older subjects and that further development may make it more useful among pre-adolescents.