Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: doença inflamatória pélvica / Brazilian Protocol for Sexually Transmitted Infections 2020: pelvic inflammatory disease / Protocolo Brasileño para Infecciones de Transmisión Sexual 2020: enfermedad inflamatoria pélvica

O tema doença inflamatória pélvica está contemplado no Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis, publicado pelo Ministério da Saúde do Brasil em 2020. A doença inflamatória pélvica é a infecção aguda do trato genital superior feminino decorrente da ascensão canalicular de microrganismos cervicovaginais endógenos e, principalmente, os de transmissão sexual. Entre os agentes etiológicos envolvidos, destacam-se Chlamydia trachomatis e Neisseria gonorrhoeae. As sequelas mais importantes são dor pélvica crônica, infertilidade e gravidez ectópica. O diagnóstico clínico apresenta-se como a abordagem prática mais importante. O tratamento com antibióticos deve ser iniciado imediatamente diante da suspeição clínica. Descrevem-se orientações para gestores e profissionais de saúde sobre testes diagnósticos, tratamento preconizado, seguimento, aconselhamento, notificação, manejo de parcerias sexuais e de populações especiais. Com a maior disponibilidade da técnica de biologia molecular no Brasil, recomenda-se o rastreio de C. trachomatis e N. gonorrhoeae como estratégia preventiva da doença.

Pelvic Inflammatory Disease is a topic included in the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health in 2020. Pelvic inflammatory disease is an acute infection of the upper female genital tract due to canalicular spread of endogenous cervicovaginal microorganisms, in particular sexually transmitted organisms. Standing out among the etiological agents involved are Chlamydia trachomatis and Neisseria gonorrhoeae. The most important sequels are chronic pelvic pain, infertility and ectopic pregnancy. Clinical diagnosis is the most important practical approach. Antibiotic treatment should start immediately upon clinical suspicion. The article contains guidance for health service managers and health professionals on diagnostic tests, treatment, follow-up, counseling, notification, handling of sexual partnerships and special populations. In view of increased availability of the molecular biology technique in Brazil, C. trachomatis and N. gonorrhoeae screening is recommended as a disease prevention strategy.

El tema de la enfermedad inflamatoria pélvica está incluido en el Protocolo Clínico y Directrices Terapéuticas para la Atención Integral para Personas con Infecciones de Transmisión Sexual, publicado por el Ministerio de Salud de Brasil en 2020. La enfermedad inflamatoria pélvica es una infección aguda del tracto genital superior femenino resultante del ascenso canalicular de microorganismos cervicovaginales endógenos y, principalmente, los de transmisión sexual. Entre los agentes etiológicos involucrados, se destacan Chlamydia trachomatis y Neisseria gonorrhoeae. Las secuelas más importantes son: dolor pélvico crónico, infertilidad y embarazo ectópico. El diagnóstico clínico es el enfoque práctico más importante. El tratamiento con antibiótico debe iniciarse inmediatamente ante la sospecha clínica. Se describen pautas para gestores y profesionales de la salud sobre pruebas de diagnóstico, tratamiento, seguimiento, asesoramiento, notificación, manejo de parejas sexuales y poblaciones especiales. Con la mayor disponibilidad de la técnica de biología molecular, se recomienda el cribado de C. trachomatis y N. gonorrhoeae como estrategia preventiva para la enfermedad.

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: doença inflamatória pélvica / Brazilian Protocol for Sexually Transmitted Infections 2020: pelvic inflammatory disease / Protocolo Brasileño para Infecciones de Transmisión Sexual 2020: enfermedad inflamatoria pélvica

Resumo O tema doença inflamatória pélvica está contemplado no Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis, publicado pelo Ministério da Saúde do Brasil em 2020. A doença inflamatória pélvica é a infecção aguda do trato genital superior feminino decorrente da ascensão canalicular de microrganismos cervicovaginais endógenos e, principalmente, os de transmissão sexual. Entre os agentes etiológicos envolvidos, destacam-se Chlamydia trachomatis e Neisseria gonorrhoeae. As sequelas mais importantes são dor pélvica crônica, infertilidade e gravidez ectópica. O diagnóstico clínico apresenta-se como a abordagem prática mais importante. O tratamento com antibióticos deve ser iniciado imediatamente diante da suspeição clínica. Descrevem-se orientações para gestores e profissionais de saúde sobre testes diagnósticos, tratamento preconizado, seguimento, aconselhamento, notificação, manejo de parcerias sexuais e de populações especiais. Com a maior disponibilidade da técnica de biologia molecular no Brasil, recomenda-se o rastreio de C. trachomatis e N. gonorrhoeae como estratégia preventiva da doença.

Abstract Pelvic Inflammatory Disease is a topic included in the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health in 2020. Pelvic inflammatory disease is an acute infection of the upper female genital tract due to canalicular spread of endogenous cervicovaginal microorganisms, in particular sexually transmitted organisms. Standing out among the etiological agents involved are Chlamydia trachomatis and Neisseria gonorrhoeae. The most important sequels are chronic pelvic pain, infertility and ectopic pregnancy. Clinical diagnosis is the most important practical approach. Antibiotic treatment should start immediately upon clinical suspicion. The article contains guidance for health service managers and health professionals on diagnostic tests, treatment, follow-up, counseling, notification, handling of sexual partnerships and special populations. In view of increased availability of the molecular biology technique in Brazil, C. trachomatis and N. gonorrhoeae screening is recommended as a disease prevention strategy.

Resumen El tema de la enfermedad inflamatoria pélvica está incluido en el Protocolo Clínico y Directrices Terapéuticas para la Atención Integral para Personas con Infecciones de Transmisión Sexual, publicado por el Ministerio de Salud de Brasil en 2020. La enfermedad inflamatoria pélvica es una infección aguda del tracto genital superior femenino resultante del ascenso canalicular de microorganismos cervicovaginales endógenos y, principalmente, los de transmisión sexual. Entre los agentes etiológicos involucrados, se destacan Chlamydia trachomatis y Neisseria gonorrhoeae. Las secuelas más importantes son: dolor pélvico crónico, infertilidad y embarazo ectópico. El diagnóstico clínico es el enfoque práctico más importante. El tratamiento con antibiótico debe iniciarse inmediatamente ante la sospecha clínica. Se describen pautas para gestores y profesionales de la salud sobre pruebas de diagnóstico, tratamiento, seguimiento, asesoramiento, notificación, manejo de parejas sexuales y poblaciones especiales. Con la mayor disponibilidad de la técnica de biología molecular, se recomienda el cribado de C. trachomatis y N. gonorrhoeae como estrategia preventiva para la enfermedad.

Brazilian protocol for sexually transmitted infections, 2020: pelvic inflammatory disease

Abstract Pelvic Inflammatory Disease is a topic included in the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health in 2020. Pelvic inflammatory disease is an upper female genital tract acute infection due to canalicular spread of endogenous cervicovaginal microorganisms and especially the sexually transmitted microorganisms. Standing out among the etiological agents involved are Chlamydia trachomatis and Neisseria gonorrhoeae. The main sequelae are chronic pelvic pain, infertility, and ectopic pregnancy. Clinical diagnosis is the most important practical approach. Antibiotic treatment must start immediately after the clinical suspicion. Guidelines for health service managers and health professionals on diagnostic tests, treatment, follow-up, counseling, notification, handling sexual partners and special populations are described. Given the increased availability of the molecular biology techniques in Brazil, C. trachomatis and N. gonorrhoeae screening are recommended as a disease prevention strategy.

Clinical study of hysteroscopy combined with laparoscopy in the diagnosis and treatment of unexplained infertility / 中华妇产科杂志

Objective@#To explore the importance of the diagnosis and treatment value of laparoscopy and hysteroscopy in patients with unexplained infertility.@*Methods@#A total of 519 cases diagnosed as unexplained infertility, received laparoscopy and hysteroscopy in Peking Union Medical College Hospital from May 2012 to December 2015. The causes of infertility were evaluated, and the subjects were followed up to observe the nature pregnancy rate.@*Results@#Among 519 unexplained infertility patients, pelvic abnormalities had been explored in 466 (89.8%, 466/519) cases. Pelvic endometriosis combined with adhesions, pelvic adhesion alone, uterine leiomyoma and uterine cavity polyp were 72.4% (376/519), 12.3% (64/519), 3.7% (19/519) and 1.3% (7/519) respectively. The total natural pregnancy rate within the 3 years of follow up was 53.9% (208/386), and the natural pregnancy rate was 29.8% (31/104) in patients aged 35 years and over.@*Conclusions@#The patients with clinical diagnosis of unexplained infertility should be examined by hysteroscopy and laparoscopy. Under the examination, the causes of infertility could be found more intuitively, and targeted treatment could be carried out to improve the pregnancy rate. The natural pregnancy rate of the elderly patients decrease obviously after operation, and the time of natural trying pregnancy should not be too long.

Actinomicosis pélvica: a propósito de un caso que simula un tumor de recto / Pelvic actinomycosis: from a case that simulates rectal tumor

Resumen Introducción: La actinomicosis, es una infección crónica rara producida por bacterias del género Actinomyces sp. La afectación pélvica es una de sus formas más infrecuentes y en gran parte de los casos se relaciona al uso de un dispositivo intrauterino de larga data o a una cirugía previa. Como otras enfermedades raras, la infección es conocida como "la gran imitadora" por su variada forma de presentación y particular comportamiento pudiendo simular una neoplasia. El tratamiento es fundamentalmente médico y de buenos resultados. Caso Clínico: Damos a conocer el caso de una paciente que se presentó con un cuadro compatible con un tumor de recto, pero que resultó ser actinomicosis. El diagnóstico se realizó en base a la tinción de Gram, el cuadro clínico y el antecedente de un dispositivo intrauterino abandonado por más de 25 años. Fue corroborado posteriormente mediante anatomía patológica y tratada en forma exitosa con antibióticos por un periodo extendido. Conclusión: Si bien la actinomicosis es una patología infrecuente, debe ser considerada en el diagnóstico diferencial de los pacientes que se presentan con tumores de la pelvis. Un alto índice de sospecha y una actitud diagnóstica activa son fundamentales para un tratamiento oportuno, seguro y eficaz de esta enfermedad.

Introduction: Actinomycosis is a rare chronic infection caused by bacterias of the genus Actinomyces sp. Pelvic involvement is one of its most infrequent forms and in many cases it is related to the use of a longstanding intrauterine device or a previous surgery. Like other rare diseases, the infection is known as "the great imitator" because of its varied form of presentation and its particular behavior, which can simulate a neoplasm. The treatment is fundamentally medical with good results. Case Report: We present the case of a patient who presented with a rectal tumor but that turned out to be Actinomycosis. The diagnosis was made based on the Gram stain, the clinical presentation and the history of an intrauterine device left for more than 25 years. It was subsequently corroborated by pathological anatomy and successfully treated with antibiotics for an extended period. Conclusion: Although actinomycosis is an infrequent pathology, it should be considered in the differential diagnosis of patients who present with tumors of the pelvis. An active diagnostic attitude and a high index of suspicion are fundamental for the timely, safe and effective treatment of this disease.

Pelvic abscess after ovulation in a patient with recurrent ovarian endometriotic cysts: case report and literature review / 中华全科医师杂志

Retrospective analysis of 1 case admitted to our hospital and 15 domestic and foreign literature reports of endometriotic cyst infertility patients with pelvic abscess clinical data after ovulation.One patient in our hospital was treated with recurrent EMS-assisted assisted pregnancy.The endometriotic cyst rupture with pelvic abscess improved after surgery.At home and abroad,15 cases of infertility were caused by ovarian endometriosis cysts,and 3 of them were recurrent.All the 15 cases showed lower abdominal pain,repeated body temperature,elevated white blood cells and erythrocyte sedimentation rate,and pelvic mass under ultrasound.7 cases were treated with surgery and 8 cases were treated conservatively.The prognosis was good.

Study On Awareness, Acceptability & Clinical Outcome Of Post Partum - Iucd Insertion In A Tertiary Care Hospital Of North India

Background:Post partum period is ideal time for family planning counselling. Accessibility to health care facility is more during this period in our country. IUCD to prevent pregnancy is a highly effective, safe, long acting, coitus independent & reversible method of contraception with very low side effects.Objectives:This study was conducted to evaluate the awareness, acceptance, safety, efficacy, complications and expulsion rate of Post–partum Intrauterine Contraceptive Device (PP–IUCD) insertion among pregnant women in a tertiary care centre.Material and Methods: This was a prospective study was carried out in the department of Obstetrics and Gynaecology, Career Institute of Medical Sciences from November 2014 to October 2016 (ie.2years). Women delivering in the hospital and fulfilling inclusion criteria were included in the study after obtaining informed consent. The study protocol was approved by the ethics committee of the medical college. Results:Out of 1820 women, only 108 (5.9%) were aware about PP–IUCD and they received information from the IEC material displayed in the antenatal clinic. Out of these 108 women, 70 women (64.8%) agreed with PP–IUCD insertion. Out of 1712 unaware women, 930 (54.3%) agreed with PP–IUCD. Agreement with PP–IUCD insertion was higher in women who were aware about the PP–IUCD. Overall acceptability was found in 1000 (55%) patients. Out of the 1000 (55%) women who accepted the PP–IUCD insertion, only 573 (31.4%) women underwent PP–IUCD insertion. After PPIUCD insertion, 67.2% of women had an uneventful course and 32.8% women had complications. Not a single woman suffered from perforation, or any other life–threatening complication. Conclusion: The acceptance of PP–IUCD was high in present study and it is comparably more than other studies done globally. Awareness of PP–IUCD among these women was very poor despite high acceptance.The PP–IUCD was also demonstrably safe, having no reported incidence of perforation with low rates of expulsion, pelvic infection, and few lost strings.

Lentinan combined with conventional antituberculous therapy for pelvic tuberculosis in women / 国际中医中药杂志

Objective To evaluate the therapeutic effect of lentinan combined with conventional antituberculous therapy in women with pelvic tuberculosis.Methods A total of 90 women with pelvic tuberculosis were enrolled and recruited into a control group and a treatment group by random number table,45 in each group.The control group was treated with anti-tuberculosis program (2HRZE/4HRE),while the treatment group was treated with lentinan tablets on the basis of the control group.Both groups were treated for 6 months.Serum levels of carbohydrate antigen 125 (CA125) and erythrocyte sedimentation rates (ESRs) were determined before and after treatment,and the therapeutic effect was evaluated.Results After treatment,the serum CA125 level (28.61 ± 9.08 U/ml vs.39.72 ± 12.13 U/ml;t=4.919,P＜0.01) and the ESR (36.13 ± 8.33 mm/h vs.41.35 ± 12.45 mm/h;t=2.338,P＜0.05) in the treatment group were significantly lower than those in the control group.The negative rate of serum CA125 after treatment than before treatment in the treatment group (93.3％ vs.20.0％;X2=46.335,P＜0.01) and the control group (82.2％ vs.8.9％;X2=37.396,P＜0.01);but there was no difference in negative rate of serum CA125 after treatment between two groups (X2=1.6571,P=0.198).The total effective rate in the treatment group was significantly higher than that in the control group (93.3％ vs.77.8％;X2=4.406,P=0.036).Conclusion Lentinan combined with conventional antituberculous therapy is effective in treatment of pelvic tuberculosis in women.

Therapeutic Observation of Triple Needling plus Warm Needling for Chronic Pelvic Inflammation / 上海针灸杂志

Objective To observe the clinical efficacy of triple needling plus warm needling in treating chronic pelvic inflammation due to cold and damp stagnation.Method Sixty patients with chronic pelvic inflammation due to cold and damp stagnation were randomized into a treatment group and a control group, 30 in each group. The control group was intervened by ordinary acupuncture, while the treatment group was by triple needling and warm needling in addition to the ordinary acupuncture method. The symptom and sign scores were evaluated before and after intervention, and the clinical efficacies were compared. Result The symptom and sign scores were changed significantly after intervention in both groups (P<0.01,P<0.05). After intervention, the symptom and sign score in the treatment group was significantly different from that in the control group (P<0.05). The total effective rate was 93.3% in the treatment group versus 80.0% in the control group, and the difference was statistically significant (P<0.05).Conclusion Triple needling plus warm needling is an effective method in treating chronic pelvic inflammation.

Clinical Study on Abdominal Acupuncture plus Herbal Medicine for Chronic Pelvic Pain Due to Qi Stagnation and Blood Stasis / 上海针灸杂志

Objective To observe the clinical efficacy of abdominal acupuncture plus herbal medicine in treating chronic pelvic pain due to qi stagnation and blood stasis after pelvic inflammatory diseases.Method Sixty patients with chronic pelvic pain due to qi stagnation and blood stasis after pelvic inflammatory diseases were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by abdominal acupuncture plus herbal medicine, while the control group was by herbal medicine alone. After 3 menstrual cycles, the Visual Analogue Scale (VAS) for abdominal pain and McCormack scale were observed.Result After intervention, the abdominal VAS score and McCormack score were changed significantly in both groups (P<0.01,P<0.05). After intervention, there were significant differences in comparing the VAS score and McCormack score between the two groups (P<0.01).Conclusion Abdominal acupuncture plus herbal medicine can reduce chronic pelvic pain due to qi stagnation and blood stasis after pelvic inflammatory diseases.

Effect of soluble hemostasis gauze on pelvic infection after cesarean section / 中国感染控制杂志

Objective To evaluate the effect of intraoperative use of soluble hemostasis gauze on postoperative pel-vic infection in parturients undergoing cesarean section.Methods Data about cesarean section parturients in obstet-ric group(n=322)and gynaecology group (n =92)were surveyed by clinical follow-up and retrospective analysis method,obstetric group adopted bulk packing of gauze,gynaecology group adopted flat lay packing ,incidence of postoperative pelvic infection between parturients who used soluble hemostasis gauze with different packing meth-ods,as well as with different pieces were compared and analyzed.Results Pelvic infection rate in obstetric group and gynaecology group was 4.04%(13/322)and 0.00%(0/92)respectively,there was no significant difference be-tween two groups(P =0.082 ).In obstetric group,pelvic infection rate in parturients who used ≤3 pieces of solu-ble hemostasis gauze was 0,used >3 pieces was 11 .82%,there was significant difference between the two (P <0.001).Conclusion Rational use of soluble hemostasis gauze in caesarean operation can effectively avoid postopera-tive pelvic infection.

Incidence of uterine post abortion infection at Hospital de Clínicas de Porto Alegre. Is prophylactic antibiotic necessary? / Incidência de infecção pós-abortamento no Hospital de Clínicas de Porto Alegre. O antibiótico profilático é necessário?

OBJECTIVE: To identify the incidence of pelvic infection after miscarriage undergoing uterine evacuation in a tertiary hospital in southern Brazil and to compare with the international literature. METHODS: we reviewed electronic medical records of the Hospital de Clinicas de Porto Alegre of all patients who underwent uterine evacuation for miscarriage between August 2008 and January 2012 were reviewed. We included all patients submitted to uterine curettage due to abortion and who had outpatient visits for review after the procedure. We calculated emographic and laboratory data of the study population, number needed for treatment (NNT) and number needed to harm (NNH). RESULTS: of the 857 revised electronic medical records, 377 patients were subjected to uterine evacuation for miscarriage; 55 cases were lost to follow-up, leaving 322 cases that were classified as not infected abortion on admission. The majority of the population was white (79%); HIV prevalence and positive VDRL was 0.3% and 2%, respectively. By following these 322 cases for a minimum of seven days, it was found that the incidence of post-procedure infection was 1.8% (95% CI 0.8 to 4). The NNT and NNH calculated for 42 months were 63 and 39, respectively. CONCLUSION: The incidence of post-abortion infection between August 2008 to January 2012 was 1.8% (0.8 to 4). .

OBJETIVO: Identificar a incidência de infecção pélvica após aborto espontâneo submetido a esvaziamento uterino num hospital terciário do sul do Brasil e comparar com a literatura internacional. MÉTODOS: Os prontuários eletrônicos do Hospital de Clínicas de Porto Alegre de todas as pacientes que foram submetidas ao esvaziamento uterino por abortamento entre agosto de 2008 e Janeiro de 2012 foram revisados. Foram incluídas no estudo todas as pacientes submetidas à curetagem uterina por abortamento e que tiveram consultas ambulatoriais de revisão após o procedimento. Os dados demográficos e laboratoriais da população estudada, number needed for treatment (NNT) e o number needed to harm (NNH) foram calculados. RESULTADOS: Dos 857 prontuários eletrônicos revistos, 377 pacientes foram submetidas ao esvaziamento uterino por abortamento; 55 casos foram perdidos no seguimento, restando 322 casos que foram classificados como aborto não infectado na admissão. A maioria da população era da raça branca (79%); a prevalência de HIV e VDRL positivos foi de 0,3 e 2%, respectivamente. No seguimento desses 322 casos, num período mínimo de 7 dias, verificou-se que a incidência de infecção pós-procedimento foi de 1,8% (IC95%0,8 a 4). O NNT e o NNH calculado para 42 meses foi de 63 e 39, respectivamente. CONCLUSÃO: A incidência de infecção pós-aborto entre agosto de 2008 a janeiro de 2012 foi de 1,8% (0,8 a 4). .

Therapeutic Observation of Acupuncture plus TDP and Auricular Point Sticking for Chronic Pelvic Infection / 上海针灸杂志

ObjectiveTo observe the clinical efficacy of acupuncture plus TDP (specific electromagnetic treatment apparatus) and auricular point sticking in treating chronic pelvic infection.MethodSixty patients diagnosed with chronic pelvic infection were randomized into two groups. Thirty cases in the treatment group were intervened by acupuncture plus TDP and auricular point sticking, while the other 30 in the control group were by acupuncture plus TDP, 10 d as a treatment course in both groups, and the therapeutic efficacies were compared after 3 courses.ResultThe total effective rate was 96.7% in the treatment group versus 83.3% in the control group, and the difference was statistically significant (P<0.05).ConclusionAcupuncture plus TDP and auricular point sticking can produce a marked therapeutic efficacy in treating chronic pelvic infection, and its total effective rate is higher than that of acupuncture plus TDP.

Endoscopic ultrasound guided fine needle aspiration biopsy of the pelvic lesions / 中华消化内镜杂志

Objective Endoscopic ultrasound guided fine needle aspiration biopsy (EUS-FNA) was performed for diagnosis and treatment of the pelvic Lesions and safety of this method were evaluated.Methods EUS-FNA was performed in 52 patients with pelvic Lesions selected by EUS,CT or MRI between March 2009 and June 2012.Both 19 and 22 gauge needles were used for EUS-FNA.The tissue specimens were analyzed by cytologic or histologic examination.The pelvic cystic lesions were drained and in which purulent lesions were lavaged with Metronidazole repeatedly.Results All patients recieved fine needle biopsy of the pelvic lesions.Among the 52 lesions,there were 42 solid lesions,10 cystic lesions.In solid lesions,cytology and pathology demonstrated malignant tumors in 28 patients,3 cases of malignant stromal tumors,3 cases of Inflammatory mass cases,2 cases of lymphoma,1 case of dermoid cyst,5 cases of other.In cystic lesions,2 cases of serous cystadenoma,perirectal abscess in 8 cases.6 purulent lesions were lavaged with Metronidazole repeatedly.Diagnosis rates of samples for immunohistology remained similar between 22 gauge and 19 gauge needles (P ＞0.05).During the operation,8 cases of perirectal abscess patients have different degree of pain.There were no other complications after the procedures except one patient suffering from fever.Conclusion EUS-guided FNA is minimaly invasive,a safe and accurate method for diagnosis of pelvic lesions.

Multicenter randomized controlled clinical study on levornidazole and sodium chloride injection in the treatment of pelvic anaerobic infections / 中华妇产科杂志

Objective To evaluate clinical efficacy and safety of levornidazole in the treatment of pelvic anaerobic infections. Methods A multicenter randomized controlled clinical study was conducted to evaluate clinical efficacy and safety of levornidazole. One hundred and fourty-three patients with pelvic anaerobic bacteria infection were classified into 70 cases treated by levornidazole in study group and 73 cases treated by Ornidazole in control group. Those patients in two groups were both administered at a dose of 0. 5 g twice daily for 5 - 7 days. The rate of clinical efficacy, bacteria clearance and adverse effect were recorded and compared between two groups. Results At the endpoint, the rate of clinical efficacy were 80% (56/70) in study group and 81% (59/73) in control group, which did not reach significant difference (P＞0. 05). The rate of bacteria clearance were 97% (36/37) in study group and 92% (22/24) in control group, which also did not reach significant difference(P ＞0. 05). The rate of adverse reaction of 3% (20/70) in study group was significantly lower than 22% ( 16/73 ) in control group ( P ＜ 0. 05 ). Conclusion It is effective and safe to treat pelvic anaerobic infections with levornidazole and sodium chloride injection.

Incidência da tricomoníase em mulheres atendidas pelo sistema único de saúde em cascavel e no oeste do Paraná / Occurrence of tricomoniasis in women attended by the main health system in cascavel and in the west of Paraná

O Trichomonas vaginalis é o agente etiológico da tricomoníase, parasita do sistema urogenital humano e está associada a sérias complicações de saúde. Infecta principalmente o epitélio do trato genital na região da ectocérvice, podendo ser assintomática ou sintomática. O objetivo do trabalho foi verificar a incidência do protozoário Trichomonas vaginalis e estabelecer a faixa etária mais atingida por este parasita em pacientes do SUS de Cascavel e na região Oeste do Paraná. Foram analisadas 211.940 amostras de exames preventivos de pacientes com idade entre 12 e 64 anos ou mais. Os dados foram obtidos pelo DATASUS, disponíveis na internet, no período de janeiro a maio de 2006. Do total de amostras analisadas, 3.752 pacientes apresentaram infecção por T. vaginalis no Paraná, sendo 13,19% (n=495) na região Oeste e 2,24% (n=86) em Cascavel. A faixa etária mais acometida foram mulheres de 20 a 49 anos, sendo que acima de 50 anos a frequência foi diminuindo gradativamente, tanto na região Oeste como em Cascavel. No nível estadual a maior frequência foi entre mulheres de 40 a 44 anos (15,06%). Já na região Oeste e em Cascavel, a faixa etária entre 45 a 49 anos apresentou maior número de casos positivos (17,37%). A queda da incidência da tricomoníase entre mulheres acima de 50 anos pode resultar da ausência do hormônio estrogênio como fator inibidor da proliferação do parasita. Já nas mulheres de 20 a 49 anos, as alterações hormonais características do ciclo reprodutivo feminino podem contribuir para aumentar os índices da doença.

The Trichomonas vaginalis is the etiological agent of Trichomoniasis, a parasite of the human urogenital system associated to a number of health problems. It infects specially the genital epithelium in the ectocervical region, being asymptomatic or symptomatic. The purpose of this study was to verify the occurrence of the Trichomonas vaginalis protozoan and to establish the age group most affected by this parasite in SUS patients in Cascavel and in the West region of Paraná. There were 211,940 analyses of samples in preventive exams in patients aging 12 to 64 years old, or sometimes even older. The data was obtained by DATASUS, available on the internet, from January to May of 2006. From the total of samples analyzed, 3,752 patients presented the infection by T. vaginalis in Paraná: 13.19% (n=495) in the West region and 2.24% (n=86) in Cascavel. The age group that was more harmed was the one composed by women from 20 to 49 years old, and the ones above 50 years old the frequency started to lower gradually, in the West region and also in Cascavel. In a state level the biggest frequency was between women from 40 to 44 years old (15.06%). In the west region and in Cascavel, the age group from 45 to 49 years old presented a bigger number of positive cases (17.37%). The drop of the occurrence of the Trichomoniasis between women above 50 years old can be a result of the lack of the estrogen hormone as a preventing factor. In women from 20 to 49 years old the hormonal alterations of the reproductive cycle can contribute to increase the levels of the disease.

Fatores de risco para complicações das feridas cirúrgicas abdominais: uma revisão sistemática da literatura / Risk factors for surgical wound complications following abdominal surgery: a systematic literature review / Factores de riesgo para complicaciones de las heridas quirúrgicas abdominales: una revisión sistemática de la literatura

INTRODUÇÃO: Neste estudo, realizou-se uma revisão sistemática da literatura com o objetivo de identificar os fatores de risco para complicações de feridas cirúrgicas abdominais. Utilizou-se uma estratégia de busca de artigos aplicada às bases de dados Lilacs, BDENF, Pubmed e Cochrane, no período de 1986 a 2006, nos idiomas inglês, português e espanhol. Somente os ensaios clínicos randomizados controlados e metanálise foram incluídos. Com base nesses critérios, fizeram parte da amostra sete estudos. RRESULTADOS: Os fatores identificados como significantes para desenvolver complicações das feridas cirúrgicas abdominais foram relacionados à técnica cirúrgica, à incisão abdominal, ao tabagismo, ao tipo de curativo utilizado na ferida operatória, tricotomia, uso de dois bisturis e de máscaras cirúrgicas em cirurgias. CONCLUSÃO: os estudos que fizeram parte desta revisão limitaram-se a cirurgias limpas e eletivas, logo, os resultados devem ser interpretados com muito cuidado quando for estendido para os demais tipos de cirurgias. Ensaios clínicos randomizados controlados envolvendo pacientes de cirurgia abdominal deverão ser realizados com o intuito de investigar outros fatores de risco para complicações na ferida cirúrgica.

A systematic literature review was carried out to identify risk factors for surgical wound complications following abdominal surgery. Studies published in English, Portuguese and Spanish in the period of 1986 to 2006 were obtained from LILACS, BDENF, PUBMED and COCHRANE database. Only randomized controlled clinical essays and meta-analyses were included. Based on these criteria, seven studies were selected. Results: risk factors associated to developing surgical wound complications included surgical technique, abdominal incision, use of two scalpels, use of surgical masks, surgical wound dressing, trichotomy and smoking. Conclusions: once the studies included in this review were limited to clean and elective surgeries, results should be interpreted with great care when extended to other types of surgeries. Controlled and randomized clinical studies involving abdominal surgery patients should be carried out to examine other risk factors for surgical wound complications.

Se efectuó una revisión sistemática de la literatura con el objeto de identificar los factores de riesgo asociados a complicaciones de heridas quirúrgicas abdominales. Fue utilizada una estrategia de búsqueda de artículos aplicada a las bases de datos LILACS, BDENF, PUBMED y COCHRANE, limitándose al período de 1986 a 2006 en los idiomas inglés, portugués y español. Solamente se incluyeron los ensayos clínicos controlados aleatorios y meta-análisis. Basados en estos criterios, se consideraron siete estudios en la muestra. Resultados: los factores identificados como significativos para desarrollar complicaciones de heridas quirúrgicas abdominales estaban relacionados con la técnica quirúrgica, incisión abdominal, tabaquismo, tipo de curativo de las heridas operatorias, tricotomía, bisturís y barbijos quirúrgicos. Conclusiones: como los estudios que formaban parte de la revisión se limitaban a cirugías limpias y electivas sus resultados deben interpretarse con mucho cuidado cuando se extiendan a otros tipos de cirugías. Deberán realizarse estudios clínicos controlados y aleatorios involucrando a pacientes de cirugía abdominal para investigar otros factores de riesgo asociados a las heridas quirúrgicas.

CT-guided transgluteal approach for drainage of deep pelvic abscesses / 中华放射学杂志

Objective To evaluate the safety and efficacy of CT-guided transgluteal approach for drainage of deep pelvic abscesses. Methods From April 2000 to August 2007, 12 patients with deep pelvic abscesses underwent CT-guided transgluteal drainage. The clinical data, number of drainage cathete rsplaced, amount of drain, duration of placement, complications and follow-up were retrospectively analysed.Results One drainage catheter was successfully placed for each patient. The amount of abscess drained was30 to 180 ml (mean 52 ml) and the duration of placement was 6 to 34 days (mean 11 days). No major complications occurred. Conclusion The transgluteal approach to the drainage of deep pelvic abscess under CT guidance was safe and effective.

The Influence of Ze Xie and Dan Shan Root on the Immunity Regulation and the Expression of Radical in Mice with Chronic Pelvic Infection / 医学研究杂志

Objective To study into the influence of Ze Xie and Dan Shan root on the immunity regulation and the expression of radical in mice with chronic pelvic infection. Methods The model of mice with chronic pelvic infection was established by putting phenol into the endometrium of the mice. The density change of serum IL -2, TNF, SOD and MDA of the mice was measure by the method of radiation immunity and the method of biochemistry. Results The expression of serum IL - 2 and SOD in Ze Xie and Dan Shan root group was obviously higher than that in the model group( P

Clinical Observation on Treating Chronic Pelvic Infection by Using Baijiang Enema Liquid Combined with Special-ray Therapeutic Apparatus / 医学研究杂志

Objective To observe the clinical curative effect of baijiang enema liquid combined with special - ray therapeutic apparatus on chronic pelvic infection. Methods 120 cases with chronic pelvic infection were randomly divided into 60 cases in treatment group and 60 in control group. Cases in the treatment group were treated by enema of Baijiang enema liquid combined with special - ray therapeutic apparatus, and cases in the control group were treated by rectal administration of Kangfu Anti - inflammatory Suppository combined with special -ray therapeutic apparatus,with 15 days for a treatment course and 2 courses for treatment. Results The comprehensive effect, TCM syndrome effect and signs effect in treatment group were better than those in control group (P