Prevalencia de infecciones de transmisión sexual e infecciones vaginales en grupo de mujeres reclusas de la cárcel de Arica

Resumen Introducción: Las infecciones de transmisión sexual (ITS) han incrementado su incidencia universalmente en la última década, incluido Chile. Una de las poblaciones afectadas es la privada de libertad. Objetivo: Evaluar la prevalencia ITS en mujeres del Centro de Detención Preventiva de Arica y Parinacota (Chile) y su asociación con factores biodemográficos. Metodología: En 127 mujeres se realizó un análisis bivariado de los resultados de serología para VHB, VHC, VIH1-2 y VDRL, y un estudio de flujo vaginal convencional microbiológico incluyendo Trichomonas vaginalis, Neisseria gonorrhoeae y Chlamydia trachomatis. Resultados: El 33,1% de las reclusas tuvo al menos una ITS; aquellas menores de 34 años, las consumidoras de drogas y con más de una pareja sexual tuvieron mayor riesgo. Las ITS prevalentes fueron infección por VIH (15,7%) y sífilis (7,9%) asociadas al consumo de drogas y relaciones sexuales antes de 14 años. Trichomonas vaginalis (12,9%) se encontró en mujeres jóvenes con más de una pareja sexual. El 53,2% tuvo un cultivo de flujo vaginal positivo, principalmente con Gardenella vaginalis (32,3%), asociada al mayor número de parejas sexuales y menor tiempo de estadía en reclusión. Candida albicans (11,3%) tuvo mayor prevalencia en mujeres entre 19 y 24 años no heterosexuales. Chlamydia trachomatis, VHB, VHC y N. gonorrhoeae tuvieron prevalencias menores. Conclusión: Existe una alta frecuencia de infección por VIH, sífilis y T vaginalis, predominio de G. vaginalis en aproximadamente un tercio de las mujeres estudiadas y en sobre la mitad de los casos estudiados se comprobó una disbiosis vaginal.

Abstract Background: Sexually transmitted infections (STIs) have increased their incidence worldwide in the last decade, as well as in Chile. One of the affected populations is the deprived of liberty. Aim: To evaluate the STI prevalence in women from the Arica y Parinacota Preventive Detention Center (Chile) and its association with biodemographic factors. Methods: 127 women were studied who underwent a bivariate analysis of the serology results for HBV, HCV, HIV1-2 and VDRL, and a study of conventional microbiological vaginal discharge including Trichomonas vaginalis, Neisseria gonorrhoeae and Chlamydia trachomatis. Results: 33.1% of the inmates had at least one STI, where, women under 34 years old, drug use and more than one sexual partner were at greater risk. The most prevalent STI were HIV infection (15.7%) and syphilis (7.9%) associated with drug use and sexual intercourse before the age of14. Trichomonas vaginalis (12.9%) was identified in young women with more than one sexual partner. 53.2% had a positive culture, mainly with Gardenella vaginalis (32.3%) associated with an increase in sexual partners and a shorter stay in prison. Candida albicans (11.3%) had a higher prevalence in non-heterosexual women between 19 and 24 years old. Chlamydia trachomatis, HBV, HCV and N. gonorrhoeae had lower prevalences. Conclusion: There is a high frequency of HIV infection, syphilis and T. vaginalis, predominance of G. vaginalis in approximately a third of the women studied and about half of the cases studied had vaginal dysbiosis.

Gynaecological bacterial infections: the physical and psychosocial consequences and challenges of management in resource-limited settings

Gynecological bacterial infections (GBIs) are prevalent in our environment and as a result pose a number of physical, social and psychological consequences. These infections are acquired through several ways. Treating GBIs is a daunting task making its control the most important strategy to alleviating its physical and psychosocial consequences. To highlight the physical, social, and psychological consequences of gynaecological bacterial infections in our resource limited setting. To highlight the hugely unresolved challenges associated with the management of gynecological bacterial infections in our resource-limited setting. Several databases (Medline, Google Scholar, Pubmed, WHO’s Hinari and Wikipedia) and some selected websites were searched using the following keywords: gynecological infections, vaginal infections and discharges, vaginal flora, sexually transmitted infections, pelvic inflammatory disease, syndromic management and challenges, psychosocial consequences, alternative medicine. A total of 5470 relevant articles were obtained between 1947 and 2018. Out of these only 256 relevant articles on the topic were reviewed. However, 213 were dropped for having an incomplete submission. Forty-three (43) articles were fully accessed and referenced. The high prevalence of GBIs poses a lot of burden on the reproductive and socio-economic lives of our women. This should be matched by behavioral changes, prompt diagnosis and early treatment; facilitated by accessible and affordable health care through improved government funding.

Prevalencia y factores asociados con vaginosis bacterianas, candidiasis y tricomoniasis en dos hospitales de los municipios de Apartadó y Rionegro -Antioquia, 2014 / Prevalence of bacterial vaginosis, candidiasis, trichomoniasis, and associated factors in two hospitals of Apartadó and Rionegro - Antioquia, 2014

RESUMEN Objetivo: determinar la prevalencia de vaginosis bacteriana (VB), candidiasis, tricomoniasis y sus factores asociados, en las mujeres que consultan al servicio de citología de dos empresas sociales del estado (ESEs) de los municipios de Apartadó y Rionegro, año 2014. Metodología: estudio descriptivo de corte transversal. Fuente de información secundaria: base de datos del Laboratorio de Citología de la Escuela de Microbiología. Población: 6447 registros de mujeres del servicio de citología de los municipios de Apartadó y Rionegro. 3.762 registros de Apartadó y 2.685 registros de Rionegro año 2014. Se calcularon frecuencias absolutas, relativas e intervalos de confianza. Se exploró la asociación entre las variables independientes con relación significativa con los microorganismos estudiados, luego se ingresaron a un modelo de ajuste multivariado de regresión logística binaria. Nivel de significación estadística del 0,05. Los datos se almacenaron y analizaron en SPSS 20,1®. Resultados: la prevalencia de vaginosis bacteriana fue 29,9 %, candidiasis del 10,7 %, y tricomoniasis del 3,2 %. No hubo diferencias significativas en las infecciones en ambos municipios. No se encontró asociación estadística significativa con los factores de riesgo estudiados. Conclusiones: el comportamiento de las VB, cándida y trichomona fue muy similar al reportado en otras investigaciones y no se encontró diferencia en el comportamiento en los municipios estudiados, a pesar de ser contextos socioeconómicos y culturales diferentes.

SUMMARY Objective: To determine the prevalence of bacterial vaginosis, candidiasis, trichomoniasis, and associated factors in women who use the cytology service of two hospitals in Apartadó and Rionegro in 2014. Methodology: Descriptive cross-sectional study. Data source: the cytology laboratory database of the School of Microbiology. Study population: 6447 samples from women who attended the cytology service in Apartadó hospital with 3,762 records and Rionegro hospital with 2,685 records. Absolute and relative frequencies with confidence intervals were calculated, the association between the independent variables that showed significant association with the microorganisms studied were explored, and then, entered in a multivariate binary logistic regression model. In all analyzes statistical significance level of 0.05 was accepted and data were stored and analyzed with SPSS 20,1®. Results: The prevalence of bacterial vaginosis was 29.9 %, candidiasis 10.7% and trichomoniasis 3.2 %. No significant differences between municipalities were observed nor statistically significant association with any of the risk factors studied. Conclusions: The behavior of BV, candida and trichomona were very similar to those reported in other researches and no difference was found between the studied municipalities, despite the differences in socioeconomic and cultural contexts.

The Effect of Supplementation of Standard Antibiotic Therapy with Oral Probiotics for Bacterial Vaginosis

Background: Bacterial vaginosis is a common cause of vaginal infection worldwide in women of child bearing age. It can be asymptomatic or mild infection but can lead to many complications especially during pregnancy. Recurrence is also frequently seen in women suffering from bacterial vaginosis. This infection usually occurs when normal lactobacillus flora in vagina is disrupted and replaced by pathogens. Administration of probiotics will restore normal vaginal flora and maintain normal pH and it could prove to be a reliable alternative to antibiotics in future. Objective: To assess the effect of supplementation of standard antibiotic therapy with oral probiotics (Lactobacillus) for treatment of bacterial vaginosis. Material Methods: It was an open labeled prospective study in which 100 women diagnosed with bacterial vaginosis were randomly divided into two groups. Diagnosis was made using Amsel’s criteria and Nugent scoring was done. Group A was given Oral Metronidazole, 400 mg BD for 7 days along with oral probiotic tablet containing Lactobacillus rhamnosus BD for 6 weeks whereas Group B was administered Oral Metronidazole, 400 mg BD for 7 days. Patients were assessed at 7 days for symptomatic improvement and again at the end of 6 weeks using Nugent scores. Results obtained were then compared. Results: Out of all patients 2 patients in Group A and 5 patients in Group B could not complete the study. At the end of 7 days, there was improvement in symptoms ie decrease in itching, odour and discharge. There was a significant difference in mean Nugent score before and after treatment between group A and group B at the end of 6 weeks. Conclusion: This study concluded that improvement in patients taking probiotics along with standard antibiotic therapy was significantly more as compared to antibiotics alone.

The Effect of Supplementation of Standard Antibiotic Therapy with Oral Probiotics for Bacterial Vaginosis

Background: Bacterial vaginosis is a common cause of vaginal infection worldwide in women of child bearing age. It can be asymptomatic or mild infection but can lead to many complications especially during pregnancy. Recurrence is also frequently seen in women suffering from bacterial vaginosis. This infection usually occurs when normal lactobacillus flora in vagina is disrupted and replaced by pathogens. Administration of probiotics will restore normal vaginal flora and maintain normal pH and it could prove to be a reliable alternative to antibiotics in future. Objective: To assess the effect of supplementation of standard antibiotic therapy with oral probiotics (Lactobacillus) for treatment of bacterial vaginosis. Material Methods: It was an open labeled prospective study in which 100 women diagnosed with bacterial vaginosis were randomly divided into two groups. Diagnosis was made using Amsel’s criteria and Nugent scoring was done. Group A was given Oral Metronidazole, 400 mg BD for 7 days along with oral probiotic tablet containing Lactobacillus rhamnosus BD for 6 weeks whereas Group B was administered Oral Metronidazole, 400 mg BD for 7 days. Patients were assessed at 7 days for symptomatic improvement and again at the end of 6 weeks using Nugent scores. Results obtained were then compared. Results: Out of all patients 2 patients in Group A and 5 patients in Group B could not complete the study. At the end of 7 days, there was improvement in symptoms ie decrease in itching, odour and discharge. There was a significant difference in mean Nugent score before and after treatment between group A and group B at the end of 6 weeks. Conclusion: This study concluded that improvement in patients taking probiotics along with standard antibiotic therapy was significantly more as compared to antibiotics alone.

Infecciones vaginales en un Centro de Salud Familiar de la Región Metropolitana, Chile / Vaginal infections in a Family Health Clinic in the Metropolitan Region, Chile

Background: Vaginal infections are a frequent cause for consultation, but their prevalence and etiology vary in different populations. Objectives: To determine the prevalence and etiologies of vaginal infection in women attending a family health center in the Metropolitan Region of Chile. Methods: The microbiological diagnosis was made by wet mount and Gram stain. Diagnosis of trichomoniasis was performed by wet mount, culture and polymerase chain reaction. Results: 101 women aged 15-54, not selected by signs or symptoms of vaginal infection, 46 of them pregnant were included. In 47 women (46.5%), vaginal infections were diagnosed. An association was observed between age and frequency of vaginal infection. The proportion of infections among pregnant and non-pregnant women was similar. The most frequent infections were bacterial vaginosis (16.8%), vulvovaginal candidiasis (11.9%) and co-infections (6.9%). We found 5.9% of intermediate microbiota cases, 3% of trichomoniasis and 2% of aerobic vaginitis. Symptoms of vaginal infection had poor agreement with microbiological findings. Otherwise physical signs had good agreement with the presence of infection, but low to moderate concordance with a specific etiology. Conclusions: We found a high prevalence of vaginal infections in the study population. It is necessary to improve the definitions and criteria of microbiological diagnosis of co-infections and intermediate microbiota, for them to be diagnosed in the clinical practice. More descriptive questionnaires are recommended to enhance the usefulness of clinical examination.

Introducción: Las infección vaginales constituyen un motivo frecuente de consulta, pero su prevalencia y etiología varían en distintas poblaciones. Objetivos: Determinar la prevalencia y tipos de infección vaginal en mujeres atendidas en un centro de salud familiar de la Región Metropolitana. Métodos: El diagnóstico microbiológico fue efectuado mediante examen microscópico al fresco y tinción de Gram y para tricomoniasis examen al fresco, cultivo y reacción de la polimerasa en cadena. Resultados: Se incluyeron 101 mujeres de 15-54 años, no seleccionadas por signos ó síntomas, 46 de ellas embarazadas. En 47 mujeres (46,5%) se diagnosticaron infecciones vaginales. Se observó asociación entre edad y frecuencia de infección vaginal. La proporción de infecciones entre gestantes y no gestantes fue similar. Las infecciones más frecuentes fueron vaginosis bacteriana (16,8%), candidiasis vulvo-vaginal (11,9%) y co-infecciones (6,9%). Se observó 5,9% casos de microbiota intermedia, 3% de tricomoniasis y 2% de vaginitis aeróbica. Los síntomas de infección vaginal tuvieron mala concordancia con los hallazgos microbiológicos. A su vez, los signos físicos tuvieron buena concordancia con la existencia de infección, pero escasa a moderada concordancia con una etiología específica. Conclusiones: Se encontró alta frecuencia de infecciones vaginales. Es necesario mejorar las definiciones y criterios de diagnóstico microbiológico de las co-infecciones y microbiota intermedia, para ser diagnosticadas en la práctica clínica. Se recomienda emplear cuestionarios más descriptivos para mejorar la utilidad del examen clínico.

Randomized, single-blinded comparison of efficacy, safety and tolerability of metronidazole 750mg - miconazole 200mg vaginal suppository vs. metronidazole 500mg - nystatin 100, 000 IU vaginal suppository in the treatment of bacterial vaginosis, vulvovaginal candidiasis, trichomoniasis, and mixed vaginal infections / Philippine Journal of Obstetrics and Gynecology

OBJECTIVE: This randomized, single-blind, two-arm controlled study compared the efficacy, safety, and tolerability of an intravaginal suppository preparation containing metronidazole 750mg + miconazole 200mg (Neopenotran Forte) with another vaginal preparation containing metronidazole 500 mg + nystatin 10000 IU (Flagystatin) in the treatment of bacterial vaginosis (BV), candidal and trichomonial vulvovaginitis (CVV, TV), mixed vaginitis and in the prevention of secondary candidal vulvovaginitis. MATERIALS AND METHODS: Women ages 18-45 years with chief complaints of abnormal vaginal discharge or vaginal/vulvar itching were examined and microbiologic confirmation of BV, VVC, TV or mixed infection was made. They were then randomly assigned to receive either treatment once daily (nightly) for 7 days. A total of 261 subjects had evaluable clinical and microbiological findings at the end of the study. Test of cure by Amsel criteria and Nugent score were performed twice after treatment. RESULTS: The overall test revealed that microbiological cure rate is significantly different between the two treatment groups. CONCLUSION: The odds of being cured microbiologically is 2.35 times more in the metronidazole 750mg + miconazole nitrate 200mg group compared to the metronidazole 500 mg + nystatin 10000 IU group. However, no significant difference in the clinical cure between the two groups was found. Both drugs are safe and convenient to use.

Application of evidence-based nursing in health education for patients with mixed vaginal infections / 现代临床护理

Objective To explore the applications effect of evidence-based nursing in the health education for patients with mixed vaginal infections.Methods One hundred and sixty-eight patients with mixed vaginal infection were divided into observation group(n=84) and control group(n=84).Based on the evidence-based nursing method,the observation group first raised questions,then sought evidence to determine the conclusion according to the literature search,and finally combined with clinical evidence to formulate a reasonable plan for health education and effectively implemented.The control group was given conventional nursing.The two groups were compared in terms of rate of disease-related awareness in return visit 1 month after discharge,behavior 2 months after discharge and disease relapse 6 months after discharge.Results The rate of disease-related awareness and behavior in the experiment group were better than those of the control group significantly(all P<0.05).The rate of disease relapse of the experiment group was lower than that of the control group(P<0.01).Conclusion Application of evidence-based nursing method for patients with vaginal infections in health education can guide the nurses' health education target,improve the patients' cognitive and behavior and reduce the rate of disease relapse.

Análisis genético y propiedades virulentas de cepas de Escherichia coliaisladas desde infección vaginal / Genetic analysis and virulent properties of Escherichia colistrains isolated from vaginal infection

Background: Escherichia coliis able to produce different infections in humans. It pathogenicity in the female genital tract is unknown. Objective:To determine the presence of virulence genes (VG) in E. colistrains isolated from the female genital tract. Material and Methods:146 E. colistrains isolated as monomicrobial cultures from vaginal infections were genetically characterized by search of hly, iucC, afa, fimH, neuC, sfa/foc, cnF1, papC, usp,and ibeAVG. Studies were performed by means PFGE and PCR. Results:Genetic analysis of the strains showed two groups with a similarity of approximately 80%. The similarity genetic intragroup was approximately 95%. The results showed strains with a high number of VG and the most common were cnf1andfimH.The afagene was not detected. Were identified eight VG combinations and the most common was papC+ hly+ iucC+ afa- neuC- fimH+ sfa/foc+ cnf1+ usp+ ibeA-. Discussion:The studied strains are concentrated in two genetic groups. Most of the strains contain a great number of VG present in E. coliisolated from extraintestinal infections. Conclusion:It is important to develop new research strategies in this area, to deepen the phylogenetic knowledge of these strains and confirm their true role in vaginal infection.

Introducción: Escherichia colies capaz de producir diferentes cuadros infecciosos en el ser humano. Su patogenicidad en el tracto genital femenino es discutible. Objetivo:Determinar la presencia de genes de virulencia (GV) en cepas de E. colide procedencia vaginal. Material y Métodos:146 cepas de E. coliaisladas desde infecciones vaginales a partir de cultivos monomicrobianos fueron estudiadas mediante EGCP y RPC. Los genes investigados fueron: papC, hly, iucC, afa, fimH, neuC, sfa/foc, cnf1, usp,e ibeA. Resultados:El análisis genético de las cepas demostró dos grupos con una similitud aproximada a 80% según Dice. La similitud genética intra-grupo fue aproximadamente de 95%. Los resultados mostraron cepas con un alto número de GV, siendo más comunes cnf1 y fimH.El gen afano fue detectado. Se determinaron ocho combinaciones de GV siendo la más común papC+ hly+ iucC+ afa- neuC- fimH+ sfa/foc+ cnf1+ usp+ibeA-. Discusión:las cepas estudiadas se concentran en dos grupos genéticos característicos y la mayoría de las cepas analizadas concentra un importante número de GV presentes en E. coliaisladas de infecciones extra-intestinales. Conclusión:Es importante desarrollar nuevas estrategias de investigación en esta área, que permitan profundizar el conocimiento filogenético de estas cepas y confirmar su verdadero rol en la infección vaginal.

Resultados de una encuesta epidemiológica de hábitos de higiene íntima en mujeres latinoamericanas / Resultof of an epidemiological survery about hygiene habits in latin american women

Describir los hábitos higiénicos íntimos femeninos de algunas mujeres de Latinoamérica durante 2008. Se aplicó una encuesta piloto, previamente diseñada, a un total de mil mujeres que acudieron a la consulta de un grupo de ginecólogos de Latinoamérica durante 2008 y aceptaron contestar voluntariamente la encuesta. Los países participantes fueron: Colombia, Costa Rica, Ecuador, Guatemala, Honduras, México, Panamá, Perú, República Dominicana y Venezuela. El 95,4 por ciento de las mujeres refirió realizar aseo corporal una o más veces al día y 2,8 por ciento, una o dos veces por semana. El 71 por ciento realiza aseo del área genital de adelante hacia atrás (de vulva a ano). El tipo de jabón más comúnmente usado es el jabón en barra, seguido de la presentación líquida. Se evidenció un porcentaje de 66,9 por ciento de mujeres que depilan su área genital. El área circunscrita al bikini es la más depilada con 32,8 por ciento y la depilación del área genital en su totalidad es de 28,8 por ciento. El material de la ropa interior en la región vulvar más utilizado por las mujeres latinoamericanas encuestadas es el algodón (65,5 por ciento), que sumado a 20,2 por ciento de las mujeres que utilizan ropa interior de cualquier material con algodón fue cercano al 86 por ciento. En relación con el uso de elementos de aseo genital durante las relaciones sexuales, 29,7 por ciento de las mujeres encuestadas refiere utilizar duchas vaginales; de las cuales 42 por ciento refirió su uso siempre que tiene relaciones sexuales y 43 por ciento, ocasionalmente. A la costumbre de orinar antes y después de tener relaciones sexuales se encontró que 37,9 por ciento de las mujeres orina después del coito; 17 por ciento, antes y 11,8 por ciento orina antes y después. Las mujeres realizan en un gran porcentaje lavado de manos después de orinar o defecar, pero el hábito de lavarse las manos antes, sigue siendo bajo. En cuanto a la técnica de aseo genital, el porcentaje de técnica inadecuada...

To describe the intimate hygienic feminine habits of some women of Latin-America during 2008. A previously designed pilot survey was applied to a total of one thousand women who assisted to the office of a group of gynecologists of Latin America during 2008 and agreed to voluntarily answer the survey. The participant countries were: Colombia, Costa Rica, Ecuador, Guatemala, Honduras, Mexico, Panama, Peru, Dominican Republic and Venezuela.95.4 percent of these women practiced corporal hygiene at least once daily and 2.8 percent, once or twice a week. 71 percent cleaned their genital area backwards (from vulva to anus). The type of soap most commonly used is the bar soap followed by liquid body wash. Evidence showed that 66.9 percent of women depilate their genital area. The bikini surrounding area is the most depilated one, with a 32.8 percent and the total depilation of the genital area is 28.8 percent. Cotton is the most commonly used material for underwear on the vulvar area by surveyed Latin American women (65.5 percent), which added to a 20.2 percent of women who use underwear of any material with cotton was nearly 86 percent. When the use of genital hygiene devices during sexual intercourse is questioned, 29.7 percent of the surveyed women opted to use vaginal showers; of which 42 percent used it every time they had sexual intercourse and 43 percent just occasionally. In relation to the habit of urinating before and after having sexual intercourse it was established that 37.9 percent of women urinate after the coitus; 17 percent before it, and 11.8 percent urinates before and after. Women, in a great percentage, wash their hands after urinating or defecating, but the habit of washing their hands before is still not as frequent. Regarding the genital (feminine) hygiene technique, the percentage of "inadequate" hygiene technique is surprisingly as low as about 28 percent. With this in mind, it is fundamental to reinforce training, improve information...

Factores de riesgo asociados al bajo peso al nacer / Risk factors associated to low birth weight

Se efectuó un estudio de casos y controles de 210 puérperas cuyos hijos nacieron pesando menos de 2 500 gramos (grupo de estudio) en el Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, durante el 2008, para identificar los factores de riesgo asociados al bajo peso al nacer. Los tomados como controles se escogieron a partir de un muestreo aleatorio sistemático por orden de consecutividad en dicho período. Entre los factores de riesgo causantes de ese déficit ponderal figuraron: procedencia rural, ganancia insuficiente de peso materno, período intergenésico menor de 2 años, hipertensión inducida por el embarazo y edad gestacional por debajo de 37 semanas. Las afecciones respiratorias y las infecciones vaginales constituyeron las principales causas de morbilidad; y la sepsis urinaria, de mortalidad.

A case-control study of 210 newly-delivered women whose children were born weighting less than 2 500 grams (study group) was carried out in "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital from Santiago de Cuba, during the 2008, to identify the risk factors associated with low birth weight. The control group was chosen from a systematic random sampling by consecutive order in this period. Among the causative risk factors of that deficit there were: rural origin, low gain of maternal weight, period between pregnancies shorter than 2 years, pregnancy induced hypertension and gestational age under 37 weeks. Breathing disorders and the vaginal infections constituted the main morbidity causes; and the urinary sepsis, the main mortality cause.

Diagnóstico y prevalencia de infecciones vaginales / Diagnosis and prevalence of vaginal infections

Las infecciones del aparato genital femenino constituyen un problema importante de la práctica ginecoobstétrica. Son causa de morbilidad, mortalidad materna y neonatal. Entre los factores que explican su frecuencia están: aborto provocado, aumento de intervenciones quirúrgicas e infecciones de transmisión sexual. OBJETIVO: Realizar el diagnóstico y determinar la prevalencia de infecciones vaginales en mujeres que asisten al Laboratorio de Microbiología del Hospital Ginecoobstétrico "Ramón González Coro" con la utilización del Juego de diagnóstico de infecciones vaginales Newvagin C-Kure. MÉTODOS: Se examinaron 150 mujeres, de edades entre 17 y 74 años, de mayo a octubre de 2007. Se utilizó examen directo, criterios de Amsel y cols, así como prueba de aglutinación al látex. RESULTADOS: La prevalencia de las infecciones vaginales estudiadas fue de 62 % al examen directo y de 58,6 % con la prueba de aglutinación al látex. La infección vaginal con mayor prevalencia fue vaginosis bacteriana, seguida de candidiosis vaginal y trichomoniosis vaginal. El grupo de edad con mayor prevalencia de estas infecciones fue el de 28-37 años. La manifestación clínica más frecuente fue la leucorrea. El inicio precoz de las relaciones sexuales, la realización del acto sexual sin protección y el uso de métodos anticonceptivos, estuvieron relacionados con la presencia de estas infecciones vaginales. CONCLUSIONES: El uso del Juego de diagnóstico de infecciones vaginales NEWVAGIN C-Kure, en consultorios de médicos de familia, policlínicos comunitarios y consultas de ginecología resulta ventajoso. La realización del diagnóstico por el personal paramédico, su rapidez y la certeza en la indicación del tratamiento médico son los principales factores a considerar

The infections of female genital tract are a significant problem of gynecologic and obstetric practice. They are cause of morbidity and of mother and neonatal mortality. Among factors explaining its frequency are: provoked abortion, increase of surgical interventions and sexual transmitted infections. OBJECTIVES:To make the diagnosis and to determine the vaginal infections prevalence in women served in Microbiology Laboratory of "Ram¾n Gonzßlez Coro" using the NEWVAGIN C-Cure diagnosis kit. METHODS: Authors examined to 150 women aged between 17 and 24 from May to October, 2007. Direct examination, Amsel et al criteria and latex agglutination test were used. RESULTS: Prevalence of study vaginal infections was of 62 percent in direct examination and of 58.6 percent using the latex agglutination test. The more prevalent vaginal infection was the bacterial vaginosis followed by vaginal candidiasis and vaginal trichomoniasis. The more prevalent age group with these infections was that aged 28-37. More frequent clinical manifestation was the leucorrhea. The early onset of sexual intercourse, the intercourse without protection and the use of contraceptive methods were related to presence of these vaginal infections. CONCLUSIONS: The use of NEWVAGIN C-Kure diagnosis kit for vaginal infections in family consulting room, community polyclinics and Gynecology consultations is very advantageous. Making diagnosis by paramedical staff, its speed and accuracy in prescription of medical treatment are the leading factors to be considered

Avaliação da influência do uso de métodos contraceptivos sobre os resultados dos esfregaços de Papanicolaou / Evaluation of the influence of contraceptive methods on the results of Papanicolaou smears

Foi avaliada a influência do uso de métodos contraceptivos como dispositivo intrauterino (DIU), contraceptivos hormonais (CPH) e preservativo (PRESER), nos resultados dos esfregaços de Papanicolaou (Pap), por meio de análise retrospectiva de seus laudos e das informações sobre métodos contraceptivos de 2251 mulheres, distribuídas em: DIU (n=80), CPH (n=172), PRESER (n=40) e não usuárias (n=1959). As não usuárias apresentaram mais resultados normais e as com DIU mais alterações benignas. Os três grupos de usuárias, principalmente DIU, manifestaram mais metaplasia escamosa do que as não usuárias. Não houve aumento de ASCUS/LIS ou câncer nas usuárias de métodos contraceptivos. Predominaram as infecções candidíase e vaginose bacteriana e em DIU houve mais vaginose. Actinomyces sp. ocorreu apenas em DIU e Trichomonas vaginalis apenas em não usuárias. Assim, é importante a realização de Pap nas usuárias de DIU e CPH para acompanhar as alterações benignas, pois as mesmas podem predispor e/ou facilitar infecções, incluindo por HPV.

This study aimed to evaluate the influence of the use of contraceptive methods, such as the intrauterine device (IDU), the hormonal contraceptive (HCP) and the preservative (PRESER), on the results of Papanicolaou smears (Pap). A retrospective analysis was conducted based on Papanicolau results and on information from 2251 women's contraceptive methods, distributed in: IDU (n=80), HCP (n=172), PRESER (n=40) and non-users (n=1959). Non-users presented more normal results; and IDU users presented benign alterations. Among the three groups, the IDU users manifested more squaly squamous metaplasia than the non-users. There was no notice of ASCUS/SIL or cancer in the users of contraceptive methods. The infections with candidiasis and bacterial vaginosis prevailed. Particularly in IDU users, there was more vaginosis. Actinomyces sp. was only noticed in IDU users, and Trichomonas vaginalis in non-users. Thus, submitting to Pap examination is mainly important for the users of IDU and HCP due to the benign alterations, because these can be predisposed to and/or facilitate infections, including HPV.

Morbilidad de la madre adolescente / Morbidity of the adolescent mother

Se realizó un estudio retrospectivo de caso control, con la finalidad de conocer la morbilidad del embarazo en las adolescentes atendidas en el hospital "Clodomira Acosta Ferrales" desde el 1ro enero,de 1999 al 31 de marzo del 2000. El grupo estudio fue de 184 adolescente y se comparó con un grupo control representado por las gestantes de 20 a 24 años (n = 439) atendidas en dicho centro, en igual periodo de tiempo. Datos referentes a antecedentes patológicos y complicaciones del embarazo, parto y puerperio, se recogieron en una encuesta habilitada al efecto y se procesaron utilizando el sistema estadístico SPSS. Entre los resultados más relevantes se destacan la alta incidencia de bajo peso materno, la mayor frecuencia de infecciones vaginales, anemia, hipertensión inducida y parto instrumentado, así como desgarros cervicales y hemorragia puerperal entre las adolescentes.

A retrospective case-control study was undertaken with the purpopse of knowing the morbidity of pregnancy in the adolescents attended at “Clodomira Acosta Ferrales” Hospital from January 1st, 1999 to March 31st, 2000. The study group was made up of 184 adolescents and it was compared with the control group composed of expectants between 20 and 24 years old. Data referring to pathological history and pregnancy complications, delivery and puerperium, were collected in a survey. Data were processed by the SPSS statistical system. The high incidence of maternal low birth, the higher frequency of vaginal infections, anemia, induced hypertension and instrumental delivery, as well as cervical tearings and puerperal hemorrhage in adolescents were among the most relevant results.