Caracterización epidemiológica, clínica e histopatológica de los tumores malignos de cérvix en las pacientes sometidas a histerectomía radical tipo Wertheim-Meigs que acuden al servicio de Ginecología y Obstetricia del Hospital General San Juan de Dios, de Guatemala (enero 2017 a diciembre del 2018) / Epidemiological, clinical and histopathological characterization of malignant tumors of the cervix in patients undergoing Wertheim-Meigs radical hysterectomy who attend the Gynecology and Obstetrics service of the San Juan de Dios General Hospital, Guatemala (January 2017 to December 2018)

Los tumores malignos de cérvix continúan siendo un problema de salud pública para nuestro país, es por ello que se consideró de importancia realizar este estudio. Se estudiaron las características clínicas más frecuentes encontradas en las pacientes sometidas dentro de los cuales encontramos como principal motivo de consulta el dolor pélvico con un 86.75%, seguido del sangrado con un 84.34% finalizando con la leucorrea con el 79.52%. En cuanto a la clasificación de los tumores malignos se comprobó que la mayoría de las pacientes presentaron el estadio CaCu IB1 con el 91.57% seguido del CaCu IA1 con el 6.02% finalizando con el CaCu IB2 con el 2.41%. Así mismo, se pudo determinar que los tumores malignos de cérvix más frecuentes en las pacientes estudiadas fue el carcinoma epitelial, seguido del adenocarcinoma de cérvix, siendo su histopatología más encontrada el carcinoma epidermoide no queratinizante de células grandes con el 53.01%. (AU)

Uterine Cervical Cancer continues to be one of the main public health problems in Guatemala, thus being important to do this type of research. The most frequent clinical characteristics found in the present study were pelvic pain (86.75%) followed by bleeding in 84.34% and vaginal discharge in 79.52%. Most of the patients were classified as Stage IB1 (91.57%) followed by Stage IA1(6/02%) and Stage IB2 (2.41%). The most frequent Histologic Type was Squamous Carcinoma. (AU)

Qualidade de vida relacionada à saúde de mulheres em cuidados paliativos em decorrência do câncer do colo do útero avançado / Health-related quality of life of women in palliative care resulting from advanced cervical cancer

Trata-se de um estudo descritivo, transversal e de abordagem quantitativa com o objetivo geral de avaliar o nível da qualidade de vida relacionada à saúde de mulheres em cuidados paliativos ambulatoriais em decorrência do câncer do colo do útero avançado. Objetivos específicos: caracterizar o perfil sociodemográfico e clínico de mulheres em cuidados paliativos ambulatoriais em decorrência do câncer do colo do útero avançado; analisar o nível de qualidade de vida de mulheres em cuidados paliativos ambulatoriais em decorrência do câncer do colo do útero avançado; analisar as relações entre a qualidade de vida relacionada à saúde de mulheres em cuidados paliativos ambulatoriais em decorrência do câncer do colo do útero avançado e as características sociodemográficas, clínicas e sintomas e discutir as contribuições para a prática de enfermagem na perspectiva da promoção da qualidade de vida. Participaram do estudo 60 mulheres com câncer do colo do útero avançado atendidas em um ambulatório de uma unidade hospitalar especializada em cuidados paliativos oncológicos do Rio de Janeiro. Foram aplicados dois instrumentos de coleta de dados: um referente aos dados sociodemográficos e clínicos e o instrumento de qualidade de vida European Organisation for Research and Treatment of Cancer Quality of Life Questionnare-core 15 PAL (EORTC QLQ-C15-PAL). Os dados foram analisados através de estatística descritiva uni e bivariada no software Stata® versão SE 13.0. O estudo foi aprovado pelo Comitê de Ética em Pesquisa conforme Resolução 466 de 12 de dezembro de 2012 do Ministério da Saúde, sendo aprovado sob o número 2.929.726. Os resultados apontaram que a maioria das mulheres possuía mais de 51 anos, se autodeclararam pardas ou pretas, sem parceiro, de religião evangélica, com renda familiar de 1 a 2 salários mínimos, ensino fundamental completo ou incompleto, KPS entre 70% a 50% e com doença pélvica avançada associada à metástase. Sangramento transvaginal e leucorreia com odor foram relatados, respectivamente, por 18,3% e 28,3% das mulheres. A prevalência de colostomia foi de 15,0%, nefrostomia 31,7%, fístula vesicovaginal 28,3% e fístula enterovaginal 11,7%. O escore médio de funcionamento físico foi de 52,5 e de 58,1 para funcionamento emocional. O sintoma com maior média (49,4 - carga moderada) foi a dor. A qualidade de vida global apresentou média de 64,7 e não foi encontrada sua associação com as variáveis sociodemográficas. Todos os sintomas apresentaram correlação negativa com o funcionamento físico e emocional, de maneira que escores mais altos de sintomas estavam relacionados a escores mais baixos de funcionamento físico e emocional. A qualidade de vida global apresentou correlação positiva com o funcionamento físico e emocional e negativa com os sintomas, de maneira que os escores mais altos de sintomas estavam relacionados à escores mais baixos de qualidade de vida global. Os resultados apontaram para o diagnóstico situacional da qualidade de vida relacionada à saúde das mulheres com câncer do colo do útero avançado e seus fatores intervenientes contribuindo para a compreensão do fenômeno e para a reflexão sobre as possibilidades de atuação do enfermeiro na perspectiva da promoção da qualidade de vida sob a perspectiva do Modelo de Adaptação de Roy.

The overall objective of this quantitative, descriptive, cross-sectional study was to assess the health-related quality of life of women in ambulatory palliative care as a result of advanced cervical cancer. Its specific objectives were to compile socio-demographic and clinical profiles of women in ambulatory palliative care as a result of advanced cervical cancer; to analyse the health-related quality of life of women in ambulatory palliative care as a result of advanced cervical cancer; to analyse relations between the health-related quality of life of women in ambulatory palliative care as a result of advanced cervical cancer and their socio-demographic and clinical characteristics and their symptoms; and to discuss contributions to related nursing practices directed to fostering quality of life. The study participants were 60 women with advanced cervical cancer attending an outpatient department of a hospital specialising in cancer-related palliative care in Rio de Janeiro. Two data collection instruments were applied, one for socio-demographic and clinical data and the other, the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire 15 PAL (EORTC QLQ-C15-PAL). Data were analysed using univariate and bivariate descriptive statistics assisted by Stata® version SE 13.0 software. The study was approved by the research ethics committee, pursuant to Ministry of Health Resolution 466 of 12 December 2012 (Approval No. 2.929.726). The results indicated that most of the women were more than 51 years of age, declared themselves to be brown or black, of the neo-Pentecostal faith, had no partner, family income of 1 to 2 minimum wages, complete or incomplete upper secondary education, KPS from 70% to 50% and advanced pelvic disease associated with metastasis. Vaginal bleeding and leucorrhoea with odour were reported, respectively, by 18.3% and 28.3% of the women. Prevalence of colostomy was 15.0%, nephrostomy 31.7%, vesicovaginal fistula 28.3% and enterovaginal fistula 11.7%. Mean scores were 52.5 for physical functioning and 58.1 for emotional functioning. The symptom with the highest mean score was pain (49.4 ­ moderate intensity). Overall quality of life scored a mean 64.7 and no association was found with socio-demographic variables. All symptoms were found to be negatively associated with physical and emotional functioning, so that higher symptom scores correlated with lower physical and emotional functioning scores. Overall quality of life was found to correlate positively with physical and emotional functioning and negatively with symptoms, so that higher symptom scores correlated with lower overall quality of life scores. The findings pointed to a situational diagnosis of health-related quality of life among women with advanced cervical cancer and related intervening factors, and contributed to understanding the phenomenon and to thinking about opportunities for nursing to act so as to foster quality of life from the perspective of the Roy Adaptation Model.

Características clínicas, prevalência e diagnóstico de vulvovaginites em ambulatório do interior do Rio Grande do Sul / Clinical characteristics and prevalence of vulvovaginitis in a clinic in the interior of the Rio Grande do Sul

Introdução: As vulvovaginites são uma das principais queixas no atendimento rotineiro de ginecologia. O diagnóstico correto e o tratamento precoce dessas afecções são importantes além de prevenir possíveis repercussões no trato genital superior. Objetivo: Conhecer as características clínicas e a prevalência das vulvovaginites. Metodologia: Estudo transversal de natureza exploratória e descritiva, de abordagem quantitativa sobre mulheres que foram atendidas na Unidade de Atendimento de um Ambulatório de Ginecologia do Sistema Integrado de Saúde (SIS) na Universidade de Santa Cruz do Sul, no período de setembro de 2014 a maio de 2015. As variáveis analisadas foram: idade, queixas clínicas, exame ginecológico e achados no exame a fresco. Os dados foram analisados no SPSS 22.0. Resultados: Do total de 200 pacientes atendidas no ambulatório, 66 (33%) foram selecionadas para realização do exame a fresco. A leucorreia fisiológica foi diagnosticada em 35 pacientes (53,0%), a vaginose bacteriana em 24 (36,5%), a candidíase em 6 (9,0%) e a tricomoníase em 1 (1,5%). Na vaginose bacteriana leucorreia com odor fétido, na candidíase leucoréia grumosa branca, prurido, ardência, vulva eritematosa e dispaurenia foram significativos para o diagnóstico (p < 0,05). Conclusões: Observou-se que a faixa etária das mulheres acometidas por vulvovaginites foi compatível com a literatura, predominando em idade reprodutiva. Constatou-se que a vaginose bacteriana foi a mais diagnosticada e que a leucorreia com odor fétido foi o sintoma estatisticamente significativo para o diagnóstico. Da mesma forma, a candidíase, com leucorreia grumosa branca, prurido, ardência, vulva eritematosa e dispareunia. (AU)

Introduction: vulvovaginitis are one of the main complaints in the routine care of gynecology. The proper diagnosis and early treatment are important to the patient and prevent possible repercussions in the upper genital tract. Objective: To analyze the clinical characteristics and the prevalence of vulvovaginitis. Methods: Cross-sectional study of exploratory and descriptive, quantitative approach, by applying a structured questionnaire and conducting fresh examination in women who were treated at the Unit Clinical Care of Gynecology of the Integrated Health System (IHS) at the University of Santa Cruz do Sul, from September 2014 to May 2015. The variables analyzed were: age, symptoms, gynecological examination and findings in fresh examination. Data were analyzed by using SPSS 22.0. Results: From a total of 200 patients seen at the clinic, 66 (3.3%) were selected for the performance of the fresh examination. The most common query reason was the collection of cytological (56.0%). Physiological leukorrhea was diagnosed in 35 patients (53.0%), bacterial vaginosis in 24 (36.5%), candidiasis 6 (9.0%) and trichomoniasis in 1 (1.5%). In bacterial vaginosis, a vaginal discharge with foul odor was a significant symptom for diagnosis, in candidiasis, white crumbly leukorrhea, pruritus, burning sensation, dyspareunia, vulvar erythema were also significant for diagnosis (p <0.05). Conclusions: It was observed that the age of women affected by vulvovaginites was consistent with the literature, predominantly at reproductive age. It was found that bacterial vaginosis was the most diagnosed and that foul-smelling vaginal discharge was a statistically significant (p<0.05) symptom for diagnosis. Likewise, in the case of candidiasis, crumbly white leukorrhea, pruritus, burning, vulvar erythema and dyspareunia were statistically significant for diagnosis and considered the cardinal symptoms of vulvovaginites. (AU)

Discussion on application of Chinese medicine treatment of gynecological diseases / 中国中药杂志

With rapid social development rhythm, the incidence of gynecological diseases gradually rise. Traditional Chinese medicine has made irreplaceable position in the treatment of gynecological disease. Due to the characteristics of gynecological diseases, the syndrome differentiation and treatment has unique characteristics. In this paper, according to menstrual disease, leukorrheal diseases, pregnancy diseases, puerperal diseases and miscellaneous diseases in order, combining documents discussion and old doctors of traditional Chinese medicine treatment of gynecological disease experiences, illustrate the key points of drug selection in the treatment process. We can get a revelation that appropriate choice of tradition Chinese medicine is an indispensable part for healing effects. Through the analysis of characteristics of drugs, we can understand the feature of each period in disease of department of gynecology, increase the ability of usinig traditional Chinese medicine and improve the level of clinical treatment.

Leucorrea como signo de infecciones cérvicovaginales / Leucorrhea as a sign of cervico-vaginal infections

Las infecciones vaginales representan uno de los problemas ginecológicos más comunes en mujeres en edad reproductiva. Objetivo: Clasificar la leucorrea fisiológica y patológica de las pacientes investigadas, además de analizar si esta última obedece a infecciones cervico-vaginales. Método: La presente investigación se realizó a población abierta de todas las pacientes que acudieron al laboratorio de biología celular de la Benemérita Universidad Autónoma de Puebla al programa de detección oportuna de cáncer (Papanicolaou) desde enero del 2001 a Diciembre 2012, en las que se obtuvo un total de 1 679 muestras vaginales mismas que fueron teñidas con el tren de tinción de Papanicolaou modificado para su posterior diagnóstico microscópico. Resultados: Se encontró que 923 fueron positivas a leucorrea, de las cuales 489 corresponden a leucorrea fisiológica, 285 leucorrea patológica y las 149 no se ubican en ningún grupo. Discusión: Las infecciones cervico-vaginales se pueden presentar como respuesta a la presencia polimicrobiana que coloniza la cavidad vaginal y que esto conlleva un conjunto de signos y síntomas no específicos de los agentes que las causen, entre los que se encuentra la leucorrea como dato clínico que motiva en muchos casos a la consulta ginecológica. De las infecciones cervico-vaginales, la vaginitis es la causa más común de descarga vaginal patológica o leucorrea seguida de la cervicitis siendo ambas causadas por diversos agentes y de los que se mencionan los más frecuentes.

Vaginal infections are one of the most common gynecological problems in women of reproductive age. Objective: To classify physiological and pathological leucorrhoea in patients investigated, in addition to analyzing whether the latter is due to cervico-vaginal infections. Methods: This research was performed with an open population of all patients who came to the cancer screening program (Pap) at the Cell Biology Laboratory of the Benemérita Universidad Autónoma de Puebla from January 2001 to December 2012, where 1 679 vaginal samples were stained with the Papanicolaou stain set, modified for subsequent microscopic diagnosis. Results: Nine hundred twenty three were found to be positive for leucorrhea; of which 489 correspond to physiological leucorrhea and 285 to pathological leucorrhea; 149 are not located in any group. Discussion: Cervico-vaginal infections may occur in response to polymicrobial presence which colonizes the vaginal cavity; and this entails a set of signs and symptoms produced by nonspecific agents, among which is leucorrhoea as a clinical manifestation that motivates, in many case, a gynecological consultation. Among cervicovaginal infections, vaginitis is the most common cause of pathological vaginal discharge or leucorrhoea; followed by cervicitis; both of which are caused by various agents, of which we mention here those most frequently found.

A Case of Vaginal Cancer with Uterine Prolapse

Primary vaginal cancer combined with uterine prolapse is very rare. We present a case of 80-year-old postmenopausal women complaints of something coming out per vagina for the past 20 years, along with blood stained discharge, foul odor leukorrhea, and severe pelvic pain for the last 3 months. A 4 x 5 cm ulcer was present on middle third of vaginal wall with marked edema and ulceration of surrounding tissue. The prolapse was reduced under intravenous sedation in operating room. On gynecologic examination, uterus was normal in size, no adnexal mass was examined, and both parametrium were thickened. Papanicolaou smear was normal. Biopsy of the ulcer at vaginal wall revealed invasive squamous cell carcinoma of vagina. Magnetic Resonance Imaging of abdomen and pelvis showed left hydronephrosis and liver metastasis. Positron emission tomography (PET)/computed tomography (CT) revealed metastasis to lung, liver and iliac bone. She died from progression of disease one month after diagnosis.

Seguridad y actividad de la Solución de Bardana como coadyuvante en el manejo del prúrito vulvovaginal en Colombia. Ensayo clínico fase II / A phase II clinical trial of burdock solution as an adjuvant in managing vulvovaginal pruritus in Colombia

El prurito genital puede ser la manifestación de problemas alérgicos, infecciones genitales, entidades sistémicas o una reacción primaria. El manejo de este síndrome es un reto para ginecólogos y médicos generales. Objetivo: evaluar la seguridad y actividad de la solución de bardana al 1,2% en aplicaciones externas diarias por 5 días, como coadyuvante en el manejo de las vulvovaginitis para generar alivio del prurito. Metodología: el presente es un ensayo clínico de fase II, multicéntrico, abierto, no comparativo, realizado en pacientes con prurito genital, quienes fueron evaluadas en 14 ciudades colombianas. En el estudio se incluyeron a todas aquellas mujeres mayores de 18 años con prurito genital sin importar su etiología, quienes no hubiesen recibido tratamiento alguno para la vulvovaginitis o la vulvovaginosis en los 30 días previos a su inclusión en el estudio y quienes, además, no hubiesen utilizado ningún producto farmacéutico de manera tópica en los 8 días anteriores al inicio del tratamiento. Asimismo, se excluyeron todas las pacientes en estado de embarazo, con trastornos psíquicos o mentales de difícil control y con antecedentes de alergias a medicamentos. Se evaluó la edad de la paciente, la intensidad del prurito, la presencia de irritación vulvar, leucorrea, los agentes infecciosos asociados con ésta y la tolerancia. Resultados: se incluyeron 154 pacientes de las cuales se excluyeron 2 por no asistir al último control. Al final de los tratamientos, 83,6% de ellas manifestaban no tener prurito o sólo en una intensidad mínima y 11,8% lo referían como leve. El prurito clasificado incialmente en 30,5% de las mujeres como severo se encontró sólo en 2,6% al segundo día y tan sólo en 1,3% persistía al final de la terapia. Similares resultados se obtuvieron en los subgrupos con infección demostrada por sólo cándida o sólo bacterias. Conclusión: la utilización local complementaria de una solución tópica de bardana en mujeres con prurito genital podría ser una alternativa eficaz de manejo.

Genital itching is associated with allergic and infectious aetiologies, systemic causes or a primary reaction. Managing this syndrome is a challenge for gynaecologists and general practitioners. Objective: evaluating the safety and activity of a 1.2% burdock solution in external applications per day, for 5 days, as an adjuvant in managing vulvovaginitis to relieve itching. Methodology: this was an open, non-comparative, multicentre, phase II clinical trial involving patients suffering from genital pruritus. The evaluation was made in 14 Colombian cities; it included women aged over 18 suffering from genital itching (regardless of aetiology) who had been not been treated for vulvovaginitis or vulvovaginosis during the 30 days prior to their inclusion in the study and had not used any topical pharmaceutical product during the 8 days before beginning treatment recommended by the study. Patients were excluded who were suffering from psychiatric or mental disorders, difficult to control, pregnant or had a history of drug allergy. The patients' ages, itching intensity, presence of leukorrhoea (vulvar irritation) and associated infectious agents were classified. Results: 152 patients were included in the study after fulfilling the inclusion criteria; 2 of them were excluded for not attending the last control at the end of the treatment. 83.6% reported no itching by this time, or only minimum intensity, and 11.8% regarded it as just being slight. Itching initially classified by 30.5% of the patients as being severe at the start was only rated so by 2.6% on the second day; 1.3% still rated it as being severe at the end of therapy. Similar results were obtained in the subgroups suffering from single candida infection or single bacteria. Conclusion: the supplementary local use of a 2% topical burdock solution in women suffering from genital itching could be an effective management alternative.

The Usefulness of Computed Tomography for Clinical Diagnosis of Pelvic Inflammatory Disease in an Emergency Department

PURPOSE: Early detection and appropriate treatment of pelvic inflammatory disease (PID) are important to prevent adverse sequelae. The purpose of this study was to evaluate the usefulness of computed tomography (CT) for diagnosis of PID in an emergency department (ED). METHODS: We undertook a retrospective review of patients with acute low abdominal pain who were checked by abdominal CT in the ED at a tertiary hospital between June 2009 and December 2009. Inclusion criteria were PID on CT or non specific findings on CT and a consultation to the gynecology department. Exclusion criteria were age less than 15 years, age greater than 60 years, definite other causes for the acute low abdominal pain seen on CT, intact virginity, and transfer to another hospital. We compared clinical characteristics and laboratory findings between group A (clinically diagnosed PID patients) and group B (non-PID patients). We calculated sensitivity and specificity of CT findings to predict clinical diagnosis of PID. RESULTS: A total of 68 patients were enrolled in this study. Median age was 31 years (24-39). Group A consisted of 51 patients; group B of 17 patients. Cervical motion tenderness (p=0.001) and WBC count (p=0.013) were significantly different between the two groups. The accuracy of PID findings on CT for predicting the clinical diagnosis of PID was 85.29%. The sensitivity and specificity were 92.16% and 64.71%, respectively. Leukorrhea had a sensitivity of 76.47% and a specificity of 47.06%. Cervical motion tenderness had a sensitivity of 87.18% and a specificity of 75%. CONCLUSION: Abdominal CT performed in the ED is a useful method for the clinical diagnosis of PID.

Utilidad de la VSG, PCR, recuento de leucocitos y plaquetas como pruebas para el diagnóstico temprano de la sepsis neonatal servicio de neonatología HIMJR octubre 2007-enero 2008 / Utility of the VSG, PCR, recount of leukocytes and platelets like tests for the early diagnosis of the sepsis neonatal service of neonatology HIMJR October 2007-January 2008

Presenta estudio utilidad de la Velocidad de sedimentación globular (VSG), Proteína C reactiva (PCR), como pruebaspara el diagnóstico temprano de la sepsis neonatal en el Servicio de Neonatología del Hospital Infantil “Manuel de Jesús Rivera”. Es un estudio tipo Ensayo Clínico donde se incluyeron un total de 118 recién nacidos se formaron dos grupos mediante muestreo probabilístico intencional con una proporción 1:1. El grupo A fueron pacientes con diagnóstico clínico de sepsis neonatal y el grupo B que fueron pacientes con patologías no infecciosas. (Ictericia, malformaciones congénita, cardiacas, del tubo neural y gastrointestinal). Las pruebas en estudio se tomaron al momento del ingreso.Para obtener la información se llenó un formulario previamente diseñado con las variables de interés y se obtuvieron resultados de las pruebas mediante la revisión del expediente clínico. Se aplicaron frecuencias simples para todas las variables y pruebas de sensibilidad especificidad, valor predictivo positivo y valor predictivo negativo a la VSG, PCR, Recuento de leucocitos y plaquetas. En la mayoría del grupo A se encontró un rango de edad entre 0-7 días, y más de la mitad del grupo B tenían una edad mayor de 8 días. Con relación al sexo se encontró una proporción de 2:1 del sexo femenino con relación al masculino y el peso fue adecuado en ambos grupos. El diagnóstico clínico de sepsis se basó en la asociación de fiebre - letárgia - cianosis en la mayoría de los pacientes.La infección de vías urinarias y la leucorrea estuvo presente en la mayoría de las madres de los pacientes con sepsis neonatal. La cuantificación del recuento de leucocitos tiene una baja sensibilidad para el diagnóstico de sepsis con una especificidad del 93 porciento. VPP 63 porciento y VPN de 51porciento. El recuento de plaquetas, la VSG y el PCR son herramientas con una sensibilidad en general > del 60 porciento para el diagnóstico de sepsis...

Caracterización de la vulvovaginitis prepuberal en una comunidad urbana / Characterization of Prepuberal Vulvovaginitis in an Urban Community

Objetivos. Describir los patógenos aislados en una población de niñas prepúberes con diagnóstico de vulvovaginitis, que consultaron a una Unidad de Ginecología Pediátrica en Santiago de Chile. Métodos. Se hizo una revisión retrospectiva de las fichas clínicas de las niñas con vulvovaginitis como primero o segundo diagnóstico, desde el 1º enero de 2004 al 31 de agosto de 2005. Resultados. El número de consultas fue de 2235; pacientes nuevas: 699; incidencia global de consulta por secreción vaginal: 39%; 54% eran de prepúberes, de las cuales, 78% correspondieron a vulvovaginitis inespecíficas y 22% a específicas. Los microorganismos patógenos aislados fueron: Staphylococcus aureus, 25%; Enterobius vermicularis, 21,9%; Candida albicans, 18%; Streptococcus, grupo A, 12,5%; Neisseria gonorrhoeae, 6,3%; Haemophilus influenzae, 6,3%; virus del papiloma humano, 3,1%; Gardnerella vaginallis, 3,1%, y Streptococcus pneumoniae, 3,1%. Conclusión. La vulvovaginitis inespecífica fue el principal diagnóstico ginecológico en pacientes prepúberes. Los casos específicos fueron principalmente debidos a S. aureus, seguido por E. vermicularis. C. albicans es una causa poco frecuente de vulvovaginitis en pacientes prepúberes y se describe asociada a factores de riesgo.

Duplicated Ureter with an Ectopic Ureteral Orifice in a Middle Aged Female Who Complained of Vaginal Discharge / 대한비뇨기과학회지

Duplication is the most common type of congenital anomaly of the ureter. It occurs more frequently in females and it is often accompanied by an ectopic orifice. Ectopic ureter is usually derived from the upper pole of the ipsilateral kidney and its orifice is attached medial & inferior from the normal opening according to Weigert-Meyer's law. Thus, sometimes the ectopic ureteral opening is made at a distal part of the external sphincter or even out of the urinary system. These conditions may result in urinary incontinence in female patients, so they can be treated early at the mean age of 5 and it's not common that ectopic ureter accompanying complete duplication of the ureter is presented in adults. We report here on a case of ectopic ureter accompanying complete duplication of the ureter in a 44 year old female who presented with leukorrhea.

Nuevo protocolo de manejo terapéutico de sepsis neonatal en unidad de cuidados intensivos neonatal Hospital Fernando Vélez Paiz julio – noviembre 2005 / New protocol of therapeutic handling of sepsis neonatal in unit of cares intensive neonatal Hospital Fernando Vélez Paiz July–November 2005

El presente estudio se realizó con el objetivo de determinar la evolución de los pacientes con sepsis neonatal posterior al manejo del nuevo protocolo terapeútico utilizado en el servicios de la unidad de cuidados intensivos neonatales (UCIN). Este estudio fue de tipo descriptivo, de corte transversal. El universo lo constituyeron los neonatos que ingresaron a la Unidad de Cuidados Intensivos Neonatales con diagnóstico de sepsis neonatal en el período de julio a noviembre del 2005, utilizando los criterios de inclusión y exclusión. Se incluyeron 22 casos diagnosticados como sepsis neonatal vírgenes a tratamiento y que iniciaron con Penicilina Cristalina y Amikacina, en el periódo que va de julio a noviembre del 2005. Los factores de riesgo maternos de infecciones de vías urinarias, leucorrea y uso de antibióticos 24 horas antes del parto fueron los más frecuentes. Los factores de riesgo de nacimiento relacionados a sepsis encontrados en nuestro estudio fueron líquido amniótico meconial mayor de 2 cruces y ruptura prematura de membranas de más de 24 horas. Los factores del producto relacionados a sepsis fueron prematurez , asfixia y bajo peso al nacer. El sexo masculino fue el mas afectado y encontrado como factor de riesgo asociado para sepsis y son de procedencia urbana

Agentes etiológicos de vulvovaginitis en niñas / Etiologic agents of vulvovaginitis in girls

La vulvovaginitis (VV) es una las causas más frecuentes de consulta ginecológica de niñas, especialmente, en centros hospitalarios públicos. El conocimiento de la frecuencia de los agentes que producen esta patología, las condiciones socio­económicas y hábitos de higiene de las afectadas contribuye al desarrollo de programas de prevención y control epidemiológicos. De las 196 niñas con el diagnóstico clínico de vulvovaginitis (presencia de leucorrea e irritación vulvar) se aislaron 330 microorganismos, siendo los más frecuentemente aislados Gardnerella vaginalis (17%) y Candida sp (13%). La frecuencia de candidiasis fue mayor en el grupo de 6 a 12 años que en las menores. Se encontró reacción inflamatoria (>10 leucocitos por campo) en 103 niñas (52,6%)y en este grupo, el 34% de las niñas presentaba G.vaginalis y 24% Candida sp, en comparación con el grupo sin reacción inflamatoria quienes presentaron G. vaginalis en el 15% y Candida sp en el 17%, pero la diferencia no fue significativa. Debido a que la vulvovaginitis ha sido asociada frecuentemente a falta higiene, sobretodo en las niñas menores de 5 años, es importante resaltar la presencia de gérmenes que provendrían de la flora fecal, tales como enterobacterias (18%) y Enterococcus sp (9%).La vulvovaginitis de origen infeccioso estuvo presente en el 52,6% de las niñas, y el resto estaría relacionado a una falta de higiene, que generalmente responden a tratamientos sintómaticos sin antibióticos.

Vulvovaginitis (VV) is one of the most common causes of gynecological consultation in girls, especially in public hospitals. The knowledge of the frequency of the causative agents of this pathology, socio­economic conditions and hygiene practices of the affected girls will contribute to development of epidemiological control programs. Out of 196 girls with a clinical diagnosis of vulvovaginitis (presence leukorrhea and vulva irritation), 330 microorganisms were isolated being the most frequent microorganisms Gardnerella vaginalis (17%) and Candida sp (13%). The frequency of candidiasis was higher in the age group of 6 to 12 years than in younger girls and inflammatory reaction (>10 leucocytes per field) was found in 103 girls (52.6%). In this group, 34% of the girls presented G. vaginalis and 24% Candida sp. in comparison to the group without inflammatory reaction where 15% presented G. vaginalis and 17% Candida sp.(difference was not significant). Since vulvovaginitis has been frequently associated to the lack of hygiene, especially in girls younger than 5 years old, it is important to remark the presence of germs from the fecal flora such as enterobacteria (18%) and Enterococcus sp (9%). The vulvovaginitis was infectious in 52.6% of the girls while the rest was related to a lack of hygiene and generally responds to symptomatic treatments without antibiotics.

A study of leucorrhoea in reproductive age group women of Nagpur City.

A community based cross-sectional study was conducted in reproductive age group women in an urban community of Nagpur, to assess the prevalence of leucorrhoea and the factors influencing the same in these women. The study participants included 506 females, out of which 149 were unmarried and 357 were married. Detailed history and clinical examination was done in all the females including gynecological examination in all the married females. Leucorrhoea was present in 139 (27.47%) females. Leucorrhoea was found significantly more in married females as compared to unmarried (p < 0.001), pregnant as compared to non-pregnant (OR = 2.10, 95% C.I. = 1.02-4.32), and women of lower socioeconomic status (p < 0.001), women with high parity (p < 0.001). Use of Cu-T was not associated with Leucorrhoea (p > 0.05).

Vulvovaginitis bacteriana en la prepúber / Bacterial vulvovaginitis in prepubertal girl

Considerando la alta incidencia de vulvovaginitis en la consulta de ginecología pediátrica y de adolescentes, y los aspectos únicos de la microbiología y endocrinología de la paciente prepúber se presenta una revisión de la literatura con lo más relevante de los últimos 5 años, en lo que se refiere a epidemiología, etiología, diagnóstico y tratamiento de la vulvovaginitis bacteriana específica de la niña prepúber. No existe claridad acerca de la microflora vaginal normal, lo cual dificulta en gran medida la interpretación de muestras. De acuerdo con la evidencia actual podemos decir que ante la vulvovaginitis específica de la prepúber debemos tener en consideración como principales agentes causales: patógenos respiratorios, epidérmicos y entéricos; higiene defectuosa, cuerpos extraños, irritantes, enfermedades dermatológicas vulvares, defectos anatómicos y abuso sexual. Streptococcus hemolitico del grupo A y Haemophilus influenzae son patógenos prevalentes.

Corrimento vaginal / Genital discharge

Os autores fazem uma revisão bibliográfica sobre as causas mais comuns do corrimento vaginal, com ênfase nas três principais etiologias vivenciadas na prática médica, objetivando a abordagem de aspectos como patogenia, manifestações clínicas, diagnóstico e tratamento