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RESUMEN Introducción: la enfermedad inflamatoria pélvica aguda es una entidad frecuente en mujeres jóvenes en edad reproductiva, y constituye causa de infertilidad y otras complicaciones. Objetivo: caracterizar el comportamiento de la enfermedad inflamatoria pélvica aguda en pacientes atendidas en el Policlínico Docente Samuel Fernández, del municipio Matanzas, en el período de enero de 2017 a enero de 2018. Materiales y métodos: se realizó un estudio descriptivo, longitudinal y prospectivo a 76 mujeres, a las que se les hizo caracterización sociodemográfica y clínico-ecográfica, que permitió su clasificación como pacientes con enfermedad inflamatoria pélvica aguda leve-moderada, requerida de tratamiento y seguimiento en atención primaria. Se evaluó la respuesta clínico-ecográfica al tratamiento médico indicado, a partir de la disminución de la intensidad del dolor pélvico y de las modificaciones de los hallazgos ecográficos iniciales. Resultados: la enfermedad inflamatoria pélvica aguda leve-moderada representó el 87,4 % de los casos evaluados en Consulta Ginecológica de la atención primaria de salud, en el período estudiado. La media de edad fue de 31,2 años. Clínicamente predominaron los casos con dolor severo. El hallazgo ecográfico inicial más frecuente fue el de anejos engrosados. La antibioticoterapia oral combinada y el uso de antiinflamatorios fue la terapia médica empleada, con resultados clínico-ecográficos favorables en el 98,4 y el 92,2 % de los casos, respectivamente. Conclusiones: la enfermedad inflamatoria pélvica leve-moderada resultó una entidad frecuente en el Servicio de Ginecología de la atención primaria de salud en el período estudiado, con evolución satisfactoria al tratamiento médico.
ABSTRACT Introduction: acute inflammatory pelvic disease is a frequent entity in young women in reproductive age, and is cause of infertility and other complications. Objective: to characterize the behavior of the acute inflammatory pelvic disease in patients attended at the TeachingPoliclinic Samuel Fernandez, of the municipality of Matanzas, in the period from January 2017 to January 2018. Materials and methods: a descriptive, longitudinal and prospective study was carried out in 76 women, who were object of socio-demographic and clinic-echographyc characterization that allowed their classification as patients with mild-moderated acute inflammatory pelvic disease requiring treatment and follow up in primary care services. The clinic-echographyc answer to medical treatment was evaluated from the decrease of the intensity of the pelvic pain and the modification of the baseline echographyc findings. Results: mild-moderated acute inflammatory pelvic disease represented 87.4 % of the cases evaluated in the primary care Gynecological consultation in the studied period. The average age was 31.2 years. The cases with severe pain predominated clinically. The most frequent baseline echographyc finding was increased annexes. Oral combined antibiotic therapy and the use of anti-inflammatory drugs was the used medical therapy, with favorable clinic-echographyc results in 98.4 % and 92.2 % of cases respectively. Conclusions: mild-moderated inflammatory pelvic disease was a frequent entity in the Gynecology service of the primary health care in the studied period, with satisfactory evolution to medical treatment.
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Objective To evaluate the clinical effect of levofloxacin combined with Jingangteng particle in the treatment of patients with chronic pelvic inflammatory disease.Methods According to the random number table, sixty -four patients with chronic pelvic inflammatory disease were divided into control group(n =32)which were treated with levofloxacin and treatment group(n =32)which were treated with levofloxacin and Jingangteng particle for three weeks.The clinical effect,symptoms and signs were evaluated and the adverse reactions between the two groups were observed as well as serum C reactive protein(CRP)were measured before and after treatment.Results The score of symptoms and signs of the treatment group were significantly lower than the control group,the difference was statistically significant [(2.61 ±2.09 )points vs.(5.32 ±3.28)points,t =3.941,P =0.000;(1.47 ± 1.02)points vs.(2.56 ±2.04)points,t =2.703,P =0.008].The level of serum CRP of the control group was (5.46 ± 1.93)mg/L,which was statistically higher than (3.76 ±1.06)mg/L of the treatment group after treatment,the differ-ence was statistically significant (t =4.367,P =0.000).The total effective rate of the treatment group was 96.9%, which of the control group was 78.1%,the difference between the two groups were statistically significant(χ2 =5.142,P =0.023).There was no significant adverse reactions during the treatment.Conclusion Levofloxacin com-bined with Jingangteng particle can obviously improve the symptoms and signs of chronic pelvic inflammatory disease, they have good safety and are worthy of clinical popularization and application.
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Introducción: el dolor pélvico es una entidad frecuente en mujeres, aunque no es un proceso exclusivo de ellas, pues también aparece en hombres. Objetivo: identificar el comportamiento del dolor crónico pélvico en mujeres en la institución sede del estudio. Método: se realizó un estudio en pacientes atendidas en la consulta de dolor crónico del Hospital Dr. Luís Díaz Soto, entre abril de 2011 y abril de 2012. Se incluyeron las pacientes remitidas a la consulta de dolor crónico, las cuales se evaluaron empleando como instrumento principal para la mensuración la escala visual análoga (EVA). Igualmente se les aplicó tratamiento multimodal con analgésicos, anti-inflamatorios, relajantes músculo liso, antidepresivos y ozono. Resultados: se incluyeron 114 pacientes. El dolor pélvico crónico apareció en 114 mujeres con una edad promedio de 26 años. De ellas 61 tenían antecedentes de enfermedad inflamatoria pélvica, y 45 cirugía ginecológica previa. Como causas contribuyentes se encontraron el empleo de monoterapia analgésica, la dosificación insuficiente y la cronofarmacoterapia inadecuada (horario). El empleo de una combinación de opioides anti inflamatorios no esteroideos antidepresivos ozono, logró aliviar a la mayoría de las pacientes (98 para el 85,96 %). Los efectos indeseables asociados a los agentes empleados predominaron con el empleo de tramadol (náuseas) y antinflamatorios no esteroideos (epigastralgia), sin determinar la suspensión del tratamiento. Conclusiones: el dolor pélvico crónico es frecuente en mujeres jóvenes, asociados a la enfermedad inflamatoria pélvica, los tratamientos deficientes son una causa contribuyente frecuente y la terapia multimodal ofreció resultados adecuados con pocos efectos indeseables.
Introduction: the pelvis pain is a frequent entity in women, though it is not a process only for women because men can suffer from pelvis pains. Objective: to identify the behavior of chronic pelvis pain in women from the institution where the study is carried out. Methods: a study was carried out in patients assisted in the chronic pain consultation at Dr Luís Díaz Soto Hospital between April 2011 y April 2012. Patients referred to the chronic pain consultation were included in the study which was evaluated making use of a principal instrument for the measurement of the analogical visual scale (EVA). Likewise, a multimodal treatment was applied with analgesics, anti-inflammatories, smooth muscle relaxer, anti-depressive and ozone. Results: 114 patients were included. The chronic pelvis pain appeared in 114 women with an average age of 26 years. 61 had previous antecedents of the inflammatory disease and 45 with a previous gynecology surgery. As contributor causes the use of mono analgesic therapy was found, the insufficient dosage and the chrono pharmacotherapy (schedule). The use of a combination of opiums - anti inflammatories non steropids - anti depressives - ozone, managed to alleviate in most of the patients (98 for a 85,96 %). The undesirables effects associated to agents employed prevailed the use of tramadol (nauseas) and anti inflammatories non steroids (epigastralgia), without determining the suspension of the treatment. Conclusion: the chronic pelvis pain is frequent in young women associated to the pelvis inflammatory disease, inefficient treatments are a contributing frequent cause and the multimodal therapy offered adequate results with few undesirable effects.
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Objective To evaluate the value of combined use of laparoscopy and hysteroscopy in the diagnosis of infertility. Methods Clinical data of 168 cases of infertility receiving examinations with laparoscopy and hysteroscopy from June 1999 to October 2003 were retrospectively reviewed.Results Hysteroscopic examinations found intrauterine diseases in 79 cases(79/168,47.0%),including 46 cases of endometrial hyperplasia or polyps(46/79,58.2%).Laparoscopic examinations showed organic pelvic diseases in 99 cases,including 85 cases of chronic pelvic inflammation,endometriosis or polycystic ovarian syndrome(85/99,85.9%).Both laparoscopy and hysteroscopy gave normal findings in 15 cases and abnormal findings in 39 cases.Unilateral or bilateral tubal obstruction was found in 90 cases by tubal patency tests under hysteroscope(90/168,53.6%) and in 78 cases by laparoscopy(78/168,46.4%). Conclusions Combined use of laparoscopy and hysteroscopy offers accurate diagnostic evidences in examinations of infertility.
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OBJETIVO: O abdome agudo em ginecologia e obstetrícia apresenta baixo risco de vida para a paciente, entretanto, o retardo no diagnóstico e tratamento influencia na morbi-mortalidade. O objetivo deste trabalho foi estudar as principais causas de abdome agudo em tocoginecologia. MÉTODOS: Foram revisados 287 casos de abdome agudo em tocoginecologia de janeiro de 1987 a dezembro de 1997 atendidos na Disciplina de Ginecologia e Obstetrícia da Faculdade de Medicina do Triângulo Mineiro. RESULTADOS: Os resultados mostraram que a prenhez ectópica foi a mais freqüente causa de abdome agudo hemorrágico com 98,5 por cento dos casos. Nestes casos, a dor pélvica foi o sintoma mais comum (69,1 por cento). Todas as pacientes foram submetidas à laparotomia e salpingectomia foi realizada em 92,6 por cento dos casos. A causa mais freqüente de abdome agudo inflamatório foi a doença inflamatória pélvica com 94,8 por cento. A dor pélvica aguda estava presente em 91,5 por cento dos casos e a febre em 56,2 por cento casos. A penicilina foi usada com sucesso em 92,1 por cento dos casos. Do total de 201 casos de doença inflamatória pélvica, 13 (6,5 por cento) foram submetidos à laparotomia. CONCLUSÕES: Os autores concluem que o abdome agudo de causa tocoginecológica apresenta quadro clínico variável, portanto, o ginecologista deve estar atento para estabelecer diagnóstico e tratamento precisos.
BACKGROUND: The gynecology or obstetric acute abdomen in woman present a low risk, although the diagnosis and treatment may be a challenge. The aim of this study was to analize the most frequent causes of acute abdomen in gynecology and obstetrics. METHODS: We reviewed 287 cases, from January 1987 to December 1997, attending in Discipline of Gynecology and Obstetrics of the Faculty of Medicine of "Triângulo Mineiro". RESULTS: Ouur results showed that ectopic pregnancy was the most frequent cause of hemorrhagic acute abdomen, with 98.5 percent of the cases. Pelvic pain was the most common symptom (69.1 percent). All patients were submitted to a laparotomy; salpingectomy was performed in 92.6 percent of cases. The most frequent cause of inflammatory acute abdomen was inflammatory pelvic disease, with 92.6 percent. Acute pelvic pain was present in 96,5 percent of the cases and fever in 56.2 percent. Penicillin was successfully used in 92.1 percent. From the 206 cases of IPD, 13(6.5 percent) were submitted to laparotomy. CONCLUSIONS:The authors concluded that acute abdomen for ginecology or obstetrical disorders shows a variability of symptoms that may lead to a wrong diagnostic. Meanwhile, the gynecologist must be aware of these variabilities to perform a correct diagnosis.