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SUMMARY OBJECTIVE: The objective of this study was to assess the clinical and uterine cervix characteristics of patients displaying vaginal discharge with positive results for Mycoplasma sp. and/or Ureaplasma spp. METHODS: An analytical cross-sectional study involving women aged 18-45 years was conducted. Microbiological assessments included Ureaplasma and Mycoplasma cultures, as well as human papillomavirus hybrid capture using ecto and endocervix swabs. All tests were two-tailed, and significance was set at p<0.05. RESULTS: Among 324 women, Ureaplasma prevalence was 17.9%, and Mycoplasma prevalence was 3.1%. The Ureaplasma-positive group exhibited a higher frequency of urinary tract infections (39.1 vs. 19%, p=0.002) and human papillomavirus (39.7 vs. 12.8%, p≤0.001) compared with controls. The Mycoplasma-positive group showed a higher frequency of non-contraceptive use compared with controls (66.2 vs. 30.0%, p=0.036). Abnormal colposcopic findings were more prevalent in the Mycoplasma/Ureaplasma-positive group than in controls (positive: 65% vs. control: 35%, p=0.001). Pap smear findings did not differ between the groups. CONCLUSION: Ureaplasma spp. was associated with urinary tract infections and human papillomavirus, while the presence of Mycoplasma sp. was linked to reduced contraceptive use. When analyzing both pathogens together, a higher frequency of abnormal colposcopic findings was observed, with no difference in cytological findings in the positive group.
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Objective:To investigate the value of abnormal protein (TAP) and C-reactive protein (CRP) levels in the prediction of human papillomavirus (HPV) infection and cervical lesions in patients with peripheral blood tumors.Methods:A total of 216 patients with cervical lesions who received treatment in Shan County Central Hospital from June 2019 to May 2021 were included in this cross-sectional study. According to HPV results, these patients were divided into a high-risk HPV infection group ( n = 122), a low-risk HPV infection group ( n = 76), and an HIV-uninfected group ( n = 18). TAP and CRP levels in peripheral blood were determined in each group and analyzed. Results:TAP and CRP levels in the high-risk HPV infection group were (243.29 ± 19.43) μm 2 and (37.49 ± 10.50) mg/L, respectively, and they were (125.46 ± 10.37) μm 2 and (26.27 ± 7.28) mg/L in the low-risk HPV infection group, and (74.51 ± 9.29) μm 2 and (74.51 ± 9.29) mg/L in the HIV-uninfected group. There were significant differences in TAP and CRP levels among the three groups ( F = 12.40, 6.34, both P < 0.001). TAP and CRP levels in the low-risk HPV infection group were significantly higher than those in the HIV-uninfected group ( t = 4.02, 3.26, both P < 0.05). TAP and CRP levels in the peripheral blood of patients with chronic cervicitis were (63.25 ± 5.80) μm 2 and (13.37 ± 5.29) mg/L, which were significantly different from those in patients with cervical intraepithelial neoplasia or cervical cancer ( F = 21.35, 8.26, both P < 0.05). TAP and CRP levels in the peripheral blood of patients with cervical intraepithelial neoplasia grade II and cervical intraepithelial neoplasia grade III were significantly higher than those in patients with cervical intraepithelial neoplasia grade I (both P < 0.05). TAP and CRP levels in the peripheral blood of patients with cervical cancer were significantly higher than those in patients with various grades of cervical intraepithelial neoplasia (all P < 0.05). The Pearson correlation analysis results showed that the load of high-risk human papillomavirus deoxyribonucleic acid (HPV-DNA) was positively correlated with blood TAP and CRP levels ( r = 0.64, 0.24, both P < 0.001). The area under the curve regarding the combined detection of TAP and CRP levels was 0.927 (95% CI: 0.873-0.967), with sensitivity and specificity of 91.0% and 93.6%, respectively. Conclusion:TAP and CRP levels in peripheral blood can reflect HPV infection and cervical lesion and are closely related to the type of HPV infection and the degree of cervical lesion. Combined detection of the two can improve the diagnostic efficiency of cervical cancer and deserves clinical promotion.
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Abstract Infections that cause cervicitis are a topic presented 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. The document was developed based on scientific evidence and validated in discussions with experts. This article presents epidemiological and clinical aspects of infections that cause cervicitis and recommendations on screening, diagnosis, and treatment of affected people and their sexual partnerships. Also, it discusses strategies for surveillance, prevention, and control of these infections for health professionals and health service managers involved in the programmatic and operational management of sexually transmitted infections. Expanding access to diagnostic tests and early treatment are crucial for controlling the spread of pathogens that cause cervicitis.
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Humanos , Masculino , Femenino , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/epidemiología , Cervicitis Uterina/diagnóstico , Cervicitis Uterina/epidemiología , Conducta Sexual , Brasil/epidemiología , Parejas Sexuales , CondonesRESUMEN
As infecções que causam cervicite são um dos temas que compõem o Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis, publicado pelo Ministério da Saúde do Brasil em 2020. Tal documento foi elaborado com base em evidências científicas e validado em discussões com especialistas. Este artigo apresenta aspectos epidemiológicos e clínicos das infecções que causam cervicite, bem como recomendações sobre a triagem, diagnóstico e tratamento das pessoas acometidas e suas parcerias sexuais. Além disso, discutem-se estratégias para as ações de vigilância, prevenção e controle desses agravos para os profissionais de saúde e gestores envolvidos no manejo programático e operacional das infecções sexualmente transmissíveis. A ampliação do acesso aos testes para diagnóstico e o tratamento precoce são cruciais para o controle da disseminação dos patógenos causadores de cervicite.
Infections that cause cervicitis are a topic presented 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. The document was developed based on scientific evidence and validated in discussions with experts. This article presents epidemiological and clinical aspects of infections that cause cervicitis, as well as recommendations on screening, diagnosis and treatment of affected people and their sexual partnerships. In addition, it discusses strategies for surveillance, prevention and control of these infections for health professionals and health service managers involved in the programmatic and operational management of sexually transmitted infections. Expanding access to diagnostic tests and early treatment are crucial for controlling the spread of pathogens that cause cevicitis.
Las infecciones que causan cervicitis son uno de los temas que integran el Protocolo Clínico y Directrices Terapéuticas para la Atención Integral a las Personas con Infecciones de Transmisión Sexual, publicado por el Ministerio de Salud de Brasil en 2020. El documento fue desarrollado en base a evidencia científica y validado en discusiones con expertos. Este artículo presenta aspectos epidemiológicos y clínicos de las infecciones que causan cervicitis, así como recomendaciones sobre el cribado, diagnóstico y tratamiento de las personas afectadas y sus parejas sexuales. Además, se discuten estrategias de vigilancia, prevención y control de estas enfermedades para los profesionales y gestores de salud involucrados en el manejo programático y operativo de las infecciones de transmisión sexual. Ampliar el acceso a las pruebas de diagnóstico y a un tratamiento precoz es crucial para controlar la propagación de los agentes patógenos que causan cervicitis.
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Humanos , Femenino , Enfermedades de Transmisión Sexual/terapia , Enfermedades de Transmisión Sexual/epidemiología , Cervicitis Uterina/diagnóstico , Cervicitis Uterina/terapia , Cervicitis Uterina/epidemiología , Conducta Sexual , Brasil/epidemiología , Infecciones por Chlamydia/clasificación , Protocolos ClínicosRESUMEN
Resumo As infecções que causam cervicite são um dos temas que compõem o Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis, publicado pelo Ministério da Saúde do Brasil em 2020. Tal documento foi elaborado com base em evidências científicas e validado em discussões com especialistas. Este artigo apresenta aspectos epidemiológicos e clínicos das infecções que causam cervicite, bem como recomendações sobre a triagem, diagnóstico e tratamento das pessoas acometidas e suas parcerias sexuais. Além disso, discutem-se estratégias para as ações de vigilância, prevenção e controle desses agravos para os profissionais de saúde e gestores envolvidos no manejo programático e operacional das infecções sexualmente transmissíveis. A ampliação do acesso aos testes para diagnóstico e o tratamento precoce são cruciais para o controle da disseminação dos patógenos causadores de cervicite.
Abstract Infections that cause cervicitis are a topic presented 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. The document was developed based on scientific evidence and validated in discussions with experts. This article presents epidemiological and clinical aspects of infections that cause cervicitis, as well as recommendations on screening, diagnosis and treatment of affected people and their sexual partnerships. In addition, it discusses strategies for surveillance, prevention and control of these infections for health professionals and health service managers involved in the programmatic and operational management of sexually transmitted infections. Expanding access to diagnostic tests and early treatment are crucial for controlling the spread of pathogens that cause cevicitis.
Resumen Las infecciones que causan cervicitis son uno de los temas que integran el Protocolo Clínico y Directrices Terapéuticas para la Atención Integral a las Personas con Infecciones de Transmisión Sexual, publicado por el Ministerio de Salud de Brasil en 2020. El documento fue desarrollado en base a evidencia científica y validado en discusiones con expertos. Este artículo presenta aspectos epidemiológicos y clínicos de las infecciones que causan cervicitis, así como recomendaciones sobre el cribado, diagnóstico y tratamiento de las personas afectadas y sus parejas sexuales. Además, se discuten estrategias de vigilancia, prevención y control de estas enfermedades para los profesionales y gestores de salud involucrados en el manejo programático y operativo de las infecciones de transmisión sexual. Ampliar el acceso a las pruebas de diagnóstico y a un tratamiento precoz es crucial para controlar la propagación de los agentes patógenos que causan cervicitis.
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Femenino , Humanos , Enfermedades de Transmisión Sexual , Cervicitis Uterina , Conducta Sexual , Brasil/epidemiología , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/terapia , Enfermedades de Transmisión Sexual/epidemiología , Cervicitis Uterina/diagnóstico , Cervicitis Uterina/terapia , Cervicitis Uterina/epidemiologíaRESUMEN
SUMMARY OBJECTIVE: Ankaferd Blood Stopper (ABS) is a medicinal plant extract used topically as a hemostatic, anti-inflammatory, and anti-oxidant agent. Its cytoprotective effect mainly depends on its pleiotropic properties by modulating inflammatory mediators such as IL-1β, IL-6, and TNF-α. This study aims to test the possible therapeutic effect of ABS in the treatment of erosive and inflammatory conditions occurring in the uterine cervix. METHODS: Twenty-four female Wistar Albino rats were used in the present study. Trichloracetic acid was applied intravaginally to establish an experimental rat model of cervicitis. The rats were randomly divided into three groups: group I (injury), group II (injury+isotoinc saline), and group III (injury+ABS). After 3 estrous cycles of ABS and isotonic saline treatment, the amount of inflammation, vascular congestion and erosion were evaluated in the cervical tissues by using a modified semi-quantitative scale of 0-3. Immunohistochemical staining with monoclonal antibodies against IL-1β was also performed. RESULTS: Compared with group I and II, the ABS group showed the least inflammatory cell infiltration, vascular congestion and cervical erosion, compared with the ABS group prominent IL-1β staining observed in group I and group II. CONCLUSION: Our data suggest that ABS is a highly effective alternative to induce normal cervical epithelium and can be used safely in the treatment of cervical inflammation with or without cervical erosion.
RESUMO OBJETIVO: Ankaferd Blood Stopper (ABS) é um extrato de plantas medicinais utilizado topicamente como um agente hemostático, anti-inflamatório e antioxidante. O seu efeito citoproteico depende principalmente das suas propriedades pleiotrópicas por meio da modulação de mediadores inflamatórios tais como IL-1β, IL-6 e TNF-a. O objetivo deste estudo é testar o possível efeito terapêutico do ABS no tratamento de condições erosivas e inflamatórias que ocorrem no colo uterino. MÉTODOS: Vinte e quatro ratas Wistar Albino foram utilizadas no presente estudo. O ácido tricloroacético foi aplicado intravaginalmente para estabelecer um modelo experimental de cervicite em ratos. Os ratos foram divididos aleatoriamente em três grupos: grupo I (lesão), grupo II (lesão + fisiológico sérico) e grupo III (lesão + ABS). Após três ciclos estrais de ABS e tratamento fisiológico sérico, as quantidades de inflamação, congestionamento vascular e erosão foram avaliadas nos tecidos cervicais usando uma escala semiquantitativa modificada de 0-3. Coloração imuno-histoquímica com anticorpos monoclonais contra IL-1β também foi realizada. RESULTADOS: Em comparação com os grupos I e II, o grupo ABS mostrou menos infiltração de células inflamatórias, congestionamento vascular e erosão cervical. Além disso, em comparação com o grupo ABS, observou-se uma coloração proeminente de IL-1β no grupo I e no grupo II. CONCLUSÃO: Nossos dados sugerem que o ABS é uma alternativa altamente eficaz para induzir o epitélio cervical normal e pode ser utilizado com segurança no tratamento da inflamação cervical com ou sem erosão cervical.
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Animales , Femenino , Ratas , Extractos Vegetales/uso terapéutico , Cervicitis Uterina/tratamiento farmacológico , Inmunohistoquímica , Cervicitis Uterina/patología , Interleucina-6/análisis , Factor de Necrosis Tumoral alfa/análisis , Ratas Wistar , Modelos Animales de EnfermedadRESUMEN
Objective To study the clinical efficacy of Baofukang suppository and recombinant human inter -feron α-2b in the treatment of HPV infection with chronic cervicitis ,and to observe the prognosis ,thus to provide reference for its clinical treatment .Methods 120 patients with chronic cervicitis with HPV infection were selected . All patients were divided into observation group and control group by random number table method ,60 cases in each group.The observation group was treated with Baofukang combined with recombinant human interferon α-2b,and the control group was treated with recombinant human interferon α-2b.The patients were evaluated before treatment ,at the end of treatment and 3 months after treatment.The cure rate,total effective rate,recurrence rate,incidence rate of adverse reactions were observed and compared .Results In the observation group ,26 cases were cured ,the cure rate was 43.33%.In the control group ,15 cases were cured ,the cure rate was 25%.The cure rate of the observation group was higher than that of the control group ,the difference was statistically significant (χ2 =4.482,P<0.05).The total effective rate of the observation group was 98.33%,which was higher than 80.00% of the control group,the differ-ence was statistically significant (χ2 =10.438,P <0.05).The negative rate of HPV in the control group was 38.33%,which was lower than 56.67% in the observation group,the difference was statistically significant (χ2 = 4.043,P<0.05).The incidence rate of adverse reactions in the observation group was 11.67%,which in the control group was 10.00%,the difference was not statistically significant (χ2 =0.086,P >0.05).After treatment for 3 months,the recurrence rate was 0.00%in the observation group and 1.67%in the control group,the difference was not statistically significant (χ2 =1.008,P >0.05).Conclusion The combination of Baofukang suppository and recombinant human interferon α-2b showed good curative effect and prognosis in the treatment of chronic cervicitis with HPV infection ,and it is worthy to be popularized in clinical practice .
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Reproductive tract infection is an important part of systemic infection,and it has become a major social and public health problem in the world.Recent studies have shown that reproductive tract infection is closely related to tumor occurrence, infertility, ectopic pregnancy, premature rupture of membranes and premature delivery and so on.Almost all reproductive tract infections are accompanied by changes of genital tract microenvironment.The development of the vaginal microecological detection system and the application of the diagnosis platform for the lower genital tract make it possible toaccurately treat female genital tract infection.Therefore, more and more attention was also paid to the standardized test of female reproductive tract infection and vaginal microecology by experts and scholars in the related fields. (Chin J Lab Med,2018,41:251-253)
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Resumen OBJETIVO: Investigar las posibles causas de los conos blancos, establecer estrategias para disminuir su incidencia y desarrollar protocolos de seguimiento. MATERIALES Y MÉTODOS: Estudio observacional, retrospectivo, de casos y controles. Se incluyeron las pacientes a quienes se efectuó una conización en el Hospital Universitario La Paz. Las variables analizadas más importantes fueron: anatomía patológica de la pieza y su relación con la biopsia y citologías previas, longitud del cono, presencia o no de artefacto y de cervicitis. Para el análisis estadístico se utilizaron: χ2, prueba exacta de Fisher, t de Student, U de Mann-Whitney, Kruskal-Wallis y Kolmogorov-Smirnov. RESULTADOS: Se integraron dos grupos: 371 conos positivos (85.9%) y 61 negativos (14.1%), con diferencias estadísticamente significativas en la citología, colposcopia y biopsia. Hubo mayor porcentaje de lesiones de menor grado en las pacientes con conización blanca. La longitud del cono fue menor en el grupo de análisis y en éste también se observó mayor porcentaje de cervicitis y artefactos. CONCLUSIONES: Las causas de lesión residual luego de una conización son variadas y difíciles de demostrar. Las pacientes con citología anómala e inflamación o atrofia deben recibir tratamiento para evitar falsos positivos y mejorar la técnica quirúrgica para impedir artefactos.
Abstract OBJECTIVES: to investigate the possible causes of the negative cones, to establish strategies to reduce their incidence and to develop monitoring protocols. MATERIALS AND METHODS: This is a retrospective observational cases and controls study of 432 conizations made in the Hospital Universitario La Paz (HULP) between 2013 and 2015. The most important analysed variables were the pathological anatomy of the piece and its relationship with the biopsy and previous cytology, the cone length, as well as the presence and artefact and cervicitis. The analysis it was used Chi - Square and Fisher´s test, T-Student, Mann Whitney U, Kruskal-Wallis and Kolmogorov- Smirnov. RESULTS: There are two groups: 371 positive (85,9%) and 61 negative cones (14,1%). We find statistically significant differences in the cytology, colposcopy and biopsy pre-conization, finding a major percentage of injuries of lesser degree in the patients with negative cone. The length of the cone was lower in the analysis group and in this we also observed a greater percentage of cervicitis and artefacts. CONCLUSIONS: The causes that make the remaining injury not appear after a diagnosed and/or therapeutic conization are a wide variety and difficult to prove. We should try to treat the patients with inflammation or atrophy to avoid false positives in the cytology and biopsy, improve the surgical technique to avoid artefacts and perform conservative management of low-risk injuries.
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Objective To investigate the prevalence of cervical human papillomavirus (HPV)infection in women with and without cervical lesions in Zhejiang province.Methods Cervical exfoliated cell samples were collected in 865 women with cervical lesions and 630 women with normal cytology from Zhejiang Provincial People's Hospital,Red Cross Hospital of Hangzhou,Maternal and Child Health Hospital of Fuyang City,and the Department of Basic Medical Sciences of Zhejiang Medical College of Zhejiang province.The flow-through hybridization technique (HybriMax) was used to detect 21 kinds of HPV genotypes.x2 and exact test were used for the comparison of HPV infection rates and genotype distributions between women with cervical lesions and those with normal cytology.Results The prevalenceof HPV infection in women with cervical lesions (27.28%,236/865) was significantly higher than that in women with normal cytology (10.32%,65/630) (x2 =65.2,P <0.01).In cervical lesion group,60 out of 236 HPV-positive patients (25.42%) were infected with multiple HPVs,including 42 patients infected with 2 genotypes of HPV,12 with 3 types of HPV,5 with 4 types of HPV and 1 with 5 types of HPV ; while in HPV-positive women with normal cytology,only 1 case was infected with multiple HPVs,with a rate of 1.54% (1/65) (x2 =18.0,P < 0.01).Totally 321 strains (covering 19 HPV genotypes) of HPV were obtained in cervical lesion group,including 188 (58.57%) strains of high-risk,114 (35.51%) strains of low-risk,and 19 (5.92%) strains of other types,and the most prevalent high-risk genotypes were HPV-16,HPV-58,HPV-33,HPV-52 and HPV-39.While in normal cytology group,66 strains (covering 16 HPV genotypes) of HPV were obtained,and the most prevalent genotypes were HPV-52,HPV-16,HPV-31,HPV-58 and HPV-ep8304.Conclusion The prevalence of HPV infection in women with cervical lesions is significantly higher than that in women with normal cytology,and the most prevalent genotypes of infection are HPV-16,HPV-58,HPV-33,HPV-52 and HPV-39.
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Objective To study the association of U. urealyticum biovar and genotype with nongonococcal, nonchlamydial mucopurulent cervicitis. Methods The study population consisted of two groups: patient group (226 female patients with nongonococcal, nonchlamydial mucopurulent cervicitis) and control group (118 healthy women). The biovar and genotype of U. urealyticum were identified in specimens positive for U. urealyticum culture by using PCR-single-strand conformation polymorphism (PCR-SSCP) analysis. Results The most common genotype in both groups was mba 3/14 in biovar 1 with the detection rate being 30.98%(57/184) in patients with mucopurulent cervicitis and 43.42% (33/76) in the controls. A significant difference was observed in the prevalence of genotype 2B in biovar 2 between the patients and controls [16.30% (30/184) vs 6.58% (5/76), χ2 = 4.367, P= 0.037). The genotype 1, 3/14 and 6 in biovar 1 predominated in the controls with their total prevalence being 81.58%. Conclusion The genotype 2B in biovar 2 of U. urealyticum may be associated with nongonococcal, nonchlamydial mucopurulent cervicitis among female patients attending an STD clinic.
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A revisão sistemática teve como objetivo avaliar a efetividade dos testes de ácido nucleico no rastreio da C. trachomatis. A maioria dos estudos foi localizada via internet, entretanto, alguns deles foram encontrados em revistas que abordavam o tema e mediante contato com especialistas. Os artigos foram selecionados após criteriosa avaliação crítica da força de evidência científica, obedecendo às regras da Associação Médica Brasileira e do Conselho Federal de Medicina, além dos critérios de Irwig, para análise qualitativa dos artigos. A revisão incluiu todos os estudos publicados a partir de 1990 que avaliavam testes de ácido nucleico em mulheres sexualmente ativas, assintomáticas e que tivessem sido submetidas à avaliação clinica e a testes moleculares. Os testes de ácido nucleico que utilizavam sondas de RNA e amplificação de DNA (PCR) foram comparados à cultura (padrão-ouro) com o intuito de determinar se seriam método de diagnóstico adequado para o rastreio da infecção. Após análise qualitativa, foram selecionados 12 estudos, mas não foi possível realizar avaliação quantitativa dos mesmos devido à heterogeneidade dos dados. A efetividade e os benefícios dos testes de ácido nucleico justificam estudos de custo-efetividade, com o intuito de avaliar o impacto do rastreio universal na redução das complicações advindas da infecção clamidiana
This systematic review aims at evaluating the effectiveness of the nucleic acid test for detection of C. trachomatis. Most of the studies were searched electronically and key journals were hand-searched. Further studies were identified in the internet and by contacting experts in the field. The articles were selected after careful critical evaluation of the strength of scientific evidence, according to the rules of the Brazilian Medical Association and the Federal Council of Medicine, besides the Irwig's criteria for qualitative analysis of article The review included all studies published from 1990 onward that evaluated nucleic acid tests in asymptomatic, young and sexually active women that have been subjected to clinical evaluation and molecular testing. The nucleic acid tests taken with the use of probes of RNA and amplification (PCR) were compared to culture (gold standard) in order to determine if a method of diagnosis would be appropriate for screening of infection. After the qualitative analysis, we selected 12 studies; it has not been possible to perform their quantitative evaluation due to the heterogeneity of data. The effectiveness and benefits of DNA testing justify the cost-effectiveness studies in order to assess the impact of universal screening in reducing the complications that arise from chlamydial infection
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Humanos , Femenino , Ácidos Nucleicos , Cervicitis Uterina/diagnóstico , Chlamydia trachomatis/aislamiento & purificación , Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/microbiología , Tamizaje Masivo/métodos , Sondas ARN , Técnicas y Procedimientos DiagnósticosRESUMEN
Objective To investigate the profile of local immunity of vagina and the immune defense mechanisms against lower genital tract infections. Methods Vaginal lavage was collected from healthy women and patients of vulvovaginal candidiasis, bacterial vaginosis, Trichomonol vaginitis, human papilloma virus infection(VVC), and chlamydia trachomatis infection. Each group included 60 cases. The level of interleukin (IL) 2,4,5, 13,8 and human defensin 5 (HD5) were detected by enzyme linked immunosorbent assay(ELISA). Results (1) Cytokine of helper T cell 1(Th1): the level of IL-2 between healthy women and VVC/ bacterial vaginosis (BV)/ trichomonol vaginitis (TV)/ chlamydia trachomatis (CT) patients had no significant difference. The IL-2 level(96±33 )×10-3 pg/L of human papilloma virus (HPV) infection patients was significantly higher than that of healthy women( P<0.05). (2)Cytokine of helper T cell 2 (Th2) : the level of IL-4 between healthy women and VVC/CT patients had no significant difference. The level of IL-5 between healthy women and BV patients had no significant difference. The IL-13 level(42±15)×10-3 pg/L of TV patients was significantly higher than that of healthy women (30±29)×10-3 pg/L (P<0.05). The IL-4 level (103±28)×10-3 pg/L of HPV infection patients was significantly higher than that of healthy women (36±22)×10-3 pg/L (P<0. 05 ). (3) IL-8 : the IL-8 level (5.8± 2.7) pg/L of TV infection patients was significantly higher than that of healthy women (2. 6±2.4) pg/L (P<0.05). The level of IL-8 between healthy women and BV patients had no significant difference. (4)HD5:the HD5 level of TV , BV, VVC, HPV and CT infection patients were significantly higher than that of healthy women (P<0.05). Conclusions (1) HD5 plays an important role in the defence of vaginal epithelial cell. (2) Th2 may be more important than Thl in lower genital tract infections.(3) IL-8 plays an important role in extrinsic source infections.
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CONTEXT AND PURPOSE: Uterine cervical ectopy (cervical erosion) is today considered to be a physiological condition, but there still seems to be a strong tendency towards treating it. The purpose of this study was to review the medical literature for evidence regarding benefits from treating cervical ectopy. METHODS: The following databases were reviewed: Medical Literature Analysis and Retrieval System Online (Medline), Excerpta Medica Database (Embase), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) and Cochrane Library databases. In addition, six medical textbooks were consulted. RESULTS: The review showed that: 1) there is probably an association between ectopy and higher risk of Chlamydia trachomatis, human papillomavirus and human immunodeficiency virus infection; 4) there is probably an association between ectopy and cervical intraepithelial neoplasia; 5) there is an association between ectopy and mucous discharge and nocturia; and 6) there is no evidence of an association between ectopy and cervical cancer, or of protection against cervical cancer associated with ectopy treatment. CONCLUSIONS: 1) No data were found in the medical literature to support routine treatment for ectopy; 2) Treatment could be recommended for symptom relief, but more symptoms are attributed to ectopy than could be demonstrated in a controlled study; 3) Further studies to test the hypothesis of protection against cervical cancer associated with treatment are necessary.
CONTEXTO E OBJETIVO: A ectopia do colo do útero é hoje considerada um fenômeno fisiológico, mas parece ainda haver uma forte tendência no sentido da intervenção (tratamento). Este estudo se propõe a realizar revisão da literatura buscando evidências de benefícios conseqüentes ao tratamento da ectopia. MÉTODOS: Pesquisa nas bases Medical Literature Analysis and Retrieval Sysem Online (Medline), Excerpta Medica Database (Embase), Literatura Latino-Americane e do Caribe em Ciências da Saúde (Lilacs), Biblioteca Cochrane e seis livros especializados. RESULTADOS: A revisão mostrou que: 1) existe provavelmente associação de ectopia com infecção cervical por Chlamydia trachomatis, pelo vírus HPV e maior risco de soroconversão para HIV; 2) existe provavelmente associação entre ectopia e neoplasia intra-epitelial cervical; 3) existe associação com mucorréia e nictúria; 4) não existem evidências sobre associação entre ectopia e câncer de colo do útero nem sobre proteção contra este câncer proporcionada pelo tratamento da ectopia. CONCLUSÕES: 1) Não foram encontrados na literatura dados que justifiquem o tratamento rotineiro da ectopia; 2) O tratamento pode ser utilizado para tratar sintomas associados à ectopia, porém mais sintomas são atribuídos à ectopia do que se pôde confirmar em um estudo controlado; 3) Seriam necessários novos estudos para testar a hipótese de proteção contra o câncer de colo proporcionada pelo tratamento.
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Humanos , Femenino , Adolescente , Adulto , Cauterización , Neoplasias de Células Escamosas/prevención & control , Erosión del Cuello del Útero/cirugía , Neoplasias del Cuello Uterino/prevención & control , Brasil , Displasia del Cuello del Útero/etiología , Displasia del Cuello del Útero/patología , Displasia del Cuello del Útero/prevención & control , Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/patología , Electrocoagulación , Infecciones por VIH/complicaciones , Infecciones por VIH/patología , Almacenamiento y Recuperación de la Información/métodos , Metaplasia/patología , Neoplasias de Células Escamosas/etiología , Neoplasias de Células Escamosas/patología , Erosión del Cuello del Útero/microbiología , Erosión del Cuello del Útero/patología , Neoplasias del Cuello Uterino/etiología , Neoplasias del Cuello Uterino/patología , Adulto JovenRESUMEN
Objective To study the relationship between M. Genitalium and nongonococcal, non-chlamydial mucopurulent cervicitis. Methods A total of 226 patients with nongonococcal, nonchlamydial mu copurulent cervicitis and 118 healthy female volunteers were recruited in this study. Cervical samples were collected and M.genitalium was detected by PCR amplification of 16s rRNA and Pa genes. Information about socio-demographic characteristics, medical history, and sexual behaviors was gathered by questionnaire from both populations. Results The prevalence of M. Genitalium infection was 11.06% (25/226) in patients with mucpurulent cervicitis, 0,85% (1/118) in the healthy controls; the difference was significant between the two groups (x2 = 11.58, P < 0.001). Single variant analysis on the 226 patients showed that the preva-lence of M. Genitalium infection was 27.78%, 16.36%, 18.28% and 14.12% in patients with ectopic pregnancy history, cervical inflammation, pelvic organ tenderness, 10 or more polymorphonuclear leukocytes (PMNs)per oil immersion field in cervical discharge, respectively, significantly higher than that in patients without ectopic pregnancy history, cervical inflammation or pelvic organ tenderness, and those with less than 10 PMNs per oil immersion field in cervical discharge (9.62%, 6.03%, 6.02% and 1.79%, all P < 0.05). M.genitalium infection was also related to multiple sex partners and the presence of mucopurulent secretion in cervix (P < 0.001). Conclusion The prevalence of M.genitalium infection is higher in patients with non-gonococcal, nonchlamydial mucopurulent cervicitis attending STD clinic than that in normal population.
RESUMEN
OBJECTIVE To investigate the infection conditions of human papillomavirus-16(HPV-16) and-18(HPV-18) in 382 healthy women and 118 uterine cervicitis and vaginitis women.METHODS Fluorescent quantitative polymerase chain reaction(FQ-PCR) was used to detect HPV-16 and HPV-18 in 382 healthy women and 118 uterine cervicitis and vaginitis women.RESULTS In 382 healthy women,two samples were HPV-16 positive,and one sample was HPV-18 positive,with 0.52% and 0.26%,respectively.In 118 uterine cervicitis and vaginitis women,eight samples were HPV-16 positive,and three samples were HPV-18 positive,with 6.78% and 2.54%,respectively.This study made a comparison of the positive rate of HPV-16 and HPV-18 between healthy women group and uterine cervicitis and vaginitis women group.There were marked differences between these two groups(P