ABSTRACT
PURPOSE: Factors influencing fallopian tube occlusion in women with a lower genital tract infection remain incompletely elucidated. We evaluated whether a polymorphism in the mannose-binding lectin (MBL) gene at codon 54 influences the occurrence of fallopian tube blockage in relation to exposure to Chlamydia trachomatis. METHODS: In a case-control study at The Hospital das Clínicas, University of São Paulo, Brazil, 75 women with hysterosalpingography-documented tubal occlusion and 75 women with patent fallopian tubes were analyzed for detection of single-nucleotide polymorphism in codon 54 of the MBL gene and for IgG anti-C. trachomatis antibodies in their sera. Both groups were matched for age, race, and sexual variables. RESULTS: Prior exposure to C. trachomatis, as evidenced by the presence of IgG antibodies, was comparable in both groups. Detection of the polymorphic MBL allele was more prevalent in women with blocked tubes (p < 0.01), regardless of whether or not there was evidence of prior chlamydial exposure. CONCLUSION: The level of MBL-related innate immunity influences the consequences of infection by C. trachomatis or other microbes.
Subject(s)
Chlamydia Infections/genetics , Chlamydia trachomatis/isolation & purification , Fallopian Tube Diseases/diagnostic imaging , Fallopian Tubes/diagnostic imaging , Infertility, Female/diagnostic imaging , Infertility, Female/genetics , Mannose-Binding Lectin/genetics , Adult , Brazil , Case-Control Studies , Chlamydia Infections/microbiology , Chlamydia trachomatis/genetics , Chlamydia trachomatis/immunology , Codon/genetics , Fallopian Tube Diseases/microbiology , Fallopian Tubes/microbiology , Female , Genetic Predisposition to Disease , Humans , Hysterosalpingography , Immunoglobulin G/blood , Infertility, Female/microbiology , Polymorphism, Genetic , Polymorphism, Single NucleotideABSTRACT
PURPOSE: More than 370 million women will experience recurrent vulvovaginal candidiasis (RVVC) during their lifetime. However, RVVC is often trivialized as clinically insignificant and not worthy of research funding. We evaluated the influence of RVVC on the quality of life in affected women. METHODS: The validated World Health Organization Quality of Life Abbreviated Assessment (WHOQOL-Bref) questionnaire was administered to 100 women with RVVC and to 101 epidemiologically matched women with no history of vulvovaginal candidiasis. RVVC was defined as at least four episodes of clinical and culture-positive vaginal candidiasis within a 1 year period. Data were analyzed by Chi square, Student t test and analysis of variance. Internal consistency of responses to questions was evaluated by Cronbach alpha. RESULTS: The Cronbach alpha coefficient was > 0.80 for responses to generalized questions and > 0.65 for answers to more specific questions, indicating substantial internal consistency. Perception of quality of life and satisfaction with their health was greatly reduced in the RVVC group (p < 0.001). Diminished responses to physical and psychological well-being were also reported by women with RVVC (p < 0.001). Various aspects of social relations including sexual activity were similarly reduced (p < 0.001) as were satisfaction with issues such as home environment, financial resources and employment (p < 0.001). CONCLUSION: RVVC affects multiple aspects of a woman's well-being. Women with this condition deserve serious attention from clinicians and research into susceptibility, prevention and treatment of this infection deserves much greater emphasis.
Subject(s)
Candidiasis, Vulvovaginal/psychology , Health Status , Quality of Life , Adult , Candida/isolation & purification , Candidiasis, Vulvovaginal/diagnosis , Case-Control Studies , Female , Humans , Recurrence , Sexual Behavior , Surveys and QuestionnairesSubject(s)
Humans , Female , Trichomonas Vaginitis , Vaginitis , Candidiasis, Vulvovaginal , Vaginosis, BacterialABSTRACT
A colposcopia representa uma precisa colaboração na detecção das lesões precursoras do câncer do colo uterino. Como é baseada em interpretações subjetivas do colposcopista, esta técnica sofre as mesmas críticas que a interpretação do exame de Papanicolaou e do exame da biópsia, por problemas de baixa reprodutibilidade. O índice colposcópico de Reid (ICR) é um método objetivo que tem como finalidade estabelecer padrões de gravidade de uma lesão pré-maligna do colo uterino detectada por exame de colposcopia. O índice categoriza quatro achados colposcópicos a serem considerados: margem da lesão, reação ao ácido acético, características dos vasos e impregnação com solução de lugol. O ICR pode predizer a classificação histológica da doença cervical e permite a diferenciação entre baixo grau e alto grau da lesão cervical. Com estes parâmetros, o uso do índice permite que o examinador formule a impressão colposcópica e realize a biópsia na região mais alterada do colo uterino.
