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1.
Front Endocrinol (Lausanne) ; 15: 1308270, 2024.
Article in English | MEDLINE | ID: mdl-38915890

ABSTRACT

Purpose: This study aims to investigate the impacts of phimosis on the health of the genitourinary system through Mendelian random analysis. Material and method: A dual-sample Mendelian randomization (MR) analysis was conducted using the publicly available genome-wide association study (GWAS) data. The inverse variance weighted based on the random effects model (Re-IVW) method was used as the main statistical analysis. Complementary methods, including weighted median, MR-Egger regression, and MR pleiotropy residual sum and outlier (MR-PRESSO), were applied to detect or correct the impact of horizontal pleiotropy. Result: Re-IVW showed a genetic predictive causal relationship of phimosis on glomerulonephritis (odds ratio [OR]: 1.37 [1.13-1.65], p = 0.00149) and IgA glomerulonephritis (OR: 1.57 [1.18-2.09), p = 0.00187). Suggestive evidence indicated that phimosis was associated with chronic nephritis syndrome (OR: 1.23 (1.00-1.51), p = 0.0481], acute nephritis syndrome (OR: 1.50 [1.13-2.01], p = 0.0058), and impotence (OR: 1.39 [1.11-1.73], p = 0.0035). Kidney and ureteral stone (OR: 1.14 [1.04-1.26], p = 0.0069), urethral strictures (OR: 1.26 [1.07-1.48], p = 0.0050), benign prostatic hyperplasia (OR: 1.07 [1.01-1.13], p = 0.0242), and decreased testicular function (OR: 0.72 [0.56-0.94], p = 0.0141) have genetically predictive causal relationships. Conclusion: In summary, we employed a series of reliable analytical methods to investigate the association between phimosis and 26 urogenital diseases. We have reported several strong associations, but more research is needed to evaluate whether this discovery is replicated in other environments and to gain a better understanding of potential mechanisms.


Subject(s)
Genome-Wide Association Study , Mendelian Randomization Analysis , Phimosis , Humans , Male , Phimosis/genetics , Phimosis/epidemiology , Female Urogenital Diseases/genetics , Female Urogenital Diseases/epidemiology , Polymorphism, Single Nucleotide , Genetic Predisposition to Disease
2.
Climacteric ; 27(3): 289-295, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38415685

ABSTRACT

OBJECTIVE: The genitourinary syndrome of menopause (GSM) is often underdiagnosed and undertreated despite its significant impact on postmenopausal quality of life. We assessed the prevalence of GSM and associated symptoms in Greek perimenopausal/postmenopausal women attending gynecology clinics. METHODS: Four hundred and fifty women, aged 40-70 years (93.1% postmenopausal), attending three gynecology clinics at university hospitals completed a validated questionnaire and underwent pelvic examination. RESULTS: GSM was diagnosed in 87.6% of the women at the study visit, whereas only 16% of the overall sample had been previously diagnosed with the condition. Vaginal dryness (72.7%), vulvar burning sensation or itching (58.0%) and dyspareunia (52.7%) were the most prevalent symptoms. Pelvic signs consisted of vaginal dryness (89.1%), loss of vaginal rugae (80.6%) and vulvovaginal pallor (86.9%). However, only 31.3% of the participants had discussed genitourinary symptoms with their health-care professionals (HCPs). Regarding management, only 11.1% of women had prior experience with any form of therapy, and currently only 8.7% were receiving treatment. CONCLUSION: GSM is highly prevalent in this Greek perimenopausal/postmenopausal population. Nevertheless, the majority of women remain undiagnosed and untreated. Education for both women and HCPs regarding GSM will lead to improved diagnosis and better management of this syndrome.


Subject(s)
Menopause , Humans , Female , Middle Aged , Greece/epidemiology , Adult , Aged , Prevalence , Syndrome , Surveys and Questionnaires , Female Urogenital Diseases/epidemiology , Dyspareunia/epidemiology , Vaginal Diseases/epidemiology , Quality of Life , Postmenopause
3.
Arch. esp. urol. (Ed. impr.) ; 76(6): 389-396, 28 aug. 2023. tab
Article in English | IBECS | ID: ibc-224890

ABSTRACT

Objective: To evaluate trends in the prevalence and clinical characteristics of urogenital diseases in hospitalized patients of secondary and tertiary hospitals in Ningbo, an east coast city in China, from 2017 to 2019. Methods: We collected the data on hospitalized patients in Ningbo secondary and tertiary hospitals from January 1, 2017 to December 31, 2019. The data included age, sex, and diagnosis identified using the International Classification of Diseases (ICD) codes, which were obtained from Ningbo National Health Information Platform. We quantified the epidemiology (age/sex-specific) trend of urogenital system disorders. Results: From January 2017 to December 2019, there were 256750 hospitalized patients with urogenital system disorders. These hospitalized patients comprised more women than men (1.45:1.00). The number of hospitalized patients with these diseases significantly increased over the 3 years (77505, 89167, and 90078, respectively; Z = 20.03, p < 0.001). The highest prevalence of these diseases was in the 40- to 64-year-old age group (47.37%), followed by the 18- to 39-year-old age group (23.94%). Over the 3 years, the five most common diseases in hospitalized male patients were male reproductive organ disorders, urolithiasis, tubulointerstitial disease, renal failure, and glomerular disease; Whereas the five most common diseases in hospitalized female patients were non-inflammatory disorders of the female genital tract, benign or dynamic undetermined tumors of the female reproductive organs, disorders of breast (according to ICD-10, disorders of breast (N60–N64) were involved in urogenital system diseases (N00–N99)), inflammatory diseases of female pelvic organs, and renal tubulointerstitial disease. In addition, the number of inpatients with renal tubulointerstitial disease significantly increased from 5952 to 9616 over the 3 years (rank increased from 6 to 3) (AU)


Subject(s)
Humans , Female Urogenital Diseases/epidemiology , Male Urogenital Diseases/epidemiology , Hospitalization/statistics & numerical data , China/epidemiology , Prevalence
4.
Menopause ; 29(3): 327-334, 2022 01 24.
Article in English | MEDLINE | ID: mdl-35213520

ABSTRACT

OBJECTIVE: This study aims to psychometrically validate the Turkish version of the Vulvovaginal Symptom Questionnaire (VSQ). METHODS: Postmenopausal women with and without genitourinary syndrome of menopause (GSM) were included as the target population and the control group. Psychometric properties were validated both for sexually active (21 items) and passive women (16 items). Several a priori hypotheses were formulated to assess construct validity. Scores of GSM-Assessment Tool, Female Sexual Function Index, Michigan Incontinence Severity Index, Female Genital Self-Image Scale, and Menopause Rating Scale and their correlation with VSQ scores were compared. RESULTS: A total of 242 postmenopausal women were included. The VSQ showed good internal consistency with a Cronbach alpha coefficient of 0.822 (0.800-0.821) and 0.873 (0.853-0.870) in sexually active and passive women, respectively. Originally proposed model (4-factor model, n = 162) showed adequate fit in women with active sexuality and the 3-factor model (n = 242) showed moderate fit. The test-retest reliability was good for symptoms, emotions, and life impact subscales (intraclass correlation coefficient [ICC]: 0.846, 0.835, and 0.755, respectively) and moderate for sexual impact subscale (ICC: 0.643). More than 75% of hypotheses were confirmed. CONCLUSIONS: Our study shows successful cross-cultural adaptation and validation with sufficient psychometric properties for VSQ to be used in Turkish postmenopausal women with GSM.


Subject(s)
Surveys and Questionnaires , Vaginal Diseases , Vulvar Diseases , Female , Female Urogenital Diseases/epidemiology , Humans , Menopause , Psychometrics , Reproducibility of Results , Symptom Assessment , Translations , Vaginal Diseases/diagnosis , Vulvar Diseases/diagnosis
5.
Best Pract Res Clin Endocrinol Metab ; 35(6): 101595, 2021 12.
Article in English | MEDLINE | ID: mdl-34711512

ABSTRACT

Menopause represents an endocrine challenge to urogenital health, as oestrogens deprivation and androgens decline significantly contributes to age-related involution of vulvovaginal tissues and lower urinary tract. Genitourinary syndrome of menopause (GSM) is a clinical entity including the chronic and progressive condition of vulvovaginal atrophy (VVA) and encompassing both anatomical and functional consequences of menopause. The term GSM describes genital, sexual and urinary symptoms with a detrimental impact on quality of life (QOL). Several treatment options are available, but many barriers are still present to adequately diagnose and treat GSM. This review aims to present current evidences about epidemiology, aetiology, diagnosis and treatment of GSM, with a focus on prescription medications [low-dose local oestrogen therapy (LET), prasterone (DHEA) and the SERM ospemifene] for urogenital symptoms in healthy postmenopausal women and in special populations, including women with premature ovarian insufficiency (POI) and breast cancer survivors (BCS).


Subject(s)
Female Urogenital Diseases , Quality of Life , Atrophy/pathology , Estrogens , Female , Female Urogenital Diseases/drug therapy , Female Urogenital Diseases/epidemiology , Female Urogenital Diseases/etiology , Humans , Menopause , Vagina/pathology
6.
Parasitol Int ; 84: 102418, 2021 Oct.
Article in English | MEDLINE | ID: mdl-34245917

ABSTRACT

The Eurasian otter (Lutra lutra) is a protected species in Denmark and at present, the population is recovering due to conservation efforts. The Danish otters are mainly found in the continental part of Denmark (Jutland), but establishment in the main islands (Fyn and Zealand) has been observed. While there is a lack of systematic studies on the parasite fauna of otters in Denmark, this study aims to screen otters for their parasite fauna, especially those of zoonotic and/or veterinary importance. Thirty-three otter carcasses, road-killed (n = 30), found dead (n = 2) and shot (n = 1), were collected between June 2013 and May 2014 and examined for cardiopulmonary, urogenital, gastrointestinal, and muscle helminths by post mortem examination. Faecal samples were analysed by modified concentration McMaster technique and direct immunofluorescence test for Giardia and Cryptosporidium. At least one parasite was found in 75.8% of animals. The parasite fauna included 13 species, consisting of five nematodes: Molineus patens (30.3%), Aonchotheca putorii (27.3%), Strongyloides sp. (24.2%), Physaloptera sp. (12.1%), Eucoleus aerophilus (10.0%); one cestode: Schistocephalus solidius (6.1%); four trematodes: Metorchis bilis (33.3%), Isthimiophora melis (15.2%), Cryptocotyle sp. (3.0%), Plagiorchis sp. (3.0%); one acanthocephalan: Acanthocephalus ranae (18.2%); and two protozoans: Giardia spp. (3.1%), and Eimeria spp. (3.1%). The study showed that otters carry parasites of zoonotic and veterinary importance. Many of these parasites can also infect native carnivores and birds, and the distribution of these parasites may be affected if the otter population continue to increase in Denmark.


Subject(s)
Otters , Parasitic Diseases, Animal/epidemiology , Animals , Denmark/epidemiology , Endangered Species , Female , Female Urogenital Diseases/epidemiology , Female Urogenital Diseases/parasitology , Female Urogenital Diseases/veterinary , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/parasitology , Gastrointestinal Diseases/veterinary , Heart Diseases/epidemiology , Heart Diseases/parasitology , Heart Diseases/veterinary , Lung Diseases/epidemiology , Lung Diseases/parasitology , Lung Diseases/veterinary , Male , Male Urogenital Diseases/epidemiology , Male Urogenital Diseases/parasitology , Male Urogenital Diseases/veterinary , Muscular Diseases/epidemiology , Muscular Diseases/parasitology , Muscular Diseases/veterinary , Parasitic Diseases, Animal/parasitology
7.
Menopause ; 28(4): 444-446, 2021 01 25.
Article in English | MEDLINE | ID: mdl-33752218

ABSTRACT

ABSTRACT: Genitourinary syndrome of menopause (GSM) is a highly prevalent and progressive condition of postmenopausal women that has significant negative effects on vulvovaginal health, sexual health, and overall quality of life. Despite many available safe and effective therapies, GSM often goes undiagnosed and untreated. This Practice Pearl addresses the pathophysiology of GSM and reviews available treatment options.


Subject(s)
Female Urogenital Diseases , Quality of Life , Atrophy/pathology , Female , Female Urogenital Diseases/epidemiology , Female Urogenital Diseases/pathology , Humans , Menopause , Syndrome , Vagina/pathology
8.
Climacteric ; 24(3): 297-304, 2021 06.
Article in English | MEDLINE | ID: mdl-33703967

ABSTRACT

OBJECTIVE: The aim of this study was to investigate genitourinary syndrome of menopause (GSM) in a large cohort, analyzing the dependency on age and menopausal status and possible differences between non-hysterectomized and hysterectomized women. METHODS: Data were assessed by validated questionnaires, collected over 2 years for all eligible women attending our 'Menopause Clinic' from 31 Chinese provinces. Simple and unconditional logistic regression analysis was used with adjustments by all analyzed factors. RESULTS: A total of 4063 women (mean age 50.53 ± 6.57 years), 2107 perimenopausal and 1956 postmenopausal, were included. Almost all GSM symptoms were more frequent and severe in postmenopausal women. GSM was more frequent in hysterectomized women compared to non-hysterectomized women. Independent of menopausal status, low sexual interest (92.78%), urinary incontinence (91.65%) and vaginal dryness (91.60%) were the top three GSM symptoms. Most severe were low sexual interest (21.01%), vaginal pain (20.10%) and decreased sexual pleasure (17.13%). Prevalence and severity of GSM were not related to age, but were related to menopausal status and increased with time since menopause. CONCLUSIONS: Within 2 years, more than 4000 women with GSM traveled from all over China to our specialized clinic, indicating the great importance of GSM. Hysterectomy can increase the risk of GSM, and GSM symptoms increase from perimenopause to postmenopause and with an increase of time since menopause, pointing to the dependency on the loss of ovarian function.


Subject(s)
Female Urogenital Diseases/epidemiology , Perimenopause , Postmenopause , China/epidemiology , Cohort Studies , Female , Female Urogenital Diseases/etiology , Humans , Logistic Models , Middle Aged , Prevalence , Syndrome , Time Factors
9.
J Minim Invasive Gynecol ; 28(3): 475-480, 2021 03.
Article in English | MEDLINE | ID: mdl-32702513

ABSTRACT

OBJECTIVE: To provide a perspective on nerve-sparing (NS) surgery in gynecology. DATA SOURCES: Literature review, English language. METHODS OF STUDY SELECTION: Systematic reviews and meta-analyses studies were selected for review for oncology; comparative studies were selected for endometriosis, and 1 comparative and 1 prospective study were chosen for sacrocolpopexy. TABULATION, INTEGRATION, AND RESULTS: Two tables summarize the results of systematic reviews and meta-analyses in oncology. Oncology, endometriosis, and urogynecology sections. Primary benefit of NS technique is decreased bladder dysfunction, and, to a lesser degree, vaginal and rectal dysfunc. CONCLUSION: NS is preferable to conventional surgery for benign and malignant conditions to reduce postoperative bladder, rectal, and vaginal dysfunction.


Subject(s)
Gynecologic Surgical Procedures/methods , Nerve Tissue/surgery , Organ Sparing Treatments/methods , Endometriosis/epidemiology , Endometriosis/pathology , Endometriosis/surgery , Female , Female Urogenital Diseases/epidemiology , Female Urogenital Diseases/pathology , Female Urogenital Diseases/surgery , Genital Neoplasms, Female/epidemiology , Genital Neoplasms, Female/pathology , Genital Neoplasms, Female/surgery , Gynecologic Surgical Procedures/adverse effects , Gynecologic Surgical Procedures/statistics & numerical data , Humans , Hysterectomy/methods , Meta-Analysis as Topic , Nerve Tissue/pathology , Organ Sparing Treatments/adverse effects , Organ Sparing Treatments/statistics & numerical data , Postoperative Period , Prospective Studies , Systematic Reviews as Topic
10.
Maturitas ; 143: 81-88, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33308641

ABSTRACT

OBJECTIVES: To examine the associations of childhood adiposity with menopausal symptoms in women aged 45-49 years. STUDY DESIGN: National population-based cohort study of 334 girls prospectively followed from childhood (aged 11-15) through to midlife (aged 45-49). Childhood overweight and obesity were defined by international age- and sex-specific standards for body mass index (BMI), and abdominal obesity was defined as waist/height ratio≥0.5. MAIN OUTCOME MEASURES: Vasomotor symptoms (VMS), vaginal dryness, total menopausal symptoms and domain-specific symptoms (somatic, psychological and urogenital) were measured during 2018-19 using the Menopause Rating Scale (MRS) and classified as none, mild, moderate or severe. RESULTS: The prevalence of mild, moderate and severe VMS was 24.0 %, 9.0 % and 3.9 %, and of vaginal dryness was 12.6 %, 4.8 % and 2.4 %. No significant associations of childhood overweight/obesity or abdominal obesity with VMS or vaginal dryness were found after adjustment for childhood age, follow-up length, smoking, socioeconomic status and diet quality. Childhood overweight/obesity was associated with increased risks of more severe total (RR:1.17, 95 % CI:1.02-1.36), psychological (RR:1.19, 95 % CI:1.04-1.35) and urogenital (RR:1.29, 95 % CI:1.14-1.46) symptoms measured using the MRS. Associations with childhood abdominal obesity were mostly stronger with more severe total (RR:2.19, 95 % CI:1.48-3.23), somatic (RR:1.52, 95 % CI:1.15-2.02), psychological (RR:1.21, 95 % CI:1.04-1.42) and urogenital (RR:2.11, 95 % CI:1.39-3.20) symptoms. CONCLUSIONS: Childhood adiposity was not associated with increased risks of more severe VMS or vaginal dryness in women aged 45-49 years. Childhood adiposity, especially abdominal obesity, was associated with more severe total, somatic, psychological and urogenital symptoms. However, the association between these symptoms and menopause is not established.


Subject(s)
Menopause , Obesity, Abdominal/epidemiology , Pediatric Obesity/epidemiology , Adiposity , Adolescent , Australia/epidemiology , Child , Cohort Studies , Female , Female Urogenital Diseases/epidemiology , Humans , Menopause/psychology , Middle Aged , Prevalence , Surveys and Questionnaires
11.
Article in Russian | MEDLINE | ID: mdl-32827369

ABSTRACT

The article presents the results of studying state and trends of incidence of adult urban population in the city of Moscow by the classes of diseases of the genitourinary system. The purpose of study was to analyze urogenital morbidity of population of metropolis as compared with similar indices of the Central Federal Okrug and the Russian Federation in 2014-2018. The corresponding official statistical data of the Minzdrav of Russia and research publications were studied. It was established that permanent monitoring of dynamics of urological morbidity can be considered as important methodological and informational and analytical base for planning medical care of population, that makes it possible to develop in practice the basis of development and implementation of integrated system of measures of development of community-based and hospital care, which must be taken into account by the administration of medical organizations and health care management at various levels.


Subject(s)
Female Urogenital Diseases/mortality , Male Urogenital Diseases/mortality , Urogenital System , Female , Female Urogenital Diseases/epidemiology , Humans , Incidence , Male , Male Urogenital Diseases/epidemiology , Morbidity , Moscow , Russia
12.
BMC Public Health ; 20(1): 1020, 2020 Jun 29.
Article in English | MEDLINE | ID: mdl-32600306

ABSTRACT

BACKGROUND: Although many species of mycoplasmas regard as normal flora, but some species causes serious genital disease. In Iran several epidemiological studies have documented the prevalence of Mycoplasma hominis, M. genitalium and Ureaplasma urealyticum in genital disorders. This meta-analysis is going to represent the prevalence of M. hominis, M. genitalium and U. urealyticum among Iranian couples and the correlation between mycoplasmas infection and infertility. METHODS: We search online databases from January 2000 to June 2019. We used following MeSH keywords (Prevalence, M. hominis, M. genitalium, U. urealyticum, male, female, fertility, Infertility, genitourinary tract infection and Iran) with all possible combinations with "OR" and "AND". Finally, forty-four articles from 2670 were chosen for data extraction and analysis by software using STATA version 14.0. RESULTS: This meta-analysis revealed that the prevalence of U. urealyticum was 17.53% in Iran and the prevalence of M. genitalium and M. hominis were 11.33 and 9.68% respectively. The rate of M. genitalium, M. hominis and U. urealyticum infection in women with symptoms of genitourinary tract infection was higher than men with genitourinary tract infection (6.46% vs 5.4, 7.67% vs 5.88 and 21.04% vs 12.13%, respectively). As expected, the prevalence of M. genitalium, U. urealyticum and M. hominis among infertile women (12.73, 19.58 and 10.81%) were higher than fertile women (3%, 10. 85% and 4. 35%). Similarly, the prevalence of M. hominis and U. urealyticum among infertile men (14 and 21.18%) were higher than fertile men (4 and 3%). Based on this analysis, the rate of U. urealyticum was higher than M. genitalium and M. hominis among infertile men and women compared to the fertile group. The prevalence rate of M. genitalium, M. hominis and U. urealyticum in central provinces is higher than other parts of Iran. CONCLUSIONS: This meta-analysis reemphasizes a significant relationship between the infertility rate and U. urealyticum, M. genitalium and M. hominis infections. Our finding help to plan the prevalence map of M. hominis, M. genitalium and U. urealyticum in Iran but further studies are needed to suggest routine screening of the pathogens.


Subject(s)
Mycoplasma Infections/epidemiology , Mycoplasma genitalium , Mycoplasma hominis , Ureaplasma Infections/epidemiology , Ureaplasma urealyticum , Adult , Female , Female Urogenital Diseases/epidemiology , Female Urogenital Diseases/microbiology , Humans , Infertility/epidemiology , Infertility/microbiology , Iran/epidemiology , Male , Male Urogenital Diseases/epidemiology , Male Urogenital Diseases/microbiology , Mycoplasma Infections/microbiology , Prevalence , Ureaplasma Infections/microbiology
13.
Climacteric ; 23(6): 603-607, 2020 12.
Article in English | MEDLINE | ID: mdl-32720549

ABSTRACT

OBJECTIVE: The purpose of this survey was to assess the prevalence of genital and urinary tract symptoms among Japanese women with declining estrogen levels. METHODS: A health-related questionnaire survey was conducted among women in their 40s or older to inquire about their genital, intercourse-related, and urinary symptoms and concern over their symptoms. RESULTS: Of the consecutive 10,000 respondents recruited, 4488 (44.9%) reported having symptoms: 3546 (79.0%) expressed concern over their symptoms. Furthermore, 2173 women (21.7%) had incontinence, 1999 (20.0%) had urinary frequency, 1648 (16.5%) had itching, and 1560 (15.6%) reported odor; these were followed by looseness, dryness, and burning. Of the 2518 (25.2%) sexually active women, 518 (20.6%) reported having dyspareunia and more reported having urinary symptoms than genital symptoms. Of the symptomatic respondents, 33.1% had genital symptoms alone, 28.4% had urinary symptoms alone, and 38.4% had both. More sexually active women had genital symptoms, while more sexually inactive women had urinary symptoms. CONCLUSIONS: Genital and urinary symptoms were shown to be common and coexist in a considerable proportion of the respondents, highlighting the pathology of genitourinary syndrome of menopause. Again, dyspareunia and lower urinary tract symptoms were shown to be quite common among postmenopausal women.


Subject(s)
Dyspareunia/epidemiology , Female Urogenital Diseases/epidemiology , Lower Urinary Tract Symptoms/epidemiology , Menopause , Symptom Assessment/statistics & numerical data , Adult , Aged , Aged, 80 and over , Dyspareunia/etiology , Female , Female Urogenital Diseases/etiology , Health Surveys , Humans , Japan/epidemiology , Lower Urinary Tract Symptoms/etiology , Middle Aged , Prevalence
14.
Int J STD AIDS ; 31(8): 773-780, 2020 07.
Article in English | MEDLINE | ID: mdl-32517577

ABSTRACT

The present study investigates the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) among women with genitourinary infection and pregnancy-related complications in Tehran. It also evaluates the demographic information, symptoms, and sequelae. Endocervical samples were obtained over a period of eight months from 360 women including 180 symptomatic patients and 180 patients with pregnancy-related complications and infertility. CT, NG, and TV were detected in 10.8%, 6.9%, and 8.3% of all patients, respectively. The prevalence of CT, NG, and TV among women in the symptomatic group was 11.1%, 7.2%, and 13.3%, respectively, and among women with pregnancy-related complications and infertility was 10.6%, 6.7%, and 3.3%, respectively. Associations between chlamydia and ectopic pregnancy (p = 0.001), and infertility (p < 0.001) were observed. Abortion (p = 0.008), infertility (p = 0.005), and ectopic pregnancy (p < 0.001) were associated with gonorrhea. Abnormal vaginal discharge (p = 0.02) and vulvar itching (p = 0.02) were associated with trichomoniasis. Overall, the prevalence rates of CT, NG, and TV were high in these patient groups. These high prevalences suggest that screening programs are required to reduce the burden of these sexually transmitted infections and their effects on genitourinary symptoms, pregnancy-related complications, and infertility.


Subject(s)
Cervix Uteri/microbiology , Chlamydia Infections/diagnosis , Chlamydia trachomatis/isolation & purification , Female Urogenital Diseases/microbiology , Gonorrhea/diagnosis , Neisseria gonorrhoeae/isolation & purification , Pregnancy Complications, Infectious/epidemiology , Trichomonas Infections/diagnosis , Trichomonas vaginalis/isolation & purification , Adolescent , Adult , Cervix Uteri/pathology , Chlamydia Infections/epidemiology , Chlamydia trachomatis/genetics , Cross-Sectional Studies , Female , Female Urogenital Diseases/epidemiology , Gonorrhea/epidemiology , Humans , Iran/epidemiology , Neisseria gonorrhoeae/genetics , Polymerase Chain Reaction , Pregnancy , Pregnancy Complications, Infectious/microbiology , Prevalence , Trichomonas Infections/epidemiology , Trichomonas vaginalis/genetics , Young Adult
15.
Lancet ; 395(10240): 1865-1877, 2020 06 13.
Article in English | MEDLINE | ID: mdl-32534649

ABSTRACT

Neisseria meningitidis is an obligate human commensal bacterium that frequently colonises the upper respiratory tract. Person-to-person transmission occurs via direct contact or through dispersion of respiratory droplets from a carrier of the bacteria, and can lead to invasive meningococcal disease. Rare sporadic cases of meningococcal urogenital and anorectal infections, including urethritis, proctitis, and cervicitis, have been reported, typically following orogenital contact with an oropharyngeal meningococcal carrier. The resulting infections were clinically indistinguishable from infections caused by Neisseria gonorrhoeae. Over the past two decades, there have also been multiple outbreaks across North America and Europe of invasive meningococcal disease among men who have sex with men (MSM). The responsible meningococci belong to a highly virulent and predominantly serogroup C lineage, including strains that are able to express nitrite reductase and grow in anaerobic environments, such as the urogenital and anorectal tracts. More recently, a distinct clade within this lineage has expanded to cause urethritis predominantly among men who have sex with women. Evolutionary events giving rise to this clade included the loss of the ability to express a capsule, and acquisition of several gonococcal alleles, including one allele encoding a highly efficient gonococcal nitrite reductase. Members of the clade continue to acquire gonococcal alleles, including one allele associated with decreased antibiotic susceptibility. This evolution has implications for the clinical and public health management of those who are infected and their close contacts, in terms of both antibiotic treatment, and prevention through vaccination.


Subject(s)
Female Urogenital Diseases/epidemiology , Male Urogenital Diseases/epidemiology , Meningococcal Infections/epidemiology , Meningococcal Infections/transmission , Neisseria meningitidis , Rectal Diseases/epidemiology , Sexually Transmitted Diseases, Bacterial/epidemiology , Female , Female Urogenital Diseases/microbiology , Female Urogenital Diseases/prevention & control , Heterosexuality , Homosexuality, Male , Humans , Infectious Disease Transmission, Vertical , Male , Male Urogenital Diseases/microbiology , Male Urogenital Diseases/prevention & control , Meningococcal Infections/prevention & control , Rectal Diseases/microbiology , Rectal Diseases/prevention & control , Sexually Transmitted Diseases, Bacterial/prevention & control
16.
Crit Care Resusc ; 22(2): 126-132, 2020 Jun.
Article in English | MEDLINE | ID: mdl-32389104

ABSTRACT

BACKGROUND: To determine the temporal trends of incidence and outcome based on different sources of sepsis using a nationwide administrative database. METHODS: From 2002 to 2012, the entire Taiwan's health insurance claims data of emergency-treated and hospital-treated sepsis were analysed for incidence and mortality trends. The information about patients with sepsis and sources of sepsis was identified using a set of validated International Classification of Diseases, ninth revision, clinical modification (ICD-9-CM) codes. The 30-day all-cause mortality was verified by linked death certificate database. RESULTS: A total of 1 259 578 episodes of sepsis were identified during the 11-year study period. Lower respiratory tract infection is the most common source of sepsis in patients, with the highest mortality rate. The incidence of genitourinary tract infection has the fastest growing rate. The sepsis mortality was declining at different rates for each source of sepsis. Co-infections in patients with sepsis are associated with higher mortality rate. CONCLUSION: The temporal trends of sepsis incidence and mortality varied among different sources of sepsis, with lower respiratory tract being the highest burden among patients with sepsis. Furthermore, sources of sepsis and the presence of co-infection are independent predictors of mortality. Our results support source-specific preventive and treatment strategies for future sepsis management.


Subject(s)
Emergency Service, Hospital/statistics & numerical data , Hospital Mortality/trends , Sepsis/etiology , Female , Female Urogenital Diseases/epidemiology , Female Urogenital Diseases/etiology , Humans , Incidence , International Classification of Diseases , Male , Male Urogenital Diseases/epidemiology , Male Urogenital Diseases/etiology , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/etiology , Sepsis/epidemiology , Sepsis/mortality , Taiwan/epidemiology , Urinary Tract Infections/epidemiology , Urinary Tract Infections/etiology
17.
JAMA Dermatol ; 156(7): 780-786, 2020 07 01.
Article in English | MEDLINE | ID: mdl-32432647

ABSTRACT

Importance: Hidradenitis suppurativa (HS) is a chronic skin disease characterized by recurrent inflamed nodular lesions and is associated with multiple comorbidities; previous studies have been of cross-sectional design, and the temporal association of HS with multiple comorbidities remains undetermined. Objective: To evaluate and characterize disease trajectories in patients with HS using population-wide disease registry data. Design, Setting, and Participants: This retrospective registry-based cohort study included the entire Danish population alive between January 1, 1994, and April 10, 2018 (7 191 519 unique individuals). Among these, 14 488 Danish inhabitants were diagnosed with HS or fulfilled diagnostic criteria identified through surgical procedure codes. Exposures: Citizens of Denmark with a diagnosis code of HS as defined by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) or as identified through surgical procedures. Main Outcomes and Measures: Disease trajectories experienced more frequently by patients with HS than by the overall Danish population. Strength of associations between disease co-occurrences was evaluated using relative risk (RR). All significant disease pairs were tested for directionality using a binomial test, and pairs with directionality were merged into disease trajectories of 3 consecutive diseases. Numerous disease trajectories were combined into a disease progression network showing the most frequent disease paths over time for patients with HS. Results: A total of 11 929 individuals were identified by ICD-10 diagnosis codes (8392 [70.3%] female; mean [SD] age, 37.72 [13.01] years), and 2791 were identified by procedural codes (1686 [60.4%] female; mean [SD] age, 37.38 [15.83]). The set of most common temporal disease trajectories included 25 diagnoses and had a characteristic appearance in which genitourinary, respiratory, or mental and behavioral disorders preceded the diagnosis of HS and chronic obstructive pulmonary disease (604 cases [4.2%]; RR, 1.57; 95% CI, 1.55-1.59; P < .001), pneumonia (827 [5.7%]; RR, 1.18; 95% CI, 1.15-1.20; P < .001), and acute myocardial infarction (293 [2.0%]; RR, 1.37; 95% CI, 1.35-1.39; P < .001) developed after the diagnosis. Conclusions and Relevance: The findings suggest that patients with newly diagnosed HS may have a high frequency of manifest type 1 diabetes and subsequent high risk of acute myocardial infarction, pneumonia, and chronic obstructive pulmonary disease.


Subject(s)
Diabetes Mellitus, Type 1/epidemiology , Hidradenitis Suppurativa/epidemiology , Myocardial Infarction/epidemiology , Pneumonia/epidemiology , Pulmonary Disease, Chronic Obstructive/epidemiology , Adult , Comorbidity , Denmark/epidemiology , Female , Female Urogenital Diseases/epidemiology , Humans , Male , Male Urogenital Diseases/epidemiology , Mental Disorders/epidemiology , Middle Aged , Registries , Retrospective Studies , Young Adult
18.
Nagoya J Med Sci ; 82(1): 113-121, 2020 Feb.
Article in English | MEDLINE | ID: mdl-32273639

ABSTRACT

In Lao People's Democratic Republic (Lao PDR), reports on disease frequency are very limited. This study aimed to report frequencies of the main cause of admission among inpatients of a tertiary general hospital (Mittaphab Hospital) in Vientiane. Subjects were inpatients who were admitted from January 3 to February 2 in 2017. The dataset were made as a pilot run to establish hospital statistics. The data on sex, age, address (province), dates of admission and discharge, and main diagnosis were collected from paper-based medical charts. International Classification of Diseases 10 was applied for classifying the main diagnosis. During the 1-month period, 1,201 inpatients (637 males and 564 females) were admitted, including 171 (14.2%) aged <20 years and 254 (21.1%) aged ≥60 years. About 20% patients were from outside of Vientiane. Among them, 67.5% (62.5% in males and 73.8% in females) were admitted within 7 days. The main causes with more than 10% in males were injury and poisoning S00-T98 (49.8%), while those in females were injury and poisoning S00-T98 (25.2%), pregnancy and childbirth O00-O99 (19.0%), and diseases of genitourinary system N00-N99 (13.7%). Injury and poisoning S00-T98 among inpatients aged <20 years was 81.8% in males and 59.0% in females. Among those aged 20-59 years, it was 49.9% and 22.4%, and among those aged ≥60 years it was 22.3% and 16.9%, respectively. This is the first report on the frequencies of main diseases among inpatients in Lao PDR. Injury was the first main cause of admission at the tertiary hospital.


Subject(s)
Female Urogenital Diseases/epidemiology , Hospitals, General , Inpatients , Male Urogenital Diseases/epidemiology , Parturition , Poisoning/epidemiology , Tertiary Care Centers , Wounds and Injuries/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Databases, Factual , Female , Humans , Infant , Infant, Newborn , Laos/epidemiology , Male , Middle Aged , Patient Admission , Pilot Projects , Time Factors , Young Adult
19.
Women Health ; 60(5): 559-569, 2020.
Article in English | MEDLINE | ID: mdl-31630645

ABSTRACT

This study examined female university students' menstrual-hygiene management and identified factors associated with genitourinary tract infections in this sample. This study was conducted as a descriptive survey. Participants were 383 female students from six universities in South Korea. Data were collected between April and June, 2017. Multiple logistic regression analysis was used to access the factors associated with genitourinary-tract infections. Multiple logistic regression revealed that genitourinary tract infections were significantly associated with low socioeconomic level, history of sexual intercourse, and vaginal douching during menstruation. We evaluated menstrual hygiene practices and their relation to genitourinary tract infections. Korean college students were relatively good at managing menstrual hygiene. However, some menstrual hygiene behaviors were improper. Therefore, school and community health agencies should provide education to maintain adequate menstrual hygiene and correct erroneous hygiene practices to prevent genitourinary tract infections.


Subject(s)
Female Urogenital Diseases/etiology , Health Knowledge, Attitudes, Practice , Hygiene , Menstruation/physiology , Coitus , Cross-Sectional Studies , Female , Female Urogenital Diseases/epidemiology , Humans , Menstrual Hygiene Products , Republic of Korea/epidemiology , Sexual Behavior , Students/statistics & numerical data , Surveys and Questionnaires , Vaginal Douching , Young Adult
20.
Eur J Clin Microbiol Infect Dis ; 39(4): 717-721, 2020 Apr.
Article in English | MEDLINE | ID: mdl-31832807

ABSTRACT

The aim of this study was to determine the occurrence of urogenital mycoplasmas in urogenital tract of women with systemic lupus erythematosus (SLE). The study group included 36 women diagnosed with SLE and 100 healthy controls. Mycoplasmas were detected with microculture and PCR in 13/36 (36.1%) women with SLE and in 25/100 (25%) controls. In both groups, U. parvum occurred significantly more frequently. M. genitalium was detected in 3/36 (8.3%) SLE patients and in 3/100 (3%) controls. FVU as a material decreased the number of positive results from 33.3% to 30.6% compared with swabs.Although the incidence of mycoplasmas in urogenital tract of women with SLE and controls did not differ statistically, it is important to consider them as a potential etiology of urogenital infection when clinical symptoms are present, but etiology is unknown or uncertain.


Subject(s)
Female Urogenital Diseases/epidemiology , Lupus Erythematosus, Systemic/complications , Mycoplasma Infections/epidemiology , Mycoplasma/isolation & purification , Urogenital System/microbiology , Adult , Female , Female Urogenital Diseases/microbiology , Humans , Lupus Erythematosus, Systemic/microbiology , Middle Aged , Mycoplasma/classification , Mycoplasma Infections/microbiology , Poland/epidemiology , Preliminary Data , Prevalence , Ureaplasma Infections/epidemiology , Ureaplasma Infections/microbiology , Ureaplasma urealyticum/isolation & purification , Young Adult
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