[Brazilian Protocol for Sexually Transmitted Infections 2020: infections that cause cervicitis]. / Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: infecções que causam 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.

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.

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.

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: infecções que causam cervicite / Brazilian Protocol for Sexually Transmitted Infections 2020: infections that cause cervicitis / Protocolo Brasileño para Infecciones de Transmisión Sexual 2020: infecciones que causan cervicitis

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.

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: infecções que causam cervicite / Brazilian Protocol for Sexually Transmitted Infections 2020: infections that cause cervicitis / Protocolo Brasileño para Infecciones de Transmisión Sexual 2020: infecciones que causan cervicitis

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.

Cervicitis: etiología, diagnóstico y tratamiento / Cervicitis: Etiology, diagnosis and treatment

La cervicitis es un cuadro de inflamación del cuello uterino. Suele ser causada por un agente infeccioso, generalmente de transmisión sexual. Frecuentemente es asintomática, y la infección silente puede originar complicaciones del tracto genital superior. Los síntomas suelen ser inespecíficos, y los más significativos son aumento del flujo vaginal y/o sangrado intermenstrual. Para su diagnóstico existen sistemas comerciales basados en técnicas moleculares que incluyen la casi totalidad de los patógenos conocidos asociados a cervicitis, aunque los cultivos no deben abandonarse por la necesidad de realizar estudios de sensibilidad a los antibióticos. Se recomienda iniciar un tratamiento empírico que incluya C.trachomatis y N. gonorrhoeae en el caso de mujeres con elevado riesgo de infección por dichos patógenos, sobre todo si el seguimiento no está asegurado o no se dispone de pruebas diagnósticas adecuadas. En mujeres con bajo riesgo el tratamiento deberá ajustarse a los resultados de las pruebas microbiológicas

Cervicitis is the inflammation of the cervix. It is usually caused by an infectious agent, usually sexually transmitted. Cervicitis is frequently asymptomatic and silent infection can cause complications of the upper genital tract. The symptoms are usually nonspecific, the most significant being an increase in vaginal discharge and/or intermenstrual bleeding. For its diagnosis, there are commercial systems based on molecular techniques that include almost all of the known pathogens associated with cervicitis, although cultures should not be abandoned due to the need to conduct studies of susceptibility to antibiotics. It is recommended to initiate an empirical antibiotic therapy that covers C.trachomatis and N. gonorrhoeae in the case of women at high risk of infection by these pathogens, especially if the follow-up is not assured or adequate diagnostic tests are not available. In women with low risk of sexually transmitted infection, antibiotic therapy should be adjusted to the results of the microbiological results

Efficacy and safety of combined high-dose interferon and red light therapy for the treatment of human papillomavirus and associated vaginitis and cervicitis: A prospective and randomized clinical study.

BACKGROUND: We evaluated the efficacy and safety of combined high-dose interferon (IFN) and red light therapy for the treatment of subclinical and latent human papillomavirus (HPV) infections. METHODS: Ninety women diagnosed with subclinical or latent HPV infection were randomized to receive topical application of low-dose recombinant IFNα-2b (1 million IU), high-dose IFNα-2b (9 million IU), or a combination of high-dose IFNα-2b and red light therapy on the cervix and vagina. All patients received treatment once daily for 4 weeks. HPV titer was measured immediately and 4, 8, and 12 weeks after treatment to determine the rates of viral clearance and infection cure. Treatment of HPV-associated vaginitis and cervicitis was also evaluated. RESULTS: Results showed that immediately and 4, 8, and 12 weeks after treatment, the HPV clearance rates and infection cure rates were higher in the high-dose IFN and combination groups compared to the low-dose IFN group. High-dose IFN and combination therapies were significantly effective against both low-risk and high-risk HPV infections. Although the cure rates for vaginitis and cervicitis were significantly higher in the high- compared to the low-dose IFN group, rates were even higher in the combination group compared to the high-dose IFN group. Mild adverse effects were reported by a very small subset of patients (3/30) in the combination group. CONCLUSIONS: This study suggests that combination of high-dose IFN and red light therapy is safe and effective against subclinical and latent HPV infections.

Clinical efficacy of cryotherapy combined with interferon in the treatment of chronic cervicitis complicated with HPV infection.

This paper aims to investigate the clinical curative effect and adverse reactions of cryotherapy combined with interferon in the treatment of chronic cervicitis complicated with HPV infection. 100 cases diagnosed with chronic cervicitis complicated with HPV infection from August 2014 to August 2015 in our hospital were selected and randomly divided into observation group (50 cases) and control group (50 cases). The preoperative and postoperative HPV-DNA changes were observed, and the vaginal discharge, time of decrustation and hemostasis, HPV negative conversion ratio and clinical efficacy were compared, to record the adverse reactions during treatment. After treatment, the level of RLU/CO value of the observation group was significantly lower than that of the control group (P<0.05); the vaginal discharge and time of decrustation and hemostasis of the observation group were shorter than that of the control group (P<0.05); 3 months after treatment, the HPV negative conversion ratio in the observation group was significantly higher than that in the control group; the total efficiency of the observation group was higher than that of the control group, with statistical significance (P<0.05). There were no serious adverse reactions in the two groups during the treatment. The efficiency of cervicitis complicated with HPV infection in the treatment of cryotherapy combined with interferon was more significantly. It can effectively reduce the load of HPV, promote the recovery of patients with pathological changes. Therefore, it is worth promoting.

Preliminary preventive protocol from first trimester of pregnancy to reduce preterm birth rate for dichorionic-diamniotic twins.

OBJECTIVE: The preterm birth rate of twins is reportedly higher than that of single pregnancies. We performed preliminary preventive interventions at our center focused on evaluating the risk of each case before 14 weeks of gestation to reduce the spontaneous preterm birth rate. MATERIALS AND METHODS: The participants included 184 dichorionic-diamniotic twins delivered at our center during the 8 years from 2006. We evaluated each patient regarding high-risk status (at least 1 additional factor as follows: threatened abortion, history of chorioamnionitis, cervicitis, and bacterial vaginosis), based on available evidence; patients deemed high risk gave their informed consent and underwent treatment for cervicitis and cerclage if indicated. We divided the patients into two groups depending on whether the management was initiated before (Group A) or after (Group B) 14 weeks. We further divided Group A into three: Group 1 underwent treatment for cervicitis, Group 2 underwent cervical cerclage in addition to treatment for cervicitis, and Group 3 did not undergo preventive treatment. We retrospectively compared the preterm birth rates of the two groups, and we also compared them between the higher-risk group (Group 1 + 2) and the no additional risk group (Group 3) in Group A. RESULTS: The spontaneous preterm birth rate < 36 weeks was significantly lower in Group A (4/90; 4.4%) than in Group B (18/94; 19.1%) (p=0.001). However, there were no significant differences between Group 1 + 2 and Group 3 (2/42 vs. 2/46). Focusing on the spontaneous preterm birth rate < 34 weeks, Group A had a lower rate than Group B (2/90; 2.2% vs. 13/94; 13.8%, p=0.0012). CONCLUSION: Even though this was a preliminary study, the results are promising, and we propose custom-made management for dichorionic-diamniotic twins: (1) earlier management from before 14 weeks; (2) high-risk selection for cervicitis and a short cervix; and (3) intervention with anti-inflammatory agents and cerclage if indicated.

Bartholinitis due to Aggregatibacter aphrophilus: a case report.

BACKGROUND: Aggregatibacter aphrophilus, a commensal of the oro-pharyngeal flora and member of the HACEK group of organisms, is an uncommonly encountered clinical pathogen. It has already been described as the causative agent of brain abscesses, empyema, meningitis, sinusitis, otitis media, bacteriemia, pneumonia, osteomyelitis, peritonitis, endocarditis and wound infections. Herein we report the first case of bartholinitis due to A. aphrophilus. CASE PRESENTATION: A 33-year-old woman was admitted for a 3-day genital pain without fever and urinary functional signs. The abscess was incised and drained; A. aphrophilus was the only micro-organism that grew from the pus. The patient received no antibiotics; the clinical course was favourable. CONCLUSION: This case highlights the importance of an effective treatment of recurrent bartholinitis such as a cold resection of the gland. It is presented for its rarity.

Chronic Cervicitis: Presenting Features and Response to Therapy.

OBJECTIVES: Chronic nongonococcal nonchlamydial cervicitis is a condition of unknown etiology. Data about treatment options are limited. Our goal was to review a single center's experience in managing women with chronic NGNCC. METHODS: We evaluated all encounters at a tertiary care center with ICD-9 code for cervicitis between April 2008 and March 2014. Cases were defined by having two of the following 3 diagnostic criteria: mucopurulent discharge noted by (1) patient or (2) practitioner, and (3) cervical bleeding upon gentle probing. All women had negative nucleic acid amplification testing for Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis. Information regarding patient demographics, symptoms, findings, treatment, and outcomes were analyzed. Cure was defined as resolution of patient-specific diagnostic criteria. RESULTS: Sixty-one women were identified. The mean age was 31 years; 73.7% were white, and 59% were nulliparous. The mean duration of symptoms was 25.2 months. Initially, all 61 patients received one of 3 antibiotic treatments. The cure rate after initial antibiotic treatment was 65.6%. Nineteen patients required at least one further treatment. Additional treatments included secondary antibiotics, hormonal treatments, vaginal hydrocortisone, silver nitrate, cryotherapy, and loop excision electrosurgical procedure. Cure rates were as follows: 57.9% with antibiotics, 50% with hormone treatment, 0% with hydrocortisone, 100% with silver nitrate, 0% with cryotherapy, and 100% with loop electrosurgical excisional procedure. Of the initial 61 women, 93.4% were eventually cured. CONCLUSIONS: Nongonococcal nonchlamydial cervicitis is a condition that can cause unremitting symptoms. Most patients will respond to antibiotics, although other treatments including surgery may be necessary.

Is Cryotherapy Friend or Foe for Symptomatic Cervical Ectopy?

OBJECTIVE: To evaluate the success rates and clinical outcomes of cervical cryotherapy applied to cervical ectopy for symptomatic relief. SUBJECTS AND METHODS: A total of 124 women who underwent cryotherapy for symptomatic treatment of cervical ectopy were included in this study. Indications for treatment were: abundant leucorrhoea (n = 114), post-coital bleeding (n = 22), recurrent cervicitis (n = 30) and pelvic pain (n = 12). Cryotherapy consisted of the use of carbon dioxide at -89°C to destroy the ectopic columnar epithelium by freezing, and it was transmitted to the ectopy through a flat cryoprobe. No routine anaesthesia or analgesia was administered. All patients were questioned about the status of their symptoms after 6 weeks of treatment. RESULTS: The highest success rate was obtained in patients with abundant leucorrhoea (n = 102; 89.5%), while the lowest success rate was achieved in subjects with pelvic pain (n = 7; 58%). After treatment, no severe complications were observed, except for hydrorrhoea for a few days. Success rates were 9 times lower in patients who had 3 or more cervicitis episodes per 6 months. CONCLUSION: In this study, the success rate of cryotherapy was highest in patients with abundant leucorrhoea and lowest in patients with pelvic pain and recurrent cervicitis. Hence, we recommend that clinicians perform the procedure in such patients without much delay.

Sexually transmitted diseases treatment guidelines, 2015.

These guidelines for the treatment of persons who have or are at risk for sexually transmitted diseases (STDs) were updated by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on April 30-May 2, 2013. The information in this report updates the Sexually Transmitted Diseases Treatment Guidelines, 2010 (MMWR Recomm Rep 2010;59 [No. RR-12]). These updated guidelines discuss 1) alternative treatment regimens for Neisseria gonorrhoeae; 2) the use of nucleic acid amplification tests for the diagnosis of trichomoniasis; 3) alternative treatment options for genital warts; 4) the role of Mycoplasma genitalium in urethritis/cervicitis and treatment-related implications; 5) updated HPV vaccine recommendations and counseling messages; 6) the management of persons who are transgender; 7) annual testing for hepatitis C in persons with HIV infection; 8) updated recommendations for diagnostic evaluation of urethritis; and 9) retesting to detect repeat infection. Physicians and other health-care providers can use these guidelines to assist in the prevention and treatment of STDs.

Strategies for partner notification for sexually transmitted infections, including HIV.

BACKGROUND: Partner notification (PN) is the process whereby sexual partners of an index patient are informed of their exposure to a sexually transmitted infection (STI) and the need to obtain treatment. For the person (index patient) with a curable STI, PN aims to eradicate infection and prevent re-infection. For sexual partners, PN aims to identify and treat undiagnosed STIs. At the level of sexual networks and populations, the aim of PN is to interrupt chains of STI transmission. For people with viral STI, PN aims to identify undiagnosed infections, which can facilitate access for their sexual partners to treatment and help prevent transmission. OBJECTIVES: To assess the effects of different PN strategies in people with STI, including human immunodeficiency virus (HIV) infection. SEARCH METHODS: We searched electronic databases (the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE) without language restrictions. We scanned reference lists of potential studies and previous reviews and contacted experts in the field. We searched three trial registries. We conducted the most recent search on 31 August 2012. SELECTION CRITERIA: Published or unpublished randomised controlled trials (RCTs) or quasi-RCTs comparing two or more PN strategies. Four main PN strategies were included: patient referral, expedited partner therapy, provider referral and contract referral. Patient referral means that the patient notifies their sexual partners, either with (enhanced patient referral) or without (simple patient referral) additional verbal or written support. In expedited partner therapy, the patient delivers medication or a prescription for medication to their partner(s) without the need for a medical examination of the partner. In provider referral, health service personnel notify the partners. In contract referral, the index patient is encouraged to notify partner, with the understanding that the partners will be contacted if they do not visit the health service by a certain date. DATA COLLECTION AND ANALYSIS: We analysed data according to paired partner referral strategies. We organised the comparisons first according to four main PN strategies (1. enhanced patient referral, 2. expedited partner therapy, 3. contract referral, 4. provider referral). We compared each main strategy with simple patient referral and then with each other, if trials were available. For continuous outcome measures, we calculated the mean difference (MD) with 95% confidence intervals (CI). For dichotomous variables, we calculated the risk ratio (RR) with 95% CI. We performed meta-analyses where appropriate. We performed a sensitivity analysis for the primary outcome re-infection rate of the index patient by excluding studies with attrition of greater than 20%. Two review authors independently assessed the risk of bias and extracted data. We contacted study authors for additional information. MAIN RESULTS: We included 26 trials (17,578 participants, 9015 women and 8563 men). Five trials were conducted in developing countries. Only two trials were conducted among HIV-positive patients. There was potential for selection bias, owing to the methods of allocation used and of performance bias, owing to the lack of blinding in most included studies. Seven trials had attrition of greater than 20%, increasing the risk of bias.The review found moderate-quality evidence that expedited partner therapy is better than simple patient referral for preventing re-infection of index patients when combining trials of STIs that caused urethritis or cervicitis (6 trials; RR 0.71, 95% CI 0.56 to 0.89, I(2) = 39%). When studies with attrition greater than 20% were excluded, the effect of expedited partner therapy was attenuated (2 trials; RR 0.8, 95% CI 0.62 to 1.04, I(2) = 0%). In trials restricted to index patients with chlamydia, the effect was attenuated (2 trials; RR 0.90, 95% CI 0.60 to 1.35, I(2) = 22%). Expedited partner therapy also increased the number of partners treated per index patient (three trials) when compared with simple patient referral in people with chlamydia or gonorrhoea (MD 0.43, 95% CI 0.28 to 0.58) or trichomonas (MD 0.51, 95% CI 0.35 to 0.67), and people with any STI syndrome (MD 0.5, 95% CI 0.34 to 0.67). Expedited partner therapy was not superior to enhanced patient referral in preventing re-infection (3 trials; RR 0.96, 95% CI 0.60 to 1.53, I(2) = 33%, low-quality evidence). Home sampling kits for partners (four trials) did not result in lower rates of re-infection in the index case (measured in one trial), or higher numbers of partners elicited (three trials), notified (two trials) or treated (one trial) when compared with simple patient referral. There was no consistent evidence for the relative effects of provider, contract or other patient referral methods. In one trial among men with non-gonococcal urethritis, more partners were treated with provider referral than with simple patient referral (MD 0.5, 95% CI 0.37 to 0.63). In one study among people with syphilis, contract referral elicited treatment of more partners than provider referral (MD 2.2, 95% CI 1.95 to 2.45), but the number of partners receiving treatment was the same in both groups. Where measured, there was no statistical evidence of differences in the incidence of adverse effects between PN strategies. AUTHORS' CONCLUSIONS: The evidence assessed in this review does not identify a single optimal strategy for PN for any particular STI. When combining trials of STI causing urethritis or cervicitis, expedited partner therapy was more successful than simple patient referral for preventing re-infection of the index patient but was not superior to enhanced patient referral. Expedited partner therapy interventions should include all components that were part of the trial intervention package. There was insufficient evidence to determine the most effective components of an enhanced patient referral strategy. There are too few trials to allow consistent conclusions about the relative effects of provider, contract or other patient referral methods for different STIs. More high-quality RCTs of PN strategies for HIV and syphilis, using biological outcomes, are needed.

Própolis / Propolis

Introdução: A própolis é substância extraída das colmeias e dita com propriedades medicinais.Objetivo: Verificar evidências do uso da própolis no tratamento de doenças.Métodos: Busca eletrônica sistematizada da literatura de artigos que avaliem o uso da própolis na terapêutica médica.Resultados: Encontramos estudos experimentais que mostraram efeitos bactericidas, principalmente em cocos Grampositivos,efeitos antivirais e efeitos antifúngicos. Um estudo experimental mostrou efeito apoptótico do extrato daprópolis em células de melanoma humano. Não encontramos nenhuma revisão sistemática. Um estudo mostrou efeitoantigiárdia semelhante a um derivado imidazólico. Dois estudos comprovaram efeito preventivo e terapêutico nasinfecções rinofaríngeas. Um estudo demonstrou efeito antiviral em herpes genital superior ao aciclovir. Outro estudoem cervicite uterina mostrou que o extrato da própolis foi superior a uma solução de lugol no tratamento infecciosoe recuperação epitelial. Dois estudos na área odontológica foram realizados: no primeiro, a própolis não mostrousuperioridade à clorexidina na prevenção da placa dentária; no segundo, a própolis foi superior a uma solução comálcool na reparação de feridas após cirurgias bucais. Em nenhum estudo há descrição de efeitos adversos.Conclusão: Pelos estudos apresentados, os efeitos anti-infecciosos tópicos da própolis estão bem demonstrados nasinfecções cutâneas, genitais e de vias aéreas superiores em estudos isolados. Há necessidade de mais estudos com boaqualidade metodológica para ratificar as demais indicações.

Tratamiento de la cervicitis aguda con Aloe Vera L: estrategia para su prevención / Treatment for acute cervicitis, with Aloe vera L: Strategy for its prevention

Se realizó un ensayo clínico en fase II b en grupos paralelos a ciegas por terceros, controlado y aleatorizado, con el objetivo de evaluar la eficacia y seguridad del Aloe vera en pacientes diagnosticadas con cervicitis aguda, además se diseñó una estrategia preventiva sobre la base de los factores de riesgo más influyentes en la aparición de la cervicitis aguda. El universo estuvo constituido por 267 mujeres con cervicitis aguda en la consulta de ginecobstetricia del Hospital 4 de Abril. La muestra quedó conformada por 120 pacientes, 60 pacientes cada grupo. Se logró una evolución favorable de las pacientes con respecto al comportamiento de síntomas, signos y la presencia de microorganismos. Resultó eficaz la terapia con el gel de Aloe vera en la cervicitis aguda, sin la aparición de efectos adversos. La estrategia preventiva diseñada es adecuada para ser aplicada para la profilaxis de la cervicitis aguda(AU)

A clinical blind assay with parallel, controlled and aleatorized groups at stage II b was carried out in order to evaluate the effectiveness and security of Aloe vera in patients diagnosed with acute cervicitis. A preventive strategy was also designed taking into account relevant risk factors at early stages aiming to decrease this disease. The universe was composed by 267 female patients from the gynecological consult at “4 de Abril” Hospital. The sample was made by 120 patients; both groups were formed by 60 patients using the simple aleatory sample. The outcome was favorable concerning signs and symptoms behaviour and the presence of microorganisms. The therapy with aloe vera gel was effective in acute cervicitis without consequences. The preventive strategy is proper to be used in the prophylaxis of acute cervicitis(EU)

Feasibility of focused ultrasound therapy for recurrent cervicitis with high-risk human papillomavirus infection.

OBJECTIVE: To investigate the feasibility of focused ultrasound therapy for recurrent cervicitis with high-risk human papillomavirus (HR-HPV) infection. METHODS: This was a prospective clinical study, in which 20 patients with HR-HPV-positive recurrent cervicitis were enrolled. Focused ultrasound therapy was performed by one gynecologist. All patients were followed up for 6 months after ultrasound therapy. Telephone interviews, colposcopic examinations and Hybrid Capture II tests were performed to assess the safety and effectiveness of focused ultrasound therapy for HR-HPV-positive cervicitis. RESULTS: Ultrasound therapy was tolerated well, and no severe complications were observed in any patient. Vaginal discharge was found intermittently in 95% of patients. Without any intervention this disappeared 1 month after ultrasound therapy. Patients' symptoms were relieved significantly by ultrasound therapy, including 88.9% patients who had abundant leukorrhea, 80% who had pelvic pain and 87.5% who had postcoital bleeding. No colposcopic evidence of cervicitis remained postoperatively in 75% of patients, and cytological examination showed that the lesions had disappeared in 80% of patients. Follow-up HPV testing revealed that 75% of patients presented negative HR-HPV infection following treatment. CONCLUSIONS: Focused ultrasound therapy is feasible and effective in the treatment of patients with HR-HPV-positive cervicitis. It may provide a useful non-invasive treatment for recurrent cervicitis with HR-HPV infection.

Biomarkers in cervical precancer management: the new frontiers.

The major cause of cervical cancer and its pre-invasive lesions is persistent infections with oncogenic human papillomavirus (HPV). Viral replication and integration in the cervix depends on the ordered expression of viral gene products, which can lead to overexpression of multiple molecular proteins or biomarkers. These novel biomarkers allow the monitoring of essential molecular events in histological or cytological specimens and are likely to improve the detection of lesions that have a high risk of progression in both primary screening and triage settings. This review focuses on these molecular markers and their role in the diagnosis and management of cervical dysplasia and cancer.

Aceite de copaiba en el tratamiento de cervicitis en mujeres en edad fertil atendidas en el consultorio de salud reproductiva - Cayhuayna. Unheval enero 2004 - Marzo 2005 / Oil of copaiba in the cervicitis's treatment in women in fertilice age taken care of in the doctor's office of reproductive health cayhuayna Unheval january 2004 march 2005

El objetivo principal del estudio fue conocer la eficacia de aceite de Copaiba en el tratamiento de Cervicitis; cuya muestra es no probalística intencional constituida por 10 mujeres en edad fértil seis con cervicitis aguda y cuatro con cervicitis crónica. El diseño de investigación fue cuasiexperimental de series cronológicas de un sólo grupo, se aplicó el estímulo en cinco sesiones con intervalo de una semana; cuya eficacia fue del 80 por ciento. Se evidencia que la recuperación de pacientes con cervicitis es a partir de la segunda sesión de tratamiento en 40 por ciento (> 50 por ciento) en cervicitis aguda; al 100 por ciento (> 50 por ciento) en la tercera sesión, en ambos tipos de cervicitis; obteniendose una recuperación total de paciente en la quinta sesión en 80 por ciento (seis casos aguda y dos casos crónica) y el 20 por ciento (dos casos de crónica) quedaron en la recuperación de > 50 por ciento comprobándose la hipotesis y concluyendo que el tratamiento de la cervicitis con el aceite copaiba fue eficaz en un 80 por ciento de los casos estudiados. Siendo la recomendación principal para obtener un resultado más óptimo de recuperación de cervicitis, brindar tratamiento en la cervicitis crónica con aceite copaiba por mayor tiempo de cinco semanas y previa al frotis del papanicolau.

The main objetive of the studio was to know the effectiveness of copaiba oil in the cervicitis treatment; whose sample it is not probabilistic intentional constituted for 10 women in fertile age: six with sharp cervicitis and four with chronic cervicitis. The investigation design was cuasi experimental of chronological series of one alone group. It was applied the stimulated in five sessions of interval of one week; whose effectiveness was of the 80 per cent. It is evidenced that the recovery of patient with cervicitis in 40 per cent ( 50 per cent being proven the hypothesis and concluding that the treatment of the cervicitis with copaiba oil was effective in a 80 per cent of the studied cases. Being but good of cervicitis recovery, to ofter treatment i the chronicle cervicitis with copaiba oil for more time of fifth weeks and previos to the smear of the papanicolau.

A comparison between ultrasound therapy and laser therapy for symptomatic cervical ectopy.

The purpose of this study was to compare the clinical efficacy of ultrasound (US) therapy and laser therapy in patients with symptomatic benign ectopy of the uterine cervix. Patients with symptomatic benign ectopy of the cervix (n = 200) were enrolled in this study. Abundant leukorrhea, contact bleeding, recurrent cervicitis and pelvic pain were also evaluated. Patients were allocated alternately to the US and laser groups. In the laser group, Nd: YAG laser was used for tissue vaporization destruction. In the US group, the therapeutic US device Seapostar (Chongqing Haifu [HIFU] Technology, Co. Ltd., Chongqing, China) was applied. Neither anesthesia nor analgesia was used. Results showed that patients in both groups tolerated the procedure well and had excellent treatment outcomes. A symptomatic cure rate of 97.33% was obtained in the US group, and 98.81% was obtained in the laser group (p > 0.05). Ectopy areas were managed with a success rate of 95.95% in the US group, and 96.43% in the laser group (p > 0.05). The rate of side effects (including vaginal reactive discharge and colporrhagia) was found to be lower in the US group than that in the laser group. Mild-to-moderate bleeding occurred in US group (8.42%) and laser group (45.56%). The bleeding rate in the US group is significantly lower than that in the laser group (p < 0.01). We conclude that focused US can treat symptomatic ectopy of the cervix successfully, with excellent clinical results and minimal risk. Focused US therapy appears to be a promising new treatment method for symptomatic ectopy of the uterine cervix.