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共208条结果
  • 1.

    【2hr】HIV Awareness and Risk Behavior among Pregnant Women in Mateete, Uganda (2010)

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    机译 乌干达马蒂特孕妇的艾滋病毒意识和风险行为（2010年）
    摘要：Background. The aim of the study was to evaluate current knowledge, risk behavior, and attitudes among pregnant women in Mateete, Uganda. Methods. We collected 100 questionnaires and performed 20 interviews among women who attended antenatal care. Findings. All the women had heard about HIV/AIDS, and 92% were aware of mother-to-child transmission. The women overestimated the risk of achieving the virus since 45% believed in transmission by mosquitoes and 44% by kissing. Many pointed out that married women as a group were infected more often because of unfaithful partners who refused to use condoms during sex. Conclusion. The women were well aware of the routes of HIV transmission. Schools and governmental campaigns have played an important role in educating people about the disease but there is still a great need to reach out to people in rural areas with both health care and correct information.
  • 2.

    【2hr】Interpretation of Controversial Teratogenic Findings of Drugs Such As Phenobarbital

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    机译 诸如苯巴比妥之类有争议的致畸性发现的解释
    摘要：Objective. To check the debated association between phenobarbital treatment during pregnancy and risk for congenital abnormalities (CAs) in their children. Study Design. It is a comparison of phenobarbital treatment in the mothers of cases with CA and matched controls without CAs in the Hungarian Case-Control Surveillance System of Congenital Abnormalities. Results. Of 22,843 cases with CA, 149 (0.65%) had mothers with phenobarbital treatment, while of 38,151 control newborn infants without CA, 209 (0.55%) were born to mothers with phenobarbital treatment (100–400 mg daily) (OR with 95% CI : 1.3, 1.1–1.7). Of 16 CA groups, only hypospadias had a higher risk after phenobarbital treatment in the critical period of this CA (OR with 95% CI : 2.4, 1.1–5.4). However, if only medically recorded phenobarbital treatments were evaluated and multiple testing bias was considered, this association would disappear. Conclusions. This study stresses the importance of the exclusion of recall bias and multiple testing bias.
  • 3.

    【2hr】Epithelial Ovarian Carcinoma Types and the Coexistence of Ovarian Tumor Conditions

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    机译 上皮性卵巢癌类型与卵巢肿瘤状况并存
    摘要：Objective. Ovarian carcinomas are presumed to arise within ovarian inclusion cysts or from a coexisting epithelial lesion in the ovary. Insight may be gained by relating different subtypes of ovarian cancer with the presence of coexisting tumor-like conditions. Methods. The Dutch nation-wide pathology database PALGA (Pathologisch Anatomisch Landelijk Geautomatiseerd Archief) identified the various histopathological subtypes of ovarian cancer in 824 patients diagnosed in 1996–2003, and recorded the presence of epithelial tumor conditions around the ovarian tumors. In addition, a PALGA database of all 153 consecutive patients referred to the Nijmegen UniversityMedical Centre in 2007 for histopathologicalwork-up was analyzed. Results.The prevalence of coexisting ovarian tumorconditions was 16.4% (135 out of 824patients,(95% CI: 8.4%–24.4%)). The coexistence was highest forendometrioid, mucinous, clear cell, andborderline malignancies. The referral grouprevealed 35% (54 out of 153 patients,(95% CI: 28%–42%))of coexisting epithelial ovarian tumorconditions. Conclusion. One insix patients with a malignant ovarian tumor hasa coexisting epithelial tumor condition in theovary, which is also rather frequently observedin the diagnostic work-uppractice.
  • 4.

    【2hr】Investigating Potential Associations between Cervical Procedures and HIV Acquisition

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    机译 调查宫颈程序与艾滋病毒感染之间的潜在关联
    摘要：Objective. Cervical human papillomavirus (HPV) infection has been associated with human immunodeficiency virus (HIV) acquisition in populations with a high prevalence of both infections. Procedures performed in the management of cervical dysplasia may facilitate HIV entry via mechanical injury. We sought to investigate the association between cervical procedures and incident HIV. Methods. Data on cervical cancer screening and procedures were collected in a cohort study evaluating the diaphragm for HIV prevention in 2040 women. In this secondary analysis, we investigated the association between cervical procedures and HIV acquisition. Results. Out of 2027 HIV-negative women at baseline, 199 underwent cervical procedures. Cumulative risk of HIV was 4.3% over 21 months of median followup (n = 88). Compared with women without cervical procedures, we observed no difference in HIV incidence after a cervical biopsy (RR 0.92, 95% CI 0.39–2.16), endocervical curettage (RR 0.29, 95% CI 0.07–1.22), or loop electrosurgical excision procedure (RR 1.00, 95% CI 0.30–3.30). Conclusions. In this cohort, cervical procedures were not associated with HIV incidence. This lack of association could be due to the small number of events.
  • 5.

    【2hr】Risk Factors of Delivery by Caesarean Section in Cameroon (2003-2004): A Regional Hospital Report

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    机译 喀麦隆剖宫产分娩的危险因素（2003-2004年）：地区医院报告
    摘要：We conducted this retrospective case-control study to identify possible risk factors of delivery through caesarean section in the Far North Region of Cameroon. Data was collected retrospectively from delivery room registers at the Provincial Hospital, Maroua, Cameroon from 01/01/2003 to 31/12/2004. The overall 125 eligible caesarean deliveries were compared with 244 women who delivered vaginally during the study period. The odds ratio as well as the 95% confidence interval was used to measure the relationship between maternal characteristic and risk of delivery by caesarean section. We found that the marital status is similar in the two study populations. Risk factors associated with cesarean section were: maternal age less than 17 years (OR 3.55, 95%CI: 1.46–8.64), maternal age over 39 years (OR 3.55, 95% CI: 1.17–10.75), nulliparity (OR 2.72, 95% CI: 1.59–4.66), grand multiparty (OR 3.43, 95% CI: 1.79–6.57), and macrosomia (OR 4.82, 95% CI: 1.49–16.44). There was a weak association with absent or poor. Caesarean delivery is associated with extreme ages of reproductive life, macrosomia, nulliparous and grand multiparous status. We strongly recommend that these factors be taken into consideration to strengthen the mother and child health programs in Cameroon and countries with similar socioeconomic profiles.
  • 6.

    【2hr】The Recurrent Vulvovaginal Candidiasis: Proposal of a Personalized Therapeutic Protocol

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    机译 复发性阴道阴道念珠菌病：个性化治疗方案的建议
    摘要：Background. Recurrent vulvovaginal candidiasis (RVC) is an increasing challenge in clinical practice. Objective. The purpose of this study was to reduce the episodes of RVC through the intake of fluconazole 200 mg/dose with a personalized regimen at growing administration intervals with a probiotic. Method. 55 patients received a 200 mg fluconazole as an induction dose for 3 alternate days. Symptoms resolution after 10–14 days made the patients eligible to continue with a maintenance therapy of fluconazole weekly for one month, followed by 200 mg after 10, 15, 20 and 30 days. Patients were allowed to move on to the next level of maintenance therapy only if they were symptom free. Patients were also given a probiotic with Beta Glucan and Echinacea Purpurea. Results. Among the 55 patients enrolled, four (7%) have withdrawn after the induction phase. 51 patients completed the whole therapeutic maintenance period, and eight (15,6%) experienced a recurrence before the end of the therapy. Five women (9,8%) relapsed (two after 2 months and three after 6 months). Conclusion. The positive results of our study prove the effectiveness of an individualized protocol for a rather short period, with a slowly decreasing administration of fluconazole + probiotic.
  • 7.

    【2hr】Experience of Emergency Peripartum Hysterectomies at a Tertiary Care Hospital in Quetta, Pakistan

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    机译 巴基斯坦奎达市一家三级护理医院急诊围产期子宫切除术的经验
    摘要：Emergency peripartum hysterectomy (EPH) is associated with significant morbidity and mortality worldwide. The purpose of our paper was to determine the incidence, morbidity, and mortality of EPH done at our institution; the largest tertiary care government hospital in the city of Quetta, Pakistan. During the study period there were 12,642 deliveries, out of which 46 women had undergone an EPH, translating into an incidence of ∼4 per 1,000 births. Disturbingly, 82.6% of these patients had received no antenatal care prior to their presentation. There were 4 (8.7%) maternal deaths and 31 (67.4%) perinatal deaths. The commonest indication noted was uterine rupture in 21 (45.7%) cases. Lack of antenatal care is indeed a modifiable factor that needs to be addressed to help reduce maternal and fetal morbidity/mortality not only from emergency hysterectomies but also from all other preventable causes.
  • 8.

    【2hr】Effect of Pregnancy and Childbirth on Sexuality of Women in Ibadan, Nigeria

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    机译 怀孕和分娩对尼日利亚伊巴丹妇女性行为的影响
    摘要：A study of 375 antenatal attendees to assess women's views and experience in sexual matters during pregnancy and following childbirth. Explanatory variables included the perception women had of sex during pregnancy and after childbirth. Outcome variables were frequency and satisfaction of sexual activity. The commonest reasons for having coitus in pregnancy were marital harmony and facilitation of delivery. Libido rose throughout pregnancy but orgasms were less often experienced. The man-on-top position became less practised. Vaginal intercourse remained the commonest type. Masturbation and anal intercourse increased, while oral sex declined throughout. Marriage (OR 9.0, 95% CI 1.0–79.5) and current cohabitation (OR 13.6, 95% CI 1.6–113.4) were predictors of sex in pregnancy. Dyspareunia and partners' extramarital affairs were deterrent. Vaginal delivery and episiotomy were not significant predictors of postnatal sex. The respondents and their partners seem able to adapt to pregnancy changes and enhance their marital bonds. Anticipatory guidance and informed counselling may encourage this.
  • 9.

    【2hr】Carcinomas of Distal Fallopian Tube and Their Association with Tubal Intraepithelial Carcinoma: Do They Share a Common “Precursor” Lesion? Loss of Heterozygosity and Immunohistochemical Analysis Using PAX 2, WT-1, and P53 Markers

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    机译 输卵管远端癌及其与输卵管上皮内癌的关系：它们是否有共同的“前体”病变？使用PAX 2，WT-1和P53标记进行杂合性丧失和免疫组织化学分析
    摘要：As the role of distal fallopian tube as organ of serous carcinogenesis is emerging, additional literature on the role of tubal intraepithelial carcinoma (TIC) as a precursor lesion in a subset of primary peritoneal serous carcinomas (PPSC is emerging as well. TIC although fallopian tube in origin can be genetically related to ovarian/peritoneal carcinomas. The role of PAX2 in primary fallopian tube carcinomas (PFTC)/PPSC is yet to be defined. The aim of our study was to understand if the biologic properties of tumors arising in the distal fallopian tube that remain as PFTC are different when they seed on to the peritoneal surface (PPSC). A panel of 6 polymorphic microsatellite markers corresponding to p53, PAX2, and WT1 tumor suppressor genes were studied. Invasive carcinomas as well as TIC arising in the distal fallopian tube when remain as PFTC appears to exhibit different LOH patterns in comparison to PPSC. PAX 2 LOH patterns might represent a “hidden PAX 2 signature” analogous to p53 signatures. PAX 2 might be an emerging marker for detection of early serous carcinomas particularly in BRCA + women.
  • 10.

    【2hr】Low-Protein Diet during Lactation and Maternal Metabolism in Rats

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    机译 大鼠泌乳和母体代谢过程中的低蛋白饮食
    摘要：Some metabolic alterations were evaluated in Wistar rats which received control or low-protein (17%; 6%) diets, from the pregnancy until the end of lactation: control non-lactating (CNL), lactating (CL), low-protein non-lactating (LPNL) and lactating (LPL) groups. Despite the increased food intake by LPL dams, both LP groups reduced protein intake and final body mass was lower in LPL. Higher serum glucose occurred in both LP groups. Lactation induced lower insulin and glucagon levels, but these were reduced by LP diet. Prolactin levels rose in lactating, but were impaired in LPL, followed by losses of mammary gland (MAG) mass and, a fall in serum leptin in lactating dams. Lipid content also reduced in MAG and gonadal white adipose tissue of lactating and, in LPL, contributed to a decreased daily milk production, and consequent impairment of body mass gain by LPL pups. Liver mass, lipid content and ATP-citrate enzyme activity were increased by lactation, but malic enzyme and lipid: glycogen ratio elevated only in LPL. Conclusion. LP diet reduced the development of MAG and prolactin secretion which compromised milk production and pups growth. Moreover, this diet enhanced the store of lipid to glycogen ratio and suggests a higher risk of fatty liver development.
  • 11.

    【2hr】Incidence, Management, and Outcome of Molar Pregnancies at a Tertiary Care Hospital in Quetta, Pakistan

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    机译 巴基斯坦奎达一家三级护理医院的磨牙妊娠的发病率，管理和结果
    摘要：Molar pregnancies represent a significant burden of disease on the spectrum of gestational trophoblastic diseases. The incidence appears to be higher in women from South Asia. The purpose of our prospective study was to determine the incidence, presentation, and outcomes of all molar pregnancies at our institution. During the study period, there were a total of 16,625 patients admitted to our department; out of whom 85 patients were diagnosed with a molar pregnancy. Vaginal bleeding was the commonest symptom (94.2%); theca lutein cysts were noted in 39% of the cases. Suction, dilatation, and curettage were noted to be the preferred method in almost all cases; hysterectomy was done in 12 (14.1%) patients. Single-agent chemotherapy was employed in high-risk patients and was well tolerated. Mean followup for these patients was 5.7 months (range 1–24 months). None of these patients developed persistent trophoblastic disease, invasive mole, or choriocarcinoma during the follow-up period.
  • 12.

    【2hr】Body Mass Index Impacts In Vitro Fertilization Stimulation

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    机译 体重指数影响体外受精刺激
    摘要：The objective of the study was to prospectively determine if body mass index (BMI) is predictive of live birth rates in patients undergoing IVF. The prospective study enrolled 117 infertility patients with the primary outcome measure being IVF success rates. Mean BMI did not differ between patients with successful outcomes and those without successful outcomes. There was a significant positive correlation between BMI and the number of stimulated follicles (r = 0.19, P < .05). A significant negative correlation between BMI and ampules of gonadotropins used (r = −0.25, P < .01) and between BMI and days of stimulation (r = −0.19, P < .05) was noted. These data demonstrate that women with an elevated BMI produce more follicles, stimulate quicker, and require less gonadotropins during IVF. However, BMI did not have a significant effect on pregnancy outcome rates.
  • 13.

    【2hr】Knowledge, Attitudes, and Practice among Women and Doctors Concerning the Use of Folic Acid

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    机译 妇女和医生关于叶酸使用的知识，态度和实践
    摘要：Background and Objective. Daily folic acid intake, prior to conception and in early pregnancy, significantly reduces neural tube defects (NTDs). We compared folic acid consumption among Jewish and Bedouin women and the recommendations of family physicians and gynecologists. Methods. We compared 64 Muslim Bedouin women and 65 Jewish women. We also compared 39 gynecologists and 60 family physicians. Results. Fifty-one Jewish women (78.5%) took folic acid during pregnancy, but only seven (10.8%) before conception. Sixty Bedouin women (93.75%) took folic acid during pregnancy, but only four (6.25%) before conception (P < .05). Five Jewish women (7.7%) and two Bedouin women (3.1%) took folic acid three months before conception. Thirty-three gynecologists (87%) recommend preconception folic acid compared with thirty-six family physicians (60%) (P < .05). Conclusions. The majority of women use folic acid during pregnancy, but only few do so to prevent NTDs. There is a significant difference between doctors' recommendations and actual practice.
  • 14.

    【2hr】A New Look at Teenage Pregnancy in Brazil

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    机译 巴西少女怀孕的新面貌
    摘要：This paper brings a synthesis of some of the main results provided by GRAVAD survey (Teenage pregnancy: multicentric study about youth, sexuality and reproduction in Brazil). GRAVAD is a study about sexual and reproductive behavior among Brazilian youth that interviewed 4,634 individuals in a population survey with a random sample. Women and men between 18 and 24 years old were interviewed in three capitals—Porto Alegre, Rio de Janeiro and Salvador. “Teen pregnancy” is not the consequence of promiscuous sexual activities, as popular beliefs currently state. It is often ignored that amidst the poorer social segments parenthood is seen as a sign of social status, given the lack of professional perspectives. Among the middle class, other sociocultural horizons give parenthood the status of an experience to be lived in later moments of live, when one's professional and financial lives have been consolidated.
  • 15.

    【2hr】Barriers to Emergency Obstetric Care Services in Perinatal Deaths in Rural Gambia: A Qualitative In-Depth Interview Study

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    机译 冈比亚农村地区围产期死亡中紧急产科护理服务的障碍：定性深度访谈研究
    摘要：Objective. The Gambia has one of the world's highest perinatal mortality rates. We explored barriers of timely access to emergency obstetric care services resulting in perinatal deaths and in survivors of severe obstetric complications in rural Gambia. Method. We applied the “three delays” model as a framework for assessing contributing factors to perinatal deaths and obstetric complications. Qualitative in-depth interviews were conducted with 20 survivors of severe obstetric complications at home settings within three to four weeks after hospital discharge. Family members and traditional birth attendants were also interviewed. The interviews were translated into English and transcribed verbatim. We used content analysis to identify barriers of care. Results. Transport/cost-related delays are the major contributors of perinatal deaths in this study. A delay in recognising danger signs of pregnancy/labour or decision to seek care outside the home was the second important contributor of perinatal deaths. Decision to seek care may be timely, but impaired access precluded utilization of EmOC services. Obtaining blood for transfusion was also identified as a deterrent to appropriate care. Conclusion. Delays in accessing EmOC are critical in perinatal deaths. Thus, timely availability of emergency transport services and prompt decision-making are warranted for improved perinatal outcomes in rural Gambia.
  • 16.

    【2hr】Endometriosis and Ovarian Cancer: A Systematic Review

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    机译 子宫内膜异位症和卵巢癌：系统评价
    摘要：Introduction. Endometriosis is one of the most common benign disorders which affects 10–15% of all women in reproductive age. The association between endometriosis and ovarian cancer has been frequently described in the medical literature. Purpose. To evaluate the literature for evidence of a correlation between endometriosis and ovarian cancer. Method. the English language literature (online MEDLINE and EMBASE database) was searched using the keywords endometriosis combined with cancer, tumour, tumor, carcinoma, or adenocarcinoma. All abstracts between January 1985 and August 2010 were reviewed. Full relevant articles were critically assessed. Reference lists of included studies were checked. Results. Seven out of the eight studies, included in our review, have shown an increased risk of ovarian cancer. However, the effect size is modest (OR, RR, and SIR) ranging between 1.32 and 1.9 (95% CI). A causative relationship between the two incidences cannot be confirmed. There is increasing evidence on the role of genetic mutations in ovarian clear-cell and endometrioid carcinoma developing from endometriosis. Conclusion. More evidence is needed before suggesting any change in the current management of endometriosis.
  • 17.

    【2hr】Management of Women with Surgically Staged 1 Uterine Papillary Serous Cancer

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    机译 外科分期1子宫乳头状浆液性癌妇女的管理
    摘要：Objective. To review the management and outcomes of women with surgically staged 1 UPSC. Methods. We report on a case series from 2008–2010 from Hamilton Canada. We summarize the data from a literature search on surgically staged 1 UPSC. Results. There is a group women with Stage 1A UPSC with no residual disease at time of surgery who do not require adjuvant therapy. Vault recurrences appear to be lower in women who received adjuvant vault radiation. Chemotherapy appears to confer longer survival for those women with Stage 1B or 1C disease compared of those observed or who had radiation alone. Conclusion. Adjuvant therapy appears to confer benefit in certain groups of women with stage 1 UPSC. A randomized controlled study would clarify the degree of benefit.
  • 18.

    【2hr】Proposed Framework for Making Focused Antenatal Care Services Accessible: A Review of the Nigerian Setting

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    机译 旨在提供重点产前保健服务的拟议框架：对尼日利亚环境的回顾
    摘要：The aim of this paper is to propose a framework for making antenatal care an effective strategy in reducing the high maternal mortality ratio in Nigeria. On-site visits to five teaching hospitals were carried out between 2006 and 2008 to assess the practice of antenatal care. Group discussions with 200 parturients on their awareness of birth preparedness/complication readiness were conducted, in October, 2008. The findings of this study are discussed in line with the proposed practice of focused antenatal care. The practice of antenatal care in all the hospitals visited was the traditional approach based on earlier European models. Awareness of birth preparedness/complication readiness, by parturients, as a goal-directed intervention during antenatal care was low (21.5%). To reduce maternal deaths through antenatal care, it is critical to link care with detecting and treating causes of maternal mortality by a skilled attendant.
  • 19.

    【2hr】Anatomy of the Clitoris: Revision and Clarifications about the Anatomical Terms for the Clitoris Proposed (without Scientific Bases) by Helen O'Connell, Emmanuele Jannini, and Odile Buisson

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    机译 阴蒂解剖：Helen O'Connell，Emmanuele Jannini和Odile Buisson对阴蒂解剖术语的修订和澄清（无科学依据）
    • 作者：Vincenzo Puppo
    • 刊名：ISRN Obstetrics and Gynecology
    • 2011年第期
    摘要：The anatomy of the clitoris is described in human anatomy textbooks. Some researchers have proposal and divulged a new anatomical terminology for the clitoris. This paper is a revision of the anatomical terms proposed by Helen O'Connell, Emmanuele Jannini, and Odile Buisson. Gynecologists, sexual medicine experts, and sexologists should spread certainties for all women, not hypotheses or personal opinions, they should use scientific terminology: clitoral/vaginal/uterine orgasm, G/A/C/U spot orgasm, and female ejaculation, are terms that should not be used by sexologists, women, and mass media. Clitoral bulbs, clitoral or clitoris-urethrovaginal complex, urethrovaginal space, periurethral glans, Halban's fascia erogenous zone, vaginal anterior fornix erogenous zone, genitosensory component of the vagus nerve, and G-spot, are terms used by some sexologists, but they are not accepted or shared by experts in human anatomy. Sexologists should define have sex, make love, the situation in which the orgasm happens in both partners with or without a vaginal intercourse.
  • 20.

    【2hr】Molecular Diagnosis of Sexually Transmitted Chlamydia trachomatis in the United States

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    机译 美国性传播沙眼衣原体的分子诊断
    摘要：Chlamydia, with its Chlamydia trachomatis etiology, is the most common bacterial sexually transmitted infection in the United States and is often transmitted via asymptomatic individuals. This review summarizes traditional and molecular-based diagnostic modalities specific to C. trachomatis. Several commercially available, FDA-approved molecular methods to diagnose urogenital C. trachomatis infection include nucleic acid hybridization, signal amplification, polymerase chain reaction, strand displacement amplification, and transcription-mediated amplification. Molecular-based methods are rapid and reliable genital specimen screening measures, especially when applied to areas of high disease prevalence. However, clinical and analytical sensitivity for some commercial systems decreases dramatically when testing urine samples. In vitro experiments and clinical data suggest that transcription-mediated amplification has greater analytical sensitivity than the other molecular-based methods currently available. This difference may be further exhibited in testing of extragenital specimens from at-risk patient demographics. The development of future molecular testing could address conundrums associated with confirmatory testing, medicolegal testing, and test of cure.
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