Acupoint Catgut Embedding for Treatment of Chronic Pelvic Pain due to the Sequelae of Pelvic Inflammatory Disease.

Chronic pelvic pain caused by the sequelae of inflammatory pelvic disease is a common clinical condition of pelvic pain in women. At present, the main challenges in its treatment are the limited effectiveness of pain relief and the frequent recurrence of symptoms, which significantly impact patients' quality of life and impose a considerable psychological burden on them. It is a clinically challenging disease. After summarizing years of treatment experience, the author's team discovered that acupoint catgut embedding demonstrated notable clinical efficacy in managing chronic pelvic pain stemming from pelvic inflammatory disease sequelae. Compared to existing Western medicine treatment methods, acupoint catgut embedding offers advantages such as a good analgesic effect, lower recurrence rate, economic benefits, and a relatively straightforward procedure. This article provides a comprehensive guide on embedding absorbable catgut into patients' acupoints for the treatment of chronic pelvic pain in females resulting from the sequelae of pelvic inflammatory disease.

A New Marker for the Diagnosis of Acute Pelvic Inflammatory Disease: Immature Granulocyte.

BACKGROUND: The goal is to assess the role of immature granulocytes (IG) in the diagnosis of acute pelvic-inflammatory-disease (PID) and to determine whether they are useful for discriminating mild/moderate and severe PID. METHODS: Patients admitted with the diagnosis of acute PID were retrospectively assessed. Diagnosis was based on CDC criteria. Patients were grouped as severe and mild/moderate PID based on need for hospitalization. Control group consisted of patients in whom PID was excluded by laparoscopy. Sample size was calculated with statistical methods. IGs were compared within the groups. Cutoff values were determined for prediction of diagnosis and severity of acute PID. RESULTS: There were 74 severe, 32 mild/moderate acute PID, and 41 control patients. Thirty patients had surgery following no response to antibiotic treatment or tubo-ovarian abscess. IGs were significantly higher in the severe group compared to mild/moderate and control groups. ROC analysis showed IG counts (≥ 0.035 µL) and percentages (≥ 0.35%) were significantly effective in predicting acute PID and were associated with severity when they were ≥ 0.055 µL and ≥ 0.42%, respectively. IG count ≥ 0.085 was found to have 58.6% sensitivity and 63.1% speci-ficity for prediction of surgical intervention need. CONCLUSIONS: IGs are components of simple CBC tests and are easily obtainable, cheap markers. They were found to be elevated in acute PID and correlated significantly with the severity of the disease. These markers may serve as adjunctive markers for the diagnosis of acute PID and may be useful in discrimination between mild/moderate and severe PID.

Mycoplasma genitalium: Key Information for the Primary Care Clinician.

Mycoplasma genitalium (MG) is an emerging sexually transmitted infection, which appears to be a cause of urethritis and cervicitis and has been associated with pelvic inflammatory disease (PID), epididymitis, proctitis, infertility, complications during pregnancy, and human immunodeficiency virus (HIV) transmission. Three Food and Drug Administration (FDA) approved tests are available. Testing should be focused to avoid inappropriate antibiotic use. The Center of Disease Control and Prevention (CDC) guidelines recommend testing for persistent male urethritis, cervicitis, and proctitis and state that testing should be considered in cases of PID. Testing is also recommended for sexual contacts of patients with MG. Testing is not recommended in asymptomatic patients, including pregnant patients, who do not have a history of MG exposure. Although resistance-guided therapy is recommended, there are currently no FDA approved tests for MG macrolide resistance, and tests are not widely available in the United States. The CDC recommends 2-step treatment with doxycycline followed by azithromycin or moxifloxacin. Moxifloxacin is recommended if resistance testing is unavailable or testing demonstrates macrolide resistance..

Clinical observation on inverted T-shaped herb-separated moxibustion for chronic pelvic pain in sequelae of pelvic inflammatory diseases. / 倒Tå­—å½¢éš”è¯ç¸æ²»ç–—ç›†è ”ç‚Žæ€§ç–¾ç— åŽé—ç—‡æ ¢æ€§ç›†è ”ç—›ç–—æ•ˆè§‚å¯Ÿ.

OBJECTIVES: To compare the clinical effect between inverted T-shaped herb-separated moxibustion combined with western medication and simple western medication on chronic pelvic pain(CPP)in sequelae of pelvic inflammatory diseases. METHODS: A total of 60 patients with CPP in sequelae of pelvic inflammatory diseases were randomly divided into an observation group and a control group, 30 cases in each group. The control group was given ibuprofen tablets 10 days before menstruation, 0.2 g each time, once a day for 10 days. After menstruation, the medication was stopped, and the treatment was given for 3 menstrual cycles.On the basis of the treatment in the control group, the observation group was treated with inverted T-shaped herb-separated moxibustion at the connection between Zhongwan(CV 12)and Zhongji(CV 3), and the connection between Zigong(EX-CA 1)on both sides.The treatment was performed once a week, with an interval of 6 days. The moxibustion was stopped during the menstrual period, the treatment was given for 3 menstrual cycles.Before and after treatment, the visual analogue scale(VAS)score of lower abdominal and lumbosacral pain, local symptom (uterine tenderness, adnexal tenderness and uterosacral ligament tenderness) score and quality of life assessment (QOL) score of the two groups were observed. RESULTS: After treatment, the lower abdominal and lumbosacral pain VAS scores, the local symptom scores of uterine tenderness, adnexal tenderness, uterosacral ligament tenderness and total scores in the two groups were lower than those before treatment(P<0.01).The lower abdominal and lumbosacral pain VAS score in the observation group was lower than that in the control group(P<0.01),and the changes of local symptom scores of uterine tenderness, adnexal tenderness and uterosacral ligament tenderness and total score in the observation group were greater than those in the control group(P<0.01). After treatment, the QOL scores of the two groups were higher than those before treatment(P<0.01), and the score in the observation group was higher than that in the control group(P<0.01). CONCLUSIONS: Inverted T-shaped herb-separated moxibustion combined with western medication can effectively reduce the pain in patients with CPP in sequelae of pelvic inflammatory diseases, relieve the local symptoms, improve the quality of life, and the curative effect is better than western medication alone.

Imaging findings in inflammatory disease of the genital organs.

This review focuses on inflammatory diseases of female and male genital organs and discusses their epidemiology, pathogenesis, clinical presentation, and imaging findings. The female section covers pelvic inflammatory disease (PID) primarily caused by sexually transmitted infections (STIs) that affect the uterus, fallopian tubes, and ovaries. Unusual causes such as actinomycosis and tuberculosis have also been explored. The male section delves into infections affecting the vas deferens, epididymis, testes, prostate, and seminal vesicles. Uncommon causes such as tuberculosis, and Zinner syndrome have also been discussed. In addition, this review highlights other conditions that mimic male genital tract infections such as vasculitis, IgG4-related diseases, and sarcoidosis. Accurate diagnosis and appropriate management of these inflammatory diseases are essential for preventing serious complications and infertility. Imaging modalities such as ultrasound, magnetic resonance imaging, and computed tomography play a crucial role in diagnosis. Understanding the diverse etiologies and imaging findings is vital for the effective management of inflammatory diseases of the genital organs.

Acupuncture therapies for relieving pain in pelvic inflammatory disease: A systematic review and meta-analysis.

BACKGROUND: Studies investigating the effectiveness of acupuncture therapies in alleviating pain in pelvic inflammatory disease (PID) have gained increasing attention. However, to date, there have been no systematic reviews and meta-analyses providing high-quality evidence regarding the efficacy and safety of acupuncture therapies in this context. OBJECTIVE: The objective of this review was to assess the efficacy and safety of acupuncture therapies as complementary or alternative treatments for pain relief in patients with PID. METHOD: A comprehensive search was conducted in eight databases from inception to February 20, 2023: PubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and Chinese Biomedical Literature Database. Randomized controlled trials (RCTs) investigating acupuncture therapies as complementary or additional treatments to routine care were identified. Primary outcomes were pain intensity scores for abdominal or lumbosacral pain. The Cochrane risk of bias criteria was applied to assess the methodological quality of the included trials. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system was used to evaluate the quality of evidence. Data processing was performed using RevMan 5.4. RESULT: This systematic review included twelve trials comprising a total of 1,165 patients. Among these, nine trials examined acupuncture therapies as adjunctive therapy, while the remaining three did not. Meta-analyses demonstrated that acupuncture therapies, whether used alone or in combination with routine treatment, exhibited greater efficacy in relieving abdominal pain compared to routine treatment alone immediately after the intervention (MD: -1.32; 95% CI: -1.60 to -1.05; P < 0.00001). The advantage of acupuncture therapies alone persisted for up to one month after the treatment (MD: -1.44; 95% CI: -2.15 to -0.72; P < 0.0001). Additionally, acupuncture therapies combined with routine treatment had a more pronounced effect in relieving lumbosacral pain after the intervention (MD: -1.14; 95% CI: -2.12 to -0.17; P < 0.00001) in patients with PID. The incidence of adverse events did not increase with the addition of acupuncture therapies (OR: 0.56; 95% CI: 0.21 to 1.51; P = 0.25). The findings also indicated that acupuncture therapies, as a complementary treatment, could induce anti-inflammatory cytokines, reduce pro-inflammatory cytokines, alleviate anxiety, and improve the quality of life in patients with PID. CONCLUSION: Our findings suggest that acupuncture therapies may effectively reduce pain intensity in the abdomen and lumbosacral region as complementary or alternative treatments, induce anti-inflammatory cytokines, decrease pro-inflammatory cytokines, alleviate anxiety, and enhance the quality of life in patients with PID, without increasing the occurrence of adverse events. However, due to the low quality of the included trials, the conclusion should be interpreted with caution, highlighting the need for further high-quality trials to establish more reliable conclusions.

Diagnosis of complicated gynaecological inflammations by computed tomography - one center experience.

The aim of this article is to acquaint the gynaecological public with our experience with the use of computed tomography in the diagnosis of fluid collections in women with clinical suspicion of complicated pelvic inflammation or a complication after gynaecological surgery. We present diagnostic dilemmas that radiologists deal with, including differential diagnoses. We also deal with the benefits for the referring gynaecologist, and we also discuss the possible discrepancy between his expectations and the result of the examination.

Principais causas ginecológicas de dor pélvica aguda em mulheres / Main gynecological causes of acute pelvic pain in women

Este trabalho buscou reunir dados essenciais sobre as etiologias de dor pélvica aguda, uma queixa constante nos serviços de emergências e ambulatórios de ginecologia, responsável por grande desconforto e impacto na qualidade de vida de pacientes mulheres. É uma condição laboriosa por causa de seu amplo espectro de causas, devendo ser abordada com cuidado e atenção pelo profissional médico, o qual deve considerar os diversos diagnósticos diferenciais, sendo a ultrassonografia o exame de maior importância para auxiliar em seu diagnóstico. As principais etiologias não obstétricas podem ser não ginecológicas e ginecológicas; essas últimas são divididas em anexiais e uterinas. Entre as causas ginecológicas, devem- -se investigar cistos ovarianos, torções anexiais, leiomiomas, doença inflamatória pélvica, abscesso tubo-ovariano, dismenorreia e complicações de dispositivos intrauterinos. A maioria das causas tem tratamento eficaz, com retorno da função do órgão e melhora da qualidade de vida, sem complicações, especialmente se diagnosticada precocemente.(AU)

The aim of this study was to gather important data on acute pelvic pain etiologies, a usual complaint in the emergency services and gynecology outpatient clinics, responsible for great discomfort and impact on quality of life in female patients. It is a laborious condition due to its wide spectrum of causes, which needs to be approached with attention by the physician, who must consider all the possible diagnoses, being the ultrasonography the most important exam to detect it. The main non-obstetric etiologies can be non-gynecological and gynecological, which are separated in adnexal and uterine causes. Among the gynecological causes, ovarian cysts, adnexal torsions, leiomyomas, pelvic inflammatory disease, ovarian tube abscess, dysmenorrhea and complications of intrauterine devices should be investigated. Most causes can be effectively treated, with return of organ function and improved quality of life, without complications, especially if diagnosed early.(AU)

Ascitis secundaria a chlamydia trachomatis tras procedimiento de reproducción asistida / Ascites secondary to chlamydia trachomatis after assisted reproduction procedure

El desarrollo de ascitis moderada o severa es infrecuente tras una enfermedad inflamatoria pélvica por Chlamydia trachomatis, una de las principales causas de infección de transmisión sexual a nivel mundial. Caso clínico: Paciente de 29 años que tras aborto diferido (gestación tras inseminación artificial) que inicia a las seis semanas con cuadro de dolor abdominal inespecífico y ascitis de predominio linfocitario. El diagnostico se realizo mediante PCR (Werfen®) tanto el liquido ascítico como en exudado endocervical. La paciente recibió tratamiento antibiótico con doxiciclina. Conclusión: Las enfermedades de transmisión sexual deben ser consideradas cuando se realiza un diagnóstico diferencial de una mujer sexualmente activa con dolor abdominal y ascitis, instaurar tratamiento antibiótico y evitar pruebas e intervenciones quirúrgicas innecesarias.

The development of moderate or severe ascites is infrequent after a pelvic inflammatory disease from Chlamydia trachomatis, one of the main causes of sexually transmitted infection worldwide. Clinical case: A 29-year-old patient who, after a delayed abortion (gestation after artificial insemination), started at six weeks with symptoms of non-specific abdominal pain and predominantly lymphocytic ascites. The diagnosis is made by PCR (Werfen®) both the ascitic fluid and the endocervical exudate. The patient received antibiotic treatment with doxycycline. Conclusion: Sexually transmitted diseases should be considered when making a differential diagnosis of a sexually activated woman with abdominal pain and ascites. Establishing antibiotic treatment, and avoiding unnecessary tests and surgical treatments.

Relationships between female infertility and female genital infections and pelvic inflammatory disease: a population-based nested controlled study

OBJECTIVES: Our purpose was to examine the associations of female genital infections and certain comorbidities with infertility. METHODS: The Taiwan National Health Research Database was searched for women with a new diagnosis of infertility between 2000 and 2013. Women without a diagnosis of infertility served as a control group and were matched with the infertility cases by age (±3 years) and index year. They were divided into two groups: ≤40 years old and >40 years old. Univariate and multivariate conditional logistic regression models were employed to identify the risk factors associated with infertility. RESULTS: A total of 18,276 women with a new diagnosis of infertility and 73,104 matched controls (mean cohort age, 31±6.2 years) were included. According to the adjusted multivariate analysis, pelvic inflammatory disease involving the ovary, fallopian tube, pelvic cellular tissue, peritoneum (odds ratio (OR)=4.823), and uterus (OR=3.050) and cervical, vaginal, and vulvar inflammation (OR=7.788) were associated with an increased risk of infertility in women aged ≤40 years. In women aged >40 years, pelvic inflammatory disease of the ovary, fallopian tube, pelvic cellular tissue, and peritoneum (OR=6.028) and cervical, vaginal, and vulvar inflammation (OR=6.648) were associated with infertility. Obesity, lipid metabolism disorders, dysthyroidism, abortion (spontaneous or induced), bacterial vaginosis, endometritis, and tubo-ovarian abscess were associated with an increased risk of infertility according to the univariate analysis but not the multivariate analysis. CONCLUSIONS: Female genital tract infections, but not the comorbidities studied here, are associated with an increased risk of infertility.

Terapia Su Jok en pacientes con diagnóstico de hidrosalpinx / Su Jok therapy in patients with hydrosalpinx diagnosis

Se realizó un estudio cuasiexperimental de 56 pacientes con diagnóstico de hidrosalpinx, que acudieron a la consulta de Medicina Natural y Tradicional del Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba - remitidas de las consultas de Ginecología e Infertilidad -, desde septiembre de 2014 hasta diciembre de 2015, para evaluar la respuesta a la terapia Su Jok. Entre las variables analizadas figuraron: edad, factores de riesgo, manifestaciones clínicas, síndromes tradicionales, evolución clínica y respuesta al tratamiento. En la casuística predominaron las féminas de 30-39 años, la enfermedad inflamatoria pélvica y las infecciones de trasmisión sexual como antecedentes patológicos (71,4 por ciento), el dolor y la secreción vaginal como síntomas principales, así como el estancamiento de Qi de hígado, Qi de riñón no firme y frío-humedad en bazo como síndromes más frecuentes. Finalmente, se logró una evolución favorable y una respuesta adecuada al tratamiento

A quasi-experiment of 56 patients with hydrosalpinx diagnosis that went to the Natural and Traditional Medicine Service of Dr Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba - referred from the Gynecology and Infertility Services -, was carried out from September, 2014 to December, 2015, to evaluate the response to Su Jok therapy. Among the analyzed variables there were: age, risk factors, clinical features, traditional syndromes, clinical course and response to the treatment. In the case material there was a prevalence of women aged 30-39, pelvic inflammatory disease and sexually transmitted infections as pathological history (71.4 percent), pain and vaginal secretion as main symptoms, as well as Qi liver stagnation, not firm Qi kidney and coldness-humidity in spleen as most frequent syndromes. Finally, there was a favorable clinical course and an appropriate response to the treatment

Enfermedad inflamatoria pélvica: un reto en el diagnóstico y tratamiento precoz / Pelvic inflammatory disease: a challenge in the early diagnosis and treatment

Actualizar los datos disponibles en referencia a la enfermedad inflamatoria pélvica para poder unificar criterios diagnósticos y terapéuticos y así minimizar las complicaciones que a corto y/o largo plazo puedan derivar. Método: Revisión de la literatura en Pubmed atendiendo sobre todo a las guías clínicas más actualizadas y ensayos clínicos aleatorizados. Resultados: La enfermedad inflamatoria pélvica es un cuadro infeccioso común entre las mujeres en edad fértil. Su mecanismo de transmisión más frecuente es la vía sexual y comparte factores de riesgo con otras enfermedades de transmisión sexual. Su diagnóstico, que es clínico, puede ser complejo y las formas subclínicas pueden pasar en ocasiones inadvertidas. Generalmente se puede comenzar con un tratamiento médico ambulatorio siguiendo las pautas recomendadas, y si la paciente no mejora o presenta un cuadro grave de inicio se indicará ingreso hospitalario y tratamiento médico endovenoso, reservando la cirugía para aquellos casos rebeldes en que fracasen los pasos anteriores. Conclusión: Es imprescindible reconocer esta entidad e instaurar el tratamiento antibiótico precoz, un retraso en el tratamiento adecuado, puede incrementar las secuelas inflamatorias a corto y largo plazo.

Update the pelvic inflammatory disease to standardize diagnostic and therapeutic criteria and to minimize its complications in the short and/or long term. Method: Search in Pubmed with especial attention to clinical guidelines and randomized clinical trials. Results: Pelvic inflammatory disease is a common infectious condition among women of fertile age. Its mechanism is the most common sexually transmitted shared risk factors and other sexually transmitted disease. Its clinical diagnosis can be complex and subclinical forms can sometimes go unnoticed. Usually it's indicated to start with medical treatment following the recommended guidelines, and if the patient does not improve or has a severe case, hospitalization and intravenous medical treatment is indicated, reserving surgery for those cases in which fail the above steps. Conclusion: It is essential to recognize this entity and establish early antibiotic treatment, so that a delay in appropriate antibiotic treatment, can lead to an increase in inflammatory short and long term sequelae.

Infecção por Chlamydia trachomatis e anticorpos contra proteína de choque térmico 60 (HPS60) associados a fator de infertilidade tubária / Chlamydia trachomatis and antibodies against heat shock protein 60 (HPS60) associated with tubal factor infertility

Chlamydia trachomatis é uma bactéria transmitida sexualmente e uma frequente causa de doença inflamatória pélvica (DIP) que, com sua evolução, pode levar à gravidez ectópica ou a fator de infertilidade túbaria (TFI). Hipóteses sugerem que reações imunes à proteína de choque térmico 60 (HPS60) de Chlamydia trachomatis induz à DIP e à consequente infertilidade. A revisão sistemática foi conduzida utilizando artigos científicos das bases de dados MEDLINE, PubMed e Scopus, com estudos que associavam o aumento do TFI à presença de anticorpos contra HPS60 em mulheres portadoras da bactéria. Foram incluídos 12 estudos. As evidências de 11 estudos caso-controle sugerem a confirmação da associação do TFI com maior produção de anticorpos contra HPS60 de Chlamydia trachomatis. Inversamente ao resultado, foi encontrado um estudo do tipo ensaio clínico controlado randomizado em que os anticorpos contra HPS60 da Chlamydia não foram significamente associados a sequelas por doença inflamatória pélvica. Nossos achados confirmam uma associação entre TFI e anticorpos para HSP60 da Chlamydia trachomatis, mas enfatizamos a necessidade de mais estudos com ensaio clínico controlado e randomizado.

Chlamydia trachomatis is a sexually transmitted bacteria and a common cause of pelvic inflammatory disease (PID); its evolution can lead to ectopic pregnancy or tubal infertility factor (TFI). Hypotheses suggest that immune reactions to heat shock protein 60 (HPS60) of Chlamydia trachomatis induces DIP and, thus, infertility. A systematic review was conducted of scientific articles using MEDLINE, PubMed and Scopus, with studies that linked the increase in the TFI HPS60 presence of antibodies in women with the bacterium. We included 12 studies. Evidence from 11 case-control studies suggest confirmation of the TFI association with increased production of antibodies against HPS60 Chlamydia trachomatis. In contrast to the result, we found a type study randomized controlled trial in which the antibodies of Chlamydia HPS60 were not significantly associated with sequelae of pelvic inflammatory disease. Our findings confirm an association between TFI and antibodies to HSP60 of Chlamydia trachomatis, but emphasize the need for more studies with randomized controlled trial.

El factor tubario en la era de la fertilización in vitro / Tubal factor infertility in the era of assisted reproduction

El desarrollo de las técnicas de fecundación asistida ha desplazado a la cirugía como procedimiento de elección en el tratamiento de la infertilidad tubaria secundaria a procesos inflamatorios pelvianos, ligadura tubaria y endometriosis. Sin embargo, la cirugía aún conserva un sitio reconocido, especialmente en casos de daño tubario leve o moderado o cuando existen limitaciones económicas y conflictos éticos o religiosos con las técnicas de fecundación asistida.

The development of Assisted Reproductive Technologies has displaced surgery as first-line treatment of tubal infertility secondary to pelvic inflammatory disease, tubal sterilization or endometriosis. However surgery might still have some place in minimal or moderate tubal damage and when financial, ethical or religious conflicts exist.

Enfermedad inflamatoria pélvica por Actinomyces y Síndrome de inmunodeficiencia adquirida (SIDA) / Pelvic inflammatory disease from Actinomyces and acquired immunodeficiency syndrome (AIDS)

La enfermedad inflamatoria pélvica en la actualidad debe sospecharse en toda mujer en edad fértil y sexualmente activa, es más frecuente y agresiva en la adolescencia. El actinomyces iraelli posee formas de presentación disimiles, lo que entorpece su diagnóstico, llega a la formación de abscesos con expansión física de un órgano encapsulado. El sida, enfermedad inmunodepresora, es capaz de facilitar y enmascarar cualquier proceso infeccioso, por lo que ante las dos circunstancias anteriores debemos pensar en esta posibilidad diagnóstica. El caso que presentamos comienza con una pequeña tumoración que después se agranda, acompañada de un cortejo sintomático respiratorio, vaso oclusivo y toma del estado general, se realiza el diagnóstico presuntivo y se impone tratamiento para el actinomyces, mejorando abruptamente toda sintomatología, llega más tarde el diagnóstico de ser portador del sida. Conclusión: siempre debemos sospechar ante una enfermedad inflamatoria pélvica en cualquiera de sus formas clínicas, la presencia del actinomyces como uno de los posibles gérmenes causales, sobre todo en pacientes con enfermedades inmunosupresoras como el sida

The pelvic inflammatory illness at the present time debit side to suspect in all woman in fertile and sexually active age, being more frequent and more aggressive in the adolescence The actinomyces iraelli possesses forms of presentation dissimilar, what hinders its diagnosis arriving to the formation of abscesses with physical expansion of an encapsulated organ. The AIDS illness inmunodepresora, is able to mask any infectious process, for what we should think of this diagnostic possibility before the 2 previous circumstances. the case that we present begins with a small tumor that later enlarges, accompanied by a breathing symptomatic retinue, occulsive glass and taking of the general state, he/she is carried out the I diagnose presumptive and empiric treatment is imposed for the actinomyces, improving all sintomatología abruptly, arriving but it takes the I diagnose of being carrier of the AIDS. Conclusion: we should. Always suspect before any Pelvic Inflammatory Illness in anyone in their clinical ways the presence of illnesses inmunosupresoras like the AIDS and the presence of the actinomyces inside their causal germs

Síndrome de Fitz-Hugh-Curtis como hallazgo durante cirugía ginecológica / Fitz-Hugh-Curtis syndrome: a case report

El síndrome de Fitz-Hugh-Curtis es una perihepatitis producida por una peritonitis secundaria al ascenso de bacterias, como resultado de una enfermedad inflamatoria pélvica. En la etapa crónica se pueden observar adherencias entre la pared abdominal y la superficie hepática, caracterizadas por la semejanza a "cuerdas de violín". Esta imagen es considerada criterio diagnóstico. Se presenta un caso de hallazgo de síndrome de Fitz-Hugh-Curtis, pesquisado durante la inspección rutinaria de la cavidad abdominopélvica, al finalizar una histerectomía laparoscópica.

The Fitz-Hugh-Curtis Syndrome is a perihepatitis secondary to peritonitis caused by ascending bacteria from a pelvic inflammatory disease. During the chronic phase may be observe adherences between the abdominal wall and the liver surface characterized by a "violin string" similarity. This image is considered criterion for the diagnosis. A case of incidental Fitz-Hugh-Curtis syndrome observed during a routinely abdo-minopelvic cavity inspection at the end of a laparoscopic hysterectomy is presented.

Evaluation of urogenital fistulas by magnetic resonance urography / Avaliação das fístulas urogenitais por urorressonância magnética

OBJETIVO: As fístulas vesicovaginais e ureterovaginais são complicações incomuns, secundárias a doenças ou a cirurgias pélvicas. O sucesso terapêutico dessas fístulas depende de adequada avaliação pré-operatória para o diagnóstico e visualização do seu trajeto. Este trabalho tem o objetivo de demonstrar o potencial da urorressonância no diagnóstico das fístulas urogenitais e na visualização dos seus trajetos. MATERIAIS E MÉTODOS: Foram analisados, retrospectivamente, os prontuários médicos e as imagens radiológicas e de urorressonância magnética de sete pacientes do sexo feminino com diagnóstico de fístula urogenital. Para a urorressonância foram realizadas seqüências 3D-HASTE com saturação de gordura. RESULTADOS: Seis pacientes apresentavam fístula vesicovaginal e uma paciente tinha diagnóstico de fístula ureterovaginal à direita. Com a utilização da urorressonância magnética, foi possível demonstrar o trajeto da fístula em seis das sete pacientes (85,7 por cento), sem a necessidade de cateterização vesical ou da injeção de contraste. CONCLUSÃO: Este estudo demonstra o potencial e a aplicabilidade da urorressonância na avaliação dessas fístulas.

OBJECTIVE: Vesicovaginal and ureterovaginal fistulas are unusual complications secondary to pelvic surgery or pelvic diseases. The therapeutic success in these cases depends on an appropriate preoperative evaluation for diagnosis and visualization of the fistulous tract. The present study is aimed at demonstrating the potential of magnetic resonance urography for the diagnosis of vesicovaginal and ureterovaginal fistulas as well as for defining the fistulous tracts. MATERIALS AND METHODS: Seven female patients clinically diagnosed with vesicovaginal or ureterovaginal fistulas had their medical records, radiological and magnetic resonance images retrospectively reviewed. Magnetic resonance urography included 3D-HASTE sequences with fat saturation. RESULTS: Six patients presented vesicovaginal fistulas and, in one patient, a right-sided ureterovaginal fistula was diagnosed. Magnetic resonance urography allowed the demonstration of the fistulous tract in six (85.7 percent) of the seven patients evaluated in the present study, without the need of bladder catheterization or contrast injection. CONCLUSION: This study demonstrates both the potential and applicability of magnetic resonance urography in the evaluation of these types of fistulas.

Sangrado uterino anormal: hallazgos clínicos histopatológicos de pacientes atendidas en el servicio de ginecología del HEODRA-León / Bled uterine abnormal: clinical findings histopatológicos of patients attended in the gynecology service of the HEODRA - Lion

El sangrado uterino anormal es una patología por la que debe interesarse todo ginecólogo ya que es una entidad clínica que se presenta con frecuencia en el servicio de Ginecología. El objetivo de este estudio fue analizar el comportamiento clínico y hallazgos histopatológicos del sangrado uterino anormal en pacientes ingresadas al servicio de Ginecología del HEODRA, durante 2002 al 2003.Se realizó un estudio de corte transversal. Población de Estudio: Todas las pacientes ingresadas al servicio de Ginecología en el período de estudio tomándose la totalidad de la población de estudio. El protocolo de investigación fue sometido al comité de ética de la Facultad de Medicina, el cual no incluía procedimientos invasivos a las pacientes, siendo por lo tanto aprobado sin modificaciones. La fuente fue secundaria a través de expedientes clínicos de pacientes. Se realizó un análisis mediante el software Epi Info 6.0. Las variables categóricas se analizaron en porcentajes y las numéricas con medidas de tendencia central y dispersión.La frecuencia de sangrado uterino anormal fue de 9.9 porciento. La mayor frecuencia ocurre en edades mayor o igual a los 35 años y procedentes del área urbana. Los Gestágenos Orales tuvieron la mayor proporción de ritmos menstruales irregulares. Otros hallazgos encontrados fueron: útero aumentado de tamaño, enfermedad inflamatoria pélvica aguda y dolor. Como método diagnóstico complementario se utilizó el legrado biopsia hemostático ya sea por legrado uterino instrumental o legrado uterino por aspiración. Se encontró con el hallazgo histopatológico que el 59.1 porciento de los casos eran sangrado uterino disfuncional exceptuando algunas patologías que serian de causa orgánica...

Prevalence of Chlamydia trachomatis in human immunodeficiency virus-infected women in Cuba

To determine the prevalence rates and serovar distribution of Chlamydia trachomatis cervical infections in Cuban women, two different groups were selected. Group I consisted of 60 human immunodeficiency virus (HIV-1) seropositive women from different regions of Cuba and group II of 60 randomly selected women HIV seronegative and apparently healthy. C. trachomatis was detected in cervical scrapes by mean of nested polymerase chain reaction (PCR) specific for major out membrane protein. The overall prevalence rate of C. trachomatis in cervical scrapes determined by nested PCR was 10 percent in group I and the estimated prevalence was 6.6 percent for group II; 83.3 percent of HIV seropositive women with C. trachomatis infection reported history of pelvic inflammatory disease followed by cervicitis (50 percent). The control group C. trachomatis-infected women referred a history of cervicitis in 75 percent of cases. Other reports in the latter group included infertility and pelvic inflamatory disease in 50 percent. The present study is the first report of C. trachomatis prevalence in Cuba. It showed that there was not significantly difference in the prevalence rate of C. trachomatis between both groups