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1.
Med Clin North Am ; 108(2): 297-310, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38331481

RESUMO

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..


Assuntos
Infecções por Mycoplasma , Mycoplasma genitalium , Doença Inflamatória Pélvica , Proctite , Uretrite , Cervicite Uterina , Gravidez , Feminino , Humanos , Masculino , Antibacterianos/uso terapêutico , Antibacterianos/farmacologia , Uretrite/diagnóstico , Uretrite/tratamento farmacológico , Uretrite/complicações , Moxifloxacina/uso terapêutico , Cervicite Uterina/complicações , Cervicite Uterina/tratamento farmacológico , Macrolídeos/uso terapêutico , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/tratamento farmacológico , Infecções por Mycoplasma/complicações , Farmacorresistência Bacteriana , Doença Inflamatória Pélvica/diagnóstico , Doença Inflamatória Pélvica/tratamento farmacológico , Doença Inflamatória Pélvica/complicações , Proctite/complicações , Proctite/tratamento farmacológico , Atenção Primária à Saúde
2.
Cell Mol Biol (Noisy-le-grand) ; 69(1): 109-113, 2023 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-37213147

RESUMO

Cervical cancer is the fourth most prevalent cancer for females with 14,100 new cases each year globally. Efficient screening and intervention at the precancerous stage is the key point to the prevention and treatment of cervical cancer. However, no widely recognized biomarkers have been discovered yet. We investigated the expression of miR-10b in cervical cells and its correlation with clinicopathological features in different pathological grades of cervical precancerous lesions. The expression of miR-10b in cervical cytology samples from 20 cases of LSIL, 22 cases of HSIL, 18 cases of early-stage cervical cancer, and 20 cases of cervicitis controls were assessed using qPCR. From the same cervical cytology samples, the human papillomavirus (HPV) load was assessed using semi-PCR and the lesion size, and gland involvement levels from the same subjects were assessed during the cervical examination. The correlation between miR-10b expression and different pathological grades of cervical lesions was analyzed. We also calculated the correlation between HPV load, lesion size, gland involvement, P16 expression, and different pathological grades. The expression of miR-10b exhibited a step-decreasing manner from cervicitis control (4.23(4.00,4.71)) to LSIL (2.67(2.52,2.90)), HSIL (1.49(1.30,1.80)) and cervical cancer group (0.65(0.55,0.80)). There is a significant difference (P<0.001) between cervicitis and HSIL, cervicitis and cervical cancer, ISIL and HSIL, as well as ISIL and cervical cancer but not between the cervicitis group and the LSIL group. In addition, more severe pathological grades were correlated with a bigger rate of gland involvement (P<0.001). We also found that different pathological grades were correlated with the intensity of P16 expression (P=0.001), and the intensity of P16 expression is positively correlated with different pathological grades (P<0.05). Repressed expression of miR-10b is related to the progression of cervical precancerous lesions. Increased gland involvement rate and increased intensity of P16 expression are risk factors for developing cervical cancers. Our result showed that miR-10b may be a potential biomarker for the screening and ranking of cervical precancerous lesions.


Assuntos
MicroRNAs , Infecções por Papillomavirus , Lesões Pré-Cancerosas , Displasia do Colo do Útero , Neoplasias do Colo do Útero , Cervicite Uterina , Feminino , Humanos , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Inibidor p16 de Quinase Dependente de Ciclina/genética , Inibidor p16 de Quinase Dependente de Ciclina/análise , Inibidor p16 de Quinase Dependente de Ciclina/metabolismo , MicroRNAs/genética , Papillomaviridae/genética , Papillomaviridae/metabolismo , Infecções por Papillomavirus/genética , Lesões Pré-Cancerosas/genética , Displasia do Colo do Útero/genética , Displasia do Colo do Útero/diagnóstico , Displasia do Colo do Útero/patologia , Neoplasias do Colo do Útero/genética , Neoplasias do Colo do Útero/patologia , Cervicite Uterina/genética , Cervicite Uterina/complicações
3.
Rev Chilena Infectol ; 39(2): 214-217, 2022 04.
Artigo em Espanhol | MEDLINE | ID: mdl-35856996

RESUMO

Cervicitis is a frequent condition caused mainly by sexually trans- mitted agents. The clinical spectrum varies from absence of symptoms to extensive inflammatory processes that may simulate a malignant neoplasm. We present a clinical case of an adolescent with genital ulcers and systemic disease. Speculoscopy revealed a tumoral-looking cervix. Laboratory studies confirm infection with herpes simplex virus 2 (HSV-2) and Mycoplasma genitalium, together with a histological study that ruled out neoplasia. It progresses favorably to antimicrobial treatment, with recovery of the appearance of the cervix. Cervicitis rarely presents with necrotic involvement. Co-infection with HSV-2 and M. genitalium infection may have been the determinant of cervical damage and the necrotic appearance. A thorough evaluation and study with highly sensitive and specific diagnostic tests allowed an adequate diagnosis and treatment.


Assuntos
Coinfecção , Infecções por Mycoplasma , Mycoplasma genitalium , Cervicite Uterina , Adolescente , Feminino , Herpesvirus Humano 2 , Humanos , Infecções por Mycoplasma/complicações , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/tratamento farmacológico , Cervicite Uterina/complicações , Cervicite Uterina/diagnóstico , Cervicite Uterina/tratamento farmacológico
4.
J Healthc Eng ; 2022: 3374655, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35463689

RESUMO

In order to investigate the expression levels of serum IFN-γ, IL-4, and tumor necrosis TNF-α in patients with cervicitis complicated with human papillomavirus (HPV) infection and clinical significance, a retrospective study was conducted on 90 patients with chronic cervicitis complicated by HP V infection who visited our hospital from June 2020 to June 2021, and they are included in the research group. According to the degree of HPV infection, the patients are divided into low-risk HPV type group (n = 65 cases) and high-risk HPV type group (n = 25 cases); 50 patients with cervicitis (without HPV infection) who received treatment in our hospital are selected as control group 1. Fifty healthy women who underwent physical examination are selected as the control group 2. The general data of the two groups of patients during hospitalization are collected, and HPV-DNA, IFN-γ, IL-4, and TNF-α are detected in all patients. For patients with cervicitis complicated by HPV infection, the IFN-indexes in the body are significantly decreased, IL-4 and TNF-αare significantly increased, and with the degree of HPV infection, IFN-γ, IL-4, and TNF-α have high diagnostic performance with HPV infection, and there is a significant correlation between the three, which can be used in cervicitis complicated with HPV infection. It is widely used in the early diagnosis and screening of infected patients.


Assuntos
Infecções por Papillomavirus , Cervicite Uterina , Feminino , Humanos , Interferon gama/sangue , Interleucina-4/sangue , Infecções por Papillomavirus/sangue , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/diagnóstico , Estudos Retrospectivos , Fator de Necrose Tumoral alfa/sangue , Cervicite Uterina/sangue , Cervicite Uterina/complicações , Cervicite Uterina/diagnóstico
5.
Rev. chil. infectol ; 39(2): 214-217, abr. 2022. ilus
Artigo em Espanhol | LILACS | ID: biblio-1388344

RESUMO

Resumen Las cervicitis es una condición frecuente causada principalmente por agentes de transmisión sexual. Su presentación clínica varía desde cuadros asintomáticos hasta procesos inflamatorios extensos, que incluso asemejan un tumor maligno. Presentamos el caso de una adolescente que presentó úlceras genitales, síntomas generales y cérvix necrótico con aspecto tumoral. Los estudios de laboratorio confirmaron una co-infección por virus herpes simplex 2 (HSV-2) y Mycoplasma genitalium. El estudio histológico descartó una neo- plasia. Evolucionó favorablemente al tratamiento antimicrobiano, con recuperación progresiva del aspecto del cérvix. La cervicitis en raras ocasiones se presenta con compromiso necrótico. La co-infección por HSV-2 y M. genitalium, en este caso, pudo ser el determinante del daño cervical y la necrosis. Una evaluación acuciosa y estudio con exámenes diagnósticos de alta sensibilidad y especificidad permitieron hacer un diagnóstico y tratamiento adecuado.


Abstract Cervicitis is a frequent condition caused mainly by sexually trans- mitted agents. The clinical spectrum varies from absence of symptoms to extensive inflammatory processes that may simulate a malignant neoplasm. We present a clinical case of an adolescent with genital ulcers and systemic disease. Speculoscopy revealed a tumoral-looking cervix. Laboratory studies confirm infection with herpes simplex virus 2 (HSV-2) and Mycoplasma genitalium, together with a histological study that ruled out neoplasia. It progresses favorably to antimicrobial treatment, with recovery of the appearance of the cervix. Cervicitis rarely presents with necrotic involvement. Co-infection with HSV-2 and M. genitalium infection may have been the determinant of cervical damage and the necrotic appearance. A thorough evaluation and study with highly sensitive and specific diagnostic tests allowed an adequate diagnosis and treatment.


Assuntos
Humanos , Feminino , Adolescente , Cervicite Uterina/complicações , Cervicite Uterina/diagnóstico , Cervicite Uterina/tratamento farmacológico , Mycoplasma genitalium , Coinfecção , Infecções por Mycoplasma/complicações , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/tratamento farmacológico , Herpesvirus Humano 2
6.
Immunobiology ; 227(2): 152189, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35220072

RESUMO

BACKGROUND: Little is known about the relationship between arginase, an immunosuppressive enzyme, and cervical lesions. The present study is aimed at evaluating arginase activity in plasma and mRNA arginase isoforms expression in cervical cells of patients with abnormal cytology and identifying their relationship with Human papillomavirus (HPV) related parameters such as: HPV type, HPV circulating viral load and anti-HPV16 IgG. METHODS: This study included 77 women with cervical lesions and 95 matched controls. Arginase activity was detected by colorimetric assay. Arginase mRNA expression and HPV viral load were evaluated by quantitative real time PCR and anti-HPV16 antibodies were assessed by ELISA. RESULTS: Compared to controls, the arginase activity was higher among women with cervicitis / low grade squamous intraepithelial lesions (LSIL) (OR: 1.872, 95% CI: 0.833-4.210), and also among women with high-grade squamous intraepithelial lesions (HSIL) / squamous cell carcinoma (SCC) (OR: 3.358, 95% CI: 1.670-8.910). Compared to controls, mRNA expression was significantly upregulated in women with cervical cervicitis and SIL for ARG1, and in women with cancer lesions for ARG2. Arginase activity was positively correlated to ARG2 mRNA expression but not to ARG1. High arginase activity was associated with HPV16, high levels of HPV viral load, and low levels of anti-HPV16 antibodies. CONCLUSIONS: Our findings demonstrated that arginase activity and isoforms expression were enhanced in women with HPV-related precancerous lesions and cervical cancer. Further studies are needed to identify how arginase enzyme induces disease progression and severity.


Assuntos
Arginase , Infecções por Papillomavirus , Cervicite Uterina , Arginase/genética , Feminino , Papillomavirus Humano 16 , Humanos , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/patologia , RNA Mensageiro , Cervicite Uterina/complicações , Cervicite Uterina/virologia
7.
Wiad Lek ; 75(11 pt 2): 2715-2721, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36591758

RESUMO

OBJECTIVE: The aim: To evaluate the prevalence of preterm birth and to determine the role of cervicitis as a cause of preterm birth in women in Ukraine. PATIENTS AND METHODS: Materials and methods: We conducted a retrospective multicentre cohort study from January 1st, 2019 to December 31st, 2021. This study included pregnant women aged 17-50 years admitted to the labor ward at the 13 hospitals from 10 regions of Ukraine. RESULTS: Results: Of the 8151 participants, the prevalence of preterm birth was 2226 (27.3%, [95% CI 26.8 - 27.8]) whereas 5925 (72.7% [95% CI 72.2-73.2]) delivered at term. Preterm birth associated with cervicitis was 76.3% (4,388/2666). History of cervicitis, maternal age, previous preterm labor or premature birth, and pregnancy with twins, triplets or other multiples were identified as independent risk factors of preterm birth. CONCLUSION: Conclusions: Preterm birth in Ukraine is widespread, the number of which tends to increase. Infection and inflammation of the cervix seem to play a significant role for preterm birth. Early detection and treatment of cervicitis can reduce the risk of preterm birth. Women who have a history of poor pregnancy outcomes are at greater risk of poor outcomes in following pregnancies. Health providers should be aware of this risk when treating patients with a history of poor pregnancy outcomes.


Assuntos
Trabalho de Parto Prematuro , Nascimento Prematuro , Cervicite Uterina , Gravidez , Feminino , Recém-Nascido , Humanos , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/etiologia , Cervicite Uterina/complicações , Cervicite Uterina/epidemiologia , Estudos de Coortes , Trabalho de Parto Prematuro/epidemiologia , Trabalho de Parto Prematuro/etiologia , Resultado da Gravidez/epidemiologia
8.
Pediatr Rev ; 41(10): 522-537, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33004664

RESUMO

Sexually transmitted infections (STIs) disproportionately affect young people, with more than half of the infections occurring in youth aged 15 to 25 years. (1)(2) This review, the second in a 2-part series on STIs, focuses on infections that may cause abnormal vaginal or penile discharge, including trichomonas, chlamydia, gonorrhea, and pelvic inflammatory disease (PID). Most infected persons, however, are asymptomatic. Nucleic acid amplification tests are the most sensitive and specific for the detection of chlamydia, gonorrhea, and trichomoniasis, and they can be performed on provider- or patient-collected swabs. Providers should have a low threshold for diagnosing and treating PID because untreated PID can have serious long-term complications for young women. Indications for hospitalization for PID include the presence of a tubo-ovarian abscess, severe illness with systemic symptoms, pregnancy, human immunodeficiency virus infection, and failure to respond to outpatient oral treatment (within 48-72 hours) or inability to tolerate the oral treatment.


Assuntos
Doença Inflamatória Pélvica/diagnóstico , Infecções Sexualmente Transmissíveis/diagnóstico , Descarga Vaginal/microbiologia , Adolescente , Candidíase/complicações , Candidíase/diagnóstico , Infecções por Chlamydia/complicações , Infecções por Chlamydia/diagnóstico , Feminino , Gonorreia/complicações , Gonorreia/diagnóstico , Humanos , Masculino , Doença Inflamatória Pélvica/etiologia , Parceiros Sexuais , Infecções Sexualmente Transmissíveis/complicações , Vaginite por Trichomonas/diagnóstico , Cervicite Uterina/complicações , Vaginose Bacteriana/complicações , Vaginose Bacteriana/diagnóstico
9.
Intern Med ; 58(15): 2251-2255, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-30996173

RESUMO

We herein report a patient with syphilitic cervicitis and cervical cancer presenting as oropharyngeal syphilis. A 31-year-old Japanese woman with a history of unprotected vaginal and oral sex visited our hospital with right submandibular adenomas and erythema in the extremities. The fornix uteri was red, with a nodule noted. The rapid plasma reagin ratio was 1:3. She was diagnosed with syphilitic cervicitis and treated with amoxicillin for four weeks. Initial cervical cytology showed cells with mild nuclear enlargement, which was thought to be metaplasia associated with syphilis. Repeated cytology a month later showed a high-grade squamous intraepithelial lesion. A punch biopsy of the lesion led to the pathological diagnosis of cervical carcinoma in situ. We performed cervical conization, and no recurrence occurred. Human papillomavirus (HPV) immunostaining was positive in the lesion. Mucosal lesions are an infrequently reported symptom of syphilis. When oropharyngeal lesions are found, the sexual history should be ascertained, and the patient should be screened for sexually transmitted diseases. HPV is especially significant because of its association with cervical cancer. Coinfection of HPV with cervical cancer must be ruled out during follow-up for women when oropharyngeal syphilis involves genital lesions.


Assuntos
Doenças da Boca/complicações , Doenças Faríngeas/complicações , Sífilis/complicações , Neoplasias do Colo do Útero/complicações , Cervicite Uterina/complicações , Adulto , Amoxicilina , Biópsia , Citodiagnóstico , Feminino , Humanos , Doenças da Boca/microbiologia , Recidiva Local de Neoplasia/patologia , Infecções por Papillomavirus/complicações , Doenças Faríngeas/microbiologia , Sífilis/tratamento farmacológico , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgia , Cervicite Uterina/microbiologia
10.
Enferm Infecc Microbiol Clin (Engl Ed) ; 37(10): 661-667, 2019 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30630634

RESUMO

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.


Assuntos
Cervicite Uterina , Feminino , Humanos , Cervicite Uterina/complicações , Cervicite Uterina/diagnóstico , Cervicite Uterina/tratamento farmacológico , Cervicite Uterina/microbiologia
11.
J Obstet Gynaecol Res ; 45(1): 86-95, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30277627

RESUMO

AIM: To assess the preventive effect on preterm birth of intravaginal ulinastatin (urinary trypsin inhibitor; UTI) administration during the mid-trimester in women with singleton pregnancy and both cervical shortening and lower genital infections. METHODS: Pregnant women with a short cervical length < 25 mm between 16 and 26 weeks of gestation and who had been diagnosed with a lower genital infection were randomly assigned for intravaginal UTI administration or placebo. All of the women were screened for infection or inflammation of the lower genital tract, and women with negative results were excluded. RESULTS: Of the 92 patients with a short cervical length who were assessed for eligibility for this study, 86 singleton patients were enrolled. All patients were randomized to one of two treatment groups: patients administered UTI (n = 35) and placebo (n = 35). There were no differences between the two groups in the incidence of preterm delivery before 28, 30, 32, 34 and 37 weeks of gestation and in perinatal outcomes. CONCLUSION: For women diagnosed with a short cervical length < 25 mm) between 16 and 26 weeks of gestation and lower genital infection, who were at risk of preterm birth, administration of transvaginal UTI with vaginal irrigation showed no apparent benefit. Future research on the efficacy of UTI should evaluate modified modes of UTI application.


Assuntos
Colo do Útero/patologia , Corioamnionite , Glicoproteínas/farmacologia , Avaliação de Resultados em Cuidados de Saúde , Nascimento Prematuro/prevenção & controle , Inibidores da Tripsina/farmacologia , Cervicite Uterina/complicações , Administração Intravaginal , Adulto , Medida do Comprimento Cervical , Colo do Útero/diagnóstico por imagem , Feminino , Glicoproteínas/administração & dosagem , Humanos , Inflamação , Gravidez , Nascimento Prematuro/etiologia , Inibidores da Tripsina/administração & dosagem
12.
Ann Emerg Med ; 72(6): 703-712.e1, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30251627

RESUMO

STUDY OBJECTIVE: We evaluate the additive value of pelvic examinations in predicting sexually transmitted infection for young female patients with suspected cervicitis or pelvic inflammatory disease in a pediatric emergency department (ED). METHODS: This was a prospective observational study of female patients aged 14 to 20 years who presented to an urban academic pediatric ED with a complaint of vaginal discharge or lower abdominal pain. Enrolled patients provided a urine sample for chlamydia, gonorrhea, and trichomonas testing, which served as the criterion standard for diagnosis. A practitioner (pediatric ED attending physician, emergency medicine or pediatric resident, pediatric ED fellow, or advanced practice provider) obtained a standardized history from the patient to assess for cervicitis or pelvic inflammatory disease according to the Centers for Disease Control and Prevention criteria. They then recorded the likelihood of cervicitis or pelvic inflammatory disease on a 100-mm visual analog scale. The same practitioner then performed a pelvic examination and again recorded the likelihood of cervicitis or pelvic inflammatory disease on a visual analog scale with this additional information. Using the results of the urine sexually transmitted infection tests, the practitioner calculated and compared the test characteristics of history alone and history with pelvic examination. RESULTS: Two hundred eighty-eight patients were enrolled, of whom 79 had positive urine test results for chlamydia, gonorrhea, or trichomonas, with a sexually transmitted infection rate of 27.4% (95% confidence interval [CI] 22.6% to 32.8%). The sensitivity of history alone in diagnosis of cervicitis or pelvic inflammatory disease was 54.4% (95% CI 42.8% to 65.5%), whereas the specificity was 59.8% (95% CI 52.8% to 66.4%). The sensitivity of history with pelvic examination in diagnosis of cervicitis or pelvic inflammatory disease was 48.1% (95% CI 36.8% to 59.5%), whereas the specificity was 60.7% (95% CI 53.8% to 67.3%). The information from the pelvic examination changed management in 71 cases; 35 of those cases correlated with the sexually transmitted infection test and 36 did not. CONCLUSION: For young female patients with suspected cervicitis or pelvic inflammatory disease, the pelvic examination does not increase the sensitivity or specificity of diagnosis of chlamydia, gonorrhea, or trichomonas compared with taking a history alone. Because the test characteristics for the pelvic examination are not adequate, its routine performance should be reconsidered.


Assuntos
Exame Ginecológico/métodos , Doença Inflamatória Pélvica/complicações , Infecções Sexualmente Transmissíveis/diagnóstico , Cervicite Uterina/complicações , Adolescente , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/etiologia , Infecções por Chlamydia/urina , Feminino , Gonorreia/diagnóstico , Gonorreia/etiologia , Gonorreia/urina , Humanos , Doença Inflamatória Pélvica/urina , Estudos Prospectivos , Sensibilidade e Especificidade , Infecções Sexualmente Transmissíveis/etiologia , Infecções Sexualmente Transmissíveis/urina , Tricomoníase/diagnóstico , Tricomoníase/urina , Serviços Urbanos de Saúde , Cervicite Uterina/urina , Adulto Jovem
13.
Haemophilia ; 24(3): 359-365, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29436075

RESUMO

BACKGROUND: Congenital plasminogen deficiency is a rare autosomal recessive condition. Plasminogen deficiency is thought to result in an inability of fibrin breakdown and therefore accumulation of fibrin and formation of ligneous changes. Ligneous lesions can form on a number of mucosal membranes including the cervix and endometrium. METHODS: We report the case of a 25-year-old woman with type 1 plasminogen deficiency with ligneous cervicitis and endometritis and her treatment and clinical course over the last few years. We then review the current literature of ligneous cases of the female genital tract and discuss available treatment options. KEY RESULTS: We found 30 reported cases of ligneous lesions affecting the female genital tract, with the cervix being the most affected part. A number of treatment options have been tried by our patient and other cases in the literature. These include use of the combined oral contraceptive pill, fresh frozen plasma infusion, topical plasmin and plasminogen and trial use of plasminogen concentrate. CONCLUSIONS: This is a chronic condition requiring a multidisciplinary approach. There is currently no definitive treatment for the condition, current trials with plasminogen concentrate replacement therapy may provide a promising option for these patients in the future.


Assuntos
Transtornos de Proteínas de Coagulação/complicações , Transtornos de Proteínas de Coagulação/patologia , Endometrite/complicações , Cervicite Uterina/complicações , Adolescente , Adulto , Biópsia , Feminino , Humanos
14.
Pak J Pharm Sci ; 30(4(Suppl.)): 1505-1508, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29044006

RESUMO

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.


Assuntos
Antivirais/administração & dosagem , Crioterapia/métodos , Interferons/administração & dosagem , Infecções por Papillomavirus/terapia , Cervicite Uterina/terapia , Administração Intravaginal , Adulto , Antivirais/efeitos adversos , China , Doença Crônica , Terapia Combinada , Crioterapia/efeitos adversos , Feminino , Testes de DNA para Papilomavírus Humano , Humanos , Interferons/efeitos adversos , Pessoa de Meia-Idade , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/virologia , Supositórios , Fatores de Tempo , Resultado do Tratamento , Cervicite Uterina/complicações , Cervicite Uterina/diagnóstico , Carga Viral , Adulto Jovem
16.
J Infect Dis ; 216(suppl_2): S406-S411, 2017 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-28838072

RESUMO

Background: Mycoplasma genitalium is very difficult to grow in culture but has been more able to be studied for disease associations since the advent of research molecular amplification assays. Polymerase chain reaction (PCR) and other molecular assays have demonstrated an association with adverse disease outcomes, such as urethritis or nongonococcal urethritis in men and adverse reproductive sequelae in women-for example, cervicitis, endometritis, and pelvic inflammatory disease (PID), including an association with risk for human immunodeficiency virus. The lack of commercially available diagnostic assays has limited widespread routine testing. Increasing reports of high rates of resistance to azithromycin detected in research studies have heightened the need available commercial diagnostic assays as well as standardized methods for detecting resistance markers. This review covers available molecular methods for the diagnosis of M. genitalium and assays to predict the antibiotic susceptibility to azithromycin. Methods: A PubMed (US National Library of Medicine and National Institutes of Health) search was conducted for literature published between 2000 and 2016, using the search terms Mycoplasma genitalium, M. genitalium, diagnosis, and detection. Results: Early PCR diagnostic tests focused on the MPa adhesion gene and the 16S ribosomal RNA gene. Subsequently, a transcription-mediated amplification assay targeting ribosomes was developed and widely used to study the epidemiology of M. genitalium. Newer methods have proliferated and include quantitative PCR for organism load, AmpliSens PCR, PCR for the pdhD gene, a PCR-based microarray for multiple sexually transmitted infections, and multiplex PCRs. None yet are cleared by the Food and Drug Administration in the United States, although several assays are CE marked in Europe. As well, many research assays, including PCR, gene sequencing, and melt curve analysis, have been developed to detect the 23S ribosomal RNA gene mutations that confer resistance to azithromycin. One recently developed assay can test for both M. genitalium and azithromycin resistance mutations at the same time. Conclusions: It is recommended that more commercial assays to both diagnose this organism and guide treatment choices should be developed and made available through regulatory approval. Research is needed to establish the cost-effectiveness of routine M. genitalium testing in symptomatic patients and screening in all individuals at high risk of acquiring and transmitting sexually transmitted infections.


Assuntos
Infecções por Mycoplasma/diagnóstico , Mycoplasma genitalium/isolamento & purificação , Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Farmacorresistência Bacteriana , Feminino , Humanos , Macrolídeos/uso terapêutico , Masculino , Reação em Cadeia da Polimerase Multiplex , Mutação , Doença Inflamatória Pélvica/complicações , Doença Inflamatória Pélvica/microbiologia , RNA Ribossômico 16S/genética , Uretrite/complicações , Uretrite/microbiologia , Cervicite Uterina/complicações , Cervicite Uterina/microbiologia
17.
J Infect Dis ; 216(suppl_2): S382-S388, 2017 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-28838077

RESUMO

Mycoplasma genitalium is increasingly appreciated as a common cause of sexually transmitted disease syndromes, including urethritis in men and cervicitis, endometritis, pelvic inflammatory disease, and possibly preterm birth, tubal factor infertility, and ectopic pregnancy in women. Despite these disease associations, which parallel those of Chlamydia trachomatis and Neisseria gonorrhoeae, the mechanisms by which this pathogen elicits inflammation, causes cellular damage, and persists in its only natural host (humans) are unique and are not fully understood. The purpose of this review is to briefly provide a historical background on the discovery, microbiology, and recognition of M. genitalium as a pathogen, and then summarize the recent advances in our understanding of the molecular biology and pathogenesis of this unique urogenital organism. Collectively, the basic scientific discussions herein should provide a framework for understanding the clinical and epidemiological outcomes described in the accompanying articles in this supplemental issue.


Assuntos
Evasão da Resposta Imune , Infecções por Mycoplasma/imunologia , Mycoplasma genitalium/genética , Mycoplasma genitalium/patogenicidade , Doenças Bacterianas Sexualmente Transmissíveis/imunologia , Feminino , Genoma Bacteriano , Humanos , Imunidade , Masculino , Mycoplasma genitalium/imunologia , Fatores de Risco , Doenças Bacterianas Sexualmente Transmissíveis/complicações , Uretrite/complicações , Uretrite/microbiologia , Cervicite Uterina/complicações , Cervicite Uterina/microbiologia
18.
J Infect Dis ; 216(suppl_2): S389-S395, 2017 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-28838078

RESUMO

Health consequences of sexually transmitted diseases disproportionately affect women, making it important to determine whether newly emerged pathogens cause sequelae. Although the pathogenic role of Mycoplasma genitalium in male urethritis is clear, fewer studies have been conducted among women to determine its pathogenic role in the female reproductive tract. Pelvic inflammatory disease (PID) is an important cause of infertility and ectopic pregnancy, and Chlamydia trachomatis and Neisseria gonorrhoeae are recognized microbial causes. Emerging data demonstrate an association between M. genitalium and PID, and limited data suggest associations with infertility and preterm birth, yet the attributable risk for female genital tract infections remains to be defined. Further investigations are needed to better define the impact of M. genitalium on women's reproductive health. Importantly, prospective studies evaluating whether screening programs and targeted treatment of M. genitalium improve reproductive outcomes in women are necessary to guide public health policy for this emerging pathogen.


Assuntos
Infecções por Mycoplasma/complicações , Infecções por Mycoplasma/diagnóstico , Mycoplasma genitalium/isolamento & purificação , Doença Inflamatória Pélvica/microbiologia , Cervicite Uterina/microbiologia , Feminino , Humanos , Infertilidade Feminina/etiologia , Masculino , Doença Inflamatória Pélvica/complicações , Gravidez , Gravidez Ectópica/etiologia , Nascimento Prematuro/etiologia , Fatores de Risco , Cervicite Uterina/complicações
19.
Medicine (Baltimore) ; 96(17): e6700, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28445274

RESUMO

The purpose of this prospective cohort study is to evaluate the importance of screening and its diagnostic accuracy compared with the pathological diagnosis of cervical intraepithelial neoplasia (CIN) with vaginal intraepithelial neoplasia (VAIN).The prospective study enrolled 419 patients (pts) and was conducted between February 1, 2015 and January 31, 2016 at Beijing Obstetrics and Gynecology Hospital, Capital Medical University.All enrolled pts underwent multipoint biopsy of cervix and vaginal wall directed by colposcopy. All samples of biopsy underwent pathological examination. Among them, 201 pts (48.0%) were diagnosed with CIN, 218 pts (52.0%) were diagnosed with cervicitis, and 51 pts (12.2%) were diagnosed with VAIN. It was found that the incidence of CIN in pts was 4 times higher than that of VAIN. In all 419 patients enrolled, 218 pts had cervicitis with 13 pts (6.0%) of VAIN. There were 201 pts of CIN with 38 pts (18.9%) of VAIN: including 53 pts of CIN3 with 12 pts (22.6%) of VAIN; 49 pts of CIN2 with 9 pts of VAIN (18.4%), and 99 pts of CIN1 with 17 pts of VAIN (17.2%). The incidence of CIN with VAIN (18.9%) was significantly higher than cervicitis with VAIN (6.0%) (χ = 16.39, P = .00). Our results showed that there was a significant consistency between cervical lesions and vaginal lesions (χ = 135.91, P = .00), which indicated that the increase of CIN grades may be related to an increase of the VAIN grades. Our results also showed the significant (p < .05) increase of CIN and VAIN with age (<40 years Kappa = 0.04; 40-50 years Kappa = 0.11; >50 years Kappa = 0.28).This study showed that cytological test can be used as a routine screening method for cervical lesions and vaginal diseases. If the cytology result shows abnormality, and pathological examination confirms that there is no obvious abnormal cervical disease, colposcopy directed vaginal multipoint biopsy should be conducted to exclude vaginal disease. All patients of CIN should routinely undergo vaginal multipoint biopsy (1/3 upper vagina), especially in patients with high-grade CIN and age older than 50 years.


Assuntos
Displasia do Colo do Útero/diagnóstico , Displasia do Colo do Útero/patologia , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/patologia , Neoplasias Vaginais/diagnóstico , Neoplasias Vaginais/patologia , Adulto , Colposcopia , Detecção Precoce de Câncer , Estudos de Viabilidade , Feminino , Humanos , Biópsia Guiada por Imagem , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Prospectivos , Neoplasias do Colo do Útero/complicações , Cervicite Uterina/complicações , Neoplasias Vaginais/complicações , Displasia do Colo do Útero/complicações
20.
Clin Infect Dis ; 64(1): 79-82, 2017 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-27694480

RESUMO

We evaluated whether genital inflammation affects the selection of the transmitted virus. Among South African women, we found that preinfection genital inflammation facilitates transmission of less infectious human immunodeficiency virus, but highly infectious viruses are able to establish infection regardless of inflammation status. This suggests that viral phenotype can influence transmission risk.


Assuntos
Infecções por HIV/complicações , Infecções por HIV/virologia , HIV-1/classificação , HIV-1/genética , Cervicite Uterina/complicações , Vaginite/complicações , Biomarcadores , Citocinas/sangue , Feminino , Infecções por HIV/sangue , Infecções por HIV/tratamento farmacológico , Humanos , Filogenia , Cervicite Uterina/sangue , Cervicite Uterina/diagnóstico , Vaginite/sangue , Vaginite/diagnóstico , Carga Viral
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